some thoughts on harm reduction theory

I've been trying to establish a personal position on harm reduction theory for a while. I go back and forth. Many times those who espouse a harm reduction philosophy in the field of substance abuse treatment are seen as far more compassionate and tolerant. They often are, but this is an entirely different issue. Harm reduction theory basically asserts that the goal of treatment is not necessarily the cessation of illicit drug use, but rather reducing the harm associated with drug use and the improvement of quality of life (which is rather subjective, as a Christian I most likely have a different opinion on what a "quality life" would look like for a recovering addict). Harm reduction measures presume that the present user is going to continue his or her drug use, and that this must be accepted as fact and all must be done to ensure this behavior is "safe" or "safer". 

Harm reduction theory has been known to produce impressive outcomes in practice. And there are many benefits to the approach. One of the things I like most about harm reduction is that it aims to preserve the dignity of the addict by providing them with options and allowing them to be active in their treatment. I do firmly believe that no human being can overcome the power addiction without admitting that addiction has power over them. Addicts must take ownership of their lives and work towards health. In some twisted way, harm reduction does promote patient dignity.

Here's the problem with harm reduction: it is in stark contrast to the nature of the Gospel message. Because of Christ's work on the cross and God's masterful plan of redemption through that work, no human being is beyond redemption. Harm reduction theory negates this fact by declaring that full recovery is just not possible with some people. Yes, some people struggle their whole lives with addiction and are never freed from the vicious cycle of drug abuse. But that doesn't mean that it wasn't possible for them to find freedom in Christ. 

Now I do think that harm reduction has produced some viable treatment modalities; methadone maintenance treatment is one of them. Many addicts are frozen by their fear of physical withdrawal symptoms and therefore are unable to quit their drug use. Heroin withdrawal is especially heinous. Think of the most awful case of the flu you've ever had, magnify it by 20x and you can begin to comprehend heroin withdrawal. Obviously, no can truly comprehend it unless they've experienced it. Upon withdrawal, the user feels restless and irritable and loses their appetite. As withdrawal peaks, the user suffers diarrhea, shivering, sweating, general malaise, abdominal cramps, muscle pains, and an increased sensitivity to pain. If flu symptoms were the only aspect of withdrawal, treatment of heroin addiction would be more manageable. Unfortunately, this is not the case and there is a symptom that is more intangible and longer-lasting. Withdrawal brings about dysphoria (the just-feeling-lousy feeling), which is quite possibly the reverse of opiate-induced euphoria. That was kind of a tangent which was too in-depth. But you get the idea: opiate withdrawal sucks and wreaks havoc on your body physically. Methadone is a synthetic opioid that is given to addicts to replace heroin. Although most patient's don't experience a high (they're much too opiate tolerant), methadone serves as a replacement on the neuronal receptors that would be receiving heroin thus masking withdrawal symptoms. 

Methadone can help addicts in their transition to recovery and abstinence. But methadone becomes an issue when drug users are enrolled in methadone maintenance treatment for their entire lives. To me, this isn't recovery. Full recovery is experiencing freedom from all pharmacological crutches, both illegal and legal. Sure, if a patient is undergoing controlled methadone maintenance treatment they are no longer involved in illicit drug use, turning tricks, prostituting, and engaging in various other avenues of criminal exploration. But they are by no means healthy, functional adults. And that should be the goal. There are so many facets of addiction. Physical, mental, emotional, and by far the most neglected: spiritual! Addicts can experience full recovery through Christ. 

Maybe someday I'll start a faith-based methadone clinic. SIGH. That would be so awesome.

Grace and peace.

Hillary

I'm okay. I think.

I'm listening to this song on repeat until finals are over. Ughhhh.

