No Church in the Wild

The title of this blog post may scare some of you. Am I about to use some Jay-Z and Kanye West in my blog to convey a point? The two guys who's names are some form of Jesus, amounting to some serious blasphemy (Jay-z aka Hova, aka J-Hova, and Kanye aka Yeezus)!? Yes I am. More specifically, it will actually be Frank Ocean. In the song "No Church in the Wild" Frank Ocean has a line that always makes me think. He asks these set of questions, "Human beings in a mob, what's a mob to a king? What's a king to a God? What's a God to a non-believer who don't believe in anything?" This is a very vital question that I think our culture wants to avoid when rehabilitating someone, especially one with our set circumstances (remember our patient X model, without a home, mentally ill and suffering from a drug addiction).

Let's say we take our patient X, through proper counseling and medication the patient is able to reach a level of consciousness and state of mind that they haven't experienced in some time. Their network of neurons that have been so jumbled up and entangled, sending off messages that made it physically and mentally impossible to interact with the world has reached a new level of homeostasis (new because they may likely never be able to return to "normal" (I will talk about the permanent effects of drugs in a later post)). They leave said rehabilitation center and walk out onto the streets. Let's say the program they were involved in (And I'm going to go on a quick tangent and let you know that there are very few, if any drug rehabilitation centers that will willingly accept and are properly equipped to deal with mentally ill patients, and few mental health hospitals that allow patients to enter not sober.) is so advanced they even have social workers that connect patient X with some sort of job center that will allow them to do something on a daily basis.

But then a question that neither patient X nor the practitioner could have foreseen comes up, why? Why would I go to work each day? Why do I not go back to using? You see, the homeostasis that patient X reached at the climax of their drug addiction and self medicating became the new normal. The normal lasted long enough to have permanent psychological and neurophysiological effects. Leaving that old homeostasis for this drug free one does not feel good. It actually feels quite terrible. I have heard this from enough people who suffered from drug addiction, the feeling hasn't gone away, the craving hasn't gone away and it is a constant battle each day. Everyday for the rest of your life, you might feel slightly depressed (if not experience full on clinical depression). And everyday you physically feel like crap. So they ask again, why?

I have wandered the streets of L.A, Pasadena, Arcadia, San Francisco and Davis in search for some answer to this question. Not by making any assumptions, but by simply asking and listening. The only answer I have ever gotten from people on the streets is, Jesus.

How can a bearded white dude with long flowing hair (jk that's dumb, homie looked more like me with tanned skin and nappy hair than he did hipster white Seattle man) be the answer to such a question 2,000 years later? Because what he offers is in the works. What he offers is unmatched. And what he offers is eternal. He offers hope, good news, he offers the gospel.

The Gospel is freedom. It is the key that unlocks the chains that hinder us. It sets us free, and gives us a reason to live and a mission to accomplish.

I don't know if or how I can scientifically prove this to you. I don't think it's a science, and so like other things that science can't measure or explain, we have to trust that the stories I hear are true, and know their truth by their fruit.

You see, the Church is absolutely essential in this process. I believe it answers a philosophical question that breaks the cycle of addiction.

But what's a God to a nonbeliever who don't believe in anything? Well good thing as the Christian Church we believe it is our mission to make disciples of ALL nations and ALL people. Good thing we are called to love the forgotten ones, the "least of these." Good thing we have a perfect example of what it means to love and sacrifice. Good thing we know that it is our job to invite those who are broken and hopeless into our lives and to show them the living water that quenches all thirst. Right?

We have a job to do. And I want to leave you, church goer, with this challenging thought that I had to ask myself. If you are not actively seeking to love and bring justice for the poor, stranger, disenfranchised, forgotten, lonely, drug addict and homeless, then are you really a follower of Christ? Because if you spend no more than 5 minutes reading the gospels then you know that's where Jesus was and what he was doing. If we claim to follow him, then shouldn't we be in the places and doing the things that he was?

Often times when I'm on the streets, I look around and say, man, Frank Ocean is right, there is no church in the wild. For us to have any impact on the issue of homelessness, there needs to be Church in the wild. So let's go, and bring the kingdom of heaven here on earth.

