Step one you say we need to talk
He walks you say sit down it’s just a talk
He smiles politely back at you
You stare politely right on through
Some sort of window to your right
As he goes left and you stay right
Between the lines of fear and blame
And you begin to wonder why you came
our team has been piecing together some ideas for a newer direction for the hiv positive patients who are (or are struggling with) dealing with substance abuse issues and healthcare adherence lapses. there are several factors which are closely related to many of these individuals challenges. trauma, stigma, depression, aging, sexual dysfunction, isolation, self-esteem, mental health are the first of many to come to mind.
most of the patients i see live below the poverty level. some by design, but most reside in this strata because this is all they know. insurance is not an issue as it is not a choice. luckily in colorado, there is a state program which is designed to give access to healthcare to every coloradan. so much of the basic and intricate healthcare issues and hiv care issues can be met. but honestly, many of these individuals don’t care about healthcare or hiv care. the avoidance of these as well as avoiding as many of their feelings beyond numb creates a perfect environment for drug and alcohol use to morph into abuse almost invisibly- at least to them. it’s quite a different story to the world around them as out of balance seems quite evident.
one thing that seems to be a reality in our city is that a sense of community and camaraderie in the world of alcohol and drugs exists and beckons. the bars- especially gay bars are community oriented and geared towards fun while you use. music, emcees, shows, drag shows, comedy, dancing, are all at our fingertips as we begin to cement our relationship with drugs and alcohol. the concept of fun is interlaced with use and as we all know it does feel good to get high. it’s moderation which becomes the issue, or maybe the lack of it.
so when people are conceptualizing themselves changing their use, or stopping their use, the idea of fun and festivity becomes a major factor. “life will be dull without the party” accompanies a belief that there will never be joy in their lives again if they stop using. seems pretty reasonable to me. felt that way myself actually. and if you think about it, the image of sobriety pales with regard to fun-loving. as a matter of fact, even though i believe that being sober has brought an unbelievable sense of calm and peace to my life, i don’t even think my using friends think of me as being very much fun. conversely, i would imagine they see me as a buzz kill.
anyway, we are trying to put together a visual and approachable set of peers who have gone through the changes involved in giving up drug use and drinking and have become conduits of joy. i know that i am much happier than i was before 9/29/04, and if you sit an chat with me for a while, i think you’ll believe it and feel it, and i know it is true of many, many others too! this is the subliminal message we want to disseminate. i am currently looking to seattle’s strength over speed for some inspiration. that grassroots effort has been in development for a few years and i believe they have affected lives. they mix together men who have stopped using meth with men who are actively using- some of those reformed are involved with 12-step and some are not. this encounter, no doubt, allows people weighing their options to see that life can easily continue successfully without the armor of substance protecting us.
the next offering is a workbook-driven curriculum for meth users that is evidence-based and hails from the Matrix Institute of CA. i worked with a version of it previously when i helped develop a program called the “mile high meth project” for another agency. the matrix has its strengths and weaknesses, but the structure works well and it is designed to engage user’s right brain in order to address the left. coming down off meth creates so much emotionality, that any process that can grab their attention is worth its weight in gold. this is not specifically for gay men. this is much more universal. this is also not poz-only. it’s not as if people discriminate when they are actively using, and i am trusting that same acceptance tendency can bring educational opportunities as well as personal growth and self-acceptance.
this layer will hopefully work as we extend our efforts here beyond gay men. in colorado, poz persons who are not gay men struggle with isolation and stigma even more intensely. there is a small sense if community among these subsets, but it is not cohesive. at least not at our workplace. thus far, we have started a drop in group for the gay poz patients and it seems to be making an imprint. this week heralds its 1-year anniversary, and i believe we have had almost 100 persons through our doors. and our substance treatment numbers for that population have quadrupled with the onset of this effort. and the work continues.
of course, what we are working towards includes helping people find their way to healthcare adherence and retention. the science has been available for some time to keep this virus manageable and undetectable. the costly and debilitating problems that unaddressed hiv infection brings can be greatly minimized by adherence. honestly, i have seen about 15 persons pass this year and most of them would be categorized in the aforementioned. i know that what i am working towards is how to save a life.
keep your fingers crossed… oh… and, can you see my heart smile?
of course the fray are from colorado turf. their stunning debut album seemed to almost usher in the latest indie music boon that we are now in the midst. i heard an interview with lead singer isaac as he talked about visiting a mountainside drug and alcohol recovery camp for youth and was inspired to write these lyrics. appropriate…. local…… lovely..