Why do we still believe that letting drug addicts "hit rock bottom" is a good thing?

Our densely populated, low-income neighbourhood of the Downtown Eastside in Vancouver has 16,000 residents and about 6,000 injection drug users. Day after day, I’ve seen kind, funny and gentle people lose their families, get sicker, become more isolated a

Including people living with addiction into society should not be revolutionary thinking in 2013. However, in many ways the addict is the modern-day “nigger”, a term used to dehumanise, alienate, torture and abuse a group of other human beings. Today, people who use drugs – “junkies” – are expected to suffer, then blamed when they do, and if they die there is almost a collective sigh of relief.

Understanding the work that my organisation, PHS, does with addicts on the streets in Vancouver can best be explained by introducing you to one of my teachers. Tilly was a waif-like, 40-year-old aboriginal woman who I met in my early twenties. Her hollow cheeks and deep-set dark eyes were childlike, imploring and innocent – in spite of her “experience”. Locked in a room and malnourished as a child, Tilly was addicted to prescription pills by the age of 11. By the time she was 15 she had tried to end her life by slitting her throat with a kitchen knife.

When I met Tilly she was working in the sex trade, injecting heroin and cocaine, and drinking. One night she was raped and beaten, and as I held her in my lap, bloodied and broken, I rocked her like a tiny bird. She told me through her sobs that it was her fault. I felt her emptiness and I understood her cries. Hers were not the cries of a criminal but of a wounded soul who felt her life was worthless.

Our densely populated, low-income neighbourhood of the Downtown Eastside in Vancouver has 16,000 residents and about 6,000 injection drug users. Here, I started running a 70-room housing project in 1991, and for 23 years I have seen the human fallout of our collective ignorance. Day after day, I’ve seen kind, funny and gentle people lose their families, get sicker, become more isolated and die.

The people I have come to know and grown to love have helped me heal myself. My own white, privileged family was not unfamiliar with tragedy. My mother suffered her own pain and left us when I was a child. I knew what it was like to feel empty and alone.

We hear all the time how addicts are selfish liars who steal from their families, cause pain, smash car windows to steal things and get into fights. We have created brutalising conditions that result in addicts being vilified and that cause enormous harm. However, I have also experienced a unique window into the resilience, humanity and strength of people trying to survive while actively addicted.

Throughout the 1990s, alongside my partner and my colleagues, I had to go against the common logic of the day as we wrestled over how to help. We intuitively gravitated to the belief that people might be able to do better if survival wasn’t so hard, and over the years we have succeeded in creating spaces that are tolerant, respectful and inclusive – where people struggling with addiction can live, find social membership, a sense of belonging and the basics.

This flew in the face of the received wisdom that said people had to “hit rock bottom” or society was somehow “encouraging them”.

As the death toll from drugs mounted in 1997, we rebranded our community “the Killing Fields”. The number of drug users developing HIV was on a par with Botswana; meanwhile, more than 400 drug overdoses happened in our province in just one year. The level of grief was profound, so we flew in experts from around the world to talk about things that we could try: supervised injection sites, heroin maintenance, harm reduction.

Drug users themselves used their voices and parent groups spoke out. Brave politicians stood up and some lost their careers. Gradually the public became educated through extensive media coverage and community debates. By 2003, the tide had shifted and on 21 September we opened North America’s first legally sanctioned supervised injection site, or “Insite”, as a partnership between our non-profit organisation and our local health authority. We saw people come in to what felt like a sanctuary – out of the back alleys to indoors, where users could inject their drugs under the supervision of a nurse.

Over these past ten years almost two million injections have happened here, and 14,000 individuals have come in. Each year, 400 referrals are made into treatment. The staff revive, on average, 40 people a month who overdose and not one person has died.

Today, we have a more sophisticated understanding that an individual, while addicted, still has the right to live. We have created places like our dental clinic, art gallery and bank, and social enterprises that are reshaping the landscape. For example, with over 4,500 members, our community bank (a partnership with Vancity Credit Union) offers savings and checking accounts to people who are unwelcome, banned or followed by security guards in conventional financial institutions. New units of housing have been funded by our provincial government, targeting the most vulnerable homeless and addicted.