The Need for a Holistic Approach

In the field of Biochemistry, a very common and mundane task that scientists have to do when working with a protein, is finding the right pH for that protein. What I mean by that is, in any system that a protein functions whether it be in plants, animals or protozoa, for the protein to do it's function properly and effectively, the pH (amount of H+ ions floating around in solution) has to be a certain number. We see these numbers all the time, 6, 7, 9. Unfortunately for biochemists, this is a log scale, so changing the pH by 1 number is really 10x more or less H+ ions! It's a huge deal. But when working with this protein and trying to understand how it works, the biochemist must, through trial and error, find out with the closest of value what pH the protein functions the best at. There are cool ways to determine how well the protein is function, but that is me just nerding out and getting way off topic. Most importantly, we see that a protein can do it's specific function at a range of pH's, but what we know is that there is a narrow range that it likes the most, that when the protein is floating around in solution with a specific number of H+ ions floating around it, it is most happy and effective.

This long and drawn out intro isn't just a way for me to geek out, but it paints the picture of why I think a holistic approach to the issue of homelessness is necessary. Throughout the past century, as the number of persons living on the street (experiencing mental illness and drug addictions (remember our target population that was mentioned in the first blog)) has increased, as a society we have tried many different things. In a sense (by not calling people experiencing homelessness scientific tests) we have been fine tuning the pH with our therapies and treatments of the issue.

But I'm going to add a 2nd layer of complexity to this analogy. When the biochemist is messing around with the solution to see what pH works best, he or she also has a vast array of varying buffers to use to make this solution just the right pH. A buffer is simply a molecule (but many of those molecules) floating around that has the ability to be an acid or base (remember your high school/college chemistry!!) and when you add a certain amount of the acid and base form in the solution, it tends to stay at a specific pH.

What I am hinting at here is that we are not in a phase with our approach that requires simply changing the pH of our methods, but also changing the buffer. The objectives might still be the same, find the sweet spot for our programs and rehabilitation, but the tools and "molecules" we use might need some changing, and what I am suggesting is that the tool is a holistic approach.

In the previous blog (which was AGES ago, I apologize) I gave a quick intro to what this intersection is, or as I called it, the corpus callosum of homelessness, which included the physical, spiritual and social aspects of the issue. So what can we do to attack all three of these things at once? Well, you attack all three of these things at once. Don't get me wrong, in no way is this an easy task, and I think just like with a buffer, it will take many years of trial and error to get it right. But I am going to tell you where I think we need to start and what the basic skeleton should look like.

To my knowledge, a few places have begun to do some really cool integrative holistic medicine (Lawndale Christian Health Center in Chicago is one), but I have yet to see or here of programs that are solely focused on homelessness with the capacity that I am suggesting.

A huge problem in the field of drug addictions, is that many rehabilitation centers don't have the resources to treat people who are also mentally ill, and many mental health centers require people to be sober to enter into the program. But wait.. what if the two are linked? What if someone's got both? Where do those people go? (to the streets)

So here's what I think needs to happen. One organization. Three parts. One program. A single program that integrates the physical, spiritual and social needs together. Yes, some rehabilitation programs have social workers to help with the transition process, but what I'm imagining is bigger than a few social workers. What I picture is a center that has each of these 3 sections working as one functional unit with one purpose, to make the person whole again.

Obviously, one of the three would be an inpatient drug rehab and mental health facility (yes I know, easier said than done, but there are a lot of smart people out there that will make this happen). The second would be a community center, which involves working with people to help get jobs, write resumes, and train certain basic skills.

The last one.. is the Church. I'm going to leave that for a whole different episode, because I believe this requires some more detail. I promise it will be less than 5 months before the next one is out. :D  

The Corpus Callosum

I learned a very interesting concept this past week in my evolution class. When evolutionary biologists work on creating phylogenetic trees to see the relationships between species and their common ancestor, the natural way that organisms are grouped is that they fall into clades or monophyletic groupings, these are all of the decendants of a common ancestor. Another commonly used grouping method is known as paraphyly, which is considered by many an unnatural way of grouping, because it includes certain decedents of an ancestor, but not necessarily all of them. One that you are probably most familiar with is reptiles! Reptiles all share many common morphological and genetic features and so we as humans have decided with our power to clump them up, but the reptile family excludes a few key players in the common ancestry line, birds and.. us!

