Michael Liimatta

I’ve spent many years working with counselors and rescue mission staff members to assist them to more effectively help homeless addicts and alcoholics.   Whenever I speak on this topic, I am usually challenged for saying clients should be immediately dismissed from a program when they are discovered to have used alcohol or drugs.   So, I thought it would be useful to restate my convictions – and my rationale for this encouraging this policy.

I am convinced that we must immediately dismiss anyone who uses alcohol or drugs while in a recovery program.   The dismissal must be for at least one month, with the possibility for an evaluation for re-admission after that time period.   If they do re-enter the program, they should start over – from day one – and not be allowed to regain whatever status they held before using.

Does this mean we should just throw them out on the street?   Not necessarily; it might mean moving out of the program part of the building and back into the transient section.   It could also mean a referral to another facility.   Or, it could mean leaving the building and finding their own way to the next place, especially in the case of those who have violated the policy repeatedly.

There must be serious consequences for alcohol and drug use while in a recovery program.   Here’s why:

A.   Drunk in the Bank – When people are new to residential recovery centers, they usually determine “how many drunks they have in the bank.”   Their first question is “How does the staff deal with clients who use drugs and alcohol while in the program?”   If the policy is dismissal after their second incident of using, this equals “two drunks in the bank.”   Then, they may actually begin planning how and when to use them.   In essence, a firm policy on dismissal after the first use of alcohol and drugs actually helps to keep participants from being tempted in this way.

B.   The Danger of Enabling – One rescue mission had a formerly homeless cook who worked for them for a number of years.   Once or twice a year, he would go off for “one of his weekends” which meant disappearing for a couple of days of heavy drinking.   Then, he would come back and “behave” himself until the next time.   Is this really helping him? And what a terrible example!   If we really believe addiction to drugs and alcohol is destructive, using them must have major consequences.

Addicts continue to use alcohol and drugs as long as they feel the benefits outweigh the costs.   Consequences are the key to their salvation. They are God’s way of breaking through denial.   But if we choose to enable people to continue in destructive ways, shouldering the consequences ourselves, we interfere in what He wants to do in their lives.

C.   Maintaining an Environment that Promotes Positive Change – A sincere desire to become free of mind-altering substances must be the first requirement for entry into a recovery program. And is it the responsibility of the staff to maintain an atmosphere that says, “people are here to recover – the program is for people who want sobriety and are committed to working on their lives.”   The consistent application of a firm dismissal policy works to promote a commitment to the recovery process among program participants.   If it is not practiced with consistency, staff members will be accused of favoritism or the program participants will assume that the staff does not take the use of alcohol and drugs seriously.   Handling the issue of dismissal on a “case by case” basis creates a system of inequity that works against the positive environment we need to have in the program.

D.   Protecting the Sincere Client – The application of this “tough love” principle is needed to protect those residents who are sincerely trying to change their lives from those who are not.   Keeping hard-hearted and disruptive people around can be extremely discouraging to those individuals who are working hard at their own recovery.   It can be truly amazing to sense the dramatic change in the atmosphere of a program when one or two disruptive individuals are removed.   Sincere people can be further motivated and reassured when they know that they will not have to contend with uncommitted and dishonest people who could undermine their efforts toward recovery.

A Final Thought – It is important to keep a recovery program “drug free.”   But, it is actually cruel to expect residents to stay sober if we do not provide them with access to activities such as addiction counseling and meetings that support them in the pursuit of a life of sobriety.   Doing this is truly setting addicts up to fail.

Excerpts from the Guide to Effective Rescue Mission Recovery Programs.

Every substance abuse counselor has probably at one time or another pointed to the “skid row bum” and said, “You don’t have to be like him to be an addict or alcoholic! ” While this type of person may represent only 5% of all addicts, Christians who are in recovery have a lot more in common with him than they may think!

A drive through the streets of any major city reminds us that the “skid row bum” has not disappeared. Alarmingly, he has been joined by hundreds of thousands of people now called “the homeless. ” Who are they? 18-35 year old men, women who are 16-30 years of age, and single parents with children now represent the bulk of the homeless population. Most are minorities and local people, not transients, who have been homeless for one year or less. On today’s “skid row” we find people who are dependent on a variety of drugs, emotionally dysfunctional, mentally ill, and medically at-risk, especially for HIV/AIDS. A high percentage of them have been sexually and physically abused.

