When Harm Reduction Becomes Enabling

 

I’ve been a recovered alcoholic/addict for many moons now having surrendered on January 7, 2005. When I first got sober I was dead set against any type of harm reduction. I was solely focused on keeping myself sober. Since then my mind has opened to certain types of harm reduction.

I’ve worked for a couple of street outreach programs over the years and handed out clean needles, crack/meth pipes, condoms and Naloxone kits. I see the need for these types of harm reduction as they keep people from contracting deadly or life altering diseases. I always say that one day an active addict may decide they want to get sober, and because they used these safe supplies, they don’t have the challenge of battling a disease on top of the very challenging journey of becoming sober – and eventually recovered.

While in support of the above mentioned harm reduction there are certain ones I’m dead set against. I’ve written a few blogs about how methadone is terrible stating that it’s just a money maker for doctors (who I’ve had tell clients, who wanted to wean off, that it would not be good for them and refused to help) as well as being harder to get off then heroin. I also believe that a big part of recovery is freedom – freedom to go and do what you want (not drinking/using of course). Having to go to a pharmacy once a day, or week, to get a drink hardly says freedom. Plus, you continue to receive methadone even if you continue to use opioids and/or other mind altering substances. A substitute for methadone is Suboxone. Before someone starts this they have to go 24 hours without anything – an uncomfortable withdrawal occurs. It’s this type of uncomfortableness that may lead someone to have a moment of clarity. You can also wean off of Suboxone far easier than Methadone.

I recently learned that there is a “harm reduction” program in Toronto, Ontario where workers teach people how to inject drugs. Why not go all the way and inject the heroin, etc. for the person? This is like trying to help an alcoholic by pouring whisky down their throat. For someone to finally decide to get sober they need to have a moment of clarity which is usually due to some sort of physical, emotional and or spiritual pain. By showing them how to inject a chance at feeling this type of pain is taken away.

Taking away any type of pain or uncomfortableness is not harm reduction but clearly crossing over that fine line of help to enabling. Enabling someone whether it be in addiction, stagnation, etc. is never a healthy thing.

Dave the Dude

DO NO HARM - Not the case here.

 

I can’t speak for other jurisdictions in Canada or other countries but in Ontario an upsetting trend has been going on with doctors and their patients for over a decade. I’ve been working in various treatment centres for over 16 years and started noticing this occurrence with some of my clients as well as with fellow members of my 12 Step Fellowship several years ago.

 What I’m talking about is people going to their doctors to seek help with their drinking/drugging and the doctor reporting the person to the Ministry of Transportation who subsequently takes away that person’s driver’s license. Not only is this punishing someone for a crime they haven’t committed (i.e. – driving under the influence) it is telling them they shouldn’t reach out for help because there will be negative consequences right away. I first reached out to my physician for help around 1998. I had not yet started to drink and drive (that would come later along with an arrest). He treated me like someone with a disease and not a criminal. As a result, I didn’t think twice about being honest with him until the day he moved away. He helped me begin my journey into sobriety as well as treating some severe mental health issues I was going through. When I did get sober, I tracked him down to make amends for showing up to his office drunk one day. If he had reported me and my license was revoked, I would have had much more stress in my life which would have caused a great deal of anxiety and depression. How did I deal with such things back then? By drinking/drugging.

 Speaking of mental health – there was a recent article in the Toronto Star about how doctors are now reporting patients to the Ministry of Transportation who come to them with signs of depression. These people subsequently lose their license as the MTO feels they may become dangerous drivers. What happens when these people lose their license? They become even more isolated thus leading to greater depression. This chaos has got to stop. I also heard on the radio (I really hope it isn’t true) that doctors, in Ontario, get $35 for every person they report to the MTO who lose their license. If this is, in fact true, I am a truly disgusted.

Dave the Dude

BFTGOG and Remember When

 

The last five years I was an active alcoholic/addict the functioning part of my alcoholism became very dysfunctional. At one point I was sleeping on a friend’s couch. If you had told me then that I was homeless I would have said you were wrong. Many years later, when I entered the field of social services, I would learn that “couch surfing” is considered homeless. I was shocked. As my disease of addiction grew bigger my apartments grew smaller. A couple of years following the couch surfing I found myself in a bed bug infested, bachelor apartment, by Sherbourne and Dundas in Toronto. It was here that my addiction grew even bigger. The funds for my rent went to drugs and alcohol and I was on verge of homelessness once again. I was only in that apartment for four months when I was whisked away, in the dead of night, by my sister to my parents’ place in Oshawa. It would be another few years before I surrendered, on January 7, 2005, and began a program that would relieve me of my obsession for alcohol. My journey of “trudging (sic) the road of Happy Destiny” (AA Big Book, 1939) began. The first month of sobriety I was walking on eggshells with my family. I knew if I slipped up I would be heading to a homeless shelter. Today I know that would have been the right choice for my family but back then I was in denial over the emotional consequences my behaviour had caused – especially to my father (my mom had passed a few years prior to this).

 

Near the end of my first year of sobriety I went back to school for a Post-grad Addictions/Mental Health Diploma as I wanted to help people who found themselves facing the same disease as me. Fast forward almost 16 years later and I began a new job as an Outreach Worker for the Mobile Jewish Response to Homelessness with a great organization called Ve’ahavta. There’s a slogan in 12 Step Programs called “But for the Grace of God go I”. Grace being an “unmerited gift”. My first week on the job this slogan went through my head over and over. I became especially choked up when we helped people at Sherbourne and Dundas. I had come full circle in life.

 

It’s a privilege to be able to help people who are in a similar situation as I once was. As an Outreach Worker, for Ve'ahavta, I hand out food, clothes, hygiene and harm reduction. When people ask me if I’m not just enabling people to use drugs by handing out harm reduction? I tell them that I’m helping them stay safe and alive because one day they may want to make the choice I did to get sober. I’m making sure the road is clear of some obstacles for that time.

 

At every job people tend to get caught up in the everyday minutia of things and slide into a routine. Whenever I feel myself doing this, I try to bring to mind the 12 Step saying “Remember When”. I always want to remember what I was like prior to getting better so I don’t lose the empathy that those I meet, as an outreach worker, need. 

 

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