How do people get off drugs without professional help?

I don’t have any definitive answer to this question and I’m sure there isn’t a single solution. But, the question has been raised due to a couple of cases I’ve examined in our interview transcripts.

Isolation: how important can it be for drug use cessation?

Let’s name the first example ‘Heath’. Heath was a cocaine user. He maintained employment and earned enough money, by both legal and illegal means, to live independently and fund his habit. But Heath decided he’d had enough. He’d been losing weight, losing sleep, and gotten involved in a number of fights. He left his job and his home, making himself intentionally homeless, to assist his drug use cessation:

“I decided to go cold turkey and make myself homeless to get myself off it”

And this was, for Heath, a rational and premeditated strategy:

“If I haven’t got a home, I haven’t got no money have I? And if I haven’t got no money, I can’t have it”

Without the money to support his habit he reports experiencing a period of six months ‘cold turkey’. He simply waited. Heath also perceived the absence of social support as a positive in his ‘recovery’: 

“I was on my own, I wasn’t seeing anyone. I was hiding everywhere. It was nice weather though so you can go a field, just sit, chill out, think about what you want to do with yourself”

And what’s more, his homelessness was perceived as a ‘small’ issue compared to the main goal:  

“I knew that being homeless was for my own good. There was a greater purpose to it, wasn’t there?”

And so that was Heath.

Let’s name the second example ‘Kieran’. Kieran used amphetamines. His motivation for giving up his habit was to prove to a family court judge that he was ‘clean’ and fit to see his children. His strategy was to accompany a friend who drives a truck long distances:

“I started going with him, just in the wagon, away all week and I did it through going with him really. Just slept it out really, ‘cos there’s no medication they can give you for withdrawal off amphetamines, just sleeping tablets really.

What Heath and Kieran have in common is they both identified a need and motivation that was powerful enough for them to undertake a ‘cold turkey’ withdrawal. They also considered they had to significantly disrupt their lifestyles by means of changing the ‘place’ in which they occupied and, by implication, the company they were keeping. In Heath’s case, too, short-term poverty was crucial for his plan to succeed. They knew what, in their current lifestyles, would harm their chances of succeeding and so they removed themselves from those potential dangers. But, they seemed to act alone: neither Heath nor Kieran talked about enlisting the support of drug cessation agencies to help them.  

These sections of the transcripts are of interest because they seem to run counter to what we (or at least ‘I’) may think of as a standard pathway for drug cessation – if there ever could be such a thing. There is little or no talk of medication, counselling or other professional intervention, and no talk of social support systems, networks, or role models. As a small chapter in a life story interview, these individuals talked about their drug cessation period as a time in which they were motivated, empowered, rational, and resourceful human beings. And they also valued isolation and freedom from possible interference and disruption from the world around them.

So this leaves me thinking: is there a ‘kind’ of motivation do people need, or harness, to cease drug use? And, what are the factors that affect whether someone decides to ‘go it alone’ or to access professional drug cessation support? To what extent can the quest for permanent cessation from drug use be considered a personal journey, and when and how can it succeed with the intervention of others?

July 9, 2011 at 3:28 pm 4 comments

The Homelessness Conversation: Time for a Change?

Over the last year or so, I have tried to keep pace with the debates, conversation, news, and information about homelessness. A growing familiarity with the debates, coupled with the pressures of completing this project work among others, has left me with a feeling of apathy about continuing participation in these conversations. I have blogged and commented less frequently and felt less inspired by what I have read about homelessness issues.

In addition to this, I have learned from writing this blog that there are significant restrictions on what I can discuss in it. The blog, as you may know, is primarily about our research project into the life stories of homeless people. But as I have discovered, this requires the challenging act of balancing two objectives: firstly, writing an engaging blog post which is deserving of the readers time and attention; and secondly, maintaining the confidentiality of the sensitive and personal issues that have been shared with me during the research interviews. There are many insightful stories about the lives of the homeless people that have been shared with me, but reformulating these into anonymous accounts for the purpose of public consumption is somewhat more difficult. Perhaps a more skilful or imaginative writer would have tackled these challenges better than I have.