We are grown but cannot see

Lost our world of make believe

Simple time snow seem so far

Used to be in my backyard

Yeah, the world was still in my backyard

But, we are okay, we are alright

We sing very loud

Yeah, we're singing

We are okay, we are alright

Close our eyes, close our mouth

Yeah, we shut our eyes though we're in doubt

Build me a home from a cardboard box

Many windows never locked

This is how we used to play

Shorter nights and longer days

With faith we would not fade away

But we are okay, we are alright

We sing very loud

Yeah, we're singing

We are okay, we are alright

Close our eyes, close our mouth

Yeah we shut our eyes though we're in doubt

And so it goes

We can never seem to find the time we lost

Though we try at any cost

We try, we sing

We are okay, we are alright

We sing very loud

Yeah, we're singing

We are okay, we are alright

Close our eyes, close our mouth

Yeah, we shut our eyes when we're in doubt

Joshua Radin "We Are Okay"

Thanks Mr. Radin. I guess I am okay. A little stressed. Okay, a lot stressed. But okay.

And CHRISTMAS IS COMING. I love Christmas in the bay area. It doesn't get much better than that.

Grace and peace.

Hillary

 

Homeless Clinic

Currently listening to: Patty Griffin-Children Running Through

So part of one of my clinical rotations this semester is participating in a clinic that Biola holds in Santa Ana for the homeless once a week. As nursing students, we get to perform physical assessments, give out medication, clean wounds, change dressing, educate patients about their diagnoses, as well as talk and pray with them. I love it because its so similar to what I want to do with my life. I love patient education, I love talking with people, I love autonomy, I love flexibility, I love seeing the same people week after week, and I love not being in the hospital setting. Last week, I had a patient who had never been seen at our clinic before. When we receive a new admit, we have to talk with them a little more about their health history etc. so that we have all the information in their chart up to date. This often times leads to deeper and prolonged conversation, which builds rapport and presents an opportunity to establish a therapeutic relationship with patients. This particular patient was a 17 year old girl who was a former meth addict. I talked to her extensively about her addiction and her efforts to remain clean. At one point in the conversation I laid into her because I didn't understand why she was hanging out in downtown Santa Ana at night. Obviously, she was looking for trouble. After doing a brief physical assessment, I sent her home and told her she should come back again next week and talk to me, but in the meantime she should probably steer clear of the streets.

Today at homeless clinic, I looked for her all afternoon. When it came time to pack up around 5pm, I still hadn't seen her and was very disappointed. I figured I was too obnoxious and reprimanded her too much. But no. When I was finishing up with my last patient, she came bounding up to me, gave me a hug and exclaimed, "I've been clean for a month and 14 days!". She also informed me she's been attending a local church and getting involved in her youth group as well getting her GED. I think it might have been my favorite moment in my nursing student career thus far. It was beautiful. It makes not sleeping during nursing school totally worth it. I think God placed this event in my life to get me through finals. Seriously. 

She then expressed her surprise that I actually remembered her. I learned something important tonight. People just want to be heard. That's one of the greatest lessons I've learned from the homeless in Santa Ana. They have no voice, and all they really want is a kind pair of ears to listen to their stories. This girl needed to be validated. She needed to be reprimanded. She needed someone to actually care about the fact that she was on the streets; care enough to tell her to get the hell out.. She needed someone to listen to her struggles with addiction. She needed someone to be excited with her about her sobriety. Because her old group of friends that she used to get high with aren't much help in that department. She needed someone. Period. I'm so thankful God blessed me with the opportunity to be that someone. I may never see her this side of heaven again, but I won't ever forget her. And my interaction with her, although brief, may be at the heart of my nursing practice for the rest of my career.

Grace and peace.

Hillary

Tis' the Season

Currently listening to: Joshua Radin "Simple Times"

Now that Thanksgiving is over, it's officially Christmas season. Top 10 favorite things about this season, ready...go!

1. Classic Christmas movies (Its a Wonderful Life, Claymation Rudolph/Frosty, White Christmas, Home Alone...you get the idea)

2. Shamelessly wearing scarves every day

3. Making New Year's resolutions that I know I won't keep. Who knows, maybe this year I will?

4. Generosity

5. Parties that consist of people who would never actually hang out together had they not all been invited to the same random "holiday mixer"

6. Cold(er) weather

7. Fruitcake (yes, I'm one of the few people who actually likes fruitcake). Actually, just food in general.

8. Christmas lights and Christmas music

9. Consumerism and marketing at its finest

10. Being OFF CONTRACT.

Bad everything

Currently listening to: eastmountainsouth

Well, its obvious I'm a terrible blogger, since I haven't blogged since July. Yeah. Whatever. In addition to being a bad blogger, lately, I have been a:

bad friend

bad daughter

bad student

bad nurse

bad CNSA secretary

bad example of Christ...

just to name a few.