Health-care services have been established that are relevant to people actively using drugs. Social enterprises have been created to give people – addicted or not – jobs, at the vintage clothing store, chocolate and coffee roasters, art studio and retail store, commercial laundry and pest-control company.

For those of us who remember how dark it felt 20 years ago, there is much to celebrate in Vancouver in 2013. People in our community are living ten years longer.

Tilly was kind, sensitive, gentle and generous, but in the end she died of Aids because no one had cared enough to make sure she had access to a clean syringe. As a society, we told her that her life didn’t matter and she believed us.

It’s time to stop punishing and start creating solutions to the walls of intolerance and hatred we’ve built. These steps, though seemingly small, can create a new social context, one that redefines the addict from a non-person to a person, a criminal to a citizen, someone “diseased” to someone who just needs love, belonging and a community, just like me.

Liz Evans is the founder and executive director of PHS Community Services Society, which helps drug users in Vancouver

Drug users at Insite, a legal supervised injection site in Vancouver. Image: Getty

This article first appeared in the 23 October 2013 issue of the New Statesman, Russell Brand Guest Edit

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“I felt very lonely”: addressing the untold story of isolation among young mothers

With one in five young mothers lonely “all the time”, it’s time for employers and services to step up.

“Despite having my child with me all the time, I felt very lonely,” says Laura Davies. A member of an advisory panel for the Young Women’s Trust, she had her son age 20. Now, with a new report suggesting that one in five young mums “feels lonely all the time”, she’s sharing her story.

Polling commissioned by the Young Women’s Trust has highlighted the isolation that young motherhood can bring. Of course, getting out and about the same as you did before is never easy once there’s a young child in the picture. For young mothers, however, the situation can be particularly difficult.

According to the report, over a quarter of young mothers leave the house just once a week or less, with some leaving just once a month.

Aside from all the usual challenges – like wrestling a colicky infant into their jacket, or pumping milk for the trip with one hand while making sure no-one is crawling into anything dangerous with the other – young mothers are more likely to suffer from a lack of support network, or to lack the confidence to approach mother-baby groups and other organisations designed to help. In fact, some 68 per cent of young mothers said they had felt unwelcome in a parent and toddler group.

Davies paints what research suggests is a common picture.

“Motherhood had alienated me from my past. While all my friends were off forging a future for themselves, I was under a mountain of baby clothes trying to navigate my new life. Our schedules were different and it became hard to find the time.”

“No one ever tells you that when you have a child you will feel an overwhelming sense of love that you cannot describe, but also an overwhelming sense of loneliness when you realise that your life won’t be the same again.

More than half of 16 to 24-year-olds surveyed said that they felt lonelier since becoming a mother, with more than two-thirds saying they had fewer friends than before. Yet making new friends can be hard, too, especially given the judgement young mothers can face. In fact, 73 per cent of young mothers polled said they’d experienced rudeness or unpleasant behaviour when out with their children in public.

As Davies puts it, “Trying to find mum friends when your self-confidence is at rock bottom is daunting. I found it easier to reach out for support online than meet people face to face. Knowing they couldn’t judge me on my age gave me comfort.”

While online support can help, however, loneliness can still become a problem without friends to visit or a workplace to go to. Many young mothers said they would be pleased to go back to work – and would prefer to earn money rather than rely on benefits. After all, typing some invoices, or getting back on the tills, doesn’t just mean a paycheck – it’s also a change to speak to someone old enough to understand the words “type”, “invoice” and “till”.

As Young Women’s Trust chief executive Dr Carole Easton explains, “More support is needed for young mothers who want to work. This could include mentoring to help ease women’s move back into education or employment.”

But mothers going back to work don’t only have to grapple with childcare arrangements, time management and their own self-confidence – they also have to negotiate with employers. Although the 2003 Employment Act introduced the right for parents of young children to apply to work flexibly, there is no obligation for their employer to agree. (Even though 83 per cent of women surveyed by the Young Women’s Trust said flexible hours would help them find secure work, 26 per cent said they had had a request turned down.)

Dr Easton concludes: “The report recommends access to affordable childcare, better support for young women at job centres and advertising jobs on a flexible, part-time or job share basis by default.”

Stephanie Boland is digital assistant at the New Statesman. She tweets at @stephanieboland