This is Your Job as an Ally
by Wendell Williams
February 29, 2020
This interview with Wendell Williams was conducted and condensed by frank news.
Would you introduce yourself?
My name is Wendell Williams. I'm an African-American male, and I've been working in substance abuse and homelessness since 1991. I was more recently employed at a large substance abuse treatment facility that is nationwide, and I was employed in the mid-Atlantic division here in the DC area as a recovery specialist. My licenses, and certification, and designation is as a recovery specialist. I'm a CPRS, which means Certified Peer Recovery Specialist, and an ACHC, which is basically a counseling assistant for sub-certified substance abuse counselors. I've been working on an OBOT program and an IMAT, which is a medication assisted treatment, and my client base has been people who are underinsured or uninsured, paid for by a three year grant from SAMHSA.
How do physical and mental health treatments intertwine in recovery programs?
First of all, it is not that clear cut. My experience has shown me that until you can get a client stabilized for a period of at least six months, it's almost impossible to diagnose if it is truly mental illness or the phenomenon of the long-term drug use – and the withdrawal from the drug use. A lot of the behavior mimics the other one. The most important thing is to get people stable and that includes treating them as a mental health client – I'm all for that. Treat them as a mental health client if you're not sure, because we aren't sure when they come to us. We don't know what this behavior is, where it's coming from, where it's manifested. So let's treat them all as if they are suffering with mental health related issues. I think that's smart, that's prudent.
What we find in most cases is that both are present. It's just harder to determine when a person has substance abuse issues as well. You have to get them moving towards being abstinent, because if a person is any way, continuing to dibble and dabble with drugs and alcohol, the chances that they're going to be compliant with a mental health regimen is slim to none.
I could make that statement based upon my own experience. I've been in a couple of state mental hospitals – I've been in several. I know that if I'm using, I'm not going to be compliant with my mental health regimen. Medicines don't work over the top of marijuana. They don't work over the top of crack cocaine. I guess it's the proverbial, is it the chicken or the egg? My personal experience shows, treat the substance abuse, and then treat the mental health. You cannot ignore the substance abuse.
It is difficult to convey to the client that there is no quick fix for mental health and substance abuse. Sorry, it may take you a couple years to get stable, to get to the point where you're able to live anything like a productive normal life.
When a new client or patient comes to you, especially uninsured or underinsured, how do you begin to get them into recovery?
I've been at this a long time. My journey was long, full of a lot of stops and starts, I almost wore myself out physically. It's such a long process because in today's arena, clients have the right to be involved in your treatment. I think sometimes clients misunderstand what that means.
It's like going to a cardiologist and telling the cardiologist what I want, or how to do the job.
Clients tend to come to mental health professionals and substance abuse professionals, and have an opinion of what's going on with them, and how they should be treated.
Definitely a catch 22. The main reason people aren't successful in recovering from substance abuse and mental health, of homelessness – the main reason the success rate is so abysmal is that people simply won't do what they're told, they do not follow instructions. They're rebellious, they're of the mindset that they know themselves better than anyone else. Why should I listen to you? They pretty much take the Golden Corral approach. Now I wouldn't eat at Golden Corral if my life depended on it, but it is like when you go to one of those buffet places and you put on your tray what you like or what you enjoy. The solution to homelessness, mental health and substance abuse, is not going to taste good going down. You follow what I'm saying?
How do you get people to take the medicine? I can remember being sick as a child. My mother and grandma were trying to get me to take some medicine that tasted nasty and I was resistant. I acted out, I shook, I cried, I screamed, then when I took the medicine I felt better. It's kind of like that, getting clients off substance abuse to take the medicine and to listen to the suggestions of people who have seen hundreds if not thousands of people just like me – but it is my thinking that I'm unique, and I'm different, and that I require a different set of solutions and an approach that keeps me caught up in a cycle that usually leads back to using again.
With treatment, I think what we're missing are treatment centers designed for people who have substance abuse and serious mental health issues. Treatments have to be designed or oriented towards the person that has those issues. They cannot be put in a treatment setting with people who don't have those issues. That would move the needle some. That would give us a little more success.
Withdrawal from substance abuse mimics mental health issues. We may have legitimate mental health issues too. Our treatment facility programmatically need to be specifically geared toward providing treatment for people with mental health issues.
If you can't afford treatment what are your options? How do you get reasonable, thoughtful, effective treatment?
Well, the thoughtful part is not an issue. All of us who work in treatment are thoughtful, we care and we are passionate about people changing their lives. But when you use the term effective, that's when the red flag comes up, because the majority of the people we're talking about, seek treatment in a community treatment setting. Are you familiar with what I mean by that term?
