SEATTLE-Mere blocks tourists who invade the Pike Place market, Stacy Lenny highlights the craft of some of her clients: "There is Todd with a wheelchair, it's a good camouflage for drugs. he said, nodding at a man sitting around the corner and cracking his motorized scooter. "Missy has a lot of drugs in this bag," she says, about another woman passing by.
A 50 year old mother with short gray hair and light blue glasses, Lenny is a ... reduction recovery specialist with a program called REACH. The job is to get around Seattle to find homeless addicts, befriend them and try to help them solve their health and housing problems
Lenny and I drove together at south of the city. trash can. Seattle has recently been tense by both increasing homelessness and heroin addiction. Last year, a record 359 people died in Seattle of a drug overdose. Most of them involved opioids-heroin or prescription painkillers.
Working with the city's most economically fragile drug addicts made Lenny skeptical about the typical rhetoric of drug abuse. that it is a choice, that users all want treatment, that addicts should be channeled quickly into rehabilitation. In rehab, they might be required to "admit to being a" junkie ", or detox and die, or return your life to God," she said.
This works for some people, but others turn through the treatment and end up on the street or use it again. So, instead of telling drug addicts what they need or where they should go, Lenny listens to what drug addicts tell him they need.
Finally, Lenny parked his car on a plate of dirt. The fence was adorned with heart-shaped ribbons and a hand-drawn sign: Second Chance Camp. Beside rows of tents and tiny makeshift homes for the homeless, there was a TV tent, a library and a kitchen filled with crispy coffee cups and cinnamon. The camp prohibits access to drugs and alcohol - the homeless living here have decided to ban drugs, "explained one resident, to avoid the violence that strikes homeless homeless camps, like the one nearby. called "The Jungle."
At Camp Second Chance's center, I met Tammy Stephen, who lives in one of a few dozen dome-shaped tents lined up on pallets. She was dressed in a black dress and Uggs-style boots, and she had such a worthy view of her life situation: "We are not homeless, we are homeless," has-she- she says. "Our Home."
Our conversation turned to one of the hottest topics in Seattle, a controversial subject that everyone - including a Uber driver and a Canadian border guard - offered his own, unsolicited take when I revealed what I was there to report. Seattle is on the verge of becoming the first US city to open a secure injection site, a place where drug addicts can openly inject heroin under the watchful eyes of nurses, who could then save them in case overdose using the opioid naloxone agonist. Even in the ultra-liberal Seattle, where marijuana is legal and where pottery workshops advertise being part of the "Resistance", the idea seems, for many, a bit too much like an empowerment [19459005
"We must stigmatize," said Mark Miloscia, a senator from Washington State, an opponent of supervised injection facilities, Al Jazeera . "We need to push people to treatment, with cultural values and cultural pressure."
For Stephen, however, safe consumption sites are "the best thing in the world." If they had existed when she was 27- Emily Hays, a one-year-old girl, was still using heroin a few years ago, "she would have had something other than a room for her." Subway baths "to shoot," said Stephen. Hays overdosed several times before cleaning himself, and some of his friends died from overdose.
Stephen had harassed the girl for her treatment, saying, "Why do not you give up? Why do not you stop?"
"I do not want to feel," she recalls of her daughter saying:
"The hard love did not work. girl, "Stephen told me.
The King County Council's September meeting, which includes Seattle and some of its suburbs, was packed. Between the pro and anti-camp camps, 41 people were registered to talk, so each tried to pitch a sincere personal story or a passionate plea.
A young dad whose 19-year-old daughter died of a heroin overdose defended the facilities as a lifeguard. "If you are dead, you can not receive treatment," he said.
"There is something precious in the horrible things."An opponent raised the crime against property. Injection sites will attract criminals: "We do not even care about that!"
Towards the end, things took a devastating turn, when a man parodied the arguments of the anti-security crowd. "You should ban airbags and seat belts because they encourage people to drive in a more dangerous way," he said. "I have no evidence, you do not need it anymore - our president clearly did so by removing the DACA!"