The problem really is that I feel like I have so many roles to fulfill, and I'm spread so thin I can't fulfill them all well. So the result is me half-assing everything. Which really irritates me. I don't really know how to fix it. Today, I had a minor breakdown when I began thinking of all the crap I have to get done for school before Thanksgiving break. I've learned that I suck at being under stress and the only way for me to deal with stress is to take things hour by hour, day by day. So for now, I've resigned myself to only dealing with what is currently at hand. I can't think about what I'm going to have to do tomorrow because then I start to freak out. So, for today, I'm just trying to study my brain into slush for my advanced medsurg test tomorrow. Blech. 

"But seek first His kingdom and His righteousness, and all these things will be given to you as well.  Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own" Matthew 6: 33-34

In all of my roles, I need to seek Him first. I know that when I do this, things tend to miraculously fall into place by the grace of God. But that doesn't make it any easier. 

And can I just say how freaking excited I am for Thanksgiving with my rad family? Well, I'm stoked. My mom's cooking is fantastic, my dad is a nutcase, and my brother is a spaz. Love it. Plus, I get to see my crazy cousins, my Disney-obsessed aunt and uncle, my freakish cat, and my other strange pets. I've been checking the weather in the bay area pretty much everyday, and its supposed to be rainy and gray over Thanksgiving. Praise GOD. I love the bay area in November; the leaves actually change color up there. Plus, Thanksgiving means its all th

e more closer to CHRISTMAS. Yes, I've been listening to Christmas music since September, and you know what? I don't care if you judge me. So here's to my mom's organic pies, my dad's tendency to have the Christmas lights up right after Thanksgiving dinner, my brother hogging the computer, walks on the Greenbelt, staying in my pajamas all day, Sadie Marie, taking pictures of leaves, my feather bed, apple cider, and reading something other than nursing textbooks. Oh, and here's to taking things day by day. Because sometimes that all you can really do. 

Homemade apple cider? It doesn't get much better than that.

Grace and peace,

Hillary

I'm a whore.

I was at work the other day and I had a frustrating encounter with a customer. I work at a scrapbooking store in Danville. We have lots of interesting customers since the people in Danville are relatively interesting. I'm seriously mortified by my thoughts about, actions towards, and words spoken to this one particular customer. She walked into the store on her bluetooth and left the store on her bluetooth. She waltzed in wearing a black leather mini-skirt and heels with her expensive boobs on display. Tanned, bleached and plastic. The first thing that crossed my mind when I saw her was "Oh. Great. Yet another Danville whore". One of my biggest pet peeves is when customers continue their cell phone conversations while I'm checking them out. Its just rude. So, I was especially miffed when she approached the counter yapping away on her bluetooth. THEN I noticed her Rolex and the massive diamond (most likely a blood diamond) that adorned her perfectly manicured hand. I couldn't help but think of how many African children could be fed, clothed and educated with the thousands of dollars spent on this woman's jewelry alone. Her total was $10.81 and she slapped down her gold AmEx. I told her that was the one card we don't accept. She smiled quaintly and then she searched through her Louis Vuitton wallet for another credit card. I think she may have had about 10 credit cards. After I bagged her items and handed her the receipt, she smiled and mouthed "thank you" as she scooped up the keys to her Mercedes and pranced out the door. After she left, I proceeded to bitch about my encounter with her to my coworkers. I'm such a brat. 