Why do I bring this up? Well, this idea of monophyletic and paraphyletic grouping prompted me to think about how best I can explain the importance and essentialness of Neuroscience, Homelessness and Jesus. Many times we create associations between things that I believe are unnatural associations. Often times they are loose associations that I don't believe are encoded within a specific concepts DNA. Take for instance my relationship with some of my friends back home, which consisted of Disney movies, Chocolate Milk and Mean Girls references. Although these 3 things are great, I don't believe they are a "monophyletic" grouping because they don't include all the essentials to friendship, but just a few (a paraphyletic grouping of friendship).

The three I write on and have devoted my life to, I believe are natural associations. NHandJ isn't something we as a culture have clumped up together because they might share some common features, rather my theory is that these three things are intertwined in an objective way, and the only way to solve the problem of homelessness (and all that comes with it: the mental illness, the poverty, the spiritual warfare and the drug addictions) is to integrate and approach it holistically. And here is where I find the corpus callosum of my blog.

The corpus callosum of the human brain is where the neurons of the right and left hemispheres meet. The two sides of the brain, which serve varying functions are able to communicate with each other. This bridging of the brain is essential to many of our vital functions. In the same way, I believe the corpus callosum of our target population meets, but from three directions (NHandJ).

I want to make a small clarification, that will better help me describe this holistic approach and crossing between these three. The idea of homelessness is the central issue, that encompasses the need for the holistic approach of these three sections: Neuroscience (physiological component), homelessness (as it's literal meaning of being without a home), Jesus (the spiritual component). It can be a bit confusing because the main theme is also a sub theme.. but I have confidence in your intelligence to see through my weak forms of communication :)

Now, I believe the rehabilitation of our target population requires practitioners to understand the vitalness of these three subjects and the lack of their independency with relation to each other. I have heard each extremes in contradiction to my belief:

1. All you need is Jesus, none of this unnatural medicine business. Jesus can Heal all. Just pray and you will stop abusing drugs, just pray and god will provide a house.
2. Through enough counseling and proper drug dosage, the patient will stabilize and reach a level to function normally.
3. Once they are off the street and into housing they can begin to get everything else in order.

I don't think these three independently could be further from the truth. But together, with a few adjustments, I think you would have a pretty solid philosophy. 

You see, within our corpus callosum, we find many, not one issue. As signals are sent through our "corpus callosum" we get them from the physiological part, the social/economic part, and then through the spiritual part. If we are only providing stimulus from one or two and not the other, we will find ourselves relapsing into one of the other issues. Here is an example that I have seen.

I one time met a man in Pershing Square. He told me how he had been addicted to cocaine for many years now, he had no job, no family left around him and he was living on the streets. But he was extremely happy, because he had gotten into an inpatient drug rehab center that was going to house him and help him get off the drugs. A month later when my friends and I returned downtown, we saw him on the streets and asked him what happened, we knew the program was longer than a month. He told us that after one week he stopped going, he saw no point in the whole thing. What was he getting better for? He didn't have any friends, and he was rejected by all his family for the abuse he put them through in the past. What was the point, he said.

This to me is a clear example of how addressing only the "neuroscience" and "homelessness" part and not the "Jesus" part will put a huge whole in the rehabilitation. But I wonder, and I really think this to be true, if there was a loving body of Christ, supporting, caring and in relationship with this man as he went through this, would his outlook be very different. Maybe something like a church? 

I have opened a huge can of worms. This holistic approach thing is one of the central ideas of this blog so I want to take the time to really develop it. For the next few weeks I want to bring up more examples of this corpus callosum and show you how necessary it is to approach this issue holistically, and also the potential damaging effects when it's not.

Toxic Charity

Doing good in this world is something that comes naturally to us, well most of us. There is some force within us that compels us to want to help someone who is in pain. In general, doing good, well, feels good. Knowing that you did something for someone and helped out gives us a sense of accomplishment.

A few weeks ago I conducted a small social (media) experiment on the Facebooks. I told everyone that if I got 200 likes that my friend would play a special benefit concert in Egypt to help bring more talented musicians to America. For anyone who is my friend, they knew it was a joke. But nonetheless within 48 hours the status had 220 likes. I'm sure there were various reasons why people "liked" the status. Some thought it was funny and support my comedic genius. Some, maybe didn't see the satire in it and thought I was being completely serious. And some wanted to simply help out. This is an observation, but it seems like adding some sort of goal to the task gave people an incentive to be involved. After liking the status they could clearly see their contribution and although it probably wasn't life changing, it probably felt a tad bit good.

