Ex-Addicts As Streetworkers : The Boyle Heights Narcotics Prevention Pro jectt

Gilbert Geis* John G. Munns

Bruce Bullington

Many statements regarding causes and concomitants of addiction to narcotics often, in essence, deteriorated into tautological psychological statements (“addicts are sick because addiction is an illness”). Others paint broad portraits of the ingredients of urban environments that ap- pear to be related not only to the use of narcotics but also to numerous other forms of behavior which are regarded as part of a contemporary malaise.

Treatment programs sometimes proceeding on the basis of empirical work on etiology, but more often operating on intuitive or pragamatic grounds, have reported a gamut of results. On the one hand, there is widespread belief that drug addiction is among the most intransigent forms of behavior, the mass of addicts showing an inexorable, almost mystical attachment of their opiates. On the other hand, reports from programs such as Synanon and research inquiries regarding the absti- nence rate of one-time addicted medical doctors indicate that addicts may be wondrously responsive to interventions that package the proper “rehabilitative” elements.

It is not too difficult to abstract, from reports of success and failure of diverse attempts to wean and/or coerce addicts into abandonment of their drug, some guidelines for further testing and refinement. Reported success in “curing” 92 per cent of addicted doctors in Los Angeles Coun- ty following so mild a punishment as withdrawal of prescription-writing privileges for a five-year period seems to suggest that addiction is not necessarily as recalcitrant a behavior as generally supposed. The reports offer the clue that a person in a position to reap sizeable rewards-such as income and prestige-is apt to align his behavior with the demands of the legal system without the necessity of severe retaliation on the part of that system.

At the same time, reported results from the Synanon experience, though less than well-rooted in numerical soil, seem to indicate that con- verted narcotic addicts possess a striking ability to deal with their fellows

tAddress presented at the PacIfic Soclological Society. March 22, 1968.

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in a manner likely to convince such persons to become drug-abstinent. In addition, of course, we now understand that permitting one person to attempt to assist a second is apt or perhaps more apt to aid the first person as it is to contribute to the well-being of the second.

Project Ingredients It was largely a combination of insights from endeavors such as the

foregoing that provided the blueprint for the Boyle Heights Narcotics Prevention Project. The program was established when specially-ear- marked federal funds for work with addicts in poverty areas became available toward the middle of last year.

The Project utilizes the presumed special talents of 29 former addicts in intervention work with practicing addicts in an area marked by the highest addiction rate in California. The Boyle Heights population is predominately Mexican-American, with high incidences of crime, sub- standard housing, and unemployment. The Project center is open 16 hours a day, seven days a week, and the activities of its workers include counseling, both of an impromptu and of a formalized nature, job refer- rals, and work with families. Detoxification efforts are carried on in a private dwelling without medical assistance. If such assistance appears necessary in individual cases, referrals are made to a local hospital. The street workers, who are paid an average of $600 a month, respond to telephone calls from addicts or those referring addicts, testify for clients in court, seek out individuals needing help, and deal with a not incon- siderable stream of business which finds its way into the center.

A second program element is concerned with work by the former addicts in two neighborhood junior high schools. Four addicts have met with health education teachers in a dozen workshops dealing with issues related to drugs, and have been used in classroom presentations. The ex- perimental schools agreed to lengthen the time given over to discussion of drugs by about one quarter, and to advise pupils of the availability of extramural Saturday morniilg meetings with the ex-addicts for youngsters who desire further information or assistance.

The Research Effort Evaluation of the school program follows rather classic experimental

lines. Two area junior high schools are being used for comparative pur- poses, and there has been a battery of pre- and post-tests, as well as monitoring of classrooms, written reports by former addicts concerning their experience, and reports by the teachers.

A hand tabulation of some 400 of the school questionnaires, which are now being prepared for machine processing, provided some verifica- tion regarding the rather pervasive drug ethos of the Boyle Heights

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milieu. A considerably larger number of the pupils (whose average age is about 14 years) reported in the pretest, for example, that they learn most of what they know about drugs from “what I myself see going on” than from parents, teachers, conversations with peers, or reading. Of the 400 questionnaires counted, more than 100 responses (including 40 girls) indicated that the youngster had witnessed somebody taking heroin.

