Image via Wikipedia

As a nurse working in a large hospital, I see my share of varied patients. This week I had the pleasure ,and I truly mean pleasure, of taking care of a 48 year old homeless gentleman.

Mr. X had a history of TB and had not been able to afford his medications. Sleeping outside in a field with only a sleeping bag and blanket as his home and with the raw freezing nights, his respiratory status quickly deteriorated.

He walked three hours with his personal belongings on his back and a blanket wrapped around his shoulders to the nearest hospital. The temperature was around 25 degrees.

He was admitted with rule out TB and possible pneumonia, placed on my floor in Respiratory/ Droplet Isolation and started back on his unaffordable medications. It was soon found his TB was not active and he did not have pneumonia, only the flu.

Mr. X was a model patient. He was kind, quiet, respectful and thankful for whatever we did for him. It was noted in his records he had a drug habit and he did often ask for pain medication. His complaint was pain in his chest from coughing. He would request IV Morphine but when told no he smiled and gave no further argument. We did give him pills for complaints of pain every four hours.

Because of his homeless situation case management was called in to help with outpatient medications, and to try and find a group home or half-way house in which he could recuperate.

Mr. X refused all our efforts to help him. I asked him why. I was told he liked the way he lived. He enjoyed sleeping outside in the quiet, even when it was cold. He didn’t need a home or family, he was fine on his own. He told me he received a small monthly check from the sale of some land he once owned in another state. This kept him in food, drugs and cigarettes.

In the end he was discharged with his belongings on his back, a months supply of his TB medications, and whatever we nurses could hide in his backpack or a bag. I know he left with a new blanket, juices, peanut butter and crackers.

I found his choice to be homeless confusing. I tried to look up statistics on the homeless by choice and could find none. I did find several personal stories by people with family members that are homeless by choice. This odd breed of the homeless population seems to be thriving and growing.
 
In my research I found on any given night in American there are between 700,000 to 2 million homeless people and the main reasons stated for their homelessness.

                        REASONS FOR HOMELESSNESS

1. Low wages.
2. Reduced benefits.
3. Shortage of affordable housing.
4. Limited access to public housing.
5. Parent or parents unable or unwilling to help a child.
6. Disputes with a spouse from divorce and or domestic abuse.
7. Mental illness or drug abusers.
8. Former prisoners.
9. Natural disasters.
10. Teen runways.

The definition for homelessness is having no home or haven. There is no definition for homelessness by choice and the reasons someone would chose this lifestyle is a bafflement to me.

Since 1973, this country has spent billions of tax dollars in what some consider being a practice in futility. The original and noble intention stated was to protect and preserve the health and well-being of each citizen in our society. Yet, treatment was never the intention and the disease model was never the theory, approach, or mindset. In efforts to stop the influx of drugs to this country, the United States proclaimed war on the inanimate and passed legislation intended to enforce this legislation by any means it deems appropriate. The United States once again proving it learned nothing from history in matters of prohibition. This was not a new concept. Yet, the United States intends force to be a means with which it can stop the spread of drugs and reduce the number of abusers and addicts within our American society. It intended to engage in practices aimed at reducing supply in this country. Now even Mexico recognizes this is an impossible task given demand remains high. Of course, The strategy has proven itself -flawed at best.

Clearly, the Nixon Administration vision did not adequately consider the rules of underground players and smugglers. Market strategies intending to limit supply and demand of an already prohibited substance is beyond the control of governmental forces. More to the point, an open market is for the buying and selling of legitimate products and goods. Such rules can not be applied to illegitimate products. The strategies aimed at supply reduction disregard the illicit nature of narcotics. Again, fair market rules do not apply to underground goods. Meaning, in spite of efforts, the application of market strategy on illicit goods will not be honored by drug cartels. These groups have their own established rules of engagement which neither acknowledge nor regard normal rules of society with law enforcement as the only exception. Illicit goods do not seek an open market due to their prohibited nature alone. Any attempt by government to the contrary is to suggest that anything and nothing short of decriminalizing the product will result in failure because a government cannot regulate that which it prohibits [1]

This is a fundamental rule and the black market will demonstrate much to the same. The only way in which to apply real market strategies of supply and reduction is to change the criminal status of the sales transaction. Economically speaking, the black market is an underground economy free of the rules of fair play and governmental regulation of the legitimate markets. No amount of effort will change this specific blanket of immunity that attaches to underground transactions until their sheer and illicit nature is changed. Thus, it is safe to suggest that policy in the United States is incorrect in attempting to apply such strategies as the supply reduction approach because the fundamental nature will not attach to an illicit good.

In the “War on drugs” despite efforts of law enforcement agencies and billions of dollars spent, it is no closer to a success than it was at any other time in history. In fact, the “War on Drugs” was closer to winning before it started than it is at the present. Americans currently purchase and consume an estimated 35% – 60% of the entire production of illicit drugs in the world [2]. In spite of the original and noble intention to protect and preserve the health and well-being of each citizen, the methods applied in the ongoing battle have proven themselves dismal failures. The only reality confirmed in the current prohibition of drugs and drug abuse specifically is that psychoactive drugs -those with mind altering properties- are firmly engrained in the fabric of our Nation just as alcohol and cigarettes, the two most commonly abused, yet, legal drugs.

Footnotes

1.Thomas, Tonya. (2004) “Harm Production vs. Harm Reduction”. Unpublished theory as it relates to Government policy in the “War on Drugs”.

2.Federal Government Spending & Privately funded studies all report different findings. This estimate is based on all in an attempt to fairly represent the amount of drugs used in American society.