Thank you so much for posting this! It really put some faces on all the talk we’ve had about harm reduction.
Don’t get me wrong, I can see the importance of the social connections that Insite is providing for individuals. At the same time, what I found most disturbing was the situation with the woman, Shelley, who came to Insite to relapse.
I felt like with her life on the line, couldn’t they do a little more to help her? Helping her get a hold of some pharmacies? Hooking her up with some non-methadone treatment?
I think one can be non-judgmental and say “You deserve sobriety” at the same time.
So, I finally watched the whole thing and here is my stream of consciousness:
Q: “How do you know if they’re ready?”
A: “It’s a judgment call. We know them…”
What does this mean? How about letting them tell you when their ready?
How on earth do people start recovery above the injection center? This place is the hub of the heroin user tribe of the culture of addiction.
Shelley – how about a little case management for Shelley? How about helping her get her prescription filled or a getting her dose as an alternative to using heroin? Is it really reducing her harm when she predictably ends up tricking in the alley a day later? Was their passivity in the face of her relapse about her needs or about their personal philosophy? I’m not suggesting use of force, yelling or shaming, but she was in a temporary emotional crisis and was about to make a decision with profound long-term consequences.
Gabor Mate – “Addiction is not a moral failing” Correct. But our communal response to addiction is a moral failing. This place is a well equipped pit of despair. How can one offer hope in a place like this with people who expect you to fail at any attempt to recover.
The worker – I’m sorry. Maybe he’s wonderful and in this for all the right reasons, but I can’t shake the feeling that the work is self-ennoblizing, a source of vicarious excitement and is more about their world-view, their needs and their image. Acceptance of people “where they are at” does not mean treating them with the message that there’s nothing wrong with staying where they are at forever. How about accepting them for what they can become?