The White Noise

The White Noise

A hit of addiction and mental illness, chased by chemistry and culture.

Policy Made Me Involved: We Need a Better Public Health System


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.


In the beginning, I said that I was a documentary writer, chronicling stories of addiction in one of the poorest communities in the United States. Strictly situationally based to tell a story, someone else's story. I've been near-obsessed with removing myself from the narrative, an observer but no more. I haven't, and still don't, believe in adding myself, an unnecessary figure in an already complicated community's tale.

Now, though, I wonder. Michael is sitting next to me on my couch as I type, awaiting transition to rehab. A 37-year old transsexual heroin addict who has lived homeless in the Bronx for years.

He was released from a seven-day detox facility on Staten Island yesterday morning, not anticipating a gap before rehab intake on Monday. A full 48 hours of freedom. Michael, like many, has no place to go, no family or friends to take him in. Though treated with suboxone in detox, Michael now has no drugs in his system, prescription or otherwise. His body is a nest of aches, even the smallest movement labored. The last time he detoxed, over 10 years ago, he was in jail and given methadone. Yesterday, he was poised to return homeless to the Bronx, chemically naked for the first time in decades.

Michael clean: Staten Island

Michael clean: Staten Island. Courtesy of Chris Arnade.

When we neared Hunts Point, the place he's called home for years, he began speaking of needles, just one hit of crack to say goodbye. Just one. No more heroin. Just crack. Just a needle in the skin one more time. He was babbling, barely coherent, tearful.

Jarred, we left the neighborhood, the clothes he came to fetch and any notion of his staying there the weekend. To remain clean, Michael wanted and needed to leave. He wanted out but didn't know where to go. He set up camp at my house, a place without the allure of prescription medication, a different neighborhood where the location of drugs was unknown. And so he's on my couch. I can't write this, what I hope to be the story of Michael's recovery, without including myself.

Policy has made me imbedded because of the few, if any, options the people I cover have, those homeless on the streets of a major city, a city seemingly ill-equipped to cogently deal with conditions of mental health for the disadvantaged. Michael is an adult who wants to get clean but has no place to go. Or, at the least, is unaware of where he could go and lacking the resources -- like a phone, a computer, or stable friends or family -- necessary to find out.

Over time, I've understood: this is the story. We -- Michael, Chris and I -- are the story. The bad policy and methodology of getting clean without aid, a near impossibility. The beginning of a documentary project that spilled into something akin to social work. My shame, journalistically, of being involved this way. My transition from journalist to writer/advocate/friend/ally.

I've spent the last year immersing myself in Hunts Point and have yet to meet anyone on the streets who has begun successful addiction recovery. There's been no story of independent success, no phoenix rising from the depths of poverty, incarceration and consistent drug use.

Readers sometimes ask, "where are the good stories?" The truth is, there are very few. "Better" is gauged in fits and spurts, in the few days after jail release, or after a stint in rehab. "Better" lasts a few days if someone's lucky.

There are gaps in the system hindering those who want to make a change, gaps that fuel arrest, rearrest, periods between treatment, continual homelessness. Resources are pebbles in the dark.

I never meant to be involved, but out of compulsory humanity, I've had to be.

Michael clean: Astoria

Michael clean: Astoria. Courtesy of Chris Arnade.

Now, it's early Sunday morning. The night was rocky, with both Michael and I scarcely sleeping. Michael periodically begging for methadone or benzodiazepines, spinning occasional romantic sentences about suicide. My half-hearted humor back. "Stop it, Michael, I like my rug and you too much."

What about a pill, just a little something. It hurts. Is it supposed to hurt? My helpless google attempts at answers: "what to do between detox and rehab nyc." My tries at coping with his depression, listing what being clean will do. My inability to promise him a sound future or a hopeful trajectory from rehab to a stable life.

In my head, I can at least say that he's not on the streets, back to what would have been immediate drug use in Hunts Point. That his efforts in detox and his dreams of a new life weren't wasted. That at least one person might, against the odds, escape the neighborhood.

There is no better judgment here, no staying objective and distanced while retaining compassion. I've never wanted to save anyone, only to record. But in a population in such desperate want of a helping hand, only to find one lacking, I can't stay in a box seat.

Public health policymakers, please take note.


More Hunts Point Addiction Writing

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Chris Arnade's Photos and his Facebook feed

The views expressed are those of the author and are not necessarily those of Scientific American.

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