I should perhaps start by saying that it occurred to me today that my personal journey working in addiction and social care has had a kind of trajectory that may not exactly prove to have been the best way round.

I started in one of Europe’s most unique rehabilitation centres where the majority of residents wanted their recovery. I mean REALLY wanted it! Then I moved on to work in a charitable organisation that had the brilliant idea of intervening at point of arrest, taking the strain off the police to take a pertinent moment to actually ask the addict whether he had considered rehabilitation. Now this is key, as it is the asking of this question at exactly the right time that can cause the spark of realisation, the light flicking on moment if you will, where the drug and alcohol abuser realises they are absolutely crap at being criminals.

They go round and round in every decreasing circles from trying to score their drug of choice funded by a MASSIVE regime of shoplifting and careless pathetic petty crime, being caught, arrested and ‘sent down’ until the time comes when the road to Damascus moment hits [or not] and enlightenment strikes that they really need to do something about it. That they really need to address their addiction or they are going to spend ever increasing lengths of time blocking the prison system from accommodating real criminals. In short in abject misery. (illustrated today with the release of official figures that state possibly as many as 77 people committed suicide whilst incarcerated this last year)

I have ended up at the opposite end of this trajectory from working at the Ley Community Rehabilitation Centre where addicts want a life back by working in a ‘move-on’ homeless hostel for 61 residents largely taken in off the streets, the majority of whom (80+%) do not wish to stop using their drug of choice. Have no inclination to stop drinking. Or drugging. Have not the slightest inkling that they may be going round and around in the ever-decreasing circle that addiction brings.

Suffice to say it can be demoralising working with folk who have little to no desire to stop using drugs and drink. Today it is New Year’s Day and seemed somewhat more depressing than usual. It should perhaps be pointed out here what we are involved in is not any kind of treatment option but feels largely about containment. These folks are not on the street therefore the powers that be, the local city council, cares little about what happens to them now so long as they are not frightening the tourists and soiling the view of Oxford’s Dreaming Spires.

This time of year causes many of us sorrow and distress at facing the facts of the loss of loved ones or alienation from friends and family. The addict is particularly susceptible to this as they may well have been ostracised by families (that would be my advice incidentally. Does that seem cruel? It isn’t) and loved ones through the moral collapse that drugs and alcohol addiction brings. So what ya gonna do at this time of year? What is the usual course of action on this the first day of a new year?

Why you go out and score.

You buy an extra bottle of cider; you steal a bottle of spirits. You ask for tick from the dealer’s runner and start the year with a bigger unpayable debt. This has advantages for the dealer, you are stuck in ever increasing ‘hock’ to the ‘pusher’ in old fashioned parlance, he has you now in the palm of his hand and can pretty much make you do anything he wants. You owe him. A friend in need is a friend in debt.

Today seems especially illustrative of the addict’s situation and I will illustrate it with three tales of particular circumstance. One being a recent addition to our clients who has come to us homeless and in need and I like him. I like him because he is a ‘chancer’, a cheeky chappie if you will. Stating he was trying to ‘cut down’ and hadn’t used Class A’s for a couple of months but still enjoyed a drink. Within a couple of days he has ‘gone over’[ overdosed], he had consumed a snowball [crack & heroin combined) so that you feel the crack hit and afterwards the come down from the crack is mellowed by the heroin.

Friday night he was found semi-conscious in the hallway by the toilets and paramedics were duly called. Today I discover he had fallen over (not the first time in his first few weeks. Snowballs will do that to a chap.) But this fall rapidly appears to be on a different scale. He was found bleeding around the neck. There is a pool of blood in the vestibule. Which seemed odd. He got to his feet however and asked for a ‘roll-up’. When removing his hat, staff immediately realised his injury was somewhat more serious as the blood was pumping out of a wound in his head. Paramedics were duly called much to his fervent objection who revealed that, had we not acted so promptly, he could have died from the blood loss. He is currently in serious critical condition in Intensive Care and the local hospital will not speak to anyone but immediate family. This perhaps you may understand is implication enough……..we can tell where this story is heading, no? I fervently hope not but it doesn’t look good

The second gentleman is an ex-Professor from Oxford colleges who it would seem, after the death of his wife, went completely to pieces and is trying his very level best to drink himself to death. He was admitted to hospital yesterday – the fourth time since Christmas Eve (seem so long ago now!) but needing a drink he discharged himself this morning complete with cannula still in his arm, to come and get some of the money we manage for him to go get a litre or two of Tesco Cider. We call the hospital to let them know. They are under the impression he is still on the ward and we have to enlighten them that he has in fact discharged himself and is back with us. They are not impressed but hardly surprised.

