Vince’s Story - How Stigma Destroyed a Father

Father & Son - Better Times

Written by and for people with Lived Experience - Port Alberni Community Action Team - Families Helping Families

Today’s Learning Moment – 08 02 21 Issue  Vince’s Story: How Stigma Destroyed a Father

Stigma kills, just as assuredly as a loaded gun wielded by an unthinking or malicious person.

Can what we think or say hurt others? Are my ideas based on actual evidence-based information? Do I carry unsupported prejudice or judgments against an idea or certain type of person?

Yes, I’m talking to YOU!. At the best of times, self-awareness can be a painful thing. Especially when it comes to long-held and cherished beliefs we think are true. Even unconscious biases can hurt others. Vince’s story explores how people and their judgement of him and his mental health and substance illness contributed to a catastrophic outcome for him and his family. The tears shed by friends and family because of the undeserved judgement and stigma placed on people with MHSU can fill an ocean. Let me tell you Vince’s story.
When I met him, Vince was struggling profoundly with opiate dependence and a mental health disorder. His story tells us how living in a safe and comfortable space is paramount to recovery and life. It also helps show us that placing sanctions on substance use alone and treating it solely as a behaviour, a choice and a crime is the glue that binds stigma we place on people with mental health and substance use. The result leads to devastating consequences.

I’ve changed his name to protect his family from further stigma, however, the chronicle of Vince’s life is as real as it gets. At one time Vince had everything. He had a lucrative job. He enjoyed a relationship with his partner and they had a little boy together. For all sorts of reasons, not the least of which included unstable times in his employment, a severe and unchecked mental health issue, and a violent, abusive, traumatic history, Vince ended up losing everything as he fell further into opiate addiction and mental illness.

There was more going on with Vince than just his addiction to opiates that he injected. He suffered from a debilitating personality disorder known as Borderline Personality Disorder (BPD). This can be devastating and life-consuming for people who suffer from it. It has ways of confusing the person’s perception and experience of love and contributes to the development of maladaptive coping habits like substance use. So it is not hard to see why Vince was isolated from the ones that he loved. However, that did not for one second kill his love for family, especially his young son.

Vince was referred to me by staff from the supportive housing he was residing at. They complained that they were finding drug paraphernalia such as unused needles and other packages and cookers etc., consistent with IV drug use. They were sincerely worried about him. However, the policy of their housing facility at the time was zero tolerance of any substance use, possession of substances or paraphernalia anywhere within the building. Any violation of that policy would result in immediate eviction of the offender. Rather than evicting him right off the bat though, they thought if he received help for his addiction, then his addiction would be brought in check and he would be able to remain at the residence. As we will see, it is never that easy.

It was a little difficult to get to know Vince. He was quite guarded and it took time for him to relax and for both of us to find our “groove” with each other so to speak. People with BPD can be inconsistent most of the time. With BPD, emotions do not necessarily have a “thermostat” to regulate the level of feeling the person is experiencing so sometimes, our sessions were quite intense. I would, after a session, feel quite drained. I am confident I never judged him though. I knew of his concurrent disorders and how difficult his situation was. In part, I’d like to believe this was one of the reasons our relationship grew in a positive way.

(My mantra became, “No judgement, no stigma. No stigma, no judgement”)

Vince’s main goal was to reconnect with his son and of course, maintain his housing. His substance use and unpredictable emotions were barriers in his relationships. Our main strategy was to work on his IV opiate dependence while developing healthier coping skills.

There was certainly a lot of inner work that we did to help him with alternative coping strategies. We focused on his love for his son. Motivation is the foundation of recovery and there is no greater motivation than love in my opinion. Vince had no shortage of that. When he was well and stable, his love was overflowing.

Fortunately, strategies for recovery from addiction and for BPD (and many other disorders) are similar. That is no surprise as substance use dependence and addiction are considered concurrent mental health disorders (more than one disorder at the same time) that often occur with other mental illnesses. We also employed a medical intervention as Vince agreed to access the methadone program at that time.

Eventually, Vince reported that his IV use had ceased. There was no visible evidence to dispute his reports. He eventually developed the ability to have supervised visits with his son and obtained a part-time job. His enthusiasm and passion for life appeared to be growing in leaps and bounds. Everyone was satisfied and happy….until.

