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Tales of a Housepunk Nothing, or: I Was a Twenty-Something Outreach Worker

September 2002

Reprinted from Harm Reduction Communication, Spring 2002. For subscription information: or visit

"No woman is required to build the world by destroying herself."

-- Rabbi Sofer, 19th Century

Until recently I worked as an outreach worker/advocate with young injectors in San Francisco. In the course of those four years I experienced enthusiasm, martyrdom, burnout, and all sorts of changes in between. This is my attempt to extract from my experiences ways that, as providers, we can take better care of each other and ourselves.

My History

My involvement with the street scene started when I was fourteen. Squatting in downtown San Francisco, I drank, sparechanged and table-dived with the rest of the homeless punks. But I was still a housepunk; one of those kidz who talks too loud about the few drugs they do and still has a job scooping ice cream two days a week. Nor was I like the kids I worked with later, who'd been homeless for years on end. I had enough social support to return to and eventually graduate high school by living with a friend.

By age twenty I had quit alcohol and other drugs and begun working as an outreach worker for the Haight Ashbury Youth Outreach Team. I'd been living indoors for several years but some of the people I'd squatted with were still on the streets and would come into the drop-in center. Being in a provider role with old friends felt awkward and difficult. Until I knew better, I dealt with my discomfort by overzealously attempting to prove that I was still "down." I eventually realized that "the kidz" (homeless youth ages 14-29) could see through my insincerity, and I finally learned to just be myself -- a housepunk.

The Work

Without knowing what it was called, I did everything a good harm reduction counselor/outreach worker/everything-else-under-the-sun could do. I met the kidz where they were at: in the park, on the concrete, high as fuck, numb or happy, twacked on sleep deprivation or down, down low. I let them hang out at the drop-in high when other programs wouldn't, keeping them awake to prevent them from overdosing. I sat by their sides in hospital waiting rooms for hours on end to ensure they got proper care from oftentimes judgmental doctors. I listened to horrific stories of pain and abuse, and gave support; talking about hope, safe shooting, taking breaks. I survived evictions and agency funding nightmares to defend the kidz against NIMBYs, and pled with probation officers to keep them out of jail. I loved those kidz, and became integrated into their lives like the mothers they never had would've, could've, should've had if things had been different. It was me and the kidz against the world and I was going to take it all on. On rainy nights I lay awake, struggling to believe that I was not inherently evil for having a bed to sleep in when others were cold, unsafe, freezing outside. Early on I was offered a raise and refused it, saying we should spend the money on socks. I thought that if I just fought hard enough, things would be okay. I was a guerilla fighter on the frontlines of the never-ending battle called harm reduction.

But it was never enough. For every kid off the streets, two came on, and one was inevitably someone who'd just left the year before. Operating in an entirely different context than the mainstream, I had to learn to define success in totally different ways. I soon learned not to have so many expectations because things didn't always change for the better. When one of the kidz would die, we'd have a memorial in the park to remember her. I learned that really all I could do was love unconditionally and hope that people would stay alive long enough to realize their own dreams. I gave a million pep talks to other service providers to remember these things. Yet, amidst all this non-judgmental, fatalistic serenity, my heart broke daily.


With every overdose, every rape, every stolen backpack, every beaten up girlfriend, every back-to-town-and-strung-out-again-after-a-year-of-doing-so-damn-good kid, the grief continued to build. In time I felt like I was going to lose my shit from the cumulative heartache. We bought a book for one of the memorials and with every death it just sank in that the book would eventually fill with the names of kidz and friends, loved and lost. I began to wonder, not if anyone else would die, but just who would be next. I obsessed about overdose; hoping to somehow stop it, rein it in. I felt panicked and traumatized, numb with constant mourning in the way that I imagine medics feel, bandaging and burying soldiers on a battlefield. Only this was the War on Drugs. I was afraid to feel, fearing what would happen if I really let myself go. I spent Friday nights watching depressing movies, waiting to release the tears I had been withholding during the week. After several years of this, I realized that as much as I immensely valued the relationships I'd taken so long to build, I was no longer putting my all into the work.

