Why don't they just stop?
“I think this will be my fifth treatment facility...
my second stay at this one. I’m tired; I gotta get help,” one of our Sisters, "Diana", said. Everyone around the table congratulates her for going to treatment. But there isn’t a lot of enthusiasm this time will be any different. It’s a bit sobering. One whispers under her breath, "Yeah, what’s the point? It never works. Another adds, " I’ve overdosed nine times. They say I have endocarditis and Hep C...I’m just tired.” Then, she pauses and says, “They’ve brought me back every time I OD’d. I don’t get it -- why won't they just let me die?"
A few minutes later, a team member knocks on my office door. She knows I’ve experienced much of what our Sisters are talking about. Discouraged and confused, she looks me in the eye. Slowly, pausing between each word, she asks: “Why-don’t-people-just-STOP-doing-what-is-clearly-killing-them? I don’t get it!”
Why don’t they just stop? is a reasonable question. But there’s no easy answer, and it requires more than a passing understanding of the situation. The division among mental health professionals, medical doctors, government agencies, and faith-based recovery programs has become intense over this very issue. Addiction is counterintuitive: You do what you don’t want to do, but you do it anyway because you can’t seem to stop. Sound familiar? (See Romans 7:18)
"Great question,” I reply. “But, look at it from a Sisters’ perspective. Imagine living in the midst of uncontrollable circumstances trying to get your needs met. Our Sisters are smart: Many lived a 'normal' life for years, have been professionals, hold college degrees. They’ve solved problems we’ve never even dreamed of. Given a situation, they consider all possible answers, and even make legitimate attempts to do the right thing, but often still choose addiction and the streets because that appears to be the most reasonable solution."
To illustrate, I give our team member an account of one Sister’s journey to her life in prostitution, homelessness, and addiction. “Sierra” is a soft-spoken, loving, compassionate, and hard working woman who came in recently having just experienced a violent rape. After collapsing into a chair and working through initial tears and shock, she opens up. Parts of her story, like many of our Sisters, are a surprise.
Although “Sierra” has a history of sexual trauma and abuse from her childhood, she lived a “normal” life for many years after that. She married and raised three children, and was a nurse at a local hospital. Unfortunately, she worked in a part of the hospital that was very challenging, and was re-traumatized often. She was also diagnosed with a very serious, painful, and progressive disease that requires ongoing treatment.
She was persistent in taking care of her disease, but the pain got beyond what she could bear, even with prescribed medication. She began taking opioids, eventually becoming dependent, which later led to an addiction to heroin and alcohol. Her husband also misused drugs and passed away last summer of an accidental overdose.
The morning we visit, “Sierra” still has bruises around her neck from the violent rape. She explains, as many of our Sisters have, this is a fairly normal experience for those working on the street. She doesn’t trust police or hospital workers enough to report it, and her physical, emotional, and spiritual pain are overwhelming to the point she just wants to die. Hopelessness hovers over her. When we finally bring up going to a treatment center for help, I realize how completely ludicrous and naive the idea seems to her. Her physical symptoms would be unbearable while she detoxes, even if we’re lucky enough to find a rehab facility willing to take her with ongoing health issues. In her mind, she has nothing to work toward -- she’s already lost her kids, house, husband, and the God she thought loved her. Later she sleeps on the couch where she feels safe, at least for an hour of her day.
To sum it up, the question “Why don’t they just stop?” has several logical answers. While it’s heartbreaking, it also makes sense that Sisters repeatedly choose substance use over treatment. They’re accustomed to loss and abuse, and survival (today, this minute) is their only foreseeable goal. And they are, simply, worn out.
Consider this: Statistically, for those opiod abusers who enter a treatment center, 90% will relapse within one year; 80% within one month. And, as of 2018, accidental drug overdose is the leading cause of death for Americans under the age of 55.
So, instead of just asking “Why?” I challenge each of us to dig deeper -- to look and understand the actual answer to the question. Only then can we hope to find treatment and answers to substance use disorder that will work and produce long-lasting results.
The good news? When things all come together women do heal! Diana, mentioned at the beginning of this story, graduated and has been working a program since October. She’s attending 12-step meetings and maintaining her sobriety, working with a health clinic near our Center. And looking at the bigger picture: More money is currently being allocated for detox and longer-term housing as more and more folks come to the table to fight for solutions.