How does this social experiment relate to homelessness and community development? Well, through many years of trial and error, community development practitioners have been able to empirically see that there are some methods of "helping" that work and some that just aren't effective and long lasting. The "liking a status" sort of help falls under that category of ineffective methods, and I will explain what that looks like in our case of homelessness in a bit.

I want to take you back 2 years. A younger and less informed Rafik was pushed by his mentor and good friend, Jeff Liou, to attend the Christian Community Development Association yearly conference with our church's community outreach director, Mayra Nolan. I didn't really know what to expect but I went and luckily got to snag one of my best friends Eliza Haney (Esq. in training) along with me. It only took 3 days for my concept of community development to be shattered and reformed into something beautiful and tangible.

When you hear someone like John Perkins speak about what it looks like to be a christian in the community development setting, and then shake hands with him and have him bless the work you are involved in in your home city, your life is forever changed.

But while I was over there I met someone that shook the foundations of my community development philosophy in a way that I was not anticipating. His name is Robert Lupton. Mr. Lupton wrote a book called Toxic Charity. During the conference he had a sit down meeting with whoever wished to join in as he explained the book. The basic premise of the book is this: Doing something for someone that they can do on their own is damaging and dis-empowers them, destroying their dignity. Lupton goes on to explain how so many forms of charity, particularly those in America, cause more damage to the target then it does good. But here's where he brings out the most dangerous part to this kind of charity, it almost ALWAYS feels good for the giver.

While walking on the street, you see a man with a long beard, rotting teeth, a sad look on his face, rugged clothes and a sign that says: please help, homeless. Your first instinct is to help by giving some change, or a couple of bucks, or shoot you're feeling REALLY generous (it's probably not generosity, just a greater amount of pity) and drop a Jackson. What have you really done though? Let's forget that the person you gave the money to might potentially be experiencing a drug addiction and that that money might get spent to support that addiction. Let's even assume that that man will use that 5 bucks you gave him to get dinner. Let's break this down and see what we've accomplished.

A potentially lonely man with little to no human interaction, sells you his dignity for 5 bucks, you take it, feel good about doing a "good" deed. Will that 5 bucks last more than 10 mins? Do you know his name? Did you provide him with something he couldn't do on his own? Did you actually just do more harm than good? I think yes you did. I won't go into to great detail as to the alternatives to what you can do that are way more beneficial for the man on the street, that will be another blog, but what I want you to see is how toxic, "giving" and "charities" can be when not done right.

The ideas that Robert Lupton uses to maintain people's dignity is quite simple, yet brilliant. In Atlanta, Georgia where he spent a lot of his time, one of the main issues that the community faced were dietary issues. Food services were not being provided in certain areas, and if they were they were simple handouts. Instead Lupton organized with his church a buy-in for the community. For 5-10$, you could get a weeks worth of groceries. I hope you don't see this as a cheap manipulative scheme. Sure it was a great deal, but the people who were opting in for this deal were essential. If they didn't provide the money, they didn't get the groceries. They became a VALUED partner in this "business" transaction. In another blog I will give more examples of this methodology and what it looks like.


Going back to our social media experiment, it was easy for us to click "like" and get a desired outcome. We felt like we helped and did something for someone, and it was easy. Just like rolling down your window and tossing some change to a homeless man on the street is pretty darn easy. But what if.. dream with me here, what if helping someone else has nothing to do with us, and the feeling we get from it should NOT be the priority?! I know it's crazy. Spending $3,000 to go hang out with some African kids and babies that you will never see again feels really good! (unless you plan on returning and committing to that community, that's a different story) But I wonder what that $3,000 could look like invested in the people of that community that are there long term?