However, as we are currently working through an analysis of these interviews, I am provoked into thinking about issues of homelessness that I see dominating public discussions and how these are matched to what I ‘see’ in our research. These two ways of perceiving homelessness do not match each other.

The common, public conversations of homelessness are usually formed in the following ways: homeless people are presented as victims of their circumstances and of the state (inadequate policy and service provision – particularly due to cuts in public spending), and homeless people with high-level needs (evidenced by the presentation of extreme case examples). These are important debates and discussions, but do they serve their intended purpose in the public domain? Personally, I think these discussions are easy to ignore. Extreme cases, by their nature, do not represent the entire spectrum of homelessness circumstances; what’s more, service cuts will take place in the context of much wider cuts in public spending. And who is participating in these debates anyway? Is it the individuals and organisations with a clear, vested interest? Or do these debates include the general public, too?

These are points of interest because I can see from our own interviews there is a different kind of conversation to be had about homelessness. Indeed, there are stories of intolerable abuse and neglect and there are stories of poverty and disadvantage. But there are also stories of individuals navigating a pathway through their lives often in ordinary ways and frequently where homelessness is depicted as an incidental period of their lives. This is not to say that homelessness is not a serious and challenging problem, but it is to say that there is much more to understand about the lives of homeless people than that which can be obtained through the public discussions about the issue. One example I have observed is someone who I follow on Twitter: @vendazero. @vendazero, a Big Issue vender but no longer homeless, does tweet about homelessness and associated issues, but he also tweets about the ordinary aspects of his life – these are the things that highlight the commonalities between us all. This is, for me, a compelling and accessible way in which I can understand more about, firstly, the man, and secondly, the homelessness. This is where I see, as I have witnessed in the interviews, grounds for a common understanding.

I guess the point of this blog post is to ask the question: are there different ways of having the conversations that we need to be having about homelessness? I have mentioned what I perceive to be the public discussions that frequently highlight extreme cases and worst-case scenarios. And I have suggested that these are more difficult to understand and to engage with than the kinds of conversations that are had by undertaking a more – dare I say it – ‘holistic’ view with those who are affected the most. By diversifying the conversations we are having about homelessness can we increase our understanding of it? Can we bring more people into the discussion? By doing this, can we open up new forms of tackling the issue?

What are your thoughts?

March 1, 2011 at 2:32 pm 7 comments

Some reflections on the research interviews

This is my ‘post-it note’ blog post on some of the things I have learned about homelessness this year. I have interviewed 104 people in the last seven months and we have yet to begin analysing the majority of the transcripts at this time. I guess this is indicative of the research process. We collect data and then work out a way to start to make sense of it all; we aim to report findings without losing accuracy and meaning, and without over-simplifying the complexities of individuals’ experiences. But here are some of the things which spring immediately to mind from what interviewees have told me:  

  • There is an enormous range of homelessness circumstances, the events which have preceded it, the ways in which it is experienced and perceived – the unique, individual, and complex experience of homelessness and exclusion is stressed across the interviews
  • The high prevalence of parental divorce in the lives of young people preceding homelessness and reports of unsettled family life
  • The widespread (and undetected by the authorities) instances of physical, emotional, and sexual abuse in childhood including rape of both boys and girls by close family members, neglect, home imprisonment, exploitation by adults for financial purposes
  • The lack of judicial involvement and any other professional input in addressing the consequences of the above abuses  
  • The apparent lack of positive role models in childhood, both authority figures and in the family
  • The identification of self as the ‘black sheep’ of the family, feelings of being treated less favourably than siblings
  • Victimisation and bullying in school, most often described as the victim, but sometimes as the perpetrator
  • Identifying the ‘wrong crowd’ as leading one astray, whilst also fulfilling a deeper need for group belonging and feelings of being wanted and popular
  • The apparent ease of which schooling can be discontinued by the age of around 14
  • A willingness to experiment with hard drugs in childhood, ignorant of what is actually being taken
  • The identification of predatory ‘friends’ and acquaintances who lead the individual into hard drug use and who are fully aware of the consequences they are leading them towards, for example, a life of crime, prostitution, gang membership
  • The apparent failure in the short-term of the criminal justice system to deter to offending behaviour, perhaps instead to even encourage or reward it
  • A lack of aspiration, and awareness, of the opportunities that can be afforded in adult life
  • An apparent lack of self-confidence and poor estimations of self-worth, feelings of resignation and powerlessness
  • In some instances, the resilience, industry, and self-discipline that can be drawn upon in spite of the exclusionary nature of homelessness and its associated problems
  • In some instances, the desires to have children and ‘right the wrongs’ from one’s own parenting
  • In some instances, the desires for future careers in the homelessness sector and wanting to help others

