Welcome to Normal

This post contains some adult themes.

One aspect of my job is doing intake interviews over the phone. I’m responsible, in a short, 15 minute or less conversation, for deciding who gets to come into our program and who “isn’t a good fit.”

These interviews involve some demographic information–what’s your birth date, social security number, phone number–and some really personal questions–have you ever been diagnosed with a mental illness, do you have any history of substance abuse or a criminal record?

A couple of weeks ago, I was having this conversation with one of our community partners, a man who’s worked with people experiencing homelessness for longer than I’ve been alive. I asked him, “Does your client have any history of substance abuse?”

And he responded, “Well, like most of us, he does have a history of using crack cocaine and heroin.”

This is the truth: most of our guests do not have a history of substance abuse. This is also the truth: during our last fiscal year, about 45% of our guests did.

It’s a thin margin.

When I started this internship, the stigma associated with drug use scared me. I thought of heroin and crack as “hard drugs,” the really bad ones, the ones that grabbed hold of you and didn’t let go until you were dead.

Now, in the last month of the internship, the way Mr. Kemp normalized his client’s drug use makes sense to me. In my (limited) experience, a history of drug use doesn’t correlate to failure in our program. Former addicts aren’t more violent, more angry, less helpful, or less friendly than any of our other guests.

They’re just…people.

I’ve had a similar experience with men who are HIV+. This isn’t as large a population in our program (7% for the same period) as individuals with histories of drug abuse, mainly because there are programs designed specifically for individuals with HIV/AIDS.

An individual’s HIV/AIDS status is protected information under HIPAA and I know that there’s significant stigma associated with the virus based on the method of transmission–unprotected sex with someone who’s positive or sharing needles–and the memory of when a diagnosis was a death sentence. I’m sure that if our residents knew which of our guests had HIV/AIDS, there would be an uproar.

But it’s become kind of commonplace for me. I don’t say this to brag. When I realized that it didn’t matter to me, I was concerned. I wondered if I was being incautious, taking unnecessary risks. But really, logically, outside of having sex or doing drugs with a guest, there’s not much of a risk (and if either of those happened, I’d have a different set of problems).

The stigma surrounding drug use and HIV/AIDS is one of the biggest barriers to treatment. I’m wondering what we can do to lessen that stigma.


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