Saturday, June 14, 2008

The IPDA challenge

So, the longer I spend at work, the more I realize that IPDA is a revolving door. On any given night I do between 10 and 20 intakes. If it's a really slow night I'll do less, but it's not usual. Of these, I maybe see 2 or 3 names that are not in the computer already (we have records for the past 10 years). Of course some of these people have been in IPDA 2 or 3 times in the past 10 years, but some of them are "the regulars". These people are in there at least every month, often more. So what do you do?

For the people who are new, I always try and make sure to talk to them. Some of them, you know are incredibly embarrassed about the situation, living a perfectly "normal" healthy life, and will likely never be back. Those people you don't need to give a lot of support to.

It's the other ones, the young ones, with that dead look in their eyes, the woman who says it's the most sober she's been in 3 years, the men who are looking for the nearest vendor on the way out. Those ones, I always want to give an extra word to. Unfortunately, we don't get a lot of time for "counseling" when we're doing discharges at the end of the night. There's this push to have people out by the start of the next shift, and so we need to get them out as fast as possible (read: I don't agree with this). I always tell people about our detox program; the opportunity to get clean. If it's the right time of day, I invite them upstairs to get soup and coffee, or a snack. I try and show them that I care, get them a jacket if it's cold, a clean t-shirt. How do we work so we don't create the revolving door of the next group.

Because, there are the people who we see on a very regular basis. We've had people show up twice in one day. We discharge them sober, they go drink some more, and get dragged back. They sleep upstairs when they don't get dragged in. They're the ones passed out on the corner, passed out in the park, passed out on the stairs of the shelter, they're the ones staggering through downtown, panhandling at the bus shelter, and scaring people away from the bank machine. And I don't know what to do with them. I really don't. I have always held out that there is hope for everyone, but sometimes, I just don't know. I really don't. Have these people's brains been so damaged by solvent and alcohol that they can't make that choice not to drink? Is it that there is nothing else in their life to do, or look forward to? Is it just such an ingrained habit that doing something else seems impossible? What must you have been through to have your life consist almost entirely of using until you pass out, getting sober, using till you pass out. Isn't there more to life then that? But is there for them?

I just don't even know what to say. I give them dry clothes to replace their urine soaked ones, I offer them encouragement (go upstairs, don't go out and get drunk), we talk about their health, and the consequences of their actions. But it never seems to stick. Does that mean we give up? I don't think so. But I'm also not sure where to go from here.


cb said...

I think it's about just looking at the small things that can be done. They can come to you for the little, possibly only acceptance that they might have in their lives. So you listen. You treat them with respect as we do for anyone (and again, it might be the only chance someone has for respect being given to them). Personally, although I don't know what it's like where you work, I'd just do that. I don't think I'd even bother about the lecture of not drinking again. Because unless you are saying something new, it isn't something they don't know. So just a welcome appreciation and contact with another human being on as equal a level as possible, is a great gift to be able to give. it might not seem like you are 'doing' or 'achieving' much as you see the same faces - but I think you might have to turn things round and look at what you ARE giving, rather than what you cannot! And keep it up, it sounds like you are doing a very fine and conscientious job!

Still Dreaming said...

thanks for that perspective. I think some of the not drinking lecture is a harm reduction thing. "Don't drink tonight, wait till tomorrow, you've already been thrown in the drunk tank twice today for being disruptive or passed out on the street".

You are SO right about looking at what I am giving instead of what I'm not. Thanks for the compliments!