December 23, 2010 at 1:07 pm 15 comments

Relocation and wholesale life change: Does it work?

‘Location is everything’ – this is a statement widely accepted as true among homebuyers and those people on the TV. But how important is location for someone who is homeless and wanting to escape the problems in their lives that are preventing them from moving forwards?

The need for relocation is considered necessary among many for a wholesale life change. But what is a wholesale life change? It is something that many homeless people talk about as being necessary for them to turn away from the problems, habits, and people that they are familiar with and move into the future and life that they desire. ‘Wholesale life change’ is the best term I can think of to describe this process. Wholesale life change may not always be wanted; it can actually be unwanted too. I’ll use two examples to illustrate my point: the first, change for recovering drug users; the second, women escaping domestic violence.

Firstly, drug users have often discussed the difficulties in breaking free of their habit. But breaking free of the habit is complex. There are key people in their lives that are linked to drug use and they are part of a community of like-minded people. Like any community there are unwritten but widely understood rules, norms, and expectations. It is a familiar existence. When they decide to stop using the drugs and exit that community they also need to find new meaningful activities, new housing, and make new friends and relationships. To slip back into the ‘old’ lifestyle can be very tempting. To create a new life in the same place is difficult and therefore a wholesale change may be needed. Change includes relocation and the chance to start a fresh, different life.

In contrast to these are victims of domestic violence. Some flee their homes and the places they know to go somewhere they can be safe and hidden. They are escaping someone who is a threat to their personal safety and well-being. But relocation presents difficulties such as moving away from family and friends, and possibly uprooting children too. It is an imposed wholesale change which can often be unwanted.

What interests me now though is to know how much value there is in these wholesale life changes. Do they work? Is this a route out of, and away from, the life that they are trying to escape? What are the long-term consequences? Are they successful in achieving the life they want by going through these changes? I am hopeful that I will be able to find, and interview, some more people who can help me to answer some of these questions.

November 3, 2010 at 6:52 pm 17 comments

How well integrated is the online homelessness community?

Over the last year I have been writing this blog and discovering more about homelessness through the numerous resources that other people have been producing online. There are, it seems, many other bloggers such as those who work in the homelessness sector and those who are homeless themselves. It’s interesting and informative to find out about the concerns and views that those people have.

I’ve also been using Twitter to find out even more and it seems as though this is a tool that is popular not just among those mentioned above, but also for the various social enterprises and the corporate Tweeters - the voluntary sector organisations who share information about their activities. There are things going on out there that I never would have imagined had I not tapped into the online community.   

But my questions to you are these:

How do you use these (online) resources and what are your reasons for doing so?   

How would you describe your experience of the ‘online homelessness community’?

How well integrated, in your opinion, are all these resources?

Please share your views…….

November 2, 2010 at 9:01 am Leave a comment

Improving the homelessness debate – Learn to ‘wow’ your readers by using evidence

By writing a blog about my research into homelessness I have undertaken a commitment to share, with all those who care to take an interest, the findings and other such details about the research. There are a number of other blogs and resources I have discovered online during this time too. Using these tools to share with the wider world the finer details and debates of homelessness I believe is a commendable activity. By reading and commenting on such blogs I am also committing myself to sharing with the authors how the evidence gathered in my own research supports or contests their views.

Evidence is important. It helps to separate fact from opinion. Evidence can also be used to support an opinion. Help to improve the quality of the debates and the clarity of your arguments by using evidence.  

