This post is part of a collaborative narrative series composed of my writing and Chris Arnade’s photos exploring issues of addiction, poverty, prostitution and urban anthropology in Hunts Point, Bronx. For more on the series, look here.
The present study examined predictors of participation and retention for patients treated at an urban, hospital-based outpatient substance abuse treatment clinic.
Using multiple regression analysis, substance use status did not predict treatment participation and retention, whereas race, gender and employment composite score were significant predictors. Specifically, patients attended more sessions and remained in treatment longer if they were Caucasian, male and had a high employment composite score. These findings suggest that type of substance abuse may be overemphasized as a predictor of outpatient drug-free treatment retention, and that greater emphasis should be placed on tailoring treatment to patients’ cultural, gender and vocational needs.¹
You can see who Jason was before: long-haired, loping, clumsily loving a wife who eventually left him in a blur of drugs and to whom he now dedicates poetry on found business cards. It was a Lower East Side-sprung love. He carries the poems in his pockets, between wrappers and his wallet, scraps held in big hands. He read one out loud once, head nodding, eyebrows raised in accentuation, eyes never leaving the words. Shadows of his wife stick fast to his person, though he has never spoken of her again.
Pockets full of importances add to a life of staying here and there. He’s slept just about everywhere and attributes his good neighborhood relations with avoiding people for the past 15 years. Short words, side streets.
His vagrancy rarely takes him home to Vermont, the place of which he speaks with mild interest but an interest he promptly drops when invited to go. He’s never able to go, despite frequent offers of free rides. He has things to take care of in Hunts Point.
His home taught him manners and in them a voiced disapproval of those who are inconsiderate, like the Mexican worker who wouldn’t help him pull a piece of metal from a deep bin. Not that it mattered. Jason’s anger did the lifting for him.
Jason: Hunts Point, Bronx. Courtesy of Chris Arnade.
His anger, like him, is slow to move. He’s a hippie, a displaced one.
He lives by breaking pieces of metal off industry trash, before someone else can, to sell. The rest of the time he spends panhandling, for this turning right down the Bruckner expressway, around the corner to the curve. The directions have their letters drawn out. Cor-ner.
Some mornings he remembers to go to his outpatient drug program, crosses the 9-laned Bruckner away from Hunts Point to the place that gives him Xanax as part of his treatment to calm down.
If someone asks, he sells it: the two milligram bar kept in his knockoff Coach wallet’s change purse. It’s down deep in the brown seam. He has to stretch and bend the circle-patterned fabric lip, dig the pill out with a nail.
He bit one quarter off this one already, but three quarters are still a fine 1.5 mg.
He guides users on how to take it: not too much, only a little, a bit at a time, less than you think. He gestures, bends his tall frame, gets close with his hands.
It’s in the same fashion that he gets methadone too. It’s a good program.
For the rest of his medicine he shoots heroin, sometimes crack, in the right side of his neck, ducking behind barriers and deep metal bins with a piece of mirror and half a lime.
Shooting Up: Hunts Point, Bronx. Courtesy of Chris Arnade.
¹ McCaul, Mary E., Dace S. Svikis, and Richard D. Moore. “Predictors of Outpatient Treatment Retention: Patient versus Substance Use Characteristics.” Drug and Alcohol Dependence 62.1 (2001): 9-17. PubMed. Web. 19 July 2013.