Last year, a Working group consisting of lawyers, law enforcement officers and public health experts drew up a list of recommendations to curb the problems of abuse. Seattle opioids Some ideas were common: "Promoting safe storage and disposal of medications." Some were more contemporary: "Expanding the distribution of naloxone in King County." Only one triggered months of litigation and acrimony: "Establish a pilot based program, at least two places of community health engagement where supervised consumption occurs for adults with substance abuse disorders in the Seattle area and King County. "
Clif Curry Analyst, a com decked out the sites at a controversial housing facility that opened in Seattle 10 years ago to deal with a population of street drunkards, many of whom had been cycling for and after decades. These chronic alcoholics had become a public nuisance - urinating and vomiting on the sidewalks - and they were costing millions in emergency bills and jail time. The county placed 75 of them in a government subsidized apartment building where they could drink as much as they wanted. They did not even have to promise to resign.
"The services were available to them, but they did not have to use them," Curry explains. Critics of the time included a local conservative radio host who ridiculed the arrangement as "berths for drunkards" and "helping and encouraging the self-destruction of someone". But, Curry said, "The research showed ... that one in five was seeking treatment on their own, even though they were allowed to continue drinking until death. "And even among those who did not ask for help," they did not die anymore, "he said, and" there is more chronic intoxication in the street. " "
Seattle's supervised injection facility for opioid users would be the first site of its kind in the US Other US cities are planning similar programs, and a site not authorized by invitation exists for several years in an unknown place in the United States.
But in spite of the success of the city the chronic alcoholic population, the decline on the sites d & Injection, for example, one of the women who spoke at the meeting was Amy, a local real estate agent who did not want me to be jailed. Used her last name because she was afraid to scare the customers. She was great i in the punk Seattle of the 1980s, doing heroin with his friends. Many of these friends died from an overdose, but for Amy, the deaths were expected. "That's what happens," she said
Yet she is opposed to safe injection sites. "My concern is that ... when we say," We'll make it easy, we'll do it safely, "we say subtly," It's okay, "she said." There is some value in the things that are horrible. "
Five towns in King County around Seattle quickly moved to ban safe consumption sites, and in four the vote was unanimous Joshua Freed, a city councilor Bothell's neighboring town, and others have introduced a measure of voting that would ban sites throughout the county.A group of experts and advocates of public health, as well as the city of Seattle itself , have filed a lawsuit to block the initiative, arguing that voters are not qualified to weigh the public health measures.On October 16, a judge blocked the initiative, but Freed appealed the decision If the Bothell Municipal Councilor succeeds, then the Council of the King County plans to take its own initiative by calling for the creation of two security sites, an initiative that would be on the ballot alongside Freed's. measurement of consumption, according to The Seattle Times
After the county council meeting, I sat down to coffee with Freed and Jalair Box, a resident and an opponent of safe consumption sites. They claim that these facilities would catch only a tiny fraction of all injecting drug users in Seattle on a given day. Worse, they say, this is tantamount to legalizing heroin.
More importantly, Box fears that sites are not doing enough to help addicts get treatment. She is upset by the possibility that a person "goes into a drug-using site and decides:" I'm done, I want to go out, I want treatment, "and the person behind the counter says: "I'm sorry, we do not have any treatment for you today, but here is your booth.
"It makes me cold," she said.
This is a common fear among opponents called harm reduction approaches. Lawrence County in southern Indiana, for example, has recently abandoned its needle exchange program for similar reasons. "Few health professionals with whom I have personally spoken believe that the needle exchange program was an effective way of involving people in treatment programs," said Rodney Fish, a member of Lawrence County Council .
King m county officials said that in addition to safe use sites, they are striving to expand overall access to all addiction treatment services "on request". Currently, the city offers opioids. drug addicts heroin withdrawal drugs, methadone or buprenorphine, or institutional treatment, in a couple of days to a week.
For Freed and Box, it's not enough. "We do not have enough resources allocated to treatment," Freed said. "Why not spend [the safe-injection money] on treatment? It's our heart. What are we doing to allow people to consume heroin and to legalize it and, really, make it more accessible?"
Freed also worried that sites become magnets for crime. I told them that I planned to visit Insite, a supervised injection site in Vancouver, Canada, which has been operating since 2003, the following day. Freed, who made several trips to the Insite neighborhood, detailed some of the shady characters he had met there: people shooting on the street; a woman, angry because Freed's mate took his picture, who started stabbing a wall with a knife; women are selling for a blow; a "gentleman" with tattoos all over his face.