As we continue with this blog and look at ways that I personally hope to incorporate into my dreams, and ways in which any person can serve along side those experiencing homelessness and poverty, my hope is that we will do it being aware of this idea of Toxic Charity. I think what it causes us to do is not just settle for doing good because it feels good for us, but to really examine what we are doing, and how effective it is for the receiver. As weird as it sounds, doing good doesn't just have a spectrum of effectiveness, but can also dip into a level of negative effectiveness, and harm the person receiving this "good" act. It will require more time and thought and that might outweigh the good feeling, but we don't love the neighbor because the Lord said it will feel good and be easy, but because we are called to live a self sacrificial life that represents and magnifies Christ.

Oath of compassionate service by Robert Lupton:

1. Never do for the poor what they have or could have the capacity to do for themselves.
2. Limit one way giving to emergency situations.
3. Strive to empower the poor through employment, lending, and investing, using grants sparingly to reinforce achievements.
4. Listen closely to those you seek to help, especially to what is not being said--unspoken feelings may contain essential clues to effective service.
5. Subordinate self-interests to the needs of those being served.
6. Above all, do no harm.

A Community Development Philosophy According to Jesus Christ

Today I want to take you back 2000 years ago and learn from a man who truly understood what effective community development looked like. He knew that unless it was long lasting, and well, eternal, that there was no point. His name was and is Jesus. Even if you don't believe He is the son of God (I really hope you do), it can be seen that his methods were ones that preserved dignity, empowered people, and were long lasting. So let's lay out a community development philosophy according to Jesus Christ. My goal is to answer the when, who, where and how questions of community developement, and particularly with regards to those experiencing homelessness.

When: Our first passage is found in most of the Gospels (I'll be reading from Matthew 12:9-14) and it is the story about the man with the withered hand. It was Jewish law that on the Sabbath one would rest and not do any work. So here we find Jesus strolling around on Sabbath and he encounters a man with a withered hand. The pharisees, who were teachers of the law were essentially out on the Sabbath trying to troll Jesus hard. They were trying to find ways to get him in trouble so that they could get rid of him. Anyways, as Jesus approaches the man with the withered hand the pharisees ask (troll) Jesus  "Is it lawful to heal on the Sabbath?" His response is this: "If any of you has a sheep and it falls into a pit on the Sabbath,  will you not take hold of it and lift it out? How much more valuable is a man than a sheep! Therefore it is lawful to do good on the Sabbath." Or in other translations: "What did the five fingers say to the face? SLAP." So when do you partake in interacting with this community? All the time silly! Jesus is essentially saying this: Use your common sense. If there is chance for you to do good, do it! I'm not going to get into a philosophical debate about ends and means here, I think this passage is supposed to be quite simple. So like, I don't know if it's Sunday morning and you're all dressed up ready to go into church and sing "How Great Thou Art" and there is someone on the street YEARNING for a conversation or maybe a shared meal, you could use your common sense and be a bit late to church or skip out on Sunday brunch with your friends and do good.

Where and Who: I'm going to answer this one in the first sentance. IN YOUR COMMUNITIES. You might think: I live in Arcadia CA, it's a really nice and wealthy neighborhood, there aren't any homeless here. WRONG. Is this what Jesus did? Yup. There isn't just one passage where we see this but many. Jesus walks around his neighborhood/community and INTERACTS with the people of it. All kinds of people. Tax collectors (Luke 19:1-10), lepers (Luke 17:11-19), prostitutes (Luke 7:36-50), adulteresses (John 8:1-11) and whole a lot of other demographics (Matthew 25). These people exist in our culture today, some in the same exact way and some have taken other forms. But nonetheless, they are here and we are called to love them. If I were to extrapolate a little bit and survey how Jesus spent his time, based on what the scriptures say, I would say he spent more time with the sick and unbelieving then he did with the believing and healthy. (Mark 2:17). And that should be no different for us.

I actually believe this requires us to simply spend more time walking around our communities. I don't think Jesus got out of his bed and said: Totes gonna heal a man with leprosy today, maybe hang out with some tax collectors, or forgive the sins of an adulteress. No, he simply spent time in his community and was available so that when the need was present, so was he. I was shocked to find that when I practiced this in Pasadena, opportunities began to pop up. Instead of taking the short route to the awesome taco shop across the street from my church, I took the long route and met a young man about my age named Chris, who was currently living on the streets. I asked him if he wanted some lunch and we went and got some tacos and had a great conversation about how the church views people like him.