Present plans call for a closer investigation, through personal inter- views, of the drug use and abuse patterns of the 3,200 pupils regarding whom we now have knowledge and attitudinal information as they con- tinue through a notably vulnerable age period. In this way, it is hoped to acquire longitudinal data uncontaminated by post fact0 distortions.

Research regarding the operation of the Project center has involved different techniques-many of them essentially ethnographic-and the material we have uncovered does not, at this early date, lend itself to overconfident generalization.

I t has proven, as we knew it would, quite difficult to pinpoint the parameters of the “client” population. Some clients kick or accept jobs and then split; others participate in all relevant program activities. It is possible to define as clients only those who remain in contact with their workers for three or more months, and who attend meetings faithfully. Such a strategy is apt to inflate the success rate, though from a program viewpoint it has the tendency of minimizing on paper the work-load car- ried by the Project staff.

The opposite tactic of attempting to gather information regarding even the most casual working contact of the ex-addict has even more compelling research difficulties associated with it. Its attraction lies in the ease with which an inflated portrait of Project efforts can be painted, and the leverage which the claimed work burden can provide in eliciting appropriations.

Of necessity, arbitrary definitions must be made in deriving a roster of program participants. It need hardly be stressed that the defined nature of the client population will almost inevitably have striking rele- vance to outcome in terms of standard criteria such as recidivism and work record.

General Observations Pending the conclusion of the Project, the following represent a

scatter of tentative observations regarding its initial phases, geared to provide some feeling for its ingredients and dynamics.

It was expected at the outset of the Project that the demands of job performance in so ambiguous and unstructured an undertaking, and in close contact with drugs and drug cures, might well propel the worker into, rather than deter him from, further involvement with drug use.

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As a group, the men and women (there are about 6 men to one woman employed as streetworkers) had been abstinent for a minimum of six months, and a median of two to three years prior to being em- ployed on the Project. Of the 40 who at any time were hired, 11 have left the Project in its first 7 months of operation. Two of the 11 quit or were dropped within their first two weeks of work. Four of the 11 are known to have returned to opiate use, one is suspected of such use, and one additional is known to have used amphetamines. One of the persons reverting to heroin did so after being implicated in a forgery charge involving collection of payroll checks from both the Project and from an- other poverty program with which she had previously been associated.

The “white-collar-crime” nature of the forgery episode is related to one of the hypobeses that we are currently looking into in some detail. Very early we were struck with the fact that the workers took on the trappings of bourgeois existence almost as soon as they received their first pay checks. New cars appeared in the parking area near the Project center, and, unsolicited, some Project workers began to wear suit jackets and ties. In anecdotal fashion, corroboration for our hunch appeared in the observation of one worker that he certainly was glad that we had elected to pay the men $600 a month since he now realized that it would have been impossible for him to have lived on anything less-indeed, he was finding it difficult to make ends meet on his present salary.

The Project’s implicit hypothesis that it is possible to purchase con- formity from former addicts is not commonly supported verbally by the Project workers, however. The workers are more apt to regard their daily experiences with practicing addicts as providing reinforcement for their own abstinent condition. Many, in fact, believe it necessary that they keep themselves in constant contact with addicts so that the memory of what they themselves once were and might again become will not fade. This drive for self-reinforcing contact with addicts appears to provide special incentive for performing a job whose demands are largely self- imposed and self-defined. In addition, the workers appear to have taken on a cliche of the social service professions, and respond in an over- whelming number of instances when asked what they would like to do in the future with: “I want to work with people.”

As might be expected, the program has shown a pronounced ten- dency toward specialization as it progresses. Perhaps the most contro- versial aspect of its daily operation was associated with detoxification. In California, it is required by law that an addict seeking medical assistance for withdrawal from drugs be reported to state authorities; presumably, such a report will be followed by arrest or (as the men see it) its euphe- mistic equivalent,, civil commitment. The original Project blueprint, therefore, did not include either funds or facilities for detoxification.