If you intend for your opinion in your blog to convince the reader that what you are arguing has some substance then consider looking for some evidence to support what you are arguing. Do not, for example, simply suggest that the answer to rough sleeping is to increase the number of hostel beds (especially if you work in a hostel or other homeless organisation). It will be clear to your reader that there is a large element of bias in your assertions, especially if you have not cited any objective evidence. You will fail to convince them.  

Do consider searching through research and publications in resources such as those being collated by Homeless Link’s Homeless Pages. Alternatively, if the point you wish to make is simply based on your own experience be explicit about it – it lets the reader know what you are using to substantiate your views and that you are not claiming to speak for the sector as a whole.

Do consider writing a post based on a piece of completed research outlining your views on how the evidence from that research may influence your own policy or practice. Invite your readers to do likewise and you will be adding value to their knowledge base too.

Remember: Researching and gathering evidence is a resource-intensive activity, the purpose of which is designed to help you increase your knowledge and help you strengthen your arguments for improved policy and practice.

October 31, 2010 at 8:36 pm 2 comments

Heroin – It’s a love affair

Heroin/gear/smack – it has a significant presence among the homeless in Stoke. It’s not everyone’s cup of tea, but for those who heroin is the habit of choice it is interesting to listen to how heroin use is talked about within the context of the life course.

Heroin is something which can be talked about as a relationship. It can be loved because of the wonderful effect is has upon the user, but hated because of the sickness it can cause and the power it holds over them. A heroin habit can be rationalised as a relationship because the ‘hate’ side is ‘something that you just put up with’. Talking about heroin use in these terms can be a useful communicative device too because  it can convey to non-heroin users in a way that they can understand some of the complexity, and confusion, of maintaining a habit.

Heroin is the only relationship that matters. For the user, maintenance of the habit is critical to well-being. It may become necessary to use heroin to simply function as a human being. It is needed ‘to feel normal’, not high anymore, just normal. Relationships with family, partners and friends are less important, as is a job and a secure home.

Though the destructive and harmful elements of a heroin habit are known to the user, the acquisition of the habit has been, in retrospect, a logical and progressive journey. Past events such as family upbringing, serious incidents of loss, and the influence of ’a bad crowd’ are given significance and assigned meaning. This assists the user to understand why they began using, and possibly why they continue. 

In the ‘storyworld’ (a term used by narrative analysts – it is not intended to sound as though the speaker is telling tales) of the user there exists other individuals who have played a complicit role in the maintenance of the habit. Family members (often, but not always acting in the interests of the user) may supply money and/or protection. But in the world of the user the other main characters are other users. Other users are frequently people who find and associate with the user or are ‘bumped into’ in places such as hostels or on the streets.

A heroin habit provides a structure for day-to-day living. Get up, use whatever is left from the previous day, if any, and then find another means of scoring. It’s a tough days work and it carries risks but the addiction is a force greater than the moral conscience. Guilt and remorse is dampened by further heroin use. 

The life of the user has been ‘time wasted’.  There is hope, in the future, to ’be somebody’. Before now life has been lived one day at a time and no future has been planned for. The future, from the present perspective, usually has no content – it’s empty.

October 27, 2010 at 3:41 pm Leave a comment

Adventures with the Rough Sleepers Team

For readers unfamiliar with the state of homeless services in the fine city of Stoke-on-Trent it is worth pointing out that the city, compared to others I have heard about, does equip itself to address the problems of homelessness and its numerous associates. Some places in Britain prefer to deny that homelessness exists in their cities (they must have some large bumps in their carpets!), thankfully there is a will in Stoke to acknowledge and address homelessness. There is a desire to get people off the streets.

The rough sleepers team were created as an outreach service to engage with people who are, as the name suggests, sleeping rough in the city. In the last couple of weeks I have been going out with them to speak to some people currently in this situation and see if they will be willing to participate in the research. The team starts its sweep of the city at 6.30 in the AM. We’ve been to car parks, shop doorways, small woods, garden sheds and the back of superstores. Its been cold out this week, especially early in the morning. The six-town geography of Stoke with its neighbouring borough of Newcastle-under-Lyme mean that there are a few miles to cover in a short space of time. It’s ok before the communters come out but by 8 o’clock the traffic really drags. It’s important to be out early to get to people before they have to move on. There are places where the landowner will have arranged things so that rough sleepers can’t get onto the land. Others are aware that people may be sleeping rough on their land but will tolerate it as long as they have left early. During the sweep we’ll check known rough sleeping spots as well as visit people who are known to the team and for one reason or another cannot go into hostel accommodation, not at the moment anyway.

