Drug use is a symptom of substance use disorder. So why do we punish those who are showing symptoms especially within the treatment industry? Why is it hard for some doctors and substance use counselors to grasp and honor this?

For decades people attending treatment and utilizing a MAT (medicated assisted treatment) have had their medications held over their heads dangling like a carrot. If you miss an appointment, have a return to use your medication is taken away from you, you are reported to dss and end up getting sanctioned, which means you loose your benefits; housing, food stamps, cash assistance. If you are on “paper” (parole or probation) your probation/parole officer is contacted. Punishment for displaying symptoms.

Or maybe they (Doctor or counselor) just decide to have you come if for observed doses for two weeks? Having to take a bus to an appointment IS work, I don’t care what you say. Especially when you are living on the streets with no concept of time because you have to electricity to charge your phone. Different scenario, you have a home, but you have kids to get on and off the bus so you have to plan trying to get to and from around their schedule, the bus schedule and the drug dealer time the doctor operates on. Already being shown that your time isn’t as valuable as theirs, but god forbid you be late. Point is no matter how this plays out, you’re looking at few hours IF you’re lucky.

When we have a return to use there is obviously an underlying issue, we are used to responding to trauma by numbing it, not facing it so we can power through the day to just survive. I know for me I was so lost in my active use I didn’t know who I was, what I wanted and how to achieve it. I looked at anyone who was trying to help me as a predator because in my personal experience there were always strings attached. When I was on a MAT program I would have to walk from Lexington Avenue by Tacoma street (in the city of Rochester,NY) to East Avenue downtown. That walk was about an hour and fifteen minutes. An hour and fifteen minutes of walking from one side of the city to the other getting offered samples of drugs. Turning down dates to make money on my hour and fifteen minute walk there. Sometimes the temptation was to overwhelming and I missed my appointment, sometimes by the time I got to my treatment center I was high. Other times I made it all the way there without succumbing to the voice in my head screaming to get numb. Putting in the effort to get there was a win for me whether I was maintaining my recovery or practicing harm reduction by reducing my use by using my MAT program.

It took me quite some time living in recovery and learning from some incredible mentores how significant that part of my journey really was and to honor that part of my story. That I was recovering! This is one piece of why I am so passionate about harm reduction and multiple pathways. The barriers and stigmas we face are running just as rampid in the treatment industry as the ones outside of it.

We can clearly see that the war on drugs and how we have not only been treating substance use disorder but mental health has failed. Denying people of their MAT medication is causing more harm than helping. If we want to get real, raw we must start following the data and lived experience from the harm reduction community, peer advocates, the boots on the ground organizations and most importantly our fellow neighbors living it. The truth is staring us right in the face if only we would open our eyes and minds to see it.

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