Quick Update

This is how we play cards at my work... wearing nitrile gloves; who knows what's on those cards!  This was one booooooring night in the drunk tank.  On the left you can see our "ghetto" crib board - a plank of wood, holes pounded with a nail and lines drawn in permanent marker, oh and don't forget the qtip pegs!  

Thank you for all your supportive comments on my last post.  My eight days are over and I told my boss I am NEVER doing that again.  I actually had two decent nights and only one fight with the enforcer (which warrants it's own post).  I had some really good van patrols though and that always makes me happy.  I LOVE going out in van.  Also, noone died, which is especially nice given that I haven't caught up on all the tragedy I want to blog about. 

I was hoping to sleep for forever today, but unfortunatly that didn't happen.  I am however taking today for ME, no pressure on myself to do anything.  Well, except feed the Sophie cat, but she makes it perfectly clear that it is not an option.  Of course, because I decided to devote this day to myself I got a horrible headache and spent much of this evening with an icepack on my forhead as the painkillers don't seem to be working.  I also went out and got coffee to feed my addiction and some gravol as that seems to help my headaches.  Actually though, I think what helped the most was getting out in the cold and having something else to think about then how much it hurt.  

I'm hoping to get a longer sleep today, whenever I decide to go to bed, or when my body conks out and decides it for me.  I have tomorrow off too, and I really need to get some laundry done!  I'd also love to go to yoga, as I've been so busy that it's been really hard to get there.  

Oh, and I changed the blog links in my side bar... I know I forgot some.  So if you think you (or someone else) should be there, comment and I'll add you  in.  

social injustice is killing people

Poverty sucks. That's all there is to it. Poverty is also a very complex issue, and like most complex issues, there is no easy answer. And certainly, throwing money at the situation is not the entire answer... not that anyone tries to throw money at it!

"People are dying early not only because of health gaps between rich and poor countries but also because of a lack of housing and clean water in wealthy countries like Canada, policy-makers said in a report to the World Health Organization on Thursday."

The article goes on to talk about the social determinants of health, the idea that health is based on more then just good medical care, but on the physical and social environment people are surrounded by. The article is good, but it's incomplete. I feel like there needs to be more to it.

I wish it were easy to get out of poverty. One of the guys I work with seems to think it is. He's always frustrated by the fact that our clients don't make a resume and go get a job. He generally puts NO emphasis on the emotional effort that it takes to do what may seem simply to him. Low self esteem and situational depression and anxiety along with drug use don't make things easy. "It's not supposed to be easy", "you got yourself here, get yourself out of it", "just stop with the drugs and drinking". If only. If only things were that simple.

not here but now

This Amnesty International campaign in Switzerland really touched me, so I thought I would share it before I went to sleep.

supervised injection sites

I can't find the first article, but I really wanted to talk about this: safe injection sites. This is a big deal right now in Vancouver, and I want to follow the issue and see what happens.

Basically, right now in Vancouver there's a place where people can go to inject drugs (heroin mostly I would think) with clean needles and medical staff. This is actually against the law in Canada, but they've been able to get out of it for now. Things are catching up with them though, and people are saying that this is a really bad practice and is just enabling people.

Very honestly, I'm not sure what I think. I often struggle with whether the things I do are enabling or helpful. This would be classified harm reduction, and I'm all for harm reduction. Also, is it really that different then just handing out clean needles? I don't know about other countries, or even other cities really, but where I live, it's really easy to get clean needles; they'll even bring them to your house.

The argument in favour of this, is that people are going to use drugs anyway. No matter what we do, they'll find a way to get those drugs into their blood stream. By giving people medical supervision, they're less likely to die. This gives them more time to make changes in their life, and it helps prevent the spread of disease which costs our health care system tons of money anyway. Why treat disease when you can prevent it?

Against supervised injection sites is the enabling argument. Giving people a safe place to do it encourages drug use. It's saying "as Canadians we think this is okay", do we want to send that message? This is medical professionals harming people. They're looking at people using illegal drugs, watching them inject themselves, and letting them do it. How can this be ethical?

I'm definitely not on the against side, I'm just not quite sure I'm on the for side. What's great about this place in Vancouver is that it has detox and transitional housing in the same building. That makes it a great place of outreach where medical staff can talk to people about quitting and getting clean. Seeing someone everyday also gives medical staff an opportunity to notice if people are getting sick and maybe catch things like TB earlier. It also gives access to referrals to things like methadone clinics.

I talked to a couple of my clients about needles, but no one was interested in saying to much. Most of the ones I work with are snorting and smoking cocaine/crack, we really don't see a lot of heroin users. Heroin users go to the medical detox at the hospital and get on methadone programs. People inject Ts and Rs, (twalin and ritalin) though, but apparently clean needles are pretty easy to get, so it seems to be a bit of a non issue.

Intersting thing to think about, and something I'm hoping to talk more to my clients about in the future.