And you know what else I am? I'm a whore. When I came home from work I began to think about that woman and God showed me how much I have in common with her. I was reminded of the parable of the pharisee and the tax collector in the gospel of Luke (chapter 18). The parable starts out like this: "To some who were confident of their own righteousness and looked down on everybody else.". As you can already see, Jesus told that parable for me, well, technically for all of us. But definitely for me. The parable goes like this: "Two men went up to the temple to pray, one a Pharisee and the other a tax collector. The Pharisee stood up and prayed about himself: 'God, I thank you that I am not like other men-robbers, evildoers, adulterers-or even like this tax collector. I fast twice a week and give a tenth of all I get.' But the tax collector stood at a distance. He would not even look up to heaven, but beat his breast and said, 'God have mercy on me, a sinner.'"

Then at the end of the parable Jesus says, "I tell you that this man, rather than the other, went home justified before God. For everyone who exalts himself will be humbled, and he who humbles himself will be exalted." I am the Pharisee in this parable and I am now most certainly, humbled. Father, forgive me. One of my first thoughts about the Danville whore was "thank goodness I'm not like her. I don't waste my money on diamonds, trips to the tanning salon, silicon implants or dress like a tramp." No, I don't do any of those things. But you know what? I do a lot of other whorish crap. My boobs are real, I try to dress modestly, I don't dye my hair, I don't wear gaudy make-up, but I'm still most certainly a whore. I'm a whore to self-righteousness, knowledge, prowess, success, education, recognition, and trends. Just to name a few. Obviously, when you look up "whore" in the dictionary, the first definition will most likely be "prostitute". But there was another definition when I looked it up: "debasing [or degrading] oneself by doing something for unworthy motives". I'm not a prostitute, but I am guilty of whoring myself to the temptations of this world. 

The only reason I am worth anything is because the Creator of the universe loves me and His Son bled for me. And you know what? The Creator of the universe loves the Danville whore too and Jesus most certainly died for her too. I guess we're all whores. Whores saved by the blood of the lamb. Hallelujah. 

Grace and peace.

Hillary

Father, forgive me. Help me to recognize the material things or ideas that I whore myself to. There are many. Anything that distracts me from You and bringing You glory is something that I'm guilty of whoring myself to. 

I'm pro-life, literally.

So I just finished reading Irresistible Revolution by Shane Claiborne. The book is absolutely phenomenal and I recommend to, well, everyone. His book was a wonderful reminder that all Christians, especially myself, need to hear: our allegiance is to a King and His kingdom. Not to a political party, the government, a nation or a specific ideology. Christians should stand apart from partisan politics. That would truly be a testament to the radical teachings of Christ which stand in stark contrast to the world in which we live. Shane's book is about much, much more than politics. But his views on politics are very fascinating and thought provoking. Before I became a Christian, I always found it odd that Christians were "pro-war" (I really dislike that term, but I couldn't think of anything else). Jesus promoted nonviolence, peace and turning the other cheek. I mean, for goodness sake, God in human flesh let the Jews nail him to a cross despite his blatant innocence. Furthermore, Jesus did this to restore peace between God and His children. Can you get anymore peaceful than that? I don't think so. 

Initially as a Christian, I just assumed that I was supposed to be a Republican. I adhered to all things Republican, espoused all things conservative and despised all things liberal. But I soon experienced a cognitive dissonance of sorts, in the sense that I felt like Jesus just wouldn't support some aspects of Republicanism. The Jesus I had come to know was peaceful and loving at all costs. He gave HIS LIFE for peace. The Republican party is hardly peaceful. Our government is not peaceful. Our world is not peaceful. But my heart belongs to the Prince of Peace. I have no doubt that Jesus would disagree with the Republican party in terms of issues such as poverty, healthcare, capital punishment, caring for the earth, and war. But I don't think He would necessarily agree with the Democratic party either. During Jesus' time He never ascribed to the ideologies that surrounded Him, He forged a new path that preached justice, inclusion, peace and equality. I saw a bumper sticker the other day that made me think "Pro-life and Pro-war? I'm Anti-Hypocrite, thanks". I've come to discover that being pro-life means far more than being against abortion. The term pro-life should be taken as literal as possible; being pro-life means you are for all life. I believe that all life is valuable and that no life is beyond redemption because Christ's sacrifice was sufficient for everything. Terrorists, zygotes, embryos, fetuses, convicted felons, rich, poor, heroine addicts, tax collectors, politicians, ragamuffins, whatever, it doesn't matter. We're all the same in God's eyes. We're all equally wretched and treasured. Its such a confusingly beautiful paradox. And our God is so great that He can make sense of such a paradox. 

