This article was published in Scientific American’s former blog network and reflects the views of the author, not necessarily those of Scientific American
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.
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To examine why court mandated offenders dropout of drug treatment and to compare their characteristics, treatment experiences, perceptions, and outcomes with treatment completers, we analyzed self-reported and administrative data on 542 dropouts (59%) and 384 completers (41%) assessed for Proposition 36 treatment by thirty sites in five California counties during 2004. At intake, dropouts had lengthier criminal histories, lower treatment motivation, more severe employment and psychiatric problems, and more were using drugs, especially heroin. Relatively fewer dropouts received residential treatment and their retention was much shorter. A similar proportion of dropouts received services as completers and the mean number of services received per day by dropouts was generally more, especially to address psychiatric problems, during the first three months of treatment. The most commonly offender-reported reasons for dropout included low treatment motivation (46.2%) and the difficulty of the Proposition 36 program (20.0%). Consequences for dropout included incarceration (25.3%) and permission to try treatment again (24.0%). Several factors predicting drug treatment dropout were identified. Both groups demonstrated improved functioning at one-year follow-up, but fewer dropouts had a successful outcome (34.5% vs. 59.1%) and their recidivism rate was significantly higher (62.9% vs. 28.9%) even after controlling for baseline differences. Understanding factors associated with drug treatment dropout can aid efforts to improve completion rates, outcomes, and overall effectiveness of California's Proposition 36 program. Findings may also aid a broader audience of researchers and policy analysts who are charged with designing and evaluating criminal-justice diversion programs for treating drug-addicted offenders.¹
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Sarah, Hunts Point. Courtesy of Chris Arnade.
The point, and the oddity, of Facebook rests in the persistent updates of friends' lives, the ability to scroll through what is new without having to talk about it.
It feels more strange when a friend is homeless and without conventional means of communication.
She might have created her profile a few years ago when things were better. Updates and photos might be more disparate.
Chain messages and invitations to play Candy Crush happen once every few months. She is in a hotel somewhere, with a date who lent his phone. She scored a few extra dollars for phone minutes.
Everyone has Facebook, and so does she.
Message: This is for u:) Read till the end! I sent an angel to watch over you last night, but it came back and asked "why?" The angel said, "angels don't watch over angels!" twenty angels are in your world. Ten are sleeping, nine of them are playing and one is reading this message. God has seen you struggling with some things and God says it over. a blessing is coming your way. If you believe in God send this message to 14 friends including me, if I don't get it back I guess I'm not one of them. As soon as you get 5 replies, someone you love will quietly surprise you... Not joking. Pass this message on. Please don't ignore it. you are being tested and God is going to fix two big things tonight in your favor. If you believe in God drop everything and pass it on TOMORROW WILL BE THE BEST DAY OF YOUR LIFE. DON'T BREAK THIS. SEND THIS TO 14 FRIENDS IN 10 MINUTES IT'S NOT THAT HARD. WHOEVER SENT THIS TO YOU MUST CARE ABOUT YOU dont know how to send it ' LOL just hold your finger on it n it should say forward
Someone else's phone can be used to update a status. Sometimes, there is money for store-bought phone minutes.
For the last year she's lived homeless in a car in Hunts Point with her husband, until she was arrested on drug possession charges. After time in jail and a court mandate to a residential drug rehab facility, she has a chance at regaining custody of her two young daughters. This is not the first mandated drug program, not the first time her children were taken.
But the first mother and child rehab where they can stay together, the first nights spent as a family in two years.
Sarah, Hunts Point. Courtesy of Chris Arnade.
The rehab itself has buzz entry and 24-hour supervision. Only approved guests may visit, made via counselor appointments a week ahead of time. Family, or pretend family, only.
No money can be handed to residents, but cash can be placed in white business envelopes that are held open by stern hands. The envelopes go from the front desk through an unknown counselor, somewhere, who decides how and when to disburse it.
When residents haven't earned permission to leave, or haven't been in residence long enough, approved family visits must happen on site, in something akin to a doctor's office waiting room, or a back patio.
On the patio, a toddler boy drives a three wheeler in loops on the concrete while his mother and another woman talk. Guests wear normal clothes; residents wear comfortable shoes with fur.
Sarah requests real food to be brought: McDonalds, eaten on the patio. Meals are cooked and eaten communally, and some girls don't know what they're doing. She baked sheets and sheets of cornbread, the good Jiffy mix kind from the bodega.
Rooms, halls and bathrooms are, too, cleaned communally. Residence aides command women from different pods of the hall to do their chores when it's their turn a few shifts per week. Women don't often like being awoken for such, and yelling fights occur near the front desk.
Visits last an hour or so: time spent catching up, celebrating improvements of looks or health, remembering goals aloud when relapse seems imminent.
Like most rehab facilities, outside contact has rules: phone calls must go through a counselor. Of course, Sarah, a self-regarded badass who doesn't abide by rules, snuck in a phone.
Here she updates Facebook, her feed showing a grid of herself and her baby daughters, the ones which whom she is reunited, new photos every few days. They stay with her in treatment, the loves of her life.
Photo: "Still a cover girl."
Status: "My life looks better and better every day."
Video: "My girls playing ball."
Status: "Wuss up people.. ..... I'm back and getting my life back on track, it will be a long process but I'm gunna take it one day at a time."
When things aren't going well, connectivity drops off. A relapse, not returning when directed after outside privileges, defying treatment protocol. Rumors in Hunts Point of being seen on the street.
Counselors don't return calls for visit requests, Facebook feed silenced.
Discovered, or reprimanded.
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More Hunts Point Addiction Writing
Chris Arnade's Photos and his Facebook feed