I lost my sister to drugs. This is how I balance helping those at risk with my well-being

This First Person column is the experience of Nicki Clarke, who lives in Regina. For more information about CBC's First Person stories, please see the FAQ.

I found him huddled in a doorway, squatting to avoid sitting on the icy concrete. His broken pipe and empty baggie lay scattered in the snow. He was in that place between consciousness and unconsciousness where the body is somehow still being held up but not strong enough to stop from swaying back and forth. That place where people can speak, but it's in slow motion and difficult to comprehend.

I spoke to him slowly and steadily while standing a metre away. "Hi. I'm Nicki. It looks like you're having some troubles. Can I be here with you?" 

He said his name, but I'll use Alan to protect his privacy. I always forget what the people I meet say next. My brain is going so quickly trying to assess their health and my safety that I never remember the conversation. I want to know as much as I can as quickly as possible, and I want to build trust while assessing if they need naloxone or if I'm in danger. It's a lot, so I never quite remember the details.

I offered him gloves and a sandwich but what Alan really needed was care. His fingers were too cold to put the gloves on. His hands were covered in tattoos: faded blue-green thick lines, indecipherable letters, random shapes. Alan's face had the same sort of messy, low-quality tattoos. I don't even try to guess at the significance of them anymore. Gang tattoos or records of violence; it's all the same to me. Whatever strength or intimidating presence he once had has disappeared. Now he is simply trying to survive the disease that's taken over his body and soul. 

Just like my sister before she died. 

Schizophrenia and substance use disorder had largely robbed Tara of the qualities that made her unique. Her artistic abilities, out-of-the-box thinking, quick wit and comedic timing had all faded away as her diseases progressed.

I wondered who Alan was before the drugs took over. 

I asked if I could massage Alan's hands and he obliged. They were dirty, chapped, with small cuts on the knuckles. I probably should have gotten gloves but I didn't want him to feel rejected, so I went ahead. They were ice cold and stiff, but only slightly swollen. I started working on them, asking if it hurt, checking to see how much each finger could bend. One winter night about 13 years ago, Tara was walking barefoot on the street. A stranger noticed and cared enough to call for help, surely saving her from frostbite and hypothermia. The police took her to the hospital and then called us. I've always been grateful for that stranger's kindness.

I want to be the person who does that for someone else's loved one, but sometimes I can't. 

Earlier that night I had to walk away from a woman I'll call Tayen. She was demanding, argumentative, and I was afraid she'd steal my phone. With Tayen, I had to disengage.

But with Alan, it was different. There's something about human touch that makes people open up. I don't know if it's the acceptance, sharing the warmth, the fact that it feels good, or something entirely different, but when I massage someone's hands they usually talk. Alan shared that his father had died two years ago. He lamented the fact that his mother has given up on him. He wept as he told me he didn't want to be on drugs. He shared that he had wanted to be a tattoo artist (I kept my opinion of his tattoos to myself). In turn, I told him he was sick with a terrible and stigmatized disease. I reassured him that no one actually wants to be addicted to drugs and his life is hard. I asked if I could give him a hug and he said yes. He went to pull away after a couple seconds but I held on. When I offer someone in that situation a hug, I want them to feel loved. I want them to get a rejuvenating hug. A hug that shows them I think they're important. 

All these encounters inevitably end. I go back to my life, and they go back to theirs. Alan was able to stand again and was ready to head to his next destination, hopefully inside, but I didn't ask. You can't ask questions you're not able to handle the answer to. Sometimes it's best not to know. I gave him a naloxone kit and told him that I really hoped to see him again. Something in me thinks that's not going to happen, though. After our encounter I cried, mourning my sister's death from drug poisoning all over again. The statistics of overdose are just too high these days, and Alan seemed too far gone. So I detach, again, to keep myself safe. 

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