The list of drugs David Bedsole has abused reads like a greatest hits of the gay club scene: Ecstasy, GHB and crystal meth.
Bedsole, age 50, says drugs became a problem for him not even three years ago, in August 2010, but it didn’t take long before his life came apart.
“Meth brought me to my knees,” he admits.
For James Carmichael, age 42 and also gay, the struggle with substance abuse began much earlier, at only 17. After abusing heroin, cocaine and crack, he hit rock bottom.
“[I was] losing myself spiritually, mentally, [facing] homelessness and wanting to live a better way of life,” he says.
Pearl, a 29-year-old transgender woman who did not want her full name used, dates her problems with marijuana back to 2000. She, too, found herself at a turning point.
In addition to struggling with substance abuse, Bedsole, Carmichael and Pearl are all HIV-positive. And all three found help and hope at Positive Impact, the HIV mental health agency celebrating its 20th anniversary with a week of events in April.
Founded in 1993, Positive Impact served 135 clients in its first year. Last year, it served more than 5,500.
The agency launched its substance abuse treatment program after achieving state licensure in December 2008. Leaders felt they needed to fill the void left by the closure of Our Common Welfare, which was the area’s only drug treatment program specifically focused on people with HIV.
Called simply IMPACT, the program is licensed by the state to provide intensive outpatient substance abuse treatment. It compliments Positive Impact’s host of other services, which include counseling for individuals and groups; psychiatric services, free HIV testing; education and empowerment programs; the MISTER Center, a drop-in center for gay and bisexual men; and more.
‘HIV is a mental health issue’
While the IMPACT program is relatively new, it fits with the philosophy that has shaped Positive Impact for two decades: Fighting the HIV epidemic takes more than simply telling people to use condoms.
“We take the viewpoint that HIV is a mental health issue,” said Michael Baker, director of advancement for the agency. “If it was just about condoms, the epidemic would be over.”
Paul Plate, Positive Impact’s founding and current executive director, has seen the issues play out throughout his 20 years with the agency.
“We know that people don’t show up with HIV as their only presenting issue,” he said. “They have a lifetime worth of stuff, and if you only look at HIV — not violence, stigmatization, depression, abuse, substance abuse — they won’t be able to take care of themselves moving forward.”
Substance abuse is often a factor in people becoming HIV-positive.
“My drug use played the major role in me contracting HIV,” Bedsole said.
Drug abuse can also have a huge impact on whether people with HIV take care of themselves to remain healthy, and whether they pass on the virus to others, since those with lower viral loads are less likely to transmit HIV.
But keeping up with complicated HIV treatment is especially difficult when also coping with addiction.
“It was hard to take meds regularly,” Pearl said.
‘We believe in them’
Moneta Sinclair, clinical director of addiction services for Positive Impact, created the IMPACT program. She speaks of the program and clients with a mixture of clinical expertise and the love of a proud parent.
The key to IMPACT, Sinclair stressed, is the inclusion of mental health services. Clients meet regularly with their therapists, and they are able to continue those meetings even if they relapse — which may help them decide to come back to treatment.
“I think substance abuse treatment focused just on drug use and relapse prevention — just not doing it — isn’t enough,” she said. “I believe, and other therapists believe, that you have to get to the core of where it comes from to give them inspiration to stop using drugs and effectively process their emotions.”
Sinclair also believes strongly in the need for substance abuse programs specifically for people who are HIV positive.
“For a lot of them, there is a lot of stigma and shame around being HIV positive, and a lot became positive because of their behavior and drug abuse,” she said. “So being able to talk about that in a group arena without having to be afraid of people’s judgment is important.”
Bedsole agrees that the program provides more than simply drug treatment, noting that he is learning “tools to becoming a better person as well as tools to help make me stay clean.”
Asked what he has learned in the program that will help most moving forward, Carmichael replied, “how to begin to love myself so that I can be a more positive individual.”
‘They are important’
Positive Impact has a week of events planned to mark its 20th anniversary, including a Restaurant Week April 1-7, the annual gala fundraiser Party with Impact on April 4, and an open house at the MISTER Center and Willy Wonka-themed party at Jungle on April 6.
But sandwiched between the Thursday night gala and Saturday’s more nightlife-oriented “Golden Ticket” party is a private event that may have even more, well, impact on those who attend.
On April 5, Positive Impact will host a private recognition ceremony at the Georgian Terrace to honor those reaching key milestones in the IMPACT program.
For some attendees, it may be the first time they have ever been recognized for doing something good, Sinclair says.
“If there is just one thing I want people to know, it is to not give up on these people,” she says. “They have gone through a lot of struggles, and due to their behavior, they often end up with limited support, so it is just letting them know they are important.”
One of those honored will be Precious, a 49-year-old transgender woman whose story can give hope to Bedsole, Carmichael and Pearl, who are still working through the program.
Precious began smoking crack cocaine in 1990 after her mother died. She acknowledges she was “sleeping with anything and everything” and probably would not have become HIV positive if she had not been on drugs. She was homeless and stopped going to the doctor.
But after four months in IMPACT, Precious has a message for others facing similar struggles:
“You may relapse, but don’t go out and stay out — it may be a life or death situation,” she said. “Positive Impact was the best thing I could have ever done for myself. It gave me tools to say no.”
To photo: A Positive Impact client meets with a counselor. The agency, celebrating its 20th anniversary, focuses on mental health for those impacted by HIV. (by SOOP Productions)