Addiction & Homelessness

Besides not having a home to call their own, most of the 500,000 to 3 million people identified as homeless have something else in common – addiction and mental illness. According to one study, up to  two-thirds  of homeless adults suffer from alcoholism and at least half suffer from drug disorders. (1) In their book,  A Nation In Denial, Alice Baum and Donald Burnes shatter many of the myths surrounding the root causes of homelessness, which have little to do with the economy, governmental social policies, lack of affordable housing, and so forth. According to their research at least 65-85% of all homeless adults suffer from chronic alcoholism, drug addiction, mental illness, or some combination of the three, often complicated by serious medical problems. At least 1/3 of the homeless suffer from severe and persistent chronic psychiatric disorders. Forty to fifty percent of these individuals are “dually diagnosed” – suffering from addiction to alcohol and/or drugs, as well. (2)

Ultimately, the condition labeled “homelessness” is best described as a state of “disaffiliation” or complete alienation from meaningful human relationships and the social support systems most people have working for them. Most homeless people are either addicts themselves, or are the products of dysfunctional families and broken homes that were significantly impacted by addiction. These are root problems and, unless they are adequately addressed, any other help we provide will not be effective. While millions of dollars may be spent on education, housing, and employment for the homeless, these efforts do little to improve their lots if they are unable to stay sober by working through the very same recovery issues that many of us are dealing with in our own lives.

Sadly enough, while these problems are on the rise, the resources that are available are usually priced beyond what those who need help the most can afford! Between 1978 and 1984 there was a 17% decrease in treatment beds for the indigent (those without insurance or funds to pay for care). According to recent congressional figures, only 12. 5% of the nation’s 6.5 million drug users have access to publicly funded treatment. (3)

Christian Recovery & Homelessness

Is it possible that what we’ve called the “Christian Recovery Movement” could be helpful in solving this problem? Recovery in the Christian community is still largely a phenomenon of the middle class. Most Christian support groups meet in predominantly white suburban churches, usually outside of the reach of inner city people who could greatly benefit from them. Additionally, almost all of the Christian self-help literature is written with a cultural and educational bias aimed at this social strata. There are, however, some encouraging signs.

Rethinking Rescue Missions

For many people, the stereotype of the “rescue mission” or “gospel mission” is that it is a place for middle-aged alcoholics gathered for a sermon, bowl of soup, and a semi-clean place to “crash” for the night. To the contrary, the types of people who now look to inner city missions for help have changed dramatically. They are younger men and women, and entire families, with deeper problems in their lives than ever before. Many rescue missions are responding by developing some very progressive and effective programs. Comprehensive recovery-oriented programs, using the   Twelve Steps   and other   treatment strategies   are now operating to help these homeless men and   women   lead healthy, stable lives.

Just how effective “Christian recovery” can be is powerfully illustrated in an  SRI Gallup study  of recovery from homelessness conducted for a rescue mission in Knoxville, TN. This study, conducted by a secular research organization, had no thought of “Christian recovery” principles factored into it. They identified six critical “life themes” that were strongly present in the lives of people who were able to recover from homelessness. (4) Interestingly enough, these “life themes” clearly reverberate through the  Twelve Steps. The following are listed according to their degree of importance:

• Spirituality –  as a source of personal strength and as the basis for rebuilding relationships with other people.
• Self-Insight –  by overcoming denial, acceptance leads to a new and accurate knowledge of oneself.
• Security  – feeling safe both physically and emotionally
• Self-Awareness  – being in touch with one’s own emotions
• People  Support – having others who care enough to be truly involved with one’s life (the total opposite of “disaffiliation”)
• Suppression  – being reconciled with one’s past and able reject negative thoughts, worries, and a poor self-concept

The movement to bring Christian recovery to the homeless is still very much in its infancy. Countless gratifying “12th Step” opportunities exist at inner city missions for Christians in recovery who are willing to transcend their cultural ” comfort zones.” Rescue missions throughout the nation are in desperate need of staff members and volunteers who understand recovery and can share it with others. If you would like to become involved,  contact the AGRM  for more information.

References

• “Mental Illness and Substance Abuse in the Contemporary Homeless Population,” Paper Submitted at the Professional Symposium, Recent Findings and New Approaches to the Treatment of Mental Illness and Substance Abuse, Pamela J. Fischer &a mp; William. Breakley, Tulsa, OK 1988
• A Nation In Denial, Alice Baum & Donald Burnes. Westview Press, Boulder, CO 1993
• Baum & Burnes
• “Rescue Ministries of Knoxville, Tennessee Recovery Study, Summary of Research,” SRI Gallup, Lincoln, Nebraska, July 1992

This article appeared in the Summer 1994 edition of  STEPS  magazine, journal of the  National Association for Christian Recovery.       © NACR, 1994, all rights reserved