This isn't the sort of thing where you say, it's not my calling, I don't feel like the Lord has told me to interact with these people. No, this is a given, a constant, something you are expected to do as a follower and imitator of Christ. But I agree with what you might be thinking. It's not easy! Approaching a man that hasn't showered in maybe a few years, wearing the same clothes, just finished getting high, and could potentially be mentally ill is not the most comfortable of situations. But we aren't called to live in comfort now are we? Jesus certainly didn't live a comfortable life, at least in worldly terms.

How: Here is were it gets a little bit technical and requires some reading into the scriptures, but I also believe it speaks out for itself. Throughout Jesus's life we see him perform many mircales and interact with many sick folk, but one thing that we see each time Jesus makes one of these radical displays of love, is that he does not just heal the person and walk away. He does not merely point out a flaw in the woman at the well, rather he tells her how she can acquire living water, that will never leave her thirsty, he tells the no longer crippled man to, "get up and walk." All of these displays of power point to something: Jesus was not just interested in fixing these people mechanically, but empowering them, lifting them up, and helping them in a holistic sense, so that they could rise and proclaim the Good news. 

This last point will lead us directly into what our next blog will focus on, a continuation of the "how". How can we do things to help people, that are effective, but also long lasting? The key is empowerment. We empower by not destroying their dignity, by only doing for them what they can't do on their own. This is what Jesus has taught me and countless others community development pioneers. 

Let's Get Physical, Physical

Olivia Newton-John, my ex-girlfriend had a request for this blog, she said: "let's get physical, physical, let me hear your body talk, your body talk" So today that is what we are going to do, we are going to get physical and hear what the body of a person experiencing homelessness, mental illness and a drug addiction might be saying. I am going to try and not be as technical as I would want to be, because 1. I don't understand all of it myself 2. I don't want you to think, "I'm not going to get anything out of this because I'm not a science geek" I will link you all of the primary research articles that I am getting my information from, if you want to check to see if I'm bsing, or if you want to read more and get a more comprehensive understanding of the material presented in this blog. Throughout this blog I will refer to "patient x" as way to simply address the population focus: those experiencing homelessness who are suffering from a drug addiction.

What first struck my interest in the field of Neuroscience/Neuropsychopharmacology (The study of the action of drugs on the brain and behavior) was when I first began interacting with seriously ill people on the streets. I was unable to carry out a simple conversation with them. There were random bursts of yelling, their thoughts were very tangled and it was often hard to decipher where they were emotionally. When I began taking biology and chemistry classes I often pondered what was going on at the molecular level of these friends that I had made on the street. To no surprise, there is quite a lot going on at that level. Mental illness and drug addictions are a REAL THING my friends. Real in the sense that we have clear evidence that shows the biochemical differences between such patients and unaffected people of drugs and mental illness. It was a fascinating idea to think that a collection of subatomic particles, interacting in a way that they weren't normally could radically change the ability of a person to have a stable conversation with me, but it was also terrifying. Terrifying because you can't simply tell an electron to stop behaving that way. But you can certainly manipulate certain variables and create new boundaries for that electron. Similar to when a child is disobedient, you don't simply yell at them and tell them to stop (unless you are a bad parent), you give them a reason to, you change the circumstances so that the child behaves in a manner that is right, this is in a sense the goal of Neuropsychopharmalogical research with regards to drugs.

Relatively recent technology such as the PET and fMRI allow us to visually study the effects of such elements. A special scan, called the pharmacoMRI (phMRI) allows us to understand the effects of drugs on patients, and how that effects their psychology, behavior and problem solving skills through various tests. (*1) We are at the point in our science where we can scan a patients brain and see how their circuitry works. It is very clear that there has been a physical change in how patient x's create, maintain and conduct action potentials in the brain (our brains way of communicating and conducting the symphony of thought and command)

One of the ways in which addictive drugs work on the brain is by something known as Neuroplasticity. Neuroplasticity is the phenomenon in which drug addiction has one of it's most dangerous effect. At the onset of drug use and through it's continual usage, the patient begins to experience a physical change in the pathophysiology of their neurons. This change occurs at the level of protein expression regulation, neurotransmitter regulation and neuronal conductance (*2). You can think of it like this: You are in route to a family vacation. When planning the trip you choose a specific path that will take you to your desired location. That path that the "normal" person takes is consistent with any trip he takes, they will avoid crowded freeways, they will stick to the road and stop periodically for breaks. Patient x's roadmap will begin to change as a result of the drugs. They won't take the same path as the normal patient, they won't drive at the same rate and they won't prepare in the same way that will bring them to point A safely, and often times they won't ever reach their destination because of this newly developed roadmap.

