“I had no idea this type of help was available.” These were the words that rang in my ears throughout the night and into the early morning, as I counted the hours for the sun to appear. Asmine*, a forty-two year old woman recovered in a coordinated effort between Seattle Police Department’s Vice Squad and Seattle’s anti-trafficking agencies, agreed to go to detox. She handed me her stash-bag, full of drug paraphernalia, and whispered, “I’m ready this time.” Her eyes were gracious and hopeful. She picked out a room at REST’s temporarily opened Emergency Receiving Center, saying she’d never seen a place like it before. “It’s the nicest shelter I’ve ever been at.”
Asmine is homeless and addicted to Heroin.
Asmine is homeless and addicted to Heroin. She thought she’d be able to make it through the night, because she had last used just an hour before her arrival. She grabbed some Gatorade and a small amount of food, declining a big meal because she knew she’d get sick. She showered and said she already felt much better. She asked to go out for a cigarette. She told me that she knew she was lucky to have been picked up and offered help that night, instead of put in jail. “Coming down while in jail is horrible. My husband is doing it like that now.” We agree that the availability of an open detox bed is a miracle and may save her life, and that her husband getting clean makes it more likely that she’ll stay clean as well.
I walked her back to her room, asked her if she needed anything, and showed her the Jolly Ranchers in my hand. She took a few and said, “These will help with the coughing.” Her cough, typical for heroin users, keeps her awake throughout the night. The detox process begins with an incessant tickle in the throat, until mucus buildup in the lungs causes pain so intense it feels like drowning. Coughing helps relieve the drowning sensation some, but eventually leads to the user feeling like her lungs are on fire. Heroin acts like a heavy cough suppressant.
“BUT, [PROSTITUTION] IS THE ONLY JOB I’VE EVER HAD TO SURVIVE.”
By the time Asmine got up again, her breathing was labored; she was wheezing and out of breath. We went out for another cigarette. “It’s going to be hard,” she says, looking everywhere except toward my face. “I know that I am ready this time. But, [prostitution] is the only job I’ve ever had to survive.” I nodded, “Asmine, when you’re ready, we can help you find alternative ways to support yourself and meet any other goals you want to work on.” Her eyes met mine, and she smiled. Her smile was timid and full of pain. It was heart breaking.
At 9:15 the next morning, I knocked on her door. She didn’t respond. I knocked again, loudly called her name, reminded her who I was, and let her know she was safe. She asked me to come in. I told her we’d be calling the detox facility in ten minutes, to do her phone screening, and asked if she was ready. She looked exhausted and scared. “I’m ready,” she said. After ten minutes, I returned, and she invited me in. I asked if she wanted to talk for a bit first. She told me that, when she woke up, she thought the whole night was a dream. She could not believe that “a place like this existed for [her].” She asked lots of questions about the detox process, but her pressing concern seemed to be whether or not the facility would really admit her. I asked her permission to sit next to her on her bed. She grabbed my hand and thanked me for making the call. We finished the screening together. Asmine was patient and forthcoming. I admired her strength.
I let her know it was about a ten-minute drive and that I would stay with her throughout the process if she wanted. While driving, she grew more and more anxious. “There’s nothing that can happen now, right? They will for sure give me a bed?” she asked. I let her know that everything was set and reminded her of what she’d said the night before: “You’re ready.” I asked if she preferred the quiet, or the radio. She said the radio would help, and her favorite station came on. “The 90’s had the best music, don’t you think?” she asked, as TLC’s “Don’t Go Chasing Waterfalls” played in the background. She knew every word. I wondered if, and hoped that, the song took her back to a happier time in her life.
Once at the facility, we completed the remaining paperwork. The nurse told Asmine she wouldn’t be able to have her phone, or smoke cigarettes while in detox. Asmine asked if we could go outside to smoke one last time. As we walked outside together, she continued to share parts of her story. She said she was afraid and didn’t know how to handle the ensuing grief. “I know I need to stop, but why do I feel like I’m grieving?,” she asked.
“Well, Asmine, Heroin is a bad boyfriend.”
“Asmine, have you ever been in a really bad relationship? The kind you knew had to end because it was really unhealthy?,” I asked. With tears rolling down her cheeks, she looked at me and said, “Oh, yeah. Definitely.” “And even though you knew you had to get out of that relationship, there were parts of you that didn’t want to let it go?,” I paused to make sure she was following. “And even after it was over, there were times when it felt like it would have been easier to go back than to deal with the pain of leaving?,” I continued. “How do you know all of that?,” she asked. “And even when you started to feel better, he’d call or you’d see something that reminded you of him, and you’d be tempted to think, ‘Maybe I could go back and things would be different?,’” I said slowly. I could tell by her reaction she was hanging on every word. “Well, Asmine, Heroin is a bad boyfriend,” I stated emphatically. She looked at me with a new sense of commitment and said, “Wow, I never thought of it that way, but you’re right.” I repeated it again: “Heroin is a bad boyfriend.”
She said she’d definitely remember my words and it really helped thinking about it in those terms. I asked her what things had helped her stay committed to the bad-boyfriend-breakup in the past. Without pause she said, “I made a list of everything he took from me.” “What a great strategy!,” I said. I asked if she could make a list of what heroin had taken from her. She agreed that a list would help and added, “I’m going to tape it to my mirror and reread it everyday.”
It was time to go back into the facility. She grabbed my hand and said, “I’m ready.” We walked through the automatic doors and heard the nurse call her name. She hugged me. I told her I was proud of her and that today was marked as the day she decided to take back what drugs had stolen from her. She squeezed me tighter, and I told her I’d call to check on her. She thanked me again and walked down the hallway with the nurse, looking back at me several times before rounding the corner out of sight.
I only had the privilege of knowing Asmine fourteen hours. When I called the detox facility two days later, she was no longer a patient. I never got to know what specific circumstances led her into a life of prostitution and drugs. I didn’t get to know whether she ever had a pimp or trafficker, but I did know Heroin was, at least in part, acting as her pimp now - forcing her to sell the only thing she felt she had, in hopes of bringing in enough money to make him happy. What I can estimate is that, if Asmine entered prostitution at 18 and worked 5 nights a week, conservatively speaking, she had been sold at least 35,000 times. And many of those times have been violent and traumatizing, only furthering her need to numb the pain with drugs and alcohol.
Washington, like much of the United States, has seen an increase in the use and harmful effects of heroin. For over three decades, Washington’s drug-related death rate has been higher than the national average, and it has been rising at an alarming rate, more than doubling in a ten year period. (1) Another study showed Washington State ranks highest in the nation for total percentage of persons addicted to drugs, 9.36 - 13.34%. Despite those shocking numbers, Washington State has only 22 detox facilities with 171 beds. That’s just not enough. These beds are a matter of life and death for our clients. Their access is crucial to restoring hope and bringing lasting change, because Heroin is not only a bad boyfriend, but also one whose breakup comes with years of pain.
Citations
1.UW Alcohol & Drug Abuse Institute, June 2013. URL: http://adai.uw.edu/pubs/InfoBriefs/ADAI-IB-2013-02.pdf