HIV and Crack Use

I found myself nodding in agreement with this study this morning. It talks about the fact that people, especially women who are HIV+ and use crack don't get nearly as much treatment as those HIV+ who are not using crack. In my experience I've found this to be very true.

People come into IPDA all the time who are HIV+. It doesn't phase me. What surprises me, is how few of them are taking any medication. There are life saving medications out there which can extend life for an indefinite period of time, and these people aren't taking them. There are of course many reasons for this, and I don't begin to blame the health care profession. It is however something to be aware of.

The article states, and again, in my experience I've found this to be true, that this population also tends to have a lot of unprotected sex, especially the women. I find it hard knowing women who are HIV+ and are working the streets. Or men, having encounters with those women.

Actually to be honest, I haven't met a single HIV+ person among the homeless population who is taking antiretrovirals. That doesn't mean there aren't, because I'm sure there are, I just haven't come across them in detox or IPDA.

The article suggests better services for this population. I wonder what that would look like...

Juxtiposition of Reality part 2: Why I don't care about the new iphone

Most of the time I go about my day to day life and just sort of take certain things for granted, reality for instance. Every now and then reality steps up and smacks me in the face. For example, my favourite blog, Shrink Rap, has been talking about the new iphone. But they're not the only ones, a lot of people I know are quite excited about the iphone coming to Canada and the new iphone in general. And I got to thinking about whether or not the iphone would have any impact on the people I work with, and what they would in fact do with an iphone. This made me laugh, and I thought I would share some of my laughter with you. It was also hard, and I thought I would share a piece of my ongoing struggle with society as well.

The thing that comes to mind is how amused some of the people at work would be by the "etch e sketch" feature. Many of the people I work with have had permanent brain damage from sniffing and drinking various solvents and non-potable alcohols. They no longer function on the same level as most of society around them, and I think they might find this amusing; particularly while intoxicated.

The second image in my head was of a sudden influx of drugs into the poorest part of town and a new breed of iphone carrying drug dealers. People will sell anything to get drugs, and I'm pretty sure most people wouldn't be able to hang onto something this valuable for long. Not all drug dealers use drugs, so it's a little easier for them to hang onto their possessions.

Then I thought about what a different place the drop in would be if everyone sat around listening to music with ear buds. One of the greatest things about work is the sense of community among the people, and I think something huge would be lost of everyone was off in their own little world all of the time. There might be less fights, but I don't think it would be worth it to lose that sense of community.

I also considered the fact that many (but not nearly all) of our clients are illiterate or computer illiterate and how this might impact their use of their iphones. On the other hand, this might be a great teaching opportunity, and a chance to give people some marketable skills. Besides that, it's a whole lot easier to get a job if you have a phone! People could call them for interviews, set up meetings etc... And think of the opportunities for them to use the internet to connect with the outside world!

But the thing is, no one is going to come around giving my city's homeless people iphones, and if they did, it would be a huge waste of money. There are so many more beneficial things we could do with the money; like provide vegetables, and a larger, less crowded space to sleep. How great would it be to never have to turn away a cold, tired, hungry person! Or maybe, instead of having a sock exchange we could give out brand new socks each time; or at least not wash them quite so many times.

And this is where I get hung up. There are people suffering, and the money invested in creating the iphone could have been spent in dozens of different ways to work to alleviate suffering, but I don't think that makes the iphone bad. In fact, I think it's kind of cool, and if anyone I know ever gets one, I'll definitely be "etch e sketching". So sometimes, instead of trying to reconcile those two views in my head, I just don't. It's sort of like, I care so much, that I can't care, because it would be too hard, and then I wouldn't be able to care as much.

So, I don't care about the new iphone. It's just easier that way.

Top 10 Myths of Mental Illness

I really like this article at Psych Central by John Grohol. I like most of what he writes and this was especially good.

The article talks about the top 10 myths about mental illness, and I think it's quite bang on. There are a lot of misconceptions about mental illness (and mental health) out there. And really, there is still a huge amount of stigma attached to being mentally ill as opposed to physically ill. A huge stigma. You just don't talk about your relative in the psych ward the way you talk about your relative on the cancer ward.

In any case, it's worth a read.

Popularity... aka, what none of us ever think we are

I read this interesting report on the psychology today blog about the importance of self esteem vs the importance of popularity. The report talks about new research findings that indicate that teenagers experience of popularity has more to do with their perceptions of it, then of their actual experiences of it. Basically, if you think you're popular and cool you'll be happy then if you don't, even if you are.

It got me thinking about high school, and about those few really annoying kids. Those ones who didn't fit in at all and yet just kept plugging away. They just seemed so incredibly happy. I also thought, wow, how can they be happy NO ONE LIKES THEM! And yet, there they were, setting themselves up to be laughed at time and time again.

Then of course, there were the "popular kids" those kids who were at the tops of the social ladder, talking to them though, they totally didn't see it. And often, they weren't happy.

gets you thinking, doesn' t

ECT

I know some people who would disagree