On the dawn of another presidential election, both the government and the public are looking at how money is being spent in public programs. During times such as these, program outcomes are scrutinized in an effort to determine if Federal and state money is being well spent. This generates concern in the field of social work and addiction treatment, where there is a high rate of relapse during and after treatment. To ensure continued funding for alcohol and drug rehabilitation programs, it becomes increasingly important to explain the issues that impact recovery success. For those who are receiving substance abuse treatment, what are the barriers to recovery?
In my volunteer work for Medicine Wheel Recovery Services, a new substance abuse treatment facility in Saint Helens Oregon, I have been in awe of the courage displayed by people experiencing addiction issues that come through the doors seeking help and willing to share their stories. While the agency is not yet accepting clients, I have taken the opportunity to visit with people who are seeking services. A common theme in what these people are sharing is the presence of trauma in their life stories. Many of these potential program participants have shared that they use substances to “numb out” painful emotions, and to avoid the realities of their lives.
Researcher Maureen Condon discussed, in the article “Interactive impacts of trauma, addiction, relapse, specialized treatment, and recovery on the lives of individuals,” how unaddressed trauma and addiction issues are intertwined, and how one issue can continue to perpetuate the others. Many people who attempt recovery from addictions relapse due to their inability to cope with memories of trauma. Condon describes that the most effective approaches to treatment address unresolved trauma. Catherine M. Anderson, and Katherine B. Chiocchio, in their book, “The Interface of Homelessness, Addictions and Mental Illness in The Lives of Trauma Survivors,” explores the prevalence of those people that have mental health issues and that have suffered abuse, and the authors discuss the impacts of physical, sexual, and emotional abuse on those with mental illness. The book has multiple case studies, and offers resources and services that are available to trauma survivors. Furthermore, it also explains how policies could be improved about this issue.
An example of the trauma and addiction cycle described by Condon, Anderson, and Chiocchio that I have observed in my time at MWRS is the story of a woman named Patricia. Patricia was raised in a household where she was physically mentally and sexually abused on a regular basis; she states during this time she never learned how to keep herself safe. In her teens to started using drugs and alcohol and ran away from home. She spent time with other homeless youth on the streets of Portland, and during this time she was brutally raped and beaten and left for dead. A social worker in the hospital helped Patricia get into a residential treatment program, and from there she entered a housing program. Petition was able to stay clean and sober for nearly 10 years, during which time she married and had two children. During her third pregnancy, she suspected her husband was being unfaithful to her, and her baby died hours after birth. Patricia experienced feelings of depression, as well as feelings of anxiety. Her marriage crumbled, and her mental health issues increased. Patricia found that she could no longer function normally; she became afraid to leave her home, and she was always afraid for her children’s health and safety. She could not work, and by the time she and her ex-husband went to court for custody, there appeared to be plenty of evidence that indicated that she was not able to care for her children. Alone, and mentally unwell, Patricia relapsed on drugs and alcohol, and soon found herself homeless. Obviously there are safety risks with being homeless, and Patricia experienced sexual assault. In Patricia’s case, she was able to identify that she started using alcohol and drugs to cope with the abuse issues that she was experiencing in her home. The substances provided the gateway for her to escape her abuse, but also put her in situations that were equally or more dangerous. For a while Patricia was able to escape the cycle of addiction and trauma, but the death of her baby triggered trauma from childhood that she had never dealt with. Again she turned alcohol and drugs to help her cope with her feelings associated with unresolved trauma. And again, this resulted in the perpetuation of even more trauma, due to being placed in risky situations.
Part of the challenge in treating participants such as Patricia is addressing the multitude of barriers that exists, such as homelessness, lack of income, disconnection from family, culture, community, and spirituality, and of course the risk of relapse that is a result of a lack of coping skills to deal with unresolved trauma. For treatment to be effective, a participant must be able to adjust the trauma issues while maintaining sobriety. This process is uncomfortable and sometimes painful. Participants must learn new coping skills to replace the use of substances.
Kim Etherington, explore case studies of people who have been affected by substance use and trauma in her book, “Trauma, Drug Misuse and Transforming Identities.” The book focuses on the value of using narrative therapy to hear the participant’s life story, and to understand how environmental factors such as culture shape people’s lives. The authors suggest that people can change their identities positively when empowered and supported to do so.
As Medicine Wheel Recovery Services nears opening, the staff have been communicating with the community about the MWRS approach to healing from addictions, mental health issues, and trauma. In an article in The Chronicle last week by Amanda Renner, Co-Executive Director Pam Daniel states, “The individual that walks through that door comes first. Above and beyond anything else, that individual comes first. They will be treated with dignity and respect, nothing less will be acceptable. Period. And they may not have that dignity and respect for themselves when they get here, but when they leave, they will have found it.” (http://www.thechronicleonline.com/news/medicine-wheel-finding-balance-and-giving-back/article_1864b65a-e00a-11e5-bfd5-ff81fa28c715.html#user-comment-area).
There are many ways that you, as a community member, can make an impact in the lives of someone suffering from addiction issues, unaddressed mental health issues, and trauma. First, become educated. Media has influenced us to stigmatize and even fear people with these issues, but education can help us develop an understanding, empathy, and a humanitarian heart to embrace our suffering neighbors. While education can happen in the classroom or on the computer, it’s always best to get the information from the source. If you know someone who experiences these issues, all you have to do is listen with an open heart and an open mind. Ask someone to share their story. Next, learn about your political candidates, and exercise your right to vote. Politicians have different agendas and priorities, and not all of them value substance abuse treatment. Finally, volunteer or give—every little amount helps. Nearly every nonprofit organization accepts the help of volunteers, and some rely entirely on the service of volunteers. To learn more about Medicine Wheel Recovery Services, visit the website at www.medicnewheelrecoveryservices.org
Anderson, Catherine M., and Katherine B. Chiocchio. “The Interface Of Homelessness, Addictions And Mental Illness In The Lives Of Trauma Survivors.” Sexual abuse in the lives of women diagnosed with serious mental illness. 21-37. Amsterdam, Netherlands: Harwood Academic Publishers, 1997. PsycINFO. Web. 5 Mar. 2016.
Condon, Maureen J. “Interactive impacts of trauma, addiction, relapse, specialized treatment, and recovery on the lives of individuals.” Dissertation Abstracts International 64. (2004). PsycINFO. Web. 5 Mar. 2016.
Etherington, Kim. “Trauma, Drug Misuse and Transforming Identities.” London, GB: Jessica Kingsley Publishers, 2007. ProQuest ebrary. Web. 5 March 2016.
Renner, Amnda. “Medicine Wheel: Finding Balance and Giving Back.” The Chronicle Online. http://www.thechronicleonline.com/news/medicine-wheel-finding-balance-and-giving-back/article_1864b65a-e00a-11e5-bfd5-ff81fa28c715.html#user-comment-area Web 03 March, 2016.