There are limits to the places that the rough sleepers team can go to though, such as squats. These are out of bounds for health and safety reasons. So it is hard to know just how many rough sleepers there are out there. For the research I am keen to speak to people who, for whatever reason, may not be engaging with services at all or only minimally. This could prove valuable and insightful for the research and allow us to learn more about homelessness and the nature of the lives of those in this situation. But it will be quite a challenge getting to them.  There are still some irons in fires, tricks up sleeves and avenues yet to explore before the fieldwork for this project can come to a close. The aim for the research was to conduct 100 interviews (that seemed like a massive number earlier this year!) and we have crossed over the three-quarter mark of that, a lot of ground has been covered and masses of data has been generated. But there remains a few more areas to explore before I can press stop on the digital recorder for the last time.

October 22, 2010 at 6:30 pm 11 comments

Tackling homelessness stigma with the ‘Compassion Contract’

Contracts

Image by NobMouse via Flickr

In this post I will discuss an idea that occurred to me which I have called the ‘Compassion Contract’. I’ve read recently about things which have made me think about attitudes to homelessness. Fellow blogger SLO Homeless has been discussing the criminalisation of homeless, We Are Visible encourages the use of social media to promote attitude change to homelessness, there has been some discussion of the matter previously in this blog, and I’ve also received personal communication to the effect of “society’s lost sympathy”. So I’m going to use this post to share a slightly off-the-wall suggestion about ‘how’ it might be possible to change attitudes.

My suggestion is inspired by the activities of town centre chuggers. While I don’t wish to go into any detail about the merits of chugging it does make me think about the message that this sends out to the public. I would argue that a side effect of chugging is the reinforcement of beliefs that tie homelessness to issues of finance. While I don’t deny the importance of money in addressing the problem of homelessness, I think that most people would agree that there is some work to be done in changing public attitudes and stigma too as evidenced by the examples given above. The public knows why homelessness is a problem but the main thing that they are being asked to actually do about it is donate money.  Why not ask them to donate their compassion instead?

The Compassion Contract asks signatories to commit themselves to thinking about their attiudes towards homeless people. It invites them to align themselves with the idea that there is something much more complex about homelessness that is not visible at the surface level. It asks them to commit themselves to challenging discriminatory and prejudicial views whenever they come across them. They are, on an implicit level, being given some ownership and responsibility for the solutions and for change. I believe that this may offer a way of creating attiudinal change which if successful can lead to additional benefits. A commitment or a contract for compassion bears no financial commitment from the donor and neither does it rely upon their fluctuating fortunes. It relies upon adopting an attitude and a way of looking at homelessness that can remain constant and can educate and influence others. A financial donation is giving somebody else the responsiblity of creating change, a petition is a way of lobbying for someone else to create change, but a Compassion Contract is undertaking personal responsibility for change.

Share your thoughts with me, I’d be interested to hear of any such ideas which have been tried out in the past or presently and what kind of reaction they get!

Photography: Supplied by NobMouse under license by CC

September 23, 2010 at 6:49 pm 6 comments

How to Use Social Media to Give the Homeless a Voice

Today we had a meeting of the research team and project advisory group in Stoke. Some of the things we discussed were around early research findings, dissemination of findings at the end of the project, and once more…. the use of social media. There was an honest exchange of views about this blog for instance, and the merits of social media and how it can be used to give the homeless a voice. Then what should appear in my Twitter feed right on cue today but a link to the following excellent resource…? (Twitter has a great way of landing useful information on you just when you need it!)

So rather than listen to me, I’d rather let the experts do the talking. Check out the following video and take a look at the useful stuff they’ve put together on the We Are Visible site too:

(NB for project advisory group members: feel free to circulate as far and wide as you would like!) 

September 17, 2010 at 5:13 pm 8 comments

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