Nonprofit community organizations have started to do treatment. Their staff may not be as effective or highly trained because of budgetary concerns. Most of these treatment centers are free, if you have Medicaid or something to that effect.
In my opinion, it turns out to be just a long detoxification.
That's not a bad thing because what we know in the recovery community is if we focus on teaching the individual not to drink or use drugs, even if they want to, their chances are greatly improved. They'll be able to stay away from the first drink or the first drug, which gives them a better chance of following through with the mental health regimen being designed for them.
Once a person starts to use they are not going to come to appointments, you're going to be spotty as far as being compliant with a whole bunch of things. But more importantly the group treatment of drug and alcohol use, is not honest enough to work in concert with the therapist or their counselor.
For years I lied to my therapists and counselors every week. You use? You getting high? Nope. You're going to meet the Mrs.? Yeah. That's why I don't have a lot of faith in this data-driven world that we work in today, where they're saying these crazy success rates based upon telephone interviewing after a person leaves some mental health or substance abuse treatment facility.
We used to sit around and laugh about lying people on those followup phone calls. Who is going to admit on a phone call, I've gone back to using. The guilt and shame and the embarrassment is already great as it is.
They're going to have somebody call me from a place and ask me am I still sober? Of course I'm going to say I am.
I don't know if you're familiar with John Oliver, he has a show on HBO. He did a complete show on the rehab industry involving substance abuse, mental health and touched on all those issues. If you watch that show, he will give you a different look of what rehab treatment is like for substance abuse and mental health issues.
There are people like me, where you get committed to a state hospital. That gives you time to stabilize. I remember a doctor telling me – we used to call him patch Adams, he was a young guy, he said, “Mr. Williams, you ain't going nowhere. We got to spin this back. We have to figure out if you’ve been properly diagnosed from the beginning and medicating properly over the years.”
I found out I was misdiagnosed. I'm taking every medication known under the sun, every psychotropic. Years later I take nothing. A lot of what was going on with me was complicated by my substance use, which mimicked mental health issues I was treated for. What I needed was some time to get stable, some time without a drink or drug to be stable.
When that happened I was more willing to be honest with the people who were charged with helping me straighten my life out. I was able to get clear-cut, straightforward answers to what was going on. I'm one of these people I see out there.
I don't think I would be living the life to date and enjoying it if it wasn't for that initial period of being closely monitored by mental health officials or workers, whatever you want to call it.
But what that requires is a willingness to submit and surrender to the fact that you by yourself will not be able to pull yourself out of this.
That's the hardest thing for people with mental health issues. Then you throw in substance abuse. The hardest thing for us to wrap our heads around is that we can't do it ourselves. It's the most difficult decision you have to make. I'm going to have to let these people help me.
But for most of us, it only comes after multiple arrests, going to prison, getting locked up on a regular basis. Living like a reptile. It only comes after all that.
I found success when I got low tech.
We live in a high tech world. The solutions I found to health issues and substance abuse issues are very low tech. Success comes when we finally become willing to do what the fuck we’re told. Sorry. That was the aha moment. After about six years of being clean and sober and living this great life, I have all the things I never thought I would have again. I had this moment where I said to myself, is this all I had to do? That's all I had to do? I mean it was just this simple? Do what they tell you to do? I was mad I threw away a couple of decades because I wasn't willing to do what I was told by mental health professionals. I thought – check this statement out – I knew just as much as they did, or more than they did, about me.
Therein lies the problem. I cannot diagnose or fix myself. That's why I need a mirror in the morning when I get dressed because I can't see myself accurately. I need somebody to tell me what they see in me and my behavior.
We cling together in this mental health, substance abuse, homeless thing, but to get our lives together, we have got to make a conscious decision to leave some people behind. Even if it's very difficult, because we laughed together, we cried together, we've huddled up to keep warm together. We shared our last 50 cents or our last cigarette together. You're telling me I have to leave these people behind to save myself?
It is very difficult. You have to stop living the way you used to live, but you’re fearful of living life. There’s no way of anticipating what it’s going to be like. We live in fear of change, and are already comfortable with the misery we’re living in. My life was the crisis of the moment, if not the crisis of the day, and it would become very comfortable.
Almost all of us will say our lives are boring. That medicine is making me boring, or that medicine is making me feel like I'm stuck in neutral. That medicine doesn't allow me to feel. It was only after I had four, five years being clean and sober that I understood what the medicine did. It kept me from swinging to the extremes. Extreme faded, extreme depressed, it gave me a better chance of managing the impulses to use drugs and alcohol.
