Please Know...

As I come to know these fine people, they share with me more of their personal and sensitive stories. Their collective story is what I am trying to share with you as my way of breaking the stereotypical beliefs that exist. "Blog names" have occasionally been given to me by the person whose story I am telling. Names are never their actual names and wherever I can do so, I might use the opposite pronoun (his/her, etc.) just to help increase their privacy.


Wednesday, February 24, 2021

Kensington Does Not Have an Opioid Crisis!

Kensington[1] Has a Crisis in its Provision of Health Care to Patients with Substance Use Disorder who are Reliant on Medicaid!

**********

Heroin[2] is an inanimate powder.  It is delivered to the customer in an inanimate little blue wrapper and sometimes in an inanimate little zip lock bag[3].

Let's look at the word:  Inanimate

Definitions include:  not in a physically live state and not active, energetic, or lively

Synonyms include:   Lifeless, dead, non-living, inert, dull, and unresponsive

As an inanimate substance, heroin is incapable of causing a crisis.  It just sits there waiting to be used for its purpose by an animate (living, alive, breathing, conscious) being, in this case, patients with Substance Use Disorder who are homeless[4] on the streets of Kensington. 

We cannot reason with an inanimate substance.  We cannot yell at heroin, scold it, put it in time out nor any such action that will encourage it to change its ways and start to behave.  It's just being itself!

Heroin is incapable of changing its ways and so we must change our ways in response to it.

Nearly 100% of the people on the streets of Kensington dealing with substance use disorder are reliant on the Medicaid system for the financial coverage of their health care.   That one simple fact alone makes it very obvious to any informed observer that this issue is not so much an opioid crisis as it is a crisis in the provision of healthcare to patients of a recognized disease known as substance use disorder.

Solve the Medicaid-related issues and you will greatly reduce the opioid issue.

**********

Here are a few examples in blogs that I've written that show how the Medicaid system has failed these patients with Substance Use Disorder:

Read about the R.N. who told a recently overdosed (and saved by Narcan) patient to"Get out of my emergency room!"

Read about the patient who was desperately seeking detox and needed to be admitted to a medical hospital for an infection.  She was treated for that infection and not treated for her detox-related symptoms.  She signed out AMA.[5]

Read a firsthand account that includes a brilliant summary by a patient who very much wanted detox and healing.

Read about the damage caused when a patient with Substance Use Disorder is not given comfort care in a timely manner - even after admission to a Medicaid level facility.

Read about the "mental rot" experienced by patients of Substance Use Disorder, as they sit in a jail cell, described as an "oversized toilet stall with cots."

Read a story that compares Medicaid provision of health care for patients with Substance Use Disorder with private insurance doing the same.

These true accounts of life in the world of Medicaid level health care provision for the patient with Substance Use Disorder make it very clear that we must change how we respond to this inanimate substance called heroin.

 **********

In a TED Talk by Johann Hari, he concludes with "The Opposite of addiction is not sobriety.  It is connection."  

Herein lies the key to ending Kensington's health care PROVISION crisis that has for so long been mislabeled as an opioid crisis.

**********

I recently asked members of a Facebook group whose members have been directly affected by this issue for their thoughts on all of this.  Here's a snapshot of their responses:



Notice that the three highest vote items all involve how  professionals who have dedicated their careers to the ideals of Hippocrates have failed within the realm of Medicaid to provide needed and very much wanted services.

**********

We must do better…

The inanimate 'opioid crisis' cannot be won because it does not exist. 

The true crisis is very much within the animate world of health care provision to Medicaid reliant and street-bound patients with Substance use Disorder and can be won.

To that end, I propose the following as described in this recent blog.

                                  

 





[1] The situation at hand goes far beyond the geography of Kensington.  For the sake of discussion, I focus on this amazing community.

[2] And it's mystery additives

[3] Originally meant to hold buttons for high-priced suits and dresses.

[4] Some in subsidized housing

[5] Against Medical Advice and is still on the streets

Sunday, February 21, 2021

If you heal the customer/buyer/patient of Substance Use Disorder, there is no drug market.

From the Philadelphia Inquirer:


Opioid Addiction

Philly City Council members announce new police station, other initiatives in Kensington


When I read this article online today, I knew I needed to respond.  I've done so in this document that I've saved as a PDF file.  I hope you'll take the time to read and consider my thoughts...



