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People in cities, suburbs, small towns and rural communities are ravaged by drugs, poverty and homelessness. Photo by Diane Nilan

Stop With the Crappy Addictions Crap!

Our War on Drugs is as ineffective and expensive as our wars on Terrorism and it’s destroying lives of people we love.

As hard as it is for me in my homelessness work to see the devastating effects of addictions, feeling powerless to help, it’s even worse when loved ones are in the grip of this monster.

I’m no expert on addictions, though genetics and my own foibles have brought me close to the edge. My brushes with childhood trauma were relatively minor (though it didn’t seem so at the time).

I’ve known plenty of people brought low by addictions. The lack of effective, accessible help has cost us both in the loss of loved ones and in the tax dollars poured into the multitude of ineffective approaches to stemming addictive behaviors.

What seems more than infuriatingly evident to me is how so many treatment providers ignore, disregard or totally dismiss the role of trauma in a person’s addictive behavior.

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Plenty of confusion on what direction to take with addictions. Photo by Diane Nilan

Trauma is expensive.

“Trauma remains… the greatest threat to our public health… We seem too embarrassed to mount a massive effort to help children and adults learn to deal with the fear, rage and collapse, the predictable consequences of having been traumatized.” Bessel van der Kolk, M.D

Too often, those who need help the most don’t find it. I’ve worked in the world of homelessness for the past 30+ years. I’ve seen dire trauma-inspired dysfunction (understandable when I’d learn more of a person’s story). I’ve seethed when people cycled through “solutions” that offered no substantive treatment, putting the “responsibility” on the person whose wherewithal was zip.

To be clear: Not all people on the streets suffer from trauma and addictions, though it is despairingly common in varying degrees. Plenty of people, those in positions of power and wealth, and those in our circle of family and friends who are not homeless, struggle with these challenges, often behind closed doors and without bearing the stigma of homelessness.

People Choose Life on the Streets?

I recently had a discussion about how common it is for people to have experienced abuse — i.e. trauma, including sexual (which I recently posted in Medium). The #MeToo movement certainly ramped up awareness of harassment and abuse, much to the dismay of some who’ve been caught with their pants down. What isn’t always as obvious is the connection of abuse with addictions and dire health issues.

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Children are often collateral damage of our failed “war on drugs,” dragged into homelessness by struggling parents. The children’s basic human needs, much less their need for help coping with traumatic experiences, often go unmet. Photo by Diane Nilan

The connection between abuse and homelessness would shock many people. The Connecticut Alliance to End Sexual Violence documents the impact on mothers:

  • 92% of homeless mothers have experienced severe physical and/or sexual violence at some point in their lives. (Brown and Bassuk, 1997)
  • 43% of homeless mothers reported experiencing sexual abuse in childhood, and 63% reported intimate partner violence as adults. (Brown and Bassuk, 1997)
  • Homeless women are more likely to have substance abuse problems than low-income women who have housing. (Wenzel et al, 2004)
  • Substance abuse may put women at greater risk for victimization. (Goodman, 2006)

Helping people cope with the trauma that accompanies abuse certainly isn’t factored into our social or medical framework. We’d rather toss them in jail, prison or the streets.

Being tossed to the streets, commonly by eviction, worsens trauma. Professor Matthew Desmond, author of Evicted, in his compelling, comprehensive examination of our housing crisis as exemplified in evictions, observes:

It’s such a consuming, stressful event, it causes you to make mistakes at work, lose your footing there, and then there’s just the trauma of it — the effect that eviction has on your dignity and your mental health and your physical health. We have a study for example that shows that moms who get evicted experience high rates of depression two years later.

We are quick to condemn those who self-medicate or numb themselves into oblivion, wanting an escape, which often brings about all kinds of troubles. Some call it “choice.” Not.

It is more complicated, as the Hungarian-born Canadian physician, Dr. Gabor Maté who specializes in the study and treatment of addiction and trauma astutely points out:

If people only got a basic understanding of the link between trauma and addiction, if they looked at the science of brain development and of childhood development, if they are willing to look at the statistical correlation between childhood adversity and addiction, if they are willing to treat people like human beings who suffered and whose addiction is a response to suffering, then we’ll have some decent treatment programs. If all the money that now goes into punitive or useless approaches would now go into compassionate approaches, boy, imagine what we could achieve.

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Knowing the back story of many of the families and youth experiencing homelessness I’ve worked with over the years, I’m not surprised at their stumbles. We all stumble. Some just fall farther, harder and lack the help to pull themselves up by busted bootstraps. Quite often, in addition to the addictive behavior contributing to and perpetuating homelessness, chronic and/or major health problems keep the person homeless.

Trauma — At the Root of Addictions and Health Problems?

Few docs seem to recognize the link between physical pain and the psychological pain caused by trauma. In an insightful, contrarian article, Dr. Maté states:

As long as we are in denial of trauma, we’re never going to understand addiction. The aha moment that needs to occur is not that we recognize how bad addictions are, but that addictions are about an escape from trauma, and this society traumatizes people. Life in this society means that a lot of people are going to become traumatized.

Ah! A respected medical doc who views trauma as an underlying cause of lots of issues, without blaming people for their problems. He makes the connection between addictions, trauma and physical health problems, pointing out that, “Those are risk factors for illness. We know that. The repression of anger suppresses the immune system as opposed to healthy expressions of anger.”

Doctor’s Straight Talk About Addiction

Absolutely, show me a person in jail who has not been traumatized. Eighty percent of prisoners in California have spent time in the foster care system. They were unwanted and did not have a steady caregiver. These are huge things that are continuously pushed off the radar screen. Drug addiction is a function of child abuse. It’s possible to become a drug addict without child abuse, but it’s very hard. (Dr. van der Kolk)

Having loved ones who’ve been locked up for addiction-related crimes, it’s hard to read van der Kolk’s absolute proclamation, but it also makes sense.

Test Your ACE

If you wonder where you score on the ACE (Adverse Childhood Experiences) test here’s the link. Before you despair, about your score or the likely score of your loved ones, the link also gives you a chance to measure your resilience.

Resilience (another story for another post), without it we’re doomed. Until we come up with better approaches to addictions, we better ramp up our resilience-building efforts.

For those caught in the throes of addictions, and for those who love, live with, and/or work with someone with addictions, the links above offer tremendous resources beyond my paltry article. May we find a better way…STAT!

Founder/pres. HEAR US Inc., gives voice & visibility to homeless families & youth, ran shelters, advocate, filmmaker, author, 15 yrs. on US backroads.

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