Why is the idea of Neuroplasticity so important? Well, it shows that you can't simply and easily just stop taking the addictive drugs. There has been a physiological shift in how patient x's biochemistry regulates their homeostasis. Not taking the drug for a few days messes with the roadmap that their brain has developed in response to the drug.

One of the effects of this new roadmap of patient x's brain and why drugs such as cocaine, crack, meth and many others are considered addictive drugs is because of their action on neurocircuitry. The action of these drugs begin to effect various areas of the brain and create a nasty cascade of events that lead to 3 specific events as noted by Koob and Volkow (*3). 'binge/intoxication', 'withdrawal/negative affect', and 'preoccupation/anticipation'. Each of these three stages act on different regions of the brain, but collectively they form the addictive patterns of the effected patient.

What does the effect of addictive drugs on neurocircuitry tell us? There is a sequential list of events that work together to create a new system, one in which is heavily dependent on these drugs. But why though?

Homeostasis. I mentioned this word earlier. Homeostasis is what we are here on this planet to do (Sorta joking/not entirely/I apologize/I digress). Every single cell, every protein, every atom every reaction in our body exist to maintain homeostasis. Homeostasis is the character of a system to maintain a specific level of conditions. Our body is constantly responding to changes in our environment to always maintain that homeostasis. At the onset of drug use our body will do everything in it's power to reject what was just taken up by our body. It doesn't like it, because the drug is messing with our homeostasis. (hangovers) 

Confession time: My senior year of high school, for the first time I drank an excessive amount of alcohol. The result wasn't pretty, it was a lot of vomit on the floor and bathroom of my prom dates house. My body rejected the large amount of alcohol, and since that point my body will continue to have that same reaction past a certain point. I have a threshold of how much alcohol I can consume, if I reach it, vomit. I had a very good response to alcohol actually, my experience with it was so bad, that I believe there was a neuroplastical (not sure if that's word it is now though) event that occurred, one that shifted in positively rejecting future large alcohol consumptions. 

How does this relate to patient x? I believe the same scenario could occur, that at the onset of drug use would cause patient x to well never become patient x, that their homeostatic controls would react in such a strong way that they would never want to touch that needle again. So why don't they? Unique circumstances. Some of which I mentioned earlier. Here are some that I think are potentially important.

1. When you are already out on the street, alone, cold, hungry, without friends, social interactions, without feeling loved.
2. Lack of support from family and friends.
3. Without goals, purpose, a tangible reason to continue maintaining homeostasis.
4. Genetic predispositions.
5. Mental illness 

When these unique circumstances are present with an individual, not limited to just one, I believe something special and unfortunate happens. Our natural response to reject something that is knowingly harmful to us changes. The natural rejection to a drug is overcome by these unfortunate circumstances, leading to a continued use and an eventual shift in the homeostatic regulation of ones body. Neuroplastic events happen and there is a new ruler of homeostasis, the addictive drug. Just like how "normal" peoples day to day activities are a culmination to maintain homeostasis, so will those of patient x's newly maintained homeostasis. What has happened now is, NOT taking the drug will mess with the newly set level of conditions. Of course these are just my observations/theory. I will work on developing some REAL Mendelian science and prove these things to you (or not).

My first reaction to all of this was saddening. This is a really complex issue with so many layers. It is as real as breaking a bone. You can't just simply go to therapy and have someone tell you that logically what you are doing is harmful and well "duh" don't do it. There is a whole new neuronal world that we MUST address and find ways to dance with it.

As we continue this blog we will look at amazing ways in which research has furthered our ability to help those addicted to drugs, including inventive ideas such as the first ever "addictive drug vaccine" to help against cocaine addiction. (A COCAINE VACCINE? ARE YOU FREAKING KIDDING ME? LET'S FREAKING GOOOOOO)

Next week we will take a slight shift from all of this nerdy science stuff and begin to examine big picture holistic community developement. Guest speaker will be, Jesus, the greatest community development pioneer ever.

