Thoughts on Addiction, Mental Health and Homelessness

Gangs and drug importation are among the biggest issues facing this country and the world.  The truth is that they have been a huge issue for this country since the mid-1700s.

Today, the issues of mental health, addiction and homelessness are the popular topics in any civic conversation.

I have put together some of my thoughts on these topics.  Because there is a lot of competent and expert information available to all of us, it may be worth doing a little research on your own.  I must disclose that I have a very limited knowledge of the causes and effects of illegal and prescription drug abuse.  I will only assume that drug and alcohol abuse share similar relationships.

First off, I am now in my late 50s which can account for some of my logic related to all of these subjects.  Being brought up through the sixties and seventies, I have seen firsthand some of the problems as well as the effects they have had on our country and communities. Throughout the years there have been differing discussions on certain specific issues, however all mental, addiction and homeless cultures share the same causes and effects regardless of what is happening in the world

Alcoholism is a disease that in some form or another effects 30% of our population.  The fact is its use is legal and openly and socially acceptable.  Although an older statistic (2013), it is reported that 570,000 people die each year from alcohol and drug use.  Deaths by alcohol account for the most.

Addiction, whether it be alcohol or drugs does not largely effect any specific group of people whether it be ethnicity, stature and financial standing.  A big exception would be the pervasive crisis of addiction among Native Americans. There are some that would argue that minorities particularly African Americans are far more susceptible to drug and alcohol abuse. Statistically, that is true for some very specific groups.  One thought is that with more and more Americans evading daily “oppression” and disadvantage, the number is slowly changing for the better.

When alcohol use turns into alcohol dependency and addiction, the user becomes unable to navigate life in a healthy manner.  Although some may think that they are functional, all alcoholics experience a difference in their ability to function without drinking.  Their ability to make decisions that are reflective of their principles change, their physical condition changes, their relationships change.  An alcoholic focuses a significant amount of time and energy every day to plan for their next drink. As a result it becomes natural and important that they make alcohol a part of their day. Because any addiction is expensive, their financial priorities change to accommodate the lifestyle.  Additionally for most, being addicted to one thing means that you are probably addicted to another.  The one thing that alcoholics believe is that people around them don’t see them as being a different person when they are under the influence.  Families and relationships become jeopardized because of the inherent selfishness and inability to be responsible for their actions.  For a while, people in an alcoholic’s world become adapted to their behavior, yet sooner or later that changes.  Some insist that because of the effects, they are likely to be more loving, caring, intelligent, nimble and successful.  It is true that some alcoholics can function during a portion of their day. For many that means that they can make decisions and act independent of the portion of their daily life when they are drinking.  In some cases, they can function during work, yet will be at the nearest liquor store within minutes after the work day is over.

Alcoholics believe that they can drive under the influence.  The common logic is the same as most sober people.  The cause of accidents is because of those who have no business driving are driving.  We all know the facts relative the diminished driving functions of someone who drinks.  The horrifying truth is that a drunk driver would never want to hurt anyone for any reason.  Unfortunately the result of their actions and tempered thinking sooner or later will probably cause a terrifying change to the lives of responsible, safety minded people who would never consider putting others in harm’s way.  Because of this, the consequences should be and are sever.  In our society, you will not find anyone who believes that a drunk driver is anything short of being in possession of a deadly weapon with no control over whether the use it to harm or kill someone else.  If you are an alcoholic that has escaped life without the consequences of your actions, the potential victims are the ones who are to be considered lucky and spared, not that you poses some special talents that separate you from everyone else.

Alcoholics believe that they are fit enough to escape the physical perils of drinking. Early on, they all are under the belief that they can control or stop their drinking any time they want. The actuality of that happening with any long term success is virtually impossible. Alcoholism can be inherited by those within an alcoholic’s family.  That is not to say that just because your uncle is a drunk, you are destined to be as well.  Alcoholism is progressive.  What that means is that an alcoholic may start out innocently enough being one that does not have any warning signs or indications of what is to come.  Understanding of the pathway that establishes at what point the addiction takes over is still open to discussion.  There are also some that would be considered heavy drinkers or even bingers who physiologically are not predisposed to the disease.  If you are keen at recognizing an alcoholic, you can’t tell the difference except surprisingly many of these people moderate or discontinue their use whenever they want.  Basically, not all drinkers are alcoholics, but all alcoholics are or were drinkers.