I am not sure what triggered the relapse. It was likely being laid off of work and the slow pace of his progress with visitations with his son that triggered it. Remember that his emotional thermostat was still broken or non-existent and he was still prone to emotional outbursts, extreme agitation and depression. This, in my opinion, was why he was using substances in the first place. Relapse is one of the typical times that an overdose will occur.

Vince likely defaulted to his old familiar ways of dealing with his moods and circumstances. Regardless of why it happened. He overdosed in his suite.

That was not the end. Staff found him on time, laying on his floor amongst scattered needles and other paraphernalia. He spent some time in hospital and was released just a couple of days afterwards. When he arrived back at his suite, the eviction letter was waiting for him. Vince was extremely upset about this and started to push everyone away, including me. He lost his visits with his son. He continued to use. He ended up homeless for a short time and stayed at our community’s shelter before he was able to find a small place with a roommate. He was constantly in our clinic for harm reduction supplies so we knew he was still in the throes of his addiction.

About four months after his eviction, he was found unresponsive in his apartment by his roommate. He did not make it. Vince fell victim to the onset of the poisoning of the illicit supply of heroin that was beginning to sweep our community at that time. Vince would never again have the chance to see his son nor his son would ever see him again. His family and his roommate were devastated. I was devastated.

The poisoning would claim so many, I stopped counting after three years at 35. I now know of over 50 whom I worked with who have lost their lives to toxic poisoning “overdose”. To date well over 21,174 deaths have been reported in Canada from this poisoning in the last 5 years.

One of the responses to the poisoning was a significant change in policies at some supportive housing facilities. You see, People, like Vince, have always used it in their rooms despite the sanctions and consequences. It was a better alternative than in an alley or some bathroom somewhere.

People have mostly used alone as well because of the illegality of possession, not just of drugs but also paraphernalia. So people choose to use in the relative privacy and safety of their own homes. Unfortunately, this turned into one of the most dangerous practices and remains so today for substance users.

People also use alone to keep their use hidden, not only from the law but from the stigma and judgment of others.  Stigma is also a barrier to seek out help.

Residential workers were becoming overwhelmed and over traumatized by walking in on overdoses and, horrifically, dead bodies. So eventually, and very quietly, so the uninformed community would not lose its mind, these facilities, including the one where Vince had lived, developed harm reduction strategies that would soon see a significant reduction in fatalities within these residences. They changed their policies from zero tolerance to harm reduction. They established safe injection/using rooms in their buildings and/or monitoring protocols with tenants so that staff were actually aware of when someone would substances and would check on them periodically to ensure safety. The result has been remarkable. The benefits have been widespread for everyone involved. There has been very little if any negative impact on communities as a direct result of this policy. And, people in these places, who are no longer stigmatized by sanctions and intolerance are now more actively seeking out help.

There are multiple options for opiate replacement therapy now and the helping community has evolved to embrace harm reduction as one step throughout recovery.  Stigma amongst the helping community has decreased significantly. 

Imagine if this had been already in place for Vince. His son would still have his father, despite his father’s challenges. People like myself could still be working with Vince and supporting him in helping to stabilize his life.

Many of the deaths that have occurred could have been prevented if we as a society would change how we see substance use disorder. If we could only see the people first and not the disorder, maybe we could save lives. The resulting stigma caused by prohibition has resulted in nothing but increased pain for the substance user, families, and the community.  Harm reduction works to save lives and preserve dignity and thus build confidence and motivation.

If anything, follow this: Compassion, not punishment. Love, not hate.

(This story has been edited for length.  The original source is below).

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Author: Ben Goerner— Ben is a retired counsellor. He advocates for people with substance illness or mental illness.

Families Helping Families is an initiative of the Port Alberni Community Action Team. We send out “Learning Moment” articles regularly to help folks understand substance illness. Knowledge is vital in understanding the illness of our family members. You may copy, distribute or share our articles as long as you retain the attribution. You can be added to our distribution list by dropping us a note at - albernihelp@gmail.com

Resources:
https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/
https://journalofethics.ama-assn.org/article/how-structural-violence-prohibition-and-stigma-have-paralyzed-north-american-responses-opioid/2020-08
https://bensharmonics.com/the-story-of-v/