Freed m pushed me to not go alone. "I will not let my wife go alone," he said. "It's a very dark place, and I'm worried about a single girl like you riding alone."
I would not end up going inside Insite. They had had too much media interest lately, and they refused to let another journalist get into what is, after all, a health care facility. I decided to check the neighborhood again later in the afternoon. But first, I went to Surrey, a city southeast of Vancouver with about half a million people. There, the administrators of a supervised injection site, SafePoint, which opened its doors last June, had agreed to make an early visit of the premises.
SafePoint looks like a run-of-the-mill trailer. It is contiguous to a tent city where drug use is rampant, but some of its 800 clients have homes and families. The sex workers come and use before they go out for the night. Some people come and go back to their convalescent homes. Once inside, addicts provide a nickname for anonymity and take clean needles or other supplies they need. In the supply zone, there is even a garbage bin marked "flavored condoms for oral sex".
I asked Fraser Mackay, who runs the site, if everything was free.
"he said, on the same tone that Daddy Warbucks could have explained to Little Orphan Annie that she no longer had to mop the floors. "These citizens have the right to the health care they need."
Inside, users sat at one of seven kiosks, and they snorted or injected their drugs as they normally would. Most SafePoint customers consume heroin or methamphetamine, but their products are usually associated with fentanyl, which is far more deadly. They are not allowed to pass drugs between cabins or to help one another. There is a clinic next door where clients can get treatment for wounds and other medical problems that often accompany long-term drug use, or start methadone. If a person overdoses, as happens two or three times a day, SafePoint employees return their chairs and administer naloxone to revive them.
They have had no deaths so far. Do not harangue people for them to follow a treatment. The staff is "very engaging, very friendly, very approachable," said Mackay, but "we can not harass people who are not ready. When we have small windows, we use them. "
" So if they are like "Man, I'd like to be able to leave" ... "I say, looking for an example of" window. "
" The staff would be everywhere, "he said, sending them to a drug rehabilitation center or an outpatient clinic where they could start cleaning themselves right away.
J & # I asked how many people had been treated by SafePoint so far. "Not a lot," he said. "I'd say a handful." (Subsequently, Victoria Lee, Chief Medical Officer of Fraser Health Authority, the health organization that runs SafePoint, estimated that about 10% of SafePoint users were entering treatment.)
A middle-aged, pale man, went out The staggering trailer, having just used heroin.He would only give his name to Glen.He has been coming to SafePoint since it opened, and he loves the feeling of comfort and security that it provides.
I asked him if SafePoint's employees urged him to go for treatment, or if he feels
"It only drives people away," he said. In addition, he had already been treated, and he liked it because "I learned a lot about myself." But he started using it anyway.
I escaped under an awning. There, I met Karen Scott, a 55-year-old former user who is now clean. Soon, she will start as a peer counselor at SafePoint.
I explained that I come from the United States, where safe consumption sites are controversial because they seem to divert attention from bringing the addicts to follow a treatment.
"You can not force someone to go on treatment," she said. "If they do not want to do it for themselves, they will not stay."
"Why would not someone be ready?" I asked. are not addicted because they want to be, but because they have had trauma in their lives, "Scott said. "Whenever the feeling of trauma begins to manifest, they want to bring it down so they do not have to feel that pain, and some people think the trauma is so severe that they will not be able to feel it. [without drugs]. "
Scott became clean at one point, then relapsed because:" I have never worked on the trauma which has brought me to the addiction in the first place, "she said.With the help of conscious meditation, she made peace with her abusive past.Now, she resists so much the temptation that she lives in a apartment a few steps from SafePoint, in the heart of the Surrey Drug Zone
This seemed to be a common theme among active and recovering drug addicts, met in Canada and elsewhere: Although some are beginning to appear in Canada. to use for fun or for the lark, most people have been are influenced by the inner turmoil.
As Lenny, the Seattle social worker, told me. leave, "they have to start managing their feelings, their problems, and the treatment does not really help me."
From Surrey, I went to Insite, Vancouver , and I dragged on the sidewalk in front of the building for a few hours.Although it was not quite the parade of horrors that Freed had promised, he also did not seem to picture from a happy reduction of damage.Between a guy selling cell phone chargers on a folding table, a man pulled heroin on the sidewalk, while another went over and asked me for "jim" - local slang for speed.While I was there, there was a kind of commotion in the corner, and the police quickly The word in the street was that someone was stabbed.