There are mixed thoughts on treatment and its effectiveness.  Most treatment programs that are available to those with alcohol or drug addiction issues are usually found at corporate health facilities that are part of a larger hospital system and are funded in part by the government as well as qualifying private insurance.  Judges are trying in earnest to force changes to individuals who let themselves become liabilities within their communities.  Unfortunately, Judges and other authorities can only prescribe the treatment programs that they are sanctioned to use.  The success rate is so bad that judges and other groups within the corrections community become frustrated that the desired outcome of their direction and intentions cannot be achieved.  The long term result is not usually good for children and families. For those of us outside of the government controlled systems, we would think that we would have an advantage to receive a better quality of treatment.  There are some treatment methods including medical intervention that can give more relief than traditional counseling based treatment plans, however the long term success rates aren’t much better for this treatment that many don’t have access to.

Most people who are faced with and committed to changing their lives and want to live free from the control they have given to their addiction. Take treatment very seriously.

I believe that for anyone faced with treatment for the first time, they have some very simple yet naive expectations.  They believe that being cured for alcoholism is similar to having your car repaired.  We drop our car off at the service department in the morning with the expectation that when you pick it up at the end of the day it will be fixed.  With alcohol and drug treatment, the actual treatment period is very long even after the initial treatment.  As an alcoholic or drug addict you must engage in life changing activities that will give you the best chance to succeed.  Anything short of that and you will have wasted someone’s time in trying to help you.  At the end of the day you need to get to the point where you can honestly tell yourself you can see yourself not ever having a drink again.  If you can’t get to that honest milestone, you will fail.  The statistics for relapse are very surprising and unbelievable to some.  As it stands, the failure and relapse rate for those who have received treatment is approximately  80%.  That means that if you have your future and your family’s future riding on your ability to fulfil your commitments, you need to do exactly what it requires to succeed.  Don’t make the mistake of listening to the false sense of victory that will run in your head.  Also, alcohol, being progressive means that if you relapse, you will be picking up where you left of or even worse.  The idea that taking a break will allow your body and your mind to step back to a more manageable time is dangerous.   The relapse is usually when the physical and mental effects turn into the most destructive.  The chemical effects in your brain become serious and usually don’t leave you as lucid as you once were.  Physically, your body no longer is able to fight off the permanent effects that your addiction had been quietly causing.  This is usually when you rarely have the option to effect any positive change.

The physical effects of long term drinking are serious and can eventually cause death.  Doctors will tell you that you need your liver to live.  Other systems including your brain are also necessary for life.  Alcohol destroys many organs and causes serious cognitive function problems within your brain.  The most commonly known organ failure is the irreversible destruction alcohol causes to your liver.  The levels of deterioration in liver function are medically described in stages. Stage one is when your liver excretes an enzyme that indicates the presence of fatty liver disease which will tip doctors off to the existence of liver disease.  Stage two is when the damage causes alcoholic hepatitis of the liver including the liver losing its supple mass of tissue and affects the ability of the liver to properly filter your blood. Stage 3 (the most common) is cirrhosis of the liver.  In this stage, the effects of the liver trying to process the toxins causes a permanent degradation and scarring on and within the liver. Stage three liver disease cannot be reversed, however, abstinence and treatment can allow the liver to continue functioning.  The scarring will obstruct the flow of blood through the liver which in turn starts the process of total liver failure.  Some of the more serious symptoms are when fluids that normally process through your liver become diverted into your abdomen.  Bacteria and interference with other organs can be very dangerous, even fatal.  Another condition would be varices. The cause of varices is a result of blood that tries to filter through the liver and becomes obstructed by a scar.  Instead of just stopping, the blood diverts to a nearby vessel which becomes swollen and filled with too much blood.  In this case, should the vessel rupture do to the pressure, very quick, severe and fatal bleeding can happen.  Stage 4 is when the liver basically fails.  In this case there are no more treatment options.  As a result, a liver transplant would be the only option for survival.  What may not be known is that an active drinker or user will not be placed with any priority on any transplant candidate list, therefore giving the chances of receiving a lifesaving liver donation very small and unrealistic.  I think the logic is that if a surgeon was to transplant a fairly healthy organ into someone who has destroyed their liver, the chances of the healthy donated liver failing are so high that the conditions of the majority of sober candidates would be considered a priority.