Pardon my tangent. Moving on. Shane Claiborne made a trip to Iraq in 2003 when the "War on Terror" was raging. He issued a purpose statement for his trip and its absolutely beautiful. It definitely makes you think. I want people to read it. Its worth your time, I promise.

"I'm going to Iraq because I believe in a God of scandalous grace. If I believed terrorists were beyond redemption, I would need to rip out half of my New Testament Scriptures, for they were written by a converted terrorist. I have pledged allegiance to a King who loved evildoers so much he died for them (and of course, the people of Iraq are no more evil or more holy than the people of the US), teaching us that there is something worth dying for but nothing worth killing for. While terrorists were nailing him to the cross, my Jesus pleaded that they be shown mercy, for they knew not what they were doing. We are all wretched, and we are all beautiful. No one is beyond redemption. May we see in the hands of the oppressors our own hands, and in the faces of the oppressed our own faces. We are made of the same dust, and we cry the same salty tears. 

I am going to Iraq in the footsteps of an executed and risen God. I follow Jesus who rode into Jerusalem on the back of a donkey at Passover, knowing full well what he was walking into. This Jesus of the margins suffered an imperial execution by an oppressive regime of wealthy and pious elites. And now he dares me and woos me to come and follow, to take up my cross, to lose my life to find it, with the promises that life is more powerful than death and that it is more courageous to love our enemies than to kill them. 

I am going to Iraq to stop terrorism. There are Muslim and Christian extremists who kill in the name of their gods. Their leaders are millionaires who live in comfort while their citizens die neglected in the streets. I believe in another kingdom that belongs to the poor and to the peacemakers. I believe in a safe world, and I know this world will never be safe as long as we try to use violence to drive out violence. Violence only begets the very thing it seeks to destroy. My King warned his followers, "If we pick up the sword, we will die by the sword". How true this has proved to be throughout history. We armed Saddam in the conflict against Iran, and we armed Bin Laden in the struggle against the Soviet Union. Timothy McVeigh, the most terrifying domestic terrorist in US history, was trained in the Gulf War, where he said he turned into an animal.

I am going to Iraq to stand in the way of the war. Thousands of soldiers have gone to Iraq, willing to kill people they do not know because of a political allegiance. I go willing to die for people I do not know because of a spiritual allegiance. The soldiers have incredible courage, courage enough to die for something they believe in. I pray that Christians would have that same courage. The command of the soldiers is handed down, through rank after rank, from a human commander-in-chief clinging to the myth of redemptive violence. My mandate is straight from the mouth of my heavenly King, through the lips of the Prince of Peace-to love my enemies- and yet still I falter. May we cling to the truth that every human is created in the image of God. Do we believe that children in Iraq are just as precious as the children of New York? A love for our own people is not a bad thing, but why should love stop at the border? We, the people of rebirth, have an allegiance that runs much deeper than nationalism.

I am going to Iraq as a missionary. In an age of omnipresent war, it is my hope that Christian peacemaking becomes the new face of global missions. May we stand by those who face the impending wrath of empire and whisper, "God loves you, I love you, and if my country bombs your country, I will be right here with you." Otherwise, our gospel has little integrity. As one of the saints said, "If they come for the innocent and do not pass over our bodies, then cursed be our religion". May our lives interrupt terrorism and war, in small ways, in large ways, in moments of crisis, and in everyday rhythms. These are extreme times. And I go to Iraq as an extremist for love.

'And now, compelled by the Spirit, I am going to Jerusalem, not knowing what will happen to me there. I only know that in every city the Holy Spirit warns me that prison and hardships are facing me. However, I consider my life worth nothing to me; my only aim is to finish the race and complete the task the Lord Jesus has given me-the task of testifying to the good news of God's grace' (Acts 20:22-24)". 

I want to be an extremist for love. 

Grace and PEACE,

Hillary