Sunday, February 7, 2021

Calming The Storm

On December 31, 2016, I visited the people of the streets of Kensington for the first time.  I have written about that experience here.

On October 1, 2018, I began employment at Recovery Centers of America (RCA) in Devon, Pa. as a driver.

It was in those weeks in October 2018 that the beginnings of a storm front developed in my soul.  The cold air of the Medicaid system of health care for patients of Substance Use Disorder clashed with the warm air of health care for patients of the same exact medically recognized condition who have private insurance.

Allow me to brag a bit about RCA and what a patient with Substance Use Disorder experiences upon arrival…

When a person arrives at RCA, they are greeted by the receptionist at the front door with words similar to:

"Hello (First name).  Welcome to RCA. I'm glad you're here. Would you like water, soda, or a snack?"

They enter a pleasantly decorated reception area and begin the process of registration.  They are offered water, soda, or Gatorade and a snack.  A full dinner prepared by on-location chefs can be made available very quickly to those who need it.  Within a short time of entering and completing the registration process, they are guided to their five-star hotel quality room and the process of detox and healing begins. 

If this patient is already experiencing dope sickness upon arrival, comfort care is made available as soon as possible and to the fullest medical extent possible.  To better understand why this expediency is so critical, please read my blog: "Drug vs Detox: A Civil War in the Mind"

Such is not the case for people on the streets of Kensington.  You can read a comparative blog here that looks at both approaches.

It is time for us to extend the best of the model of health care demonstrated by RCA to the needs of the patients of Substance Use Disorder who are on the streets of Kensington. 

I am envisioning a storefront on Kensington Avenue.

1.  It would be decorated in a warm and welcoming style.

2.   It would not be inside a larger facility.  This welcoming area would be visible from the street.  By entering one door, the patient of Substance Use Disorder would be walking into a welcoming environment to learn more about their options and, if they are ready to do so, an expedited dignity and respect filled entree into detox.

This storefront has large windows through which passersby can see a warmly decorated, well lit and welcoming environment staffed by caring people who are prepared to register anyone who is contemplating detox/rehab services.  Further back in the storefront would be the private offices and exam rooms.

1.       Anyone who is contemplating:  For various reasons, an individual may not be ready to go to detox.  They may be ready to have their contact and insurance information on file for that time when they are ready to go.  This storefront would gather this information and be ready to expedite the patient's entry to a detox facility when the patient decides they are ready.

2.       Partial registrations would be acceptable.  If someone wants to give just their street name and nothing else, so be it.  They would be encouraged to come back any time and keep an eye on the storefront window that will display how many beds are available throughout the system.

3.       Staff on site would make every reasonable effort to greet this person by name whenever they see each other at or near this storefront. 

4.    A staff member would be available outside the storefront chatting with people letting them know what this is all about and building relationships and trust.  

5.    Partnering with the Kensington Storefront and Prevention Point employees/volunteers with their already established community connections would prove very worthwhile. 


As referenced above, staff would know the availability of beds throughout the city and suburbs for patients reliant on Medicaid.  There would be in the window a continuously updated bed availability sign.  Bed availability would already be a known factor.

1.       Philadelphia based Medicaid and that of the suburbs require two different processes for admission to detox.  The staff of this storefront would understand these differences and provide services accordingly.  It would not be a requirement of a Philadelphia based Medicaid patient to go to a crisis center for this process.  This storefront would meet this requirement.

2.       One of the delays for a Medicaid reliant patient in a crisis center is the process of that center's staff calling around to find a bed.  This can take many hours.  Having a system in place where bed availability is a known factor would greatly reduce this waiting time and eliminate experiences as related to me in this blog.

3.       Patients with private insurance would enter the private insurance health care system.  

An expedited registration system would be in place so that a person can be evaluated.  

1.       If there are no additional medical conditions to be dealt with prior to admission to the detox facility, the person would be registered and taken by designated car service to the facility that will be detoxing the patient.  Every reasonable effort will be prearranged with local facilities to streamline the "warm handoff" process between the storefront and the facility, therefore, greatly reducing the wait time between initial intake and the first steps of detox care.

2.       If the patient needs medical evaluation, they will be taken by this same car service to a hospital that has agreed to take these patients and WILL treat them with dignity and respect.[1] 

3.       If at all possible, the driver will wait with the patient and transport them to the awaiting detox facility upon medical clearance.  There would be no need to come back to the storefront.

