The Politics of “Resolving” Homelessness and “Treating” Drug Addiction

By Majeeda Amadadeen

The following was written in response to a writing prompt for an essay for a graduate course on mental illness. The subject is a five-day program addressing homelessness at a local clinic.

I work in the Solomon Carter Fuller Mental Health Center, 185 East Newton Street, Boston, MA 02118. This locale is in the middle of Boston’s South End.

Given the geographic location of the program, we serve what is called the “Mass Ave” population. That is the name given to what some people term as the largest homeless community in Boston. The principal demographic of the population we serve is the homeless. We serve the homeless population in Boston’s South End.

Inside that group is the economically most poor, who also happen to be made up of People of Color, the recently incarcerated, the LGBTQ community, people with mental illnesses, refugees and immigrants, and patients with HIV/AIDs.

Any brief examination of these groups, taken together reveals immediately that they have defining overlap with each other. The poorest are People of Color. People of Color make up the large majority of the immigrant/refugee population. Those people suffering from lack of services for their contraction of, and for living with HIV/AIDS are the economically poorest among us, and they tend to be homeless.

Independent of the portrayal of this community as a homeless community — this portrayal proffered by the media and certain government agencies — any close look reveals that it is really a drug addict/drug dealer community. There are numerous City programs addressing homelessness. What people who chose to live on Mass Ave have most in common is that they are either drug addicted, drug dealers, or both. This is the bottom-line demographic of the population I serve.

I am a master’s level Mental Health Clinician. In this capacity I have worked with homeless populations for over a decade. However, as stipulated in my answer to question #1, the most accurate demographic describing my client population would not be homeless, though each of the members of the population may be homeless. The most accurate demographic would be the substance abusing population, and the population suffering from the disease of addiction. My educational background has given me a broad understanding of the relationship between the epidemic of drug abuse, including the major challenge posed by the proliferation of Fentanyl in our communities.

It has also helped me to navigate the intricacies of policy at the governmental level regarding the intervention, at a corporate monopolist level, of Big Pharma in what is called “healing” and “treatment.”

However, it is my participation in the 12-Step recovery communities, particularly those of Alcoholics Anonymous, Narcotics Anonymous, and Sex and Love Addicts Anonymous that have given me insight into the real workings of processes which either exacerbate or are source of the epidemic, on one hand, and those community campaigns which are part of the solution, on the other.

My greatest successes come in helping addicts connect to the recovery community. I could focus on one or two of the “success stories,” but each of them follows, within a broad range, a typical route. Unlike Big Pharma’s “Medicated Assisted Treatment,” which “treats” drug addiction by providing … legal drugs which are equally as dependance-creating; and unlike the government’s provision of programs named as “Harm Reduction,” which endeavors to keep addicts alive while they continue to abuse drugs; the 12-Step programs assist those addicted to become the agents of their own health, the determinants of their own recovery from the disease of addiction. It is from this perspective that my greatest success has been and continues to be suggesting the recovery groups in the area, suggesting the recovery meetings in the area, and helping people get to these meetings. This recovery work begins with total abstinence. Anyone can do it.

I am grateful for the master’s program from which I gained my degree for introducing me to the Recovery Movement. In fact, the Recovery Movement’s success has led Social Work programs, Nursing degree programs, as well as programs for Mental Health Clinicians to study the 12-Steps and 12-Traditions, and to participate in recovery meetings, each as required elements of the curriculums of these programs. Were it not for this requirement, I may not have learned of this community movement for self-determined recovery from substance abuse.

The people of the population I serve, again called “Mass Ave,” are the definition of underserved. Drug addiction drives poverty. Drug addicts are, by definition, mentally ill. It happens that these characteristics also coincide with the most economically poor, with people who are discriminated against for their sexual preference — the LGBTQ community — and with People of Color and immigrants. For my practice, each of these are coincident populations. The communities in which I live, and work have identical populations. That is my lived and professional experience.

From a perspective — one which is held by certain government officials, the corporations of Big Pharma who provide psychotropic drugs as the “cure” for… drug addiction, and by many psychiatrists today, who together form the frontline of drug providers to the drug addicted communities (thereby surpassing the street corner drug dealer of ill fame and a bygone era) — my practice setting is not under-resourced but is over-resourced. The plethora of legally prescribed psychotropic drugs is more than enough to addict the entire population of the City.

The issue of under-resourced comes in when actual techniques as proven paths to recovery are examined. There is minimal support in my practice setting for the kind of counseling which would organically lead the addicted population to self-help groups like those of the 12-Steps and 12 Traditions of the Recovery Movement. The two government-sponsored Recovery Centers which serve the Mass Ave population — Gavin House in South Boston, and STEProx in Nubian Square, Roxbury — were both enjoined by the City to disallow Narcotics Anonymous and Alcoholics Anonymous meetings. In the case of STEProx, their entire clientele was recovering drug addicts who frequented the meetings at the Center. In this condition the Center lost its clientele, and the Center went the way of the rest of the gentrified property in Nubian Square — they had to close. The policy, on one hand, and its economic effect on the other, taken together, form the definition of “under-resourced.” At Solomon Carter Fuller, mine is a 5-day program which provides medication to detox from Fentanyl and other drugs but provides no time to detox from the medication.

Given the above, the challenge becomes to engage, to a more rigorous degree, the principles of community self-determination, in a situation in which the city government and Big Pharma are conspiring to perpetuate the hopelessness of drug addiction. My program manages symptoms for five days. It provides no resolution for the root cause.

However, decades of practice have proven that the Recovery Movement is a working-class movement in that no money changes hands, there is no hierarchy, and the experts on recovery are the subjects of the disease of addiction themselves. It is in this context that the resolution of this contradiction in the provision of services to this population necessarily resides in the hands of this population itself, and in the service providers who support them, such as me and many other professionals who truly care about our clients.

I want to engage a career in public policy. From the ground floor I see how the problem is not at its base medical. It is political. Public policy today supports a dictatorship of Big Pharma in addicting the entire population, with an army of psychiatrists as their frontline soldiers.

With my background and experience in serving this population from the perspective of a Mental Health Clinician who cares about her people, I am more than qualified to represent my community, my constituency, my clients at the table where the policies are made. I want to represent the clients I serve, that is, the people of my community, at a governmental level so that we can overturn this cycle of violence perpetrated by government-and-corporate-induced slavery to drugs. 30 years ago, Treatment on Demand, a campaign born of the recovery movement in my neighborhood, won the policy change which led to all addicts being able to get a bed when they sought to recovery. This policy has since been watered down. It is policies like this which must be revisited, and through government service I could contribute to this needed progress.