On January 4, 2023

Substance abuse disorder doesn’t work like that

Dear Editor,

‘I don’t give them money, because they’re just going to buy drugs with it. I don’t want to feed their addiction.’

Let’s unpack that statement that was just repeated to me for what felt like the gazillionth time today. Maybe they are, maybe they’re not.

But let’s say for argument’s sake they are actively dependent on illicit substances, struggling and panhandling to feed a substance abuse disorder. Do you think that not giving them money will starve the disorder and that will be what forces them to stop?

Based on my years of embedded observations and experience, it won’t. Substance abuse disorder doesn’t work like that. If it were that simple, the so-called “war on drugs” would have worked. Instead, we have one of the highest rates of substance abuse disorder in the world.

Addiction of any sort is tenacious, but substance abuse disorder is downright Herculean in the strong hold it has over those who struggle with it. One way or another, it will get what it needs. And it relies on us focusing on the outcomes — and not the root causes — to continue thriving and growing in our communities.

So what happens when someone who is struggling with substance abuse disorder can’t meet the demands of addiction, and panhandling doesn’t work?

What I’ve witnessed is that, depending on the substance one is addicted to, some get incredibly sick and desperate. It truly is a disease.

Some (not all, not even most) get so sick and desperate that they go to incredible lengths, but in the sickness they are not steady, their decision-making abilities are compromised, their inhibitions reduced, and ability to care for self, others, anything but what it will take to make that pain stop, goes out the window.

This can look like selling whatever they have, including themselves, to whoever will pay, no matter how awful they are. It can mean allowing dealers to set up in their home and take over, turning it into a trap house — a place where they are literally entrapped, being fed a small supply to keep them compliant, and often being subjected to violence when they are not. Or it can mean taking whatever they can find to sell, and sometimes that looks like breaking and taking from you, me, our community.

And after all of that, when the disease is momentarily satiated, they know what they’ve done to get there and so often hate themselves more for it, so they medicate more, deepening the cycle and making it harder to get out.

That’s why I give money without question.

Panhandling is a desperate enough act for my compassion and I don’t want anyone to be pushed to further desperation. I give because I hope that, if they are using, it will hurt less to use in a supported way than whatever they would otherwise do to have fed that need.

Because they are suffering, they deserve connection and support. I care that they stay alive and hope that they may find a way to live without the torment of substance abuse disorder someday.

The data indicates over and over that the most successful outcomes are almost always rooted in harm reduction approaches and not from casting judgments or withholding aid.

Please consider this before you decide that you’re not going to give support to someone who is sick. Until we as a society can do better, we as individuals must act with more thought and compassion.

Laura Chapman,
Putney

 

 

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