4.       If the patient needs to be admitted, this hospital WILL assure (through prior established agreement) that comfort care for all detox/dope sickness related symptoms are promptly and completely addressed to the fullest extent medically possible simultaneous with medical interventions specifically associated with the direct reason for admission.  Here is a blog that looks at this issue of treating the primary reason for hospital admission and not treating symptoms of dope sickness.  It is titled "Damaged Determination."

5.      In the event that this patient needs a multiday admission, representatives from this storefront will call and/or visit the patient each day to offer encouragement and address any issues that the person identifies - therefore serving as their advocate during this time of medical provision prior to entry into an actual detox facility.  All clearances related to HIPPA will be appropriately addressed so as to assure that this storefront representative can freely discuss the patient's situation with representatives of the hospital.


Patients of Substance Use Disorder who are reliant on Medicaid for their detox/rehab needs are incredibly underserved, neglected and, on occasion, verbally abused by a system of health care staffed by professionals who had dedicated their careers to the ideals of Hippocrates.  It is WAY past time for us who love these street bound patients of Substance Use Disorder to identify new ways to serve them and save their lives.  In so doing, we will greatly reduce[2] suffering and the tragedy of overdose, reunite families, and slow the increase in the population of orphans created by this ongoing tragedy.

Calming the storm of the clash of the warm air of private insurance with the cold air of Medicaid is a very viable way to bring further healing to this population of people who have a great desire for healing and no significant professional support for achieving it.

Let us fine-tune and further develop this proposal and make it happen!



[1] Episcopal Hospital has such a bad reputation among this population of people that arranging with some other hospital would prove adventitious.

[2] Sadly, never totally eliminate

Tuesday, January 19, 2021

The people on the streets of Kensington are not nor have they ever been nor will they ever be 'zombies.' The people on the streets of Kensington are inspirational human beings made in the image of God and are worthy of dignity, honor, respect and love.

Our dear friends on the streets of Kensington endure many inappropriate and derogatory titles from people who know no better and take no time to better understand what's going on in that person's world.  I won't repeat any of these titles here with the exception of the one I'd like to address in this blog:

 Zombie

According to Wikipedia, A zombie is a mythical dead person who has returned to life as a walking corpse. Mythical things that have been "re-animated" are called undead, and a group of them can be called the living dead. The Zombie myth came from the Caribbean.

To the stigma focused eye of a person traveling down Kensington Avenue, the men and women of the streets might seem to be zombie-like with their mannerisms and behaviors.  "Dipping" is not the behavior of a zombie.  It is the evidence of being high in an addiction, (more properly known as Substance Use Disorder), that has no easy way of escape.

Incoherence to the world around them, wobbling rather than walking, laying on the sidewalk in all kinds of obviously uncomfortable positions, uncontrollable drooling,…  These are some of the outward behaviors that lead the stigma focused onlooker to refer to these men and women as "zombies." Without getting out of the car to actually meet one of these people, the idea of them being "zombies" will only continue. 

By taking the time to step out of your car and comfort zone and talk to one of these people, you will discover that the person of your displeasure is actually a real person who had a real childhood and who lives in their adulthood with hopes, feelings, and dreams for the future.

Rather than explain this point further, allow me to reintroduce you to "Melanie."  In this blog written on July 27, 2018, you will see misconstrued behaviors of a 'zombie.'  Look closer.  Read about her embarrassment in front of 'Dad,' her desire to dress beautifully, her love of McDonald's and chocolate milkshakes, and having her hair brushed while watching Saturday morning cartoons. 

"Melanie" represents hundreds of other people on the streets of Kensington who are not nor have ever been nor will ever be 'zombies.'

"Melanie" represents hundreds of other people on the streets of Kensington who are inspirational human beings made in the image of God and who are worthy of dignity, honor, respect, and love.

P.S.:  With the judicial system and the Medicaid level medical system having failed her miserably, Melanie remains on the streets 2.5 years after I wrote the blog titled:  "Before The demon Came Calling….

Saturday, January 9, 2021

Where were these people in 4th grade.?

I wasn't going to say anything about this incident. But I see a lesson in this...

