Case Study: Patricia’s Story

Before we begin this article, we want to let you know that it describes a true story involving sexual abuse. Please note names and minor details have been changed to protect the privacy of individuals. We would also like to remind our readers that this story contains some graphical descriptions of traumatic experiences of substance use, therefore any potential impact on your own mental wellbeing should be considered before proceeding within this step.

The experience of trauma in the lives of people who use drugs is being recognised as a significant factor that needs to be addressed in how organisations provide their services. This applies from when a person first knocks on the door to when that person decides they are ready to move to the next stage of their journey. The excerpt below is based on a true story told by the Lead Educator.

To be honest I don’t know why services didn’t recognise this before, and I include myself in this remonstration, particularly when I read the story of Patricia whom I first encountered in my research in 1990. At this point I would like to share with you the true story of this resilient woman whom I encountered in my research on addiction.

The outline of Patricia’s story and the ongoing trauma she has endured and survived as captured through her appearances across my work is described below. I am sorry to say it is a sad read but is also a story of a woman’s endurance, strength and survival.

Patricia was born in 1965. At the age of seven when most little girls in the Ireland of 1965 were preparing for their first holy communion (catholic sacrament) and were excited about their new dress and the big day out, Patricia was sexually abused. At the age of 15 in 1980, when most young girls were thinking about school, friends and the pending state examination, Patricia first injected drugs. At the age of 20 in 1985, Patricia had her first relationship with another woman when same sex partnership in Ireland was a criminal offence and would remain so until 1993. At the age of 24 in 1989, when homosexuality was still illegal, when AIDS raged across the globe and after many relationships with men and injecting drug use, Patricia was diagnosed as HIV positive. And at the age of 45 in 2010, when harm reduction was the prevailing treatment philosophy, Patricia was required to undergo regular urine screening while in treatment.

That was the last time I encountered Patricia. She had survived though drugs were in her life and continued to be so. She was in treatment for opiate use, cocaine, cannabis and benzodiazepines. She had been abused as a child, criminalised for her sexual orientation as an adolescent, been handed a HIV life sentence as a young woman in her 20’s and as a woman in her 40’s she was peeing into a cup on a weekly basis so that she could receive her methadone.

Across the decades from 1980 to 2018, how did we not see and appreciate the trauma that Patricia and thousands of other Patricias and Patricks suffered? Our services and treatment helped keep people like Patricia alive, but now we have to give them back their lives and their dignity, and recognise the need for trauma informed services. I am only sorry we, and I, did not recognise this before.