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Early in the program the ex-addicts began to use their own resi- dences as “kicking pads.” Daily solicitations were made among Project personnel for funds to feed detoxifying addicts, numbering at times as many as 14 persons in one house. Informal “babysitting“ arrangements were established by the workers to provide constant attendance at the pads. The three non-addict administrators of the Project were ambivalent about the impromptu withdrawal operation. These was wide discontent regarding the apparent obstinancy of the federal authorities in coming to grips with what was seen as an obvious gap in the funded program, and annoyance regarding the constant need for money donations. There was staff concern as well about possible legal liability in connection with detoxification, and about the reported interest of narcotic agents in the existence of the “kicking pads.”

It took 5 months for the problem to be resolved through procure- ment of legal opinions advising that use of a private dwelling, mainain- ing not more than five persons for purposes of withdrawal from drugs, did not come within the statutory demand for reporting. In the wake of this opinion, one apartment was selected as the official kicking site. Fifty- one persons have passed through it during the past two months. The average length of stay was 6 days, and range from 3 days to 3 weeks. Thirty-three persons were regarded as completely withdrawn from drugs by the time they left the pad. House rules and work schedules were formalized in the facility. Almost simultaneously, the Project shifted some personnel into specialties such as intake, orientation, pad super- vision, and similar delimited spheres. There appears to be consensus that the bureaucratization has, for the moment, added stability to the Project.

A major function has in addition evolved in the Project that was un- anticipated at its outset. Staffing arrangements placed a former career employee of the Department of Corrections (who was hired by a com- mittee composed largely of ex-addicts) in the top administrative post. His contacts in the official world permit him to intervene between an absconding addict and the authorities, and to represent the addict’s plight in its most attractive establishment light. Because of this, the Project has been particularly apt to be contacted by addict P.A.L.s (parolees on the run). The pattern of informal contacts between the Project and the cor- rectional agencies may at times earn for the man a reprieve from Nalline testing for a limited period, providing he agrees to remain under Project auspices. Thus, in the manner that the slum politician intercedes for the slum dweller with a remote and incomprehensible City Hall, the Project offers to the practicing addict a refuge from a system with which he feels inadequate to cope.

I t is worth noting that the tone of the program has recentIy taken

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on a more authoritarian and stringent air than it initially possessed. The New York experiment with narcotic addicts and the experience of Synanon both led their workers to conclude that, for success in produc- ing drug abstinence, control should be tough and forceful. True or not, t h i s philosophy appears to have become official in the present Project.

Summary The foregoing outline of the intellectual impulses which gave birth

to the Boyle Heights Narcotics Prevention Project is intended to provide background concerning the forces which shaped particular intervention decisions and related matters of strategy. For example, the campaign for relatively high wages for the workers was carried on under the as- sumption that the larger his stake in conforming behavior the more apt the individual is to remain abstinent.

We have also attempted to provide information regarding the re- search approach in terms both of the use of ex-addicts in junior high schools and the work of the Boyle Heights center. Finally, we have at- tempted to spell out in brief detail some of the ideas we have at the moment about aspects of the program and the manner in which it is pro-

It is traditional to place on record, finally, in preliminary papers such as this, a warning regarding the tentative nature of early reporting on what is a quite complex and multi-faceted undertaking. It is less traditional and more personal to add in conclusion the observation that we are, at least for the moment, impressed with the early achievements and the high potential presently associated with this endeavor.

ceeding.

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NOTES

Bloomquist, E. R. (1958). “The Doctor, the Nurse and Narcotic Addiction.”

Casriel, D. H. (1963). So Fair a House: The Story of Synanon. Englewood Cliffs, N.J.: Prentice-Hall.

Diskind, M. H. and Klonsky, G. (1964). Recent Deuelopenfs in the Treatment of Paroled Offenders Addicted to Narcotic Drugs. Albany: New York State Division of Parole.

Jones, L. E. (1968) “How 92% Beat the Dope Habit.” BuUetin, Los Angeles County Medical Association, 19,3740.

Quinn, W. F. ( 1961). “Narcotic Addiction: Medical and Legal Problems with Physicians.” California Medicine, 9, 214-217.

Vollanan, R. and Cressey, D. R. (1963). “Differential Association and the Rehabilitation of Drug Addicts,” American Journal of Sociology, 49, 129-142.

Yablonsky, L. (1965). The Tunne2 Back: Symnon. New York: Mamillan.

GP, 18, 124-129.

‘The authors of this manuscript are all affiliated with the Department of Sociol- ogy, California State College at Los Angeles.

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