Last Sunday (January 3, 2021) I had a wonderful conversation with a man of Hispanic descent who was in his mid-thirties I would guess. The conversation was only a couple of minutes and during that time he shared briefly how he's been a very committed Christian as long as he could remember. We agreed that made us brothers in Christ. We gave each other a little fist bump and off he went walking around the corner and out of sight. 

A very few minutes after that inspiring conversation, a group of men I would guess also in their thirties was walking down the sidewalk passing my car as I parked at Kensington And Somerset.  A group such as this is rather unusual to see at this location.  One of the men toward the front of this group started giving me a difficult time about how I bring bananas. His conversation was verbally abusive and I was picking up the vibe that this might be turning physical. I looked at a couple people who I know and simply said I think it's time for me to leave. 

As I was closing the trunk of my car with my back turned to this man I heard a loud thud. No... It was more of a pop...  No.  It was more of a...  Well, maybe these graphic words from the vintage Batman and Robin series can clarify what I heard behind me...

I turned around and saw my new Hispanic friend holding what looked like a baseball bat-shaped board and he had just given this guy who was harassing me a tough crack against his upper back. The man had fallen part way and was starting to get up when my Hispanic brother in Christ gave him another crack across his back.  I could not help but notice might and determination to defend me on his face and not anger, rage, or anything similar.

The guy went down again and immediately ran away. I knew it was time for me to leave and I got in the car. 

I came back an hour later and people who had seen this and know me from what I do told me that the man who had harassed me "got the s*** beat out of him for disrespecting" me. 

My immediate thought and perhaps this is somewhat selfish was:

Where were these people who defended me today when I was in fourth grade and getting beat up on a regular basis on the playground at Concord Elementary School? 

More simply stated:  Where were these people in their 4th grade? 

It's a question that gave me pause as I reflected on the various stories I've heard of the childhoods of so many of these men and women who now call the streets of Kensington home:

  • His life was perfect until 10th grade when an injury on the baseball field led to months of surgery and opioid-based painkillers to manage the physical agony of that time in his life. 
  • Her life was pure hell from day one and in fourth grade, her uncles started "playing with" her in ways that no uncles should ever play with their nieces. 
  • He watched his mother and her father die in their addiction and he knew (inaccurately) that he had little choice but to follow in their footsteps. 
  • Her perfect life found an emotional pain killer in a little blue packet in the days after her husband and children died in a fiery crash.
  • And more...

Their stories are factual and inconceivably painful. 

One thing is certain. 

None of the hundreds of people who at this moment call the streets of Kensington 'home', when they were in fourth grade, had in their plan of things to become in life that of a street bound adult trapped in active substance use as part of their Substance Use Disorder

Where were these people in 4th grade? 

Sunday, January 3, 2021

Thank You for Praying for Us.

I had prayed and asked my friends on Facebook to pray that I would find specific people who live on the streets of Kensington and with whom I try to keep in close communication.  I drove to a common corner, an intersection of two main streets, to find one who is from Delaware County. 

Not there… I drove up one street, looped around, drove down that same street several blocks past the original point, looped around again and came back one block short of the common corner where I felt certain I'd find her. 

Even though she was fully dressed for the winter cold and had her back to me, a tiny tuft of her curly hair with its uncommon shade announced her identify as would any "Hello, my name is…" sticker worn at so many social gatherings.

"Hi, Melanie,"  I called out as she stood on what I presume is her favorite corner when looking for a date.  I'm permitted a bit to presume this.  After all, it was on this corner where she took me on Friday, July 27, 2018 and I told you about in a blog titled  Before The demon Came Calling... (The section of that blog that speaks specifically of this street starts out with: After dinner, as we drove, Melanie asked me to pull over on a side street…)

Today, as I parked my car on that same side street, I noticed that she was in no rush to greet me further.  When I gingerly approached her, she looked sad and sick.  Sniffles and her general appearance told me and she confirmed that she was fully dope sick and standing there trying to find a 'date' so as to fund her next injection of 'heroin' which is hardly heroin at all these days.

We chatted only for a bit.  Before we parted, she was the first of this day to receive a care package that had been donated to me very recently by one of my former high school classmates years ago.  This care package, and about 50 others, have been or will be distributed one by one in the very near future. 

Melanie also told me that she needed a new pair of boots because the ones she had on were just about worn out.  I still had a pair of boots in my car that had been given to me by a now-retired administrator at my former college - Eastern University.  They fit her almost perfectly.

