Harm Reduction? Therapeutic Communities — What rally works?
For weeks now my mind has been mulling over one of Canada’s most visible and serious social problems. This is a problem that has just gotten worse despite Municipal, Provincial, and Federal governments throwing BILLIONS of dollars yearly in failing attempts to lessen much less successfully solve this deadly social dysfunction that is spreading throughout Canada’s civic body. The city of Vancouver alone presently spends $360 million annually to deal with it. But the problem just refuses to go away and everybody knows and sees it. So why do our government bureaucracies continue with what is evidently a losing “game”? Why are they so intractable?
The problem, of course, that I’m thinking of tackling for our next documentary is: drug addiction, homelessness, and social marginalization. This is a depressing insidious mix if there ever was one. But in a perverse way this mix of social evils has become a real sustainable growth industry here in Canada. And it has been employing increasing legions of police, social workers, and medical personnel. Why?
How effective can a government program be if it locks down the facility at night so no one can enter or leave, but during the day people can come and go as they please and on “Welfare Wednesday”, when the cheques are passed out, some of the project’s residents head for the streets and the waiting drug dealers? After a few days of totally wasting themselves they stumble back to the project for a place to sleep and food to eat while they wait for the next distribution of money from the government. Government sponsored city-centre harm-reduction programs like this have a very, very low “cure” rate. And even when they bother to keep statistics government finds that only 5 to 15% of such clients ever break free from their addictions.
In contrast to such a faint hope, band-aid type of program there are functioning therapeutic communities. These mostly private programs have “cure” rates in the low to mid 70 percentile, meaning that about 75 of every 100 people who enter such programs get a new life! A key difference between harm reduction programs and therapeutic communities is the will to change.
About 2,000 years ago Jesus of Nazareth taught this truth foundational to human change:
“There was a man who had two sons. the younger of them said to his father, ‘Father, give me the share of the property that will belong to me.” So he divided his property between them. A few days later the younger son gathered all he had and traveled to a distant country, and there he squandered his property in dissolute living. When he had spent everything, a severe famine took place throughout that country, and he began to be in need. So he went and hired himself out to one of the citizens of that country, who sent him to his fields to feed the pigs. He would gladly have filled himself with the pods that the pigs were eating; and no one gave him anything. But when he came to himself he said, ‘How many of my father’s hired hands have bread enough and to spare, but here I am dying of hunger! I will get up and go to my father, and I will say to him, “Father, I have sinned against heaven and before you…” (Luke 15:11-18 NRSV).
Jesus’ teaching in the story up to that point was that change could not, and did not occur before the dissolute young man came to himself and found the will, the motivation to turn his life around. Then it was the turn of the caregiver, his father, to extend mercy and to help. To extend mercy without a will to change by the one being helped tends to merely perpetuate a destructive cycle.
It’s not just the addicted who need to change, so must the caregivers. They need to learn to practice tough love, useful kindness, and gentle strength when assisting people with severe problems. The goal should be to help them ‘get a life’ — a purpose and sense of wholeness — rather than merely making them more comfortable while they not-so-slowly kill themselves with their dissolute, destructive habits.
