frankzappaWhen I was 9 I wrote Frank Zappa a letter and he wrote back. What happened; in my beloved Marvel Comics, along-side the x-ray specs and Atlas work-out ads, was an ad for his “fan club”, United Mutations, and when you joined they sent a questionnaire and I filled it out. I was probably whiny (the letter’s long gone) and complaining about my parents. His response was along the lines of, “Shut up you little twerp, I’m not Ann Landers. Go to the library and educate yourself”. I took him at his word and proceeded to do just that. In truth, I was taught to read early, there were books around the house, my brother turned me on to important books, ideas, etc. and I just grew it from there. This applied to every stage of my life, so when recovery entered my life and then later treatment became my work I applied myself to self-education. In truth, many great teachers and mentors were placed in my path and I worked to stay open. I realized over time that I was being given a very well-rounded education in what our treatment continuum consists of in the United States. That morphed into understanding the underlying paradigms. That idea, paradigm shifting, is a theme of mine because of some of these teachings. A major mentor for me is in this concise page from the New Yorker on homelessness. Philip Mangano crossed my path, some 16 years ago, and it took me a couple of years to grasp the implications but the shift was worth the work. If you would, read the page linked and then meet me back here.

It was, for me, counter-intuitive after I got in recovery, the idea that we should be handing out free apartments. This succinct idea, that you help people with full, basic services, on their way to change, was quite revolutionary. So much of the media blather, the Fox “News”, Rush radio, Koch-fed, Republican/Democrat, right/left noise is around services for those hurting. They say we are spending too much on “welfare” and we need to get back to good old American initiative. It is true that people need to take initiative, exert effort, participate in their own recovery and rise above their circumstances. We’re talking about hands-up, not hand-outs. Those suffering need support to do it, sometimes you can’t do it alone. I was badly addicted, living in the streets, headed (soon) to prison or death, you take your pick which is worse. And a “free” treatment center, a peer-centered recovery home, lovingly run, saved my life. Literally. And from that day, over 21 years ago until now, instead of me in prison costing society tax monies, I have been working and paying taxes. I have paid off debt instead of impending bankruptcy. Etc. Etc. Etc.

The beauty of this whole Housing First philosophy is that it works, in hard dollars-and-cents ways. It saves money, HUGE money, in city after city. I participated in those initiatives and saw them succeed in other cities. It’s time to make it a national priority. We hear a lot of lip service to that, Veterans needing better care and all. There are plenty of pockets of just that happening, and now it needs to be a true national priority. I’m no bleeding heart liberal. I have no problem with appropriate consequences, as long as they are applied evenly throughout all strata of society. Wall Street looted hundreds and hundreds of billions recently and no one went to prison. The system engenders a lot of resentment which fosters an “I’d better get mine any way I can, they got there’s” attitude throughout our society. So, we can talk about “welfare” all you want as long as we include the vast corporate welfare that’s been going on for decades.

A note on all this. A key component, an element of the bigger picture is: the workers; EMT, nurses, case managers, counselors, peer support specialists, licensed people, etc., they have to be really good at their job to create change. To hold a space that both meets and accepts clients exactly where and as they are and lovingly support the motivation for change takes real skill. The field is filled with those kinds; passionate, working to make-a-difference, mission-driven people. Now, the issue is; THEY NEED TO BE SUPPORTED. The workers need effective, healthy supervision from administrations not to mention a fuller web of recovery supports in place beside them, to be truly successful. This is what a Recovery Oriented System of Care is about. Though there may be some front-loading cost in the early stages, much of this is ultimately in the nature of free supports that are naturally there in the community. Because that is what creates full success, the community working together. Lack of community/disconnect is what makes us sick, what creates dis-ease. Community creation/connection is what makes us well. As the system creates change and increases success, what we like to call “improved outcomes”, the whole chain of workers feel empowered which creates an upward spiral of increasing success. They get charged up. Then we go beyond recovery all the way to healing.

Here’s a short PBS news video of a New Jersey Doctor (plus a link to a larger New Yorker article) applying the same ideas from a medical perspective saving millions of Medicaid dollars. In one city. Millions.

I would like to close with this note from our historian, William White, on “What Distinguishes Addiction Counseling from Other Helping Professions?”

“What the addiction counselor knows that other service professionals do not is the very soul of the addicted-their terrifying fear of insanity, the shame of their wretchedness, their guilt over drug-induced sins of omission and commission, their desperate struggle to sustain their personhood, their need to avoid the psychological and social taint of addiction, and their hypervigilant search for the slightest trace of condescension, contempt or hostility in the posture, eyes or voice of the professed helper….If there is a therapeutic stance most unique to addcition counseling, it is perhaps the virtue of humility. While seasoned addcition counselors muster the best science-based interventions, they do so with an awareness that recovery often comes from forces and relationships outside the client and outside the therapeutic relationship. It is in this perspective that the addiction counselor sees himself or herself as much a witness of this recovery process as its facilitator. In the end, the job of the addictions counselor is to find resources within and beyond the client (and the counselor) that can tip the scales from addiction to recovery. To witness (and to be present within) that process of transformation is the most sacred thing in the field, and what would most need to be rediscovered if the field collapsed today.”