As we parted, Melanie reached out for a hug and did not let go for a while… And so, there I was… To the unknowing eye and stigma thinking brain of an out of town observer, I was hugging an addict, a prostitute, and I won't even utter the additionally derogatory terms often associated with women in her situation.

But no!

To anyone who has taken the time to get to know Melanie, you will know that I was hugging an orphaned former Delaware County resident who knows of Aston, Chichester and Glen Mills, Concord Road, Saint John's Episcopal Church, Elam United Methodist Church and all point in between and around.

Melanie is not any of the derogatory titles often applied to a person in such a situation.  Melanie is not even part of "them" or "they."  Melanie and the hundreds she represents on the streets of Kensington are no less than an extension of "us" and "we" and have every right to receive all of the dignities associated with such a classification.

Thank you for praying for Us. 

Friday, January 1, 2021

Her nearly lifeless underweight and naturally petite body drifted down the steps of the Somerset El stop.

Her nearly lifeless underweight and naturally petite body drifted down the steps of the Somerset El stop[1] as street bound soles continued in their street bound life, mass transit commuters dashed to their destinations and two of Philadelphia's Finest in blue stood by as crowd control. 

I held in my arms this bluing childhood resident of Philadelphia's suburbs and now of Kensington's streets as she drifted further toward death and down the steps at the same time.  I was doing what I could to keep her head from bouncing down each step as she drifted.  With two Narcan given and no breaths detected, I provided the slightest of mouth to mouth resuscitations - only the third time in over 20+ years of medical work that I've needed to do so.

"'First Name', don't do this to your children!"  I pleaded into her ear as I held back my own tears in needing to stay focused on my friend and overdosing medical patient of Substance Use Disorder laying all but lifeless in my arms. 

By the grace of God and the stunning miraculous nature of Narcan, she regained consciousness.  In a state of disorientation, she walked to an awaiting ambulance stretcher, was taken by that ambulance with its blaring lights and sirens to the local denominationally named hospital[2] and, within minutes of arrival, was told by the on duty Registered Nurse to "Get out of my emergency room!"

**********

In my blog "Damaged Determination," I shared with you the situation that "Rose" experienced and the poor medical provision she received by a Philadelphia hospital that treated her medical infection and not her detox/withdraw symptoms of dope sickness.  The understandable end result was that she left AMA[3] so as to find her own healing from the $5.00 contents of a little blue bag of heroin.

**********

In my blog "Drug vs Detox: A Civil War in the Mind," I shared with you the determination of one of my loved ones who was laser focused on being done with heroin - a determination that ended when the detox facility could not provide prompt comfort care during detox to her: their patient who they had beautifully accepted into their care only hours before.

**********

These are three examples of failures of the Medicaid funded medical provision process offered to patients of Substance Use Disorder who are residents of the streets of Kensington.  These three people sought care either through a near death experience or through arriving at that moment of 'being ready' or finding 'rock bottom' that we often hear about as being a required destination prior to detox. 

These three…

No…      

Wait… 

It's time that I share with you a bit of insider information… 

These three factual accounts of what I witnessed firsthand involve not three but two very real people[4]  Two people who I still see and love and hug as they remain actively using their 'medicine'

With that thought in mind of three actually being two, imagine being the one person who is described two times in these three factual accounts of what they experienced as a Medicaid reliant patient of Substance Use Disorder! 

From their perspective, life is much less of a nightmare to continue with fundraising and injecting than it is to seek medical help from a medical provider for their medical diagnosis that is clearly described as such and labeled Substance Use Disorder in the DSM-5.

**********

If you have lost a loved one to overdose and that loved one was reliant on Medicaid for their health care funding, first of all, I'm very sorry for your loss…

Secondly, please know that at some point in your loved one's life on the streets, they probably sought healing.  They most likely found the process of getting to that healing so absurd that they gave up or actually overdosed in the midst of taking their medicine while jumping through the Medicaid required hoops and gross incompetency's on their desired way toward healing.

Let's boil this down further…

When your loved one transitioned by way of overdose from this world to their next, overdose did claim them in that moment.  Medicaid funded health care incompetency's set the stage for that moment.