I was exhibiting the classic signs of burnout, "psychic numbing," "compassion fatigue" and "post traumatic stress syndrome." I felt unable to feel or give anything emotionally. I found myself hiding in the office, hoping no clients would come in. I would spend hours piddling around with paperwork, organizing the outreach supplies closet, attempting to establish some sense of control and order amidst the chaos around me. When new kidz came to town, I found that I no longer had the same enthusiasm I'd once had for establishing rapport with them. I was less and less able to listen to the kidz I already knew, and quick to snap when they went on and on about how they were going to change their lives. After years of the work, I felt like a sopping wet sponge, so saturated with grief that I could not absorb another drop.

I will never forget this one kid, "Jeffrey" (not his real name) who told me he only smoked pot and would never touch injection drugs as long as he lived. Without even realizing it I said something like, "Yeah, right. That's what they all say. You'll probably just get strung out and OD like the rest." I had heard people say that line so many times before and still get strung out, only in the past I had been able to censor the cynical reaction in my head. This time however, my cynicism got the best of me, and my sense of boundaries totally failed. Luckily, Jeffrey called me on it and I apologized profusely telling him I'd just seen so many kidz go down hill and it was a hard process to watch. Jeffrey never did progress to the hard stuff but even if he had, that comment would have been totally uncalled for. I could have expressed my concern, and told him what other street kidz had experienced without treating him like his fate was already written. Although I sometimes see Jeffrey and we laugh about it, that experience was a painful wake-up call for me. I saw that I could not continue on the path I was on; that something had to give.

Thinking About Using

As burnout settled in, I felt overwhelmed by such immense suffering and sought ways to shut off. For a while all I could think about was wanting to shoot up. I had been straightedge (abstinent from alcohol, cigarettes, coffee, and other drugs) for years and had no experience using heroin. The people I was surrounded by were not happily moderating their drug use, taking their time to find a vein in a clean, well-lighted place for shooting up. They were fucking miserable, and told me so daily. Their lives were marked by dopesickness, hustling, cops, abscesses, hepatitis C, jail, inaccessible treatment programs and friends dying. I saw the ramifications of heroin addiction daily, so why was I at home looking at the phone thinking, "I could call so and so, she'd show me what to do. I've got syringes, I know where people cop, it would be so easy ..."?

I have heard it said that the mind imbibes the qualities of the things it contemplates, so it makes sense that I would want to use when I was surrounded by it every day. I was also a harm reductionist operating without much support on an agency or community level, which led to feelings of martyrdom and accelerated the burnout I was feeling -- and contributed to my desire to use. Like so many others, I had become so identified with the provider role that I could scarcely take care of myself, or ask for the help or support that I needed. Nor could I think outside of the box; in my world the only roles available were of helper and helped. Feeling like I could not handle being the helper anymore, the only other option was to do what the "helped" were doing: shooting up.

White Privilege and Survival Guilt

Working as a provider, I wanted to use in order to deny my privilege, and to "feel the pain" of the kidz. Part of me felt pulled by the Drugstore Cowboy romanticization of heroin use. Using represented the forbidden permission to lose control. It would enable me to absolve myself from responsibility, and simultaneously merge into the chaos of oneness with the kidz, thus absolving myself of my white/middle-class/living-indoors privilege. (Or so I thought.) Shooting up seemed like a viable option, since I had friends in the harm reduction field who had done exactly the same up once they'd started doing needle exchange. I envied their release, the street cred that came with being an out IDU/provider and the manner in which they were taken care of -- in a way that their clients rarely were -- by other providers. Yet, as much as I felt tempted to, I did not return to old modes of coping. I realized that using would only decrease my abilities to deal with my own issues and to help the kidz.

My Role as a Provider

The kidz had peers on the streets; the role that I played was different. I wasn't someone to rip off, nor someone who would take advantage of them if they let down their guard. I was someone outside of the scene that they could trust, because I wasn't like them. I believed that my role in their lives was to show that it is possible to hold onto your values, freedom, anarchy, etc., while taking care of yourself. Using and getting sloppy strung out would hardly have supported that role. (I know myself -- I would've gotten sloppy.) If anything, absolving myself from responsibility through drug use would have communicated a message that was contrary to the one I claimed to teach. If I expected drug users to be responsible for their behavior, then the same should be expected of me. My starting to use, however "responsibly," would not have been a responsible decision. It would be me not dealing with my own problems. I did not want to use to "get high," although not feeling would have been an added bonus. I wanted to use to fuck up; to destroy the life and responsibility that I had created for myself.