But I didn't go to Harvard so people don't tend to listen to me, because I ain't got a whole bunch of data driven stuff to back this up. I only have my experience, and the experience of other people who have recovered. We don't do studies in research. We see it in people's faces. We know that they were as bad or worse than us, and we see them, they're beaming. Good life, healthy jobs, apartments, cars, houses, marriages, kids, and have been maintaining it for years.
This idea of not being able to help someone suffering with addiction until they’re ready for it goes against our instincts, I think. People will always try to help the people they love.
There's some truth in that. There's an old saying, you can take a horse to water, but you can't make them drink.
That is true, and that's what people mean when they say you can't make them get clean.
But see, my job, and our job as allies to the people who are suffering, is to make them thirsty.
You don't have to make them drink, you have to make them thirsty as hell, so they feel like drinking. They know where the water is. I understand you can't make them do it. That is indeed correct. But you make the ring so small people can't run. That's our job as loved ones and allies.
Our job is to stop enabling and let them experience what they need to experience to become willing to make the change themselves. Otherwise it won't work. People have to learn how to stop – and I understand people may die, but they have a right to die. They can choose life or they can choose death. Here's your choice as an ally or a loved one, you can help them plan for a better future, or you could plan a funeral. When we continue to enable them, make life soft and make soft landings for them, we're helping them plan a funeral. I speed up the timeline theoretically, where that person gets to the part where he says, you know what? I don't want to do this anymore. And that's the only true organic reason that works where people get clean and sober and seek mental health treatment.
The more you tell an addict, especially a person suffering from mental health and addiction, they need to do something, the more you tell them they need some help, or the more you try to force them into help, the more resistant they're going to be – they're going to comply so they don't lose the roof over their head or their mom's support, so mom doesn't stop paying the iPhone bill. But the heart's not going to, I see it every day at work.
It does a disservice as a society to be sending people to drug treatment at 15, 14 18, 19 years old repeatedly. I recently had a 19 year old, loved him to death. Great kid. I didn't see what all the ring and row was about. I was pretty much like, leave him alone and let him figure life out. When we were 18 ain't none of us knew what we wanted to do. But the kid's been to treatment seven times already. The danger in that is, if it ever comes to a point that he seriously thinks and believes he needs to do something, he's going to be burnt out on the treatment process.
Why don't we save it until they express they're ready? Let's put things in place to minimize the damage to family and loved ones and let them seek help when they're ready to seek help. You cannot force them into recovery. It does not sustain. And that's why the quote unquote relapse rate is so horrific. I don't believe in using that term. It will not stick and hold until they're doing it because it's what they wanted to. I think that's where we go wrong.
A whole industry has sprung up around the fear that parents feel for losing their child, or people feel for losing a loved one. That's what John Oliver is talking about in that particular program. People getting in and being mercenary about it. In terms of the money being made.
The fear is that I got to get my person into treatment. That person may not be ready or even seeking treatment. He'll go, please you, or to keep their job. And don't get me wrong. Sometimes it works. Sometimes I'm not going to say it never works, but in most cases it doesn't.
Everything is driven by big pharma.
The profit motive with more and more States allowing Medicaid to pay for treatment, both mental health and substance abuse, a whole bunch of industries have sprung up.
Let me give you one as an example. The transportation industry for Medicaid clients who go to treatment, mental health, substance abuse is a booming profitable field. A Medicaid client gets a ride to and from treatment every day. I don't care if they come in 80 miles. I've had some clients come from as far away as 90 miles every day to treatment. The outpatient treatment.
Medicaid pays for their cab to and fro. It's where the business opportunity has come in not feeding directly from the Medicaid process, but from associated or affiliate or ally industries. So everybody's making money but boots on the ground. I'm not impressed or enthusiastic about the number of people who are improving their lives and saving their lives.
People say Wendell, how can you say that? It is on the CDC website. If you look at emergency room visits and drug overdose, in 2017, 76,000 people died of drug overdose for that last reporting period. And in this opinion of the center for disease control, they are looking for eight to twelve percent increase in the next reporting year, which will be 2018.
What should that tell us? You know politicians use that term. The country's headed in the right direction or the countries headed in the wrong direction. I think people care about these issues should be looking at those hard nose statistics at the CDC. That gives you some microscopic view of if we get in the right direction in helping people deal with these issues. Think that's enough. But I don't know if that's any help to you. That's my opinion. And it's not precise to any mathematical degree.
I usually tell people it's all my opinion based on my experience and the experience of other people like me who have recovered.
I really appreciate your time and openness. Thank you.
We need more opportunities to share our truth.