It is way past time for any and all of us who care about this issue to work together in whatever role we play in society so as to make the changes that are needed.  In so doing, we will save the lives of our Moms and Dads, Brothers and Sisters, and all other manners of relationship from this barbaric and incompetent Medicaid system that has completely flushed the ideals of Hippocrates upon which it is absolutely intended to be fitted upon its firm foundation.



[1] https://www.google.com/maps/@39.9913207,-75.1228445,3a,25.2y,289.65h,88.48t/data=!3m6!1e1!3m4!1s3lwJFv-DKrPelbXW1B7sGQ!2e0!7i16384!8i8192?hl=en

[2] Which is THE hospital in THE bulls eye of THE heroin crisis for THE entire east coast of THE United States of America.  You would think that emergency nursing staff in such a setting could be more professional than this but such was not the case.

[3] Against Medical Advice

[4] As I write my blogs, I often mix pronouns (he/she) and names so as to add anonymity for their privacy.

Monday, December 28, 2020

Drug vs Detox: A Civil War in the Mind

With lazar focus and his eyes on detox, rehab, and reclaiming the joys of pre-substance use life, he called me at 6:00am.  We developed a plan for me to pick him up and take him to a specific detox facility.  The people there are wonderful.  They care like no others I've encountered in other Medicaid level health care facilities. In a perfectly reasonable time frame, he was greeted, interviewed, given a basic medical exam, and offered a detox bed right then and there.  Each step along the way was awash in dignity and respect for this child of God.  I was thoroughly impressed![1]

There was one minor medical issue that needed further review and so we went to the nearest emergency room.  The R.N. at the detox assured us that this issue was nothing that would prevent this young man from coming back for the beginnings of his detox experience. 

The hospital staff was great.  Within a couple hours, we were heading back to the detox facility.  Final admissions paperwork was completed and within a few minutes this young man, still laser-focused on detox, ascended the steps at 6:00pm for the beginnings of his whole new life.

At 9:00am the following morning, this laser-focused child of God called me from his cell phone.  I knew right away what he was going to say.  

"I left and am already home." 

He told me that he was given no comfort care through the night as his fears and feelings of dope sickness[2] were growing and so he had to leave to find his own 'medicine' and bring comfort back to his being. 

***** 

This issue of signing out of detox or even the intake process itself is an all too common issue that is literally leading to the deaths of thousands of people each year.  

Why? 

The human brain in that moment of decision for detox is in something resembling a civil war.  One side[3] of the brain wants healing while the other side wants drug.  Each side of the brain has its own artillery to fight this battle in the brain.  

The side of the person's brain that wants detox and healing has the determination of the person with that brain and the expertise of medical professionals who have committed their careers to the ideals of Hippocrates.  

The side of the person's brain that wants the drug has knowledge of the extended orgasmic nature of a "good high" and knowledge of how unpleasant and painful dope sickness can be. 

While this person waits for hours during the intake process or for hours through the night for the doctor to return the next morning so as to prescribe suitable comfort care medications, thoughts of that "good high" which will bring relief from growing dope sickness take over.  The civil war in the brain is being won by the side that wants the drug.  Determination for detox is beginning to lose the battle. 

As dope sickness grows and determination for detox fades, the side of the brain seeking the drug reminds the person of the final piece of its artillery that is needed to win this civil war in the mind.[4]  This side of the brain reminds the person that they can leave the facility and for only $5.00 they can buy a blue packet and inject its contents.  The "good high" will be found and even if the high is not all that "good," this injection will end dope sickness for the time being.  That's all that matters in this civil war of the mind. 

Sometimes pictures help us understand the issue. 

Here are pictures[5] of three facilities within Philadelphia that provide Medicaid level health care to patients of Substance Use Disorder who are seeking detox: 

Gaudenzia: 

Kirkbride: 

The Net: 


These buildings house all of the medical wherewithal and employ the medical personnel who have committed their careers to the ideals of Hippocrates that is needed to provide detox and rehab.  These great buildings and those who work within are up against a mighty enemy: 

The Little Blue Packet:  

Barely the size of a couple of pennies placed side by side, these little blue packets contain within them all the artillery that is needed to win the battle of the mind in favor of the drug. When the medical professionals[6] fail to provide prompt and dignified care to that patient with Substance Use Disorder who has come to them for detox and rehab they allow the little blue packet to win the battle.[7] 

It is way past time for the medical professionals and all persons in positions of policymaking to put their minds together to further develop their artillery.  

