Monday, December 06, 2010

The Home For Old Atomizers

Bob Shaw wrote an interesting article today in the St. Paul Pioneer Press about a government partnership with Catholic Charities to provide a place for homeless drunks to live. The unique aspect of St. Anthony Residence is that it allows its residents to drink on site. The program doesn't even attempt to stop them.

There, 60 men can — and often do — drink until they die. There are no counselors, no scolding, no 12-step programs, no group hugs.

Basically, these residents are poor souls that have nothing but alcohol. When that is all you have, it must be really annoying to have do-gooders pressuring you to give it up. Marion Hagerman's story is typical:

Hagerman has been drinking for 39 years. He drinks despite decades of lectures, prayers and punishment. He drinks despite two years of homelessness, six DWI convictions, six treatments for alcoholism and 13 months in jail.

What's ahead for Hagerman? The 54-year-old can see only one thing in his future — more drinking.

Of course, there are a whole bunch of Minnesotans that think this program is the worst thing in the world:

Some experts attack places like St. Anthony. "To me, a wet house is nothing more than a house of despair and death," said William C. Moyers, vice president of foundation relations for Hazelden treatment centers.

It sounds to me like Big Treatment feels threatened by an alternative that's proving to be a cost efficient use of government resources.

It's not uncommon for a homeless alcoholic to cost the public more than $1 million during decades of drinking — for multiple jail stays, emergency room visits, rounds of alcoholism treatment and other costs. But the costs and the suffering are greatly reduced once they arrive at St. Anthony.

The cost is estimated at $18,000 per person per year. The residence gives them a clean and warm place to sleep and a place to drink. Most residents resent the traditional treatment regimen:

They arrive as refugees of countless anti-drinking treatments. "Treatment is a bunch of B.S.," snapped Ricky Isaac, a three-year resident, as he drank a beer on the center's drinking patio. "Those AA (Alcoholics Anonymous) people make me sick. I hate hearing about other people's problems. I have my own problems. If you want to quit, you quit on your own."

They rebel against the chirpy optimism of abstinence-based programs: Try harder. Pray. Ask for help. Don't give up. We feel your pain. In contrast, St. Anthony feels like Death Row. The message is refreshingly grim: Everyone is going to keep drinking, it's probably going to kill them, and no one's going to talk them out of it.

"It's just so honest here," Hockenberger said. "I ask someone, 'Have you had a drink today?' and they say: 'Definitely! I wish I had some more!'

I have a real problem with forced treatment. If someone wants to change their life, they can be helped. However, most of these people are poor bums that don't want to change. Using government resources to harass them into changing their lives is inefficient, and potentially cruel. I don't think that this is the answer for younger, potentially employable men. However, that doesn't appear to be the target audience.

This is a powerful piece. Residences like St. Anthony may change the way we think about programs for severe alcoholics. Some experts on homelessness agree:

The St. Anthony model accepts the obvious — that a certain number of alcoholics are indeed hopeless, said Katie Tuione, program manager at Dorothy Day Center in St. Paul, a homeless shelter. "This is about meeting people where they are and loving them. It's not rocket science," she said. "They still grieve, love and hurt. They still need food and shelter. They are you and I."

Dr. Steven Miles, professor of medicine and bioethics at the University of Minnesota, agreed. The reason to support St. Anthony is not the money saved but the kindness extended to the residents. "It is the humanity of it, just like humanity drives the hospice system," he said.