Fast train to homelessness

For anyone experiencing homelessness, moving into housing is a dream come true. But it can become a nightmare for methamphetamine users, especially if they are struggling to quit.

The Homeless and Housing Resource Center produced a video on best practices for transitioning people who use meth into permanent supportive housing like where I live, Fusion Studios in Denver. People who use meth can develop disruptive behaviors when they are “overamping,” experts in the video explain, so it’s important to have a safety plan if that happens. The center also produced a methamphetamine use guide for people who work with homeless drug users.

Homeless meth users moving into housing need to be taught how to survive instances of overamp, according to the panelists in the video. Sometimes a change of scenery such as a walk in nature can help, they said. Avoiding noise and stimuli is critical.

Panelists in the video included Courtney Pladsen, director of clinical and quality improvement, National Health Care for the Homeless Council, Portland, Maine; Kate Gleason-Bachman, clinical and quality improvement nurse manager, National Health Care for the Homeless Council, Philadelphia; Christopher Lee Thomas, training and education manager, Sonoran Prevention Works, Phoenix; Chloe Cekada, director of Freedom Place, Amistad, Portland, Maine, and Jeffrey Jackson, assistant director of housing, Pathways to Housing PA, Philadelphia.

Power tools at all hours

Meth use in homeless housing can be extremely disruptive, the panelists in the video explain. Some people “tech out” and use power tools to build things in their rooms while high on meth. Noise echoes throughout the building at all hours. I have experienced this at Fusion. Management addressed it and this has not occurred at Fusion in a few months.

Other rooms become hangouts for drug users. I have seen this occur, too, especially with the dealers. People come and never go. Dealers flourish on every floor. That means people knocking on their doors at all hours and sometimes even yelling and pleading for the dealer to answer. Some people wake up entire floors carrying on about getting their fix.

The panelists said it’s important for meth users to understand the terms of their lease and how it relates to their use. They should be encouraged to think about how their move into housing might affect their use of the drug, the panelists recommended. They should understand rules about guests, noise, and conflicts with neighbors, they said.

A difficult addiction to treat

According to a presentation during the online seminar, meth users should define their own version of recovery and how to get there. Treatment through such a harm reduction lens does not conflict with sobriety, according to the panel of experts, because a reduction in meth use may lead to cessation of meth use.

Treating meth use is challenging because few FDA-approved medications for it exist. Success has been seen with contingency management approaches, according to the presentation. The concept is simple: People in recovery who provide a clean meth screen are given a chance to win cash and prizes. While such an approach may sound corny, it has been proven effective, according to the presentation.

Panelists said people who use meth should be treated with dignity and compassion. They noted that Americans who drink beer buy it from government regulated breweries that label alcohol content on the packaging. A person who drinks alcohol in the U.S. knows exactly what they’re getting. But meth users are buying a drug filled with dozens of unknown substances that haven’t even been studied. Each experience can be different, according to the presentation. The unregulated drug supply is dangerous, the panelists explained.

Meth users’ rooms are sometimes taken over

The rooms of meth users become ripe for takeovers, where visitors move in and refuse to leave, according to the presentation. Sometimes, a person will abandon their own apartment when this happens, according to the panelists.

When overamping, paranoia can become acute. People who use meth can minimize anxiety by locking their door, closing their curtains, and asking guests to leave, according to the presentation. This isn’t always easy, which is why a step by step plan is needed.

People who use meth often find themselves hosting their homeless friends who use meth. People who live in homeless housing need a plan for getting people to leave when they wear out their welcome, according to the panelists.

Reminding meth users to eat and sleep

Meth users must be encouraged to eat, hydrate and sleep, according to the presentation. Because of the effects of the drug, users often don’t take care of their basic physical needs. This can lead to even greater psychosis, the panelists explained.

Places that house formerly homeless meth users can provide lock boxes on residents’ doors. People who use meth frequently lose their keys. When this occurs, the resident will often try to break into their own apartment, making a great deal of noise and damaging property. With a lock box, a code opens a box containing the key, which is tethered inside the box. This suggestion seems genius and I would love to see my landlord, Colorado Coalition for the Homeless, try it at Fusion.

People who use meth face several roadblocks to quitting the drug, the panelists emphasized. First, its effect on the central nervous system is profound. It floods the brain with dopamine, causing “comedowns’ filled with extreme aggravation and anxiety. Anyone who uses meth should have a safety plan when they intend to stop using it, the panelists said. They won’t be successful if the comedown is so unbearable they decide to use it over and over again.

Homelessness often occurs before meth use

The other problem with meth is that it seems tailor made for people experiencing homelessness. It allows them to be up all night, which is desirable to homeless people for their personal safety and protecting their property. Many homeless people don’t use meth and then become homeless; they become homeless and then start using meth to survive, the panelists explained.

Some people believe that once they become housed, it will be easy to stop using meth. But for most people it’s not, the panelists said. In addition to homelessness contributing to meth use, so do adverse childhood experiences, also known as ACES, according to the presentation. People with high ACES scores are more likely to use meth, studies show. And people who are homeless are more likely to have high ACES scores. So, it’s a double whammy.

The other dilemma permanent supportive housing providers face is the comingling of hardcore meth users with people trying to quit. When management turns a blind eye to obvious drug activity, they are contributing to lawlessness. Dealers flourish. The use of meth becomes normalized for people living in that building. People trying to quit face temptation at every turn.

The panelists admitted they don’t have all the answers yet, and said more research is needed into the intersection of meth use and homelessness.