Little blue packets are the artillery for continuing addiction in this civil war.  Little blue packets can't think on their own.  All they have to offer is their presence on the battlefield of this mental civil war.      

Medical professionals are the artillery to interrupt addiction in this civil war.  Medical professionals can think on their own.  Medical professionals can determine to strengthen their artillery and in so doing help their patients of Substance Use Disorder win this civil war of their mind and find healing.                                                                                                                                           



[1] Please contact me privately if you'd like to know exactly where we went.

[2] Symptoms of dope sickness – and their intensity – can vary by person, the drug of choice, and the amount of drugs used on a regular basis. However, common signs of dope sickness include Nausea, vomiting, diarrhea and/or constipation, Loss of appetite/huge return of appetite, Hot and cold flashes, muscle aches and spasms, The sensation of bugs crawling on or under the skin, Hyper-awareness, Dry mouth, Headaches, Insomnia, and Sweating.  These physical effects are often accompanied by mental and emotional symptoms. Those who are dope sick may also experience: Agitation, Anxiety, Paranoia, Frustration, Depression, Despondency 

[3] Not literally 'side' as in right vs. left.

[4] and end all prospects for detox on this day and maybe forever if an overdose is found first

[5] From Google Maps Street View

[6] who have committed themselves to the ideals of Hippocrates

[7] And the war if an overdose is found before determination for detox is found again

Monday, December 21, 2020

Substance Use Disorder is a disease process like no other. It does not fit neatly inside a box labeled "Diseases people can get."

When a person has a cold[1], that person has symptoms of that disease process.  That person will probably take some medicine that will reduce or completely wipe out whatever is going on inside them.  The cold gets neutralized in some way by the medicine and the person feels better. 

Almost always, the person is instructed to take their medicine once every four hours.  If they don't follow the instructions to take their medicine this way, the cold starts to take over again and those horrible symptoms come back making the patient feel crappy.  The virus that is causing the cold is present in the body of the patient and the medicine alleviates the discomfort and eventually evicts or kills the virus.  The absence of medicine allows the virus to build back up and continue creating symptoms.  

Substance Use Disorder is similar and yet completely backward from this model of disease.  In the absence of their 'medicine,' the person dealing with Substance Use Disorder will have horrible symptoms.  They take their 'medicine' approximately every four hours (at a minimum) so as to avoid these symptoms.  In this sense, Substance Use Disorder has the characteristics of a cold.

The presence of Substance Use Disorder in a person is not the same as the presence of a virus that causes a cold.  There is no virus that causes Substance Use Disorder and yet to not take one's 'medicine' is to, without exception, invite withdraw symptoms to come back and create discomfort beyond the wildest imaginations of those of us who have never experienced them.

With Substance Use Disorder, it is not the presence of the virus that causes the discomfort that is eliminated by the consumption of the medicine.

With Substance Use Disorder, it is the absence of the medicine that causes the discomfort that is eliminated by the consumption of the medicine.

But wait…

Maybe, just maybe…  

Is it possible that the "virus" does exist but not within the standard definition of virus[2]?  Could it be that the "virus" in the Substance Use Disorder patient IS:

  • the generational continuance that is often seen
  • the agony to the soul created by that family member who knew this patient in their childhood in a way that no adult should ever know a child?
  • the family tragedy that pushed this person to find an emotional pain killer.
  • Etc…

If we as a larger society could begin to see the consumption of their 'medicine' by the person with Substance Use Disorder as exactly that - consuming their medicine so as to eliminate the symptoms of their virus - and stop adding stigma, then maybe, just maybe we could open our hearts, honor our Hippocratic Oaths and find the solutions to eliminate this outside the box virus from the patient and bring healing once and for all.

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For the record, I am not a medical expert by any means.  This blog is my humble interpretation of observations I've made during my few years of serving to the best of my ability on the streets of Kensington (a community in Philadelphia, Pennsylvania).



[1] a viral infection of the nose, throat, and bronchial tubes, characterized by sneezing, nasal congestion, coughing, and headaches

[2] a submicroscopic parasitic particle of a nucleic acid surrounded by a protein that can only replicate within a host cell. Viruses are not considered to be independent living organisms.