He was admitted this time as he was passing black stools and in stomach pain, actually more accurately described as black diarrhoea. The blackness here an indication of internal bleeding. The last time I was on shift and I called 999 for him, he had vomited up blood all over the carpet in room, tried to fill his sink with it and spluttered much of it down his shirt, though admittedly it was difficult to tell this last detail as the port red wine tends to spill down his front on a regular, nay daily, basis. The paramedic greeted him with a groan and said ‘Hello, Paul’ [not his real name] sighed and said ‘I thought I told you yesterday in the hospital to stop your drinking?!” Paul smiled wanly and suitably chagrined was admitted again.

That was time number two over the Christmas holiday. Today he argued with me that had needed his money and whilst we give him a fiver in the morning and a fiver in the afternoon (it IS his money after all) we had given him a tenner to enable him to return to hospital and gather his belongings left there, not to mention the medication they had issued him with. He claims he has been back up there and needs more money. I explain that he clearly hasn’t gone back as he has only had time to release himself and go and get a drink but he is not happy and wanders off into the streets only to come back with two large bottles of Becks beer. They have bottle tops on. We are instructed to decant anything in glass bottles and he wanders off to return with three used milk cartons still caked in congealed milk residue.

“Have you got a bottle opener, Paul?”

‘No, haven’t you?’ he smiles another wan smile

“Nope! I am not a bloody barman you know!” This makes us both laugh and he wanders off into the darkening dusk. Doubtless to return to hospital……well if not voluntarily, soon and for sure.

Now the last gentleman is a wonder. I really like this resident. I’ll call him Paddy. Admitted to us with a drink problem, a history of drug use admittedly  but “not currently using”. Since his arrival when he must have weighed about 14 stone; a handsome ladies man, dark haired and cheeky, he appears to have lost a remarkable amount of weight. When asked to check him during welfare checks at 8.30am, I found the figure of a little old emaciated man stooped, thin and bent double with broken ribs, clearly under the influence of serious ‘medication’. Dribbling, unsteady on his feet often sliding off his bed and face down on the carpet in a foetal position and muttering incoherently, he maintained he had not used today, that he was in fact “fine” was maybe going to have a couple of ciders through the day but when challenged about his drug intake he did admit to ‘being given ‘ some ‘Methadone’ as he found it helpful to ease the pain of his broken ribs.  I chastised and admonished him for using someone else’s medication but this seemed to hold no significance with him whatsoever. He ‘knew what he was doing’ and did I “think he was an idiot” (sic) and he just wanted ‘to be left alone’

I should perhaps also point out Paddy is  currently on ‘tag’ for shoplifting at which he is clearly rubbish if not profligate. He has turned up with everything from clothing to model airplanes and a plethora of radio controlled helicopters (sic!) The tag is biting into the flesh of his leg and I have tried calling the security service to get them to adjust it as it is biting into his ankle but they have “been busy” and I guess it’s not a priority over absconding villains they need to track down and report. I did point out that our other resident on tag had disappeared several days ago and we had not seem anyone after him as such but the point seemed lost on the rather world weary voice on the other end of the phone.

By this afternoon another resident comes to reception expressing concern that Paddy is having a stroke!

Numb all down his left side, I decide to call the paramedics and he discloses to us that he has taken quite a lot of Methadone, liquid Valium, smoked crack, several joints of cannabis and there are three empty litre bottles of cider in his room.

 He is taken to the local hospital by the ambulance who are rightly concerned about his mixing his own little cocktail of substances, each of which on it’s own could cause us all problems but in combination can easily prove fatal. The other client, Bob, who has cracked ribs also as a curious coincidence, you fall down a lot when you are THAT off your head, states he has stopped using his methadone and Valium as he is detoxing himself. This hasn’t stopped Bob collecting his prescriptions however for 120 ml of ‘meth’ which is sold or shared to others ‘on the street’ and is a valuable bargaining commodity much in demand. He last had in his room about 5 of these bottles any of which on it’s own would probably kill me. What do we do about that, I hear you ask? Nothing. We cannot confiscate legitimate client belongings. Indeed we shouldn’t even take paraphernalia away or drugs for that matter but merely report the fact and have the police come and collect any nefarious items. This doesn’t happen, well not unless its kilo or so!

Thus we can’t imagine where Paddy has got hold of the drugs he is on today but we are fairly good at putting two and two together, despite the protestations of both Bob and Paddy that this is not the case and that there is an entirely legitimate reason for them to have consumed what they have consumed. It’s called self medication…….

Might any of these chaps be around tomorrow?

 I sincerely hope so but I won’t be holding my breath…………….

Happy New Year!

ADDENDUM:
I am duty bound to point out that this somewhat depressing view should rightly be tempered by the fact that the hostel where I currently work does also house the wonderful ARP (Alcohol Recovery Project) a six bed treatment service for alcoholics run by the brilliant Will Bentley and enjoying an extremely high success rate. It was with clients from the top floor of the 62 bed hostel with whom I spent Christmas day. Good company and funny to a fault they humoured my 100 question general knowledge quiz so that it took Two and Half Hours(!?) and a great time was had by all....well me anyway!