Even I had heard the rumor. I suffer a certain isolation from my co-workers and the clients who forgo acupuncture treatments, first by the things I don't do: facilitate a group required for graduation or by the courts to stay out of jail; carry a one-on-one counseling case load; write letters to Judges, Probation Officers, Parole Officers or Child Protective Services; I don't sign disability papers, bus-pass orders, SSI, General Assistance or Section 8 Housing paper work. And secondly, by the thing I do; which is remain in the acupuncture spaces almost all the time I am at work. All contribute to my isolation. If I do leave, I put up a sign that I will be back in five minutes. The things I don't do mean that people seek me out for acupuncture and tea and to talk but, since acupuncture is not compulsory, they can drop in any time I am scheduled, making staying in or close to my spaces necessary.
While I make it my business, with the help of every counselor, case manager and clerical staff, to meet and orient every new client; any ongoing relationship is contingent upon the client's continued voluntary attendance to acupuncture services. The once a week staff meetings and the acupuncture regulars keep me well informed but, information slips by me. But, even I had heard the rumor: a client was selling.
But, a rumor is just that, a rumor. At the staff meeting, the issue was discussed in abstract since no one came forward to give us a name. Two counselors were saying clients were complaining that things were tense due to "someone" bringing up drug usage in a positive way and then intimating this person was doing even more. At this point there was nothing we could do. A few days later, people were saying someone was selling. The groundskeepers found baggies outside the building. On the streets being a "snitch" can get you hurt or dead. The "no snitching" value is a hard one to counteract but, eventually, a couple of clients trusted the community and staff enough to tell their counselors who was selling, which lead to more people giving up the same name [I will call her "Sue"].
Some staff thought we should call the police, but quickly the consensus was that counteracting the "no snitch" mentality was difficult to begin with but it was doubtful any client would cooperate if we called the police.
First, we would confront her with the info, giving her a chance to own up to it or dispute it and then, if she could not counteract the overwhelming evidence, counsel her out of the program by offering her a referral to a residential program since outpatient did not seem to be working for her. This is an ethical issue and every attempt is made to get failing clients into another program. What she did with that information was her decision, but she would be immediately discharged from the program. It is the right of any client who is dismissed to be given the name and phone number of a patient advocate/ombudsman who would help her take the issue to the hospital authority.
It didn't go that way. She didn't come back for a few days and this is not the kind of thing done over the phone. When she did finally show up, late to a monthly community meeting, she had no idea what was going to happen and neither did we. We were prepared to quietly take her aside and remove her from the program and the next day, call another community meeting and discus the rule about no drugs or alcohol and no selling of drugs, which every client new or returning, agrees to in writing and is clearly stated at the beginning of every monthly community meeting. All program rules are posted in every group room as well.
It turns out the community spontaneously decided to take care of it during the meeting. I am sure she had a bad feeling within a few seconds of arriving. Many people were staring at her as she walked to a seat. You could feel an uncomfortable tension forming. She got a very defensive look on her face. Her body language became edgy. The staff member running the community meeting got it back on track; giving out certificates for attendance and phase movements. We have three phases in the program and at each move the client is awarded with a certificate. It is amazing how important this symbol of recognition is to most clients; often, even to the most jaded of street thugs.
The community meeting got back to normal for a while until we got to the part of the meeting where the Clinical Coordinator takes questions from the clients; which at first where of the usual type: how to get some service such as housing or child care or who to see to get help with court issues. But then, one man stood up, half turned to look at Sue and back at the Clinical Coordinator and said he wanted to know what the program was going to do about someone selling. His anger was palpable. People began to turn and look at Sue who became very agitated and defensive. Before the Clinical Coordinator could address the subject other people began to yell out their anger too.
I am sure the few who bought from her kept quiet, as did many who probably just wanted the whole thing to go away but a small vocal group of clients addressed both the entire staff and Sue with their anger and under it, their fears that these events had jeopardized their sobriety. The first man to broach the subject said, "This is my sobriety you are messing with, this is my life. My last run I overdosed and almost died. I thought I would be safe here." That sentiment was echoed by the other vocal participants. They shared their anger with the staff for not protecting them and with Sue for putting them in jeopardy of using. Eventually, the anger gave way to fear and the difficulty of maintaining sobriety was discussed. The community meeting became a cathartic experience for those who spoke up and as we heard later, as well for those who had not. And, hopefully, it was a learning experience for those who bought drugs and we could only hope, even more so for Sue.
Sue never owned up to selling. She said nothing the whole meeting, but for the people that were able to confront her, the meeting was a step forward and we can only hope for her, too. She had been part of the community. A part that had become like a cancer and the community cut her out. The staff felt this ending was better for everyone than the quietly removing her scenario, although we did give her both referrals. She perhaps learned something. Those that resisted her selling and then finally confronted her learned they can stand up for their sobriety. The "snitch mentality" was defeated.
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