Coping Strategies

I worked as an outreach worker for four years, and never used. I decided that it wasn't an option for me, that I wanted to feel even if it brought on a flood of emotions I didn't want to face. Choosing to feel meant I had to find new ways to deal with my burnout. To cope, I baked cookies, I wrote, I went dancing, I talked to friends, I watched sad movies and poured myself into my work and school. For a long time I knew that these things would only tide me over but that I needed a long break from the work. For personal and programmatic reasons I felt like it was never the right time to leave. I felt guilty, like I would be abandoning the kidz to struggle against adversity alone. Like leaving would mean I was an uncaring sellout, who wasn't down for the struggle. It had to get to the point where I just couldn't put off taking care of myself any longer. And it did.

I quit my job and spent three months traveling in Mexico and have since returned to take an extended break from direct service work. It's been a challenge to remember that taking care of myself is actually the best thing I can do for the world right now but I have faith that I am doing the right thing. This article has been my attempt to make sense of my experience, with the hopes that those still doing the work might learn from them. Is it inevitable to burnout on this work? Maybe. But I don't believe we should have to get to the point of no return before we stop to take a break. There must be better ways of taking care of ourselves while we do this work. To that end, I offer these suggestions.

  1. Prioritize taking care of yourself, personally and professionally.

    1. Personally, this means staying active in other areas of your life. Seek out and keep up the things that are fun and that give you peace of mind. For me this is writing, dancing, long walks, but most importantly, drinking tea, eating toast and talking with my closest friends. For you this might be painting, reading, cooking, doing graffiti, playing sports, bike-riding, camping, swimming, listening to and playing music, lighting candles, taking a hot bath, meditating, or any combination of an infinite number of possibilities. It also means recognizing the signs of burnout and giving yourself permission to contribute in ways that are less demanding emotionally.

    2. Programmatically, this means providing short and extended breaks, a realistic workload, decent pay (or if there's no money, some decent appreciation), clinical supervision, counseling, mental health days, staff retreats and training. People that take care of themselves run sustainable programs. For programs with little funding (i.e., most programs), taking care of staff may mean providing less comprehensive services, a hard but worthwhile choice.

  2. If you're from a privileged background, acknowledge your privilege and move on. It is important to be an ally to oppressed people without trying to take on their oppression. The best way to be an ally is to take care of yourself and make good use of your privilege.

  3. If you're using or not, evaluate how you feel about it and go from there. If your level of use feels good to you, then please use safely and with company. If not, find support to change it to a level that feels better, even if that means abstinence. For some, moderated use is not a realistic option and that's okay.

    I believe in harm reduction, and know how revolutionary it is to believe that users deserve health and dignity. In an ideal world it would be possible to use without so much harm to the individual, but we do not live in an ideal world. This is the real world and not all use is implicitly okay for everyone.

  4. Dialogue, of course. Talk about what's going on with you, even if it seems pale in comparison to what you see other people going through everyday. Talk to your friends, your co-workers. If you don't feel like you have anyone you can trust to talk to, or even if you do, check out individual therapy. If it's not provided by your agency, there are usually sliding-scale programs around. You may also think about starting a harm reduction workers' support group.

  5. Keep an eye out for your friends, drag 'em along to your support group!

I don't buy the racist bullshit line in "Traffic" where the Mexican drug czar says that overdose acts as treatment. I'm not waiting anymore for my friends in the harm reduction movement to be dead or suicidal to remember to tell them I care and am concerned about their welfare. No more waiting until I'm too numb to be real with people before I start taking care of myself. The biggest tragedy of my own burnout was realizing that I'd become so numb from grieving for all the ones I'd lost that I was doing a shitty job of being there for the people that were still alive. So, instead of forever listing the names of the ones that are gone from my life, whom I will always love and remember, this is my shout out to holding onto the ones that are still here. Please, for fuck sake, remember that loving yourself is the greatest gift you can give to the world. Now, give away.

This is dedicated to all youth H.R. providers in San Francisco, past, present and future. HAYOT, ATC, SFNE, UFO, EVRC, G-HOUSE, DIMENSIONS, HH (RIP), YI (RIP) and HIFY.

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This article was provided by Gay Men's Health Crisis. It is a part of the publication GMHC Treatment Issues. Visit GMHC's website to find out more about their activities, publications and services.
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Ask Our Expert, David Fawcett, Ph.D., L.C.S.W., About Substance Use and HIV
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