“Burdens shared are easier to bear.” Jesse Jackson
A Troubled Beginning
By the time he was 13, Marcus had bounced in and through a dozen homes, if that’s what you called them, a pattern which was to continue throughout his 42 years. He was smoking weed regularly by his teen years and had dabbled with a handful of other drugs, which he mostly picked up off the nightstand in his mother’s bedroom. From time to time when his mother was in jail, Marcus stayed with one of her boyfriends or his mother’s sister. It didn’t much matter where he stayed. Even though the scenery was different, the environment was the same. School was tough for Marcus because of ADHD, and a less than happy home life. A depression crept unnoticed into his life and surrounded him like a dense gray fog.
After his dismal sophomore year of high school, Marcus quit. His life was now riddled with drugs, petty crime, and damaged relationships. Unable to get or keep a job, he wandered from couch to couch. He found work in a car wash for a couple of years. He spent his twentieth birthday in jail serving a short sentence for fifth degree possession. This began an often repeated cycle of living on the street, followed by jail, ER, treatment, and back to drug use on the street.
There were a few good months here and there for Marcus. He had a relationship that lasted for almost six years that was begun and destroyed because of his drug use. He had two sons from two different women. One son he tried to see regularly and the other seemed lost in the maze of disconnections caused by moves, jail, and relational conflicts. For Marcus, life had been reduced to a boring assortment of disappointments and depression, followed by another round of attempted escape through his addiction. When I met him, he was on a seemingly endless trip on a toll road he couldn’t afford, which forever promised an exit he couldn’t find.
Addressing the Whole Problem
When I look at Marcus’ case, it is evident that he is held captive in a tangle of interrelated problems common to people with chronic mental health and substance use disorders. To help Marcus, and people like him, a holistic approach may offer the best chance for sustained recovery.
When treating someone like Marcus, the following psychosocial concerns need to be addressed.
- Co-occurring mental health and substance use treatment and relapse prevention
- Resolution of legal problems and criminal recidivism
- Stable affordable housing
- MAT and psychiatric medication follow through consistency
- Relational stability with partner and children
Rising to the Challenge
Instead of seeing five unrelated obstacles, these difficulties became one interrelated challenge. It was a challenge Marcus, with renewed commitment and the aid of good support, was willing to take on. He entered residential treatment this time with a high level of determination. He was started on a depression medication within the first few days. He was prescribed a suboxone taper to reduce opioid withdrawal effects and given naltrexone to reduce cravings for opioids and alcohol. In group and individual therapy, he addressed issues of anxiety, depression, and relational problems.
A chronic pessimist, Marcus began to challenge his own negative thinking, replacing the irrational distortions with positive, reality-based thoughts. Positive momentum soon developed. He completed his residential treatment portion and moved to intensive outpatient treatment with lodging for the next four months. Stable in his mental and emotional health, he continued to resolve relational problems and managed to re-establish his connections with his son. Finding a job in a warehouse, Marcus saved a few dollars and transferred to sober housing, living with five other guys. Living in a stable and sober environment gave him the structure he needed to stay at his job. Having money made it easier to resist the petty crime and drug dealing that Marcus usually relied on for income. Marcus made great progress because he had addressed the interrelated psychosocial issues that had so often derailed his recovery.
Putting it Together
Hope is not wishful thinking and effortless fantasy. Hope arises through strategic and disciplined effort, infused with the belief that good things and better days are ahead. The successful conquering of the challenges in every recovery journey come through the numerous touches of a hundred hands, knowing that “burdens shared are easier to bear.”
Recovery is a journey. Enjoy the ride!