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Harm Reduction Helps Women Recover: Maya’s Place and Crossroads for Women
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In Albuquerque, New Mexico, two sister programs offer a harm reduction approach for women struggling with substance abuse, trauma histories, and homelessness. HRC guest writer Ann Powers shares the story of a graduate of Maya’s Place and Crossroads for Women who is now a resident manager at the same program that helped her find recovery.

Tracy grew up with a "mean drunk" of a father. Her older siblings introduced her to marijuana at age seven, alcohol at 12 and crack-cocaine by the time she was 16. A neighbor and a relative sexually abused her at a young age.

"We would all get around the table together and smoke crack," she says. "That was our version of a family reunion." Soon, Tracy was not only addicted to drugs and alcohol, but also to the streets - all the while suffering from untreated depression.

“I started going into the hood - this world of people who smoked crack and I thought it was fascinating,” she recalls. “I was addicted to the streets; I was addicted to the drug. I did sexual acts for more drugs. Off and on I would try to sell. I became a hustler. My main concern was just to get my next high. I didn't care about food, shelter, or family. Hell, if I could wear a diaper I wouldn't care about going to the bathroom because it was just an inconvenience. I just wanted my alcohol and crack. I was homeless, passing out behind dumpsters, showing up at my parents’ house, going into a crack coma for three days and that's if I wasn't in jail."

Tracy's criminal record lists nearly 40 arrests, five felonies and 35 misdemeanors with time served in both county jail and state prison. She had entered that rapacious revolving door of addiction, untreated mental health issues, homelessness, incarceration and degradation.

Today, Tracy is working toward her master’s degree in counseling at the University of New Mexico. She is a resident manager at the very place where she finally found her own successful road to recovery - Maya’s Place and its sister organization, Crossroads for Women in Albuquerque. She’s been sober for nearly three years.

But Tracy had been through several attempts at rehab before, only to return to the streets and chemical dependency. How did Maya’s Place and Crossroads for Women make a difference for her this time?

Maya’s Place and Crossroads for Women offer a non-traditional approach to harm reduction. Harm reduction is a set of practical strategies intended to reduce the negative consequences of high-risk behaviors. It works on the premise that it is easier to get people to make small changes versus big ones. For example, instead of demanding perfect abstinence, harm reduction is supportive of anyone who wishes to minimize the harm associated with a high-risk behavior such as drinking or drug use.

While many experts agree traditional approaches to substance abuse problems based on 12-step models are tremendous resources to the people they work for, studies show relatively low success rates. Some estimates suggest that a large number of clients who enter abstinence-only programs either drop out or fail to stay sober.

In contrast, Maya’s Place has a graduation rate of 75 percent and Crossroads for Woman boasts a rare 90 percent graduation record, according to the program’s Clinical Director Larrea Lavoiscia. “I think there are several things we do right,” says Larrea.

Named after the famed poet, Maya Angelou, Maya’s Place offers a six-month congregate housing program to women experiencing homelessness and co-occurring mental health and substance abuse disorders who are transitioning from jail or prison back into society. Larrea says “wrap around services” are administered by trained professionals on site including life skills, substance abuse treatment, parenting classes, nutrition services, exercise, vocational skills, mental health education, group therapy and trauma-informed recovery support. At any given time residents may be practicing yoga, planting a garden, doing art therapy, meditating or submitting resumes to potential employers.

After graduation from Maya’s Place, residents are referred to Crossroads for Women, a scattered site, two-year housing and treatment program for women and their children. Support services include intensive case management, therapeutic day programs, counseling, parenting assistance, vocational services and healthy community activities.

Staff members say these services, combined with an individualized harm-reduction model in a nurturing and safe environment, account for the program’s high success rate. “I’d be lying if I didn’t say the ultimate goal is about getting clean and sober,” says Crossroads Executive Director K.C. Quirk. “But, most people don’t change their behavior the first time around. The key is empowering the individual with the knowledge necessary to make healthier life choices the next time around, and not condemn them for relapse. It’s a more humane approach, not a moralistic one.”

The harm reduction model has been used as a behavioral health option for everything from safer driving to safer sex. Education is provided as a tool to allow individuals to live healthier, happier and more productive lives. People are not punished for a perceived setback.

“We do not kick women out if they relapse,” says Larrea. “I’m not going to kick somebody out for the very behavior that got them here. At Crossroad we may work with them through 10 or 15 relapses” (At Maya’s Place only one relapse is allowed because of the congregate living structure and the effect one person's relapse may have on others). “The reason we support women through relapse is because relapse is an integral part of recovery. I've seen some amazing things come when people relapse and then come back, some very insightful things. Things that they learned in that relapse that are a key piece in their puzzle so that they're able to go forward in their recovery."

Amazing things and moving forward in the solution is what it is all about for the graduates of Maya’s Place and Crossroads.

“Education is key,” explains Tracy. "Looking back over the years of my addiction, each time I would get sober I was able to do some more healing. At Maya’s Place and Crossroads I've learned structure, to finally think about my health for the first time, to grow-up and become an adult and how to communicate. Today I want to live and not just exist. I want to become a better person. Today I have family and responsibility. I have peace. I get along with me. When I was in my addiction, I couldn't stand me. Today I'm okay. If obstacles come my way or fear wants to creep up, I can depend on something. I like being clean.”

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