Thursday, December 17, 2020

Melanie Walking Alone and Looking Lonely

In the past few weeks, as I was driving down a particular street in Kensington in my luxury vehicle provided by Recovery Centers of America where I am employed as a driver, I was about to pick up a person who has private insurance and wanted to be done with his Substance Use Disorder issues. 

As I was driving, I saw Melanie walking alone and looking lonely.  I so much wanted to stop and spend a bit of time with her to let her know she's loved and cared for.  The only thing that stopped me was the lack of parking and the long line of cars already stacked up behind me. 

And so, I drove on to meet this person who had called 1-800-RECOVERY a few hours earlier, had his[1] insurance cleared and scheduled a time to be picked up at an address of his choosing.  As I did so, I thought about Melanie:

  • the times we had chatted on these same streets and under bridges and in my car as we dined at McDonald's
  • as we sat side by side in the visitor's area at the woman's jail while she, as a patient of Substance Use Disorder, sat next to me in her one-piece orange jumpsuit as a prisoner of the city and developed a plan for her future.
  • the time I spoke under oath on her behalf at one of her court sessions
  • and more.

When I arrived at the address that this new (potential) RCA patient had requested for pickup, we saw each other.  He looked at me and stated that since it was "Banana Man" picking him up, he would go even though he was hesitant to do so.[2]  And so, off we went toward RCA and the high-quality care that comes with private insurance detox and rehab.

As I write this blog, this private insurance patient of Substance Use Disorder has gone through the process of rediscovering life on a healthy path.  Melanie, also a patient of Substance Use Disorder but reliant on Medicaid for her detox and rehab is trying to be found on the streets of Kensington by her caseworker who has some exciting news...


[1] As a way of further adding anonymity and privacy in my blogs, pronouns (his/her, etc.) are very often switched up.  This story, while very real, may or may not be about a man who I brought to RCA.

[2] Our paths had crossed only a bit at some point in the past.  This person was not one of my "regulars" but I did recognize him as having seen him before.

Monday, December 14, 2020

43 Minutes

In my blog Song Sheets and Pop-Top Lids…, I shared with you the results of resources given to me to benefit the people of Kensington.  This theme continued yesterday (Sunday, December 13, 2020) partly involving these exact items and also the gifts of prepared dinners that I witnessed being distributed by an outreach group.

I had parked my car at the corner of Kensington and Somerset, pulled my cooler with its water, bananas, song sheets, and several items from the food cupboard out of my trunk.  As I strolled down "The Ave" as it's called, I walked past a pickup truck.  The back hatch was down and being used as a table as several people were distributing premade hot meals in black bowls with tight-fitting lids.  I continued to visit the people along that block that includes Martin's Deli (home of the best bacon cheeseburger I've ever had) and eventually made my way back to my Nisan Altima.  I sat on the back bumper with the trunk opened and that's when it happened…

A man, perhaps in his forties, walked up to me and opened his paper bag so I could give him two bottles of water at his request.  He showed me the two black bowled chicken, rice, and corn dinners that were at the bottom of that brown paper bag.  He then said this with a tear of thankfulness running down his cheek… 

                        "My son and I will be able to have Sunday dinner together today."


As I sit here writing this blog, from my desk, I'm looking out my living room window.  In front of me is the Concordville Inn and a sign that references their "Sunday Brunch."  Sunday brunch at the Concordville Inn is a glamorous experience with the fanciest of all possible breakfast (and more) related items. 



The Concordville Inn's Sunday brunch is a common post-church destination for many of the suburban faithful here in the Glen Mills area.  After attending church those who can afford the prices of this lunch occasionally make their way to this feast.

Why do I tell you about the Concordville Inn's Sunday Brunch and the tearful man with the two chicken dinners who is happy to know that he and his son will be able to have dinner together on this one day?

Here's why…

This morning, our drive from one point to the other is 43 minutes and a psychological world away… 



It's high time that those of us in the suburbs recognize that the mission field, the land of hunger and suffering is not far away.  Kensington is a community of homeless Substance Use Disorder patients AND deeply impoverished homeowners/renters AND blessings beyond your wildest imagination.  I invite you to consider making the drive to meet the people who - I guarantee you - will awaken your heart for the anguish of the suffering forever.

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For further reading on this topic of outreach, I invite you to read my recent blog: 

Start Right Here In The Name of Jesus