(*1): Imaging

(*2): Neuroplasticity

(*3): Neurocircuitry

Other useful articles:

http://www.nature.com/npp/journal/vaop/ncurrent/full/npp2013261a.html

http://www.nature.com/npp/journal/v21/n2/full/1395295a.html

http://www.nature.com/npp/journal/v11/n2/pdf/npp199437a.pdf

(now dance a little!)

The Demographic

Last blog I talked about the idea of approach and the importance of it when looking at the homeless population. I touched upon the notion of approach that doesn't neglect where a person was coming from that was experiencing homelessness and not JUST looking at where they are currently, understanding where the came from and how they got to the point they are at, helps us identify what our role is in the rehab and healing process.

The mentally ill, substance abuse, chronically homeless population is primarily what the focus of this blog will be, but I also want to paint an accurate picture and give everyone an idea of just how complex the issue of homelessness is.

There are those that are experiencing, what I referred to earlier, as chronic homelessness. The US Department of Housing and Urban Development (HUD) defines chronic homelessness as: “either (1) an unaccompanied homeless individual with a disabling condition who has been continuously homeless for a year or more, OR (2) an unaccompanied individual with a disabling condition who has had at least four episodes of homelessness in the past three years.” *1 

There are those experiencing transitional homelessness. These are people who could have been recently laid off their job, or have fallen on payments for their house for too long and have been evicted. Many of these are families.

There are those who you would think are experiencing homelessness, but in actuality they may not be. Those include many panhandlers who you find on the streets. I was first informed of what panhandling is for the most part after talking to a good friend of mine in Pasadena who panhandles each day on the same corner. He explained to me, shamelessly, that this is his full-time job. He lives in an apartment down the way and this is how he makes payments on it. Andy Bales, C.E.O of the Union rescue mission also writes on this idea (see below for link) *2

There are those who may look like they are homeless, simply by their appearance, that are NOT panhandling. A good friend that I was able to make and meet with on a regular basis in Pershing Square, LA has all his teeth missing, is in his 70's, has a fuzzy gray beard, wears a beanie and old clothing actually has a place to stay and is very comfortable there. He isn't mentally ill. He isn't an alcoholic and he makes his house payments on time and is responsible about it.

This is in no way shape or form a comprehensive or detailed enough list, but I simply want to show you the varying degrees and shapes of homelessness. The next step requires practitioners to focus on these different groups and listen to stories, hear people out and understand the process that led them to where they are currently and through that we can 1. help be a part of their journey to reaching where they want to be and also 2. help identify common issues that lead to homelessness to help prevent others from ever entering into it.

Different cities will have varying needs. For example the 2012 Pasadena Homeless Survey identified a total of 904 persons experiencing homelessness (including children) of this 904, 50% were chronically homeless, 70% were men, 33% have a mental illness and 14% are substance abusers. *3 The 2013 Great Los Angeles Homeless Count reported that there were 70,000 people experiencing homelessness in Los Angeles. (wow). 30% were mentally ill and 30% were substance abusers. *4. 

Knowing this data allows us to focus our services and care in certain areas. Not to say we should not provide all kinds of care, but in a city such as Pasadena the need for excessive mental health and drug rehab centers isn't as needed as in skidrow.


Here is a chance for you to get involved! I referred to two different homeless counts. These are usually conducted by fellow citizens of the city! This is a very cool and practical opportunity for you to be of great help in your community and directly get a sense and understand of what it's needs are with regards to homelessness. I will provide a link at the bottom for the 2014 Pasadena Homeless Count, if you live in or near that area please be involved! I wish I was around so that I could, so instead you can for me :). Check online and find out when your city or county is doing a Homeless Count and get involved! *5


Sorry if this was somewhat uninteresting, the facts and numbers need to be laid out to get an idea of what we are dealing with here. 

Next blog I will get into the science behind drug addictions and how it begins to affect the mind.

1*: HUD
2*: Andy Bales Blog "Why I am Weary of Giving Money to People Panhandling"
3*: 2012 Pasadena Homeless Survey
4*: 2013 Greater Los Angeles Homeless Count
5*: 2014 Pasadena Homeless Count