It has been my observation that the life of a drug user is very similar and can cause the body and mind to deteriorate quickly.  Social issues related to illegal drug use demonstrate the destruction drug addiction can cause to the individual, their families and their community.  I don’t profess to know the impact of so called “gateway” drugs except observations of the discussions related to the process that causes legal drug users to take up the use of illegal drugs because of the affordability disparity.  I do know that from the 60s until today,  the drugs that are most popular have changed or have returned to popularity today.   Heroin, cocaine, lsd and amphetamines where the most common in the 70s.  One drug anyone younger than 40 doesn’t probably know is that in the 60s there was a practice of  reckless prescribing and abuse of Valium, a narcotic that causes a calming sedative quality.  This drug and addiction was usually thought of as a housewive’s drug of choice being no more dangerous than alcohol.  Cheaper drugs such as heroine, crack cocaine, crystal meth and others have been most common among users today.  Compared to alcohol abuse, the causes and effects are very similar.  More prevalent to drug addicts is the theft and deception required to continually get the money to obtain drugs which causes a direct and grave impact to the communities they live in.

I do believe that marijuana use has been unfairly placed in the same package as other drugs.  Although I personally believe that an addiction is an addiction whether we’re talking about weed or not.  I also believe that marijuana use does not necessarily cause the same serious conditions and consequences that other drugs, including alcohol do.

Mental health is a subject that is popular in the discussion of substance abuse and homelessness.  It is so important to remember that when a condition elevates to the point that requires professional attention, you cannot look at these conditions and believe that the individual has the control to pick themselves up and return to normal.  Mental conditions usually relate to a system or systems in the brain that stops functioning correctly.  Since the brain is really just one big mixture of chemicals and electrical impulses, the symptoms and treatment can provide relief for short or even a long term.  Symptoms vary greatly,  the causes vary greatly, the treatments vary greatly.  Some conditions present very dangerous symptoms.  For instance those who suffer from PTSD and major depression are subject to suicide rates of up to 20%.  For others, cognitive (memory, logic and intelect  functions), physical and mental conditions can become very serious, especially without treatment.

There is a very real direct or indirect connection between mental health conditions and homelessness.  It seems to me that most homeless people haven’t always had problems controlling their ability to participate in a normal society.  The available statistics can be so different that it’s really impossible to get a grasp of the numbers, including determining who has mental or substance abuse issues that result in them being homeless.  The tragic fact is that a very large percentage of the homeless are made up of people who in some cases did not have control over there internment to homelessness.  Sometimes, it is as simple as losing a job or the splitting up of a family or even an environmental catastrophe.  I have never met anyone in this category of the homeless population who wants to be there or wouldn’t do anything in their power to change their homeless circumstances, including addressing the related causes.  For some, they don’t possess the ability to navigate systems that are in place to help them.  The priority of support services is much higher for those with displaced families that include children.

Homelessness as it is commonly thought of has been an issue since the beginning of the human race.  It is interesting that in history, the lifestyle of a homeless person today would be considered very normal.

There are so many different variables that can cause an individual to lose or sustain the ability to keep themselves functioning in a healthy manner, including keeping a roof over their head.

Like I pointed out, there are so many mental and emotional conditions, that we could never start to understand them all.  If you would like to check for yourself, there is a reference book called the DSM V (Diagnostic and Statistical Manual of  Mental Disorders version five).  This is a medical reference book that is used by most professionals to identify and diagnose specific conditions.  Do not try to self-diagnose, you will most definitely not help yourself. The commonly known mental illnesses such as post traumatic syndrome, depression, bi-polar depression and even psychosis are just an extremely small portion of the overall number of serious illnesses. .

Some of these factors contribute to the reason that some homeless people have no desire to return to a normal society.  Sometimes when you have adapted to your environment, you don’t see any different lifestyle.  One of the larger issues is the common effects that homelessness causes to neighbors and nearby communities.  Usually, the conditions within the homeless communities can be very unhealthy or even dangerous.  Drug use, crimes, squalor and violence are all too often the norm within the homeless community.  That is not to say that all homeless people have no scruples or don’t care about other people…just that the culture is created and sustained by many who suffer  mental or chemical abuse issues that don’t give them incentive to consider the effects of their actions.  The one big blessing for our society is the groups and volunteers who are committed to assisting.  Without them, we can only imagine the outcomes caused by all of the different variables.  These groups are very effective in providing outreach, food, advocacy, housing, health assistance and general support.

Being in a funk is normal for everyone, however, If you feel like you just can’t function the way you feel you normally would and should it last for weeks and months, talk to your doctor.  If it turns out that you need some attention, take it because your feelings will only get worse…Trust me.

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