Advocates of safe consumption sites say that l The Vancouver neighborhood was already like this, even before Insite was on the scene. It is a low-income area whose moderate climate, by Canadian standards, makes it attractive place for the homeless.
Studies on Insite have shown that it has helped reduce overdose deaths. Injection sites in general do not increase crime rates and do not result in more drug trafficking. One study noted that the use of "Insite" has also been associated with an increase in the use of detoxification services (Box, the opponent of the secure injection site). from Seattle, challenged these studies and said that places like Insite
Insite customers with whom I spoke - most of whom would only give their first names or monikers because heroin remains illegal - was not belligerent.They seemed grateful.
A 22-year-old girl, freshly released from methamphetamine at Insite, said she had been treated several times, "I never said I did not want to go back," she said, but "I'm not ready to face real life." [19459005
A 21-year-old with a devil-horn headband and scars on her arms said that she loves Insite because "c "It is a safe place if you" She said that she had "emotional problems, attachment problems" that prevent her from going to treatment. The heroine, she says, "makes everything disappear". Insite does not put her under pressure for her to be treated. "They're not really here to tell you to do that, tell you to do that," she said. "When I'm ready, I'll know I'm ready."
When I told her we did not have safe consumption sites in the United States, she seemed puzzled. "Where do they get their appliances?", She said, learning about the clean packages of needles and stoves that Insite provides.
A few blocks from Insite is the Powell Street Getaway. establishment. Compared to Insite, the neighborhood was quieter: the only person on the outside was a woman who seemed to smoke something under a tarpaulin, which doubled her house.
An employee walked out of the Powell Street building and agreed to speak anonymously because she was not allowed to speak to the press and was afraid of losing her job. She had a skeptical view of the effectiveness of supervised injection sites. "For me, it goes a little further in empowerment," she said.
An addict who comes to the establishment knows that "this guy has come out higher than a kite now," she added. "And you know what it makes. There is nothing to break the cycle. She said that she regularly saw people standing out of the way of drugs. "One might think that being clinically dead and strangers bringing you back to life would be enough to make a change." But that's enough for "probably one in 30".
Yet drug addiction experts doubt that even it is possible to stimulate people, even those who have, by definition, reached the "bottom of the scale" - to get rid of The usual
Linda Rosenberg, president of the National Council for Behavioral Health, said that any of them could follow treatments and participate in support groups. But, she added, "the belief that everyone is ready for treatment is simply not true."
The guidelines of the National Institute on Drug Abuse are as follows: "Interventions" such as are commonplace in television programs are effective in convincing people that they have a problem or motivate them to change. It is even possible that such confrontational encounters degenerate into violence or return by other means. "
" There are motivational steps, and you start with someone who is not very interested. "" They do not want to face the pain of their lives. " they are not high. "
This is what happened to Emily Hays, the daughter of Tammy Stephen, 27, who I met In the homeless camp, she had been using heroin since the age of 18 and went into treatment several times, but the treatment centers, which relied on 12 steps, discouraged methadone and she repeatedly recidivated.
When she was 21 years old, she was homeless, walking in the street at night and doing methamphetamine, and during the day she was taking drugs. Heroine while diving in quick-service baths or jumping behind a fence.It has overdosed six times
Her mother has suggested methadone, but Hays continued to use it. "I remember telling my mother that I wanted to die from a heroin overdose," she said. "No matter how much I wanted to purify myself, I was too scared to not have this medicine."
Eventually, Hays developed a neck abscess, which became infected and made his face swell. Bastard, "the character of Austin Powers as his mother described it." She went to the hospital to get her drained, turned to the doctor and asked : "Can I take methadone?" Thirty minutes later, she had her first dose, and today she has been clean for two and a half years.
"I am very injection injection sites, "said Hays, adding that she believes that they will keep drug addicts safer and reduce the amount of drug paraphernalia in the street. After all, the more addicts stay alive, the more likely they will be to get help.
The Hays experience is illustrative of what Lenny discovered during his work: l & rsquo; Importance of listening to addicts As frustrating as it may be, they are not ready until they are ready and when they are ready, they will tell you.
[ad_2]
Source link