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Changing minds on drugs

It saddens me to see Fair Havens close but I have high hopes that the facility will soon re-open to serve some other good social purpose.

In any event, I think it is important to tell Bermudians why, I believe, the project did not succeed. And to talk about two important lessons to be learned - involving how Bermudians see the problem - and where, in the future, this Island decides to direct its resources to deal with the problem.

Let's talk about money. I have no way of knowing the exact figures but I have been told that, through various agencies and bodies, the Bermuda Government spends something like $5 million or $6 million this past year (on drug treatment). Fair Havens received about $300,000 of that amount, which sounds like a considerable amount until you factor in the mortgage and the fact that treatment is expensively labour-intensive. That is, you have staff on board seven days a weeks, 24 hours a day with medical, nursing and counselling services a large, large part of the package. But we had friends, corporations and benefactors on the Island and, as they say, we made the payroll. Sometimes just.

Fair Havens opened with high expectations and we met them. We developed a treatment programme that operated at a high international standard; a programme that had the final touches put in place when we brought in consultants from the Betty Ford Center to work side-by-side with our staff, a staff composed mostly of Bermudians who were very dedicated people and highly educated in the field. The facility itself was attractive, modern, well-equipped and well-run. So why wasn't it successful? I think that sometimes we are all too ready to point a finger of blame and say it is the fault of the Government, some agency or what someone did or didn't do, but the simple answer in this case is that Bermudian women did not come for treatment. Why?

Partly it was the result of history. In years past the place had been run "differently" and the perception from those days continued to hang over Fair Havens. Because it certainly was true that at one time the facility was used as a parking place for addicts and alcoholics to get them off the streets - perhaps to avoid jail. And addicts themselves found it a convenient temporary stopover - staying there for just enough time to let them begin to feel a little better. It wasn't a place with any form of treatment, system or rules - just a come-and-go place that some women began to feel was their entitlement. And while it did serve a purpose there were no real changes in the way these women led their lives. Indeed it became a merry-go-round with the same women recycled in and out of the place over a number of years. One of them four times. And so, later on, we could never seem to get the message through that all of that had changed.

Then there was the continuing issue of a small population on a small island, where it seems that everyone is connected in some way with everyone else. And the vital question for many potential patients and their families was: "How do we keep our private lives private after checking in for treatment?"

Tied directly to that question is the most important reason of all. Many women did not come into treatment because of the way the general population looks at the problem. People who work in the treatment field call addiction a disease. Perhaps, in some cases, one that was originally self-induced, but nonetheless a disease. And certainly, in the way it can gain control of your mind and body, it is as hard to fight as any major disease you can name. And it can be just as terminal. But with all the shame and all the blame surrounding this dependency many people on this Island look at a drug or alcohol problem and see it simply as a personal weakness of the will - as a lack of resolve - a selfish and irresponsible pattern of behaviour by people who could stop if they wanted to! All too often, with family and friends, it has such a stigma of shame that it is ignored, covered up or firmly denied. After all, things like drinking too much or taking drugs only happen in someone else's family. and of course the alcoholic or addict who "hasn't got a problem" goes right along with that.

But what are we really talking about when we say someone abuses substances or is drug dependent? Is it some 40-year-old woman who only drinks "a little" but is also leaning far too heavily on sleeping pills or tranquillisers or painkillers prescribed by her doctor? A combination that has her "hooked" and is changing her behaviour, her relationship and her health? Or is it someone who never falls down drunk, never slurs his or her words, hardly ever misses work and only drinks from Fridays to Sundays? Looking at the way they are thinking these days, the changes in their body and the ever increasing amount they consume to get them feeling "right", might tell you.

Addiction/dependency is not simply about cocaine or Angel Dust or Ecstasy - things you buy from some dark figure on a corner - it is about all kinds of combinations, too much of one chemical or, simply, your personal reaction to that chemical. Chemicals (and alcohol is one) that, because of the change in you, also profoundly affect the lives of people all around you - from children to grandparents.

But the problem remains, especially when you see all the shame and fear and denial that surround such a problem here. And how do you get the message across that there is truly professional and life-saving help available right here in Bermuda?

I believe the answer - for the future - lies in a concerted programme of education. A programme about the disease, its consequences and, most importantly, about choices. A plain-talking series, that in concrete terms, gives Bermudians a personal understanding about alcohol and drug dependency and what it can do to your health and every part of your future. How it can profoundly affect the well being of those who love and support someone with a dependency. A programme that becomes an alternative to burying the problem deeper and deeper - and deals directly with those issues of shame and denial and blame. One that talks about what treatment is and how it goes about bring people "back to a real life".

A series, in appropriate versions, for different audiences, could be taken into the schools, the churches, the clubs and the media and every other place you can find a forum with a broad audience. Designed to help Bermudians to become informed - to become much needed evangelists for treatment and recovery - to substitute intolerance and resentment with something we call self-protective tough love and perhaps help some people deal, in a healthy and constructive way, with such issues in their own lives.

You see, what we are talking about is a long-term attitude change. Where, in the future, a boy or girl "just says no" to drugs not because they have been exposed to a facile statement, but because they have a real understanding of what drugs mean. Where women come to understand that there is a real danger that the odd drink with those tiny prescription pills they take every day can begin to take a hold of them - and have a real impact on their minds, their health, their marriages, their relationships with children and all the others in their life. We also need to show people that, most importantly, they are not alone, that whatever they thought of as a weakness or a stigma is far less important to their lives than the effects of the dependency. And - that there is help available.

Finally, I want to speak about what I call tough-minded compassion. Getting people to turn their lives around is not a game. On both sides - staff and patient - it is hard, often painful and stressful work. And while it is vital that no one is denied treatment, it is also vital that no one gets a free ride. Whether their treatment is $10,000 or some token payment for a month of treatment, there should be a dollar commitment based on what that person can truly afford. Suggesting that to you is not about some monetary housekeeping, it is about a patient's commitment to seeing things through - and you have no idea how imperative it is to undermine that belief in some minds that treatment is a rest stop or an entitlement.

Obviously these are a just a few parting thoughts about a much longer picture, but I wish you had been a fly on the wall the week of December 7 when we had a gathering of staff, some volunteers and a large number of women who had been in treatment at Fair Havens. Evidence of some wonderful results was all around the table. I will take that memory of those smiling faces - with their wonderful spirit of refound hope - with me when I leave Bermuda. My hope is that - sometime again - scenes like that will be repeated over and over again in Bermuda.