Housing The Homeless Not Only Saves Lives -- It's Actually Cheaper Than Doing Nothing


mentalfloss
#1
Housing The Homeless Not Only Saves Lives -- It's Actually Cheaper Than Doing Nothing

It's cheaper to give homeless men and women a permanent place to live than to leave them on the streets.

That’s according to a study of an apartment complex for formerly homeless people in Charlotte, N.C., that found drastic savings on health care costs and incarceration.

Moore Place houses 85 chronically homeless adults, and was the subject of a study by the University of North Carolina Charlotte released on Monday. The study found that, in its first year, Moore Place tenants saved $1.8 million in health care costs, with 447 fewer emergency room visits (a 78 percent reduction) and 372 fewer days in the hospital (a 79 percent reduction).

The tenants also spent 84 percent fewer days in jail, with a 78 percent drop in arrests. The reduction is largely due to a decrease in crimes related to homelessness, such as trespassing, loitering, public urination, begging and public consumption of alcohol, according to Caroline Chambre, director the Urban Ministry Center’s HousingWorks, the main force behind Moore Place.

One tenant, Carl Caldwell, 62, said he used to go to the emergency room five to seven times a week, late at night, so he could spend the night there. “You wouldn’t believe my hospital bills,” Caldwell, who hasn’t had health insurance for years, told The Huffington Post. Caldwell was a teacher for 30 years and became homeless five years ago, when he lost his job and his roommate moved out.

While living on the street, he was diagnosed with prostate cancer. The disease was particularly challenging for Caldwell, who said he spent his days “trying not to get robbed or killed” and trying to find bathrooms and shelter from freezing weather. Since he moved into Moore Place when it opened in March 2012, Caldwell has gained a regular doctor and has undergone radiation. Now his cancer is in remission. Without having to worry about where he will sleep, he can take his medicine regularly and keep it in his mini fridge.

“Moore Place saved my life,” Caldwell said. “When you’re homeless, you are dependent on everybody. Now I am independent and can give back." Caldwell said he regularly helps feed homeless people now and has reconnected with family members he hadn’t spoken to in years.

Chambre said she expects Moore Place tenants’ mental and physical health to continue to improve with consistent access to health care. “The idea of having a primary care doctor was just a fantasy when they were living on the street,” said Chambre. “Now they all have a regular doctor.”

Moore Place is the first homeless facility in Charlotte with a “housing first” model. Housing first is based on the notion that homeless individuals can more effectively deal with other issues –- such as addiction, employment and physical or mental health -– once they have housing. The other permanent housing facility for the homeless in Charlotte does not follow the “housing first” model, requiring sobriety as a prerequisite.

“Charlotte also has several large shelters with very robust front doors,” Chambre said. “But you have to also have a back door -- a way for people to escape homelessness. Shelters are overcrowded, with people living there for years, which defeats the purpose of emergency shelters.”

Moore Place tenants are required to contribute 30 percent of their income -– which for many residents comes from benefits like disability, veterans or Social Security -– toward rent. The rest of their housing costs, which total about $14,000 per tenant annually, are paid by a combination of private and church donations, and local and federal government funding.

The land and construction for the facility cost $6 million, which Chambre predicted will be surpassed by the millions of dollars the facility will save in health care and incarceration costs.

The UNCC study is one of several studies that have found that providing housing first reduces the overall cost of homelessness.

UNCC assistant professor Lori Thomas, who directed the study, said she found the health care and incarceration improvement among the tenants particularly notable, given how vulnerable the tenants are. Most tenants have two or more disabling health-related conditions, and nearly half suffer from post-traumatic stress disorder, the study reported.

“This compassionate perspective is a better way to honor the humanity of a person, but it also works from a fiscally responsible perspective,” Thomas said. “This really is a win-win.”

Housing The Homeless Not Only Saves Lives -- It's Actually Cheaper Than Doing Nothing
 
petros
#2
Sometimes feral people don't want to live in a cage.
 
SLM
No Party Affiliation
+2
#3
Quote: Originally Posted by petrosView Post

Sometimes feral people don't want to live in a cage.

To be fair, non-feral people don't really want to live in a cage either. But there is usually a difference between a cage and shelter from the elements. A fair portion of the people on the streets might feel that way though, and of those probably a good portion of them are mentally ill. That has to be dealt with first or it doesn't matter how many homes you provide for them, they'll end up back on the streets.
 
petros
+1
#4
Quote: Originally Posted by SLMView Post

To be fair, non-feral people don't really want to live in a cage either. But there is usually a difference between a cage and shelter from the elements. A fair portion of the people on the streets might feel that way though, and of those probably a good portion of them are mentally ill. That has to be dealt with first or it doesn't matter how many homes you provide for them, they'll end up back on the streets.

To the feral an LHK suite is a cage.
 
captain morgan
Bloc Québécois
+1
#5
Quote: Originally Posted by SLMView Post

To be fair, non-feral people don't really want to live in a cage either. But there is usually a difference between a cage and shelter from the elements. A fair portion of the people on the streets might feel that way though, and of those probably a good portion of them are mentally ill. That has to be dealt with first or it doesn't matter how many homes you provide for them, they'll end up back on the streets.


... And herein lies one of the big problems.

Can you force someone (against their will) to consume these drugs under the guise that it is in their best interests?

At some point, there will be no hospital bed available and/or the shelter is full.... We've had a remarkably cold and snowy winter this year that has been very tough on this demographic.... So, in light of the restrictions on the available resources, what becomes the answer?
 
SLM
No Party Affiliation
#6
Quote: Originally Posted by petrosView Post

To the feral an LHK suite is a cage.

LHK? (I'm over worked and tired, so I might be missing the obvious here.)

Quote: Originally Posted by captain morganView Post

... And herein lies one of the big problems.

Can you force someone (against their will) to consume these drugs under the guise that it is in their best interests?

At some point, there will be no hospital bed available and/or the shelter is full.... We've had a remarkably cold and snowy winter this year that has been very tough on this demographic.... So, in light of the restrictions on the available resources, what becomes the answer?

That's the really hard question isn't it? And the truth is, there's no good answer to it. On the one hand, I would hate to live in a society that would regularly impose the will of many upon the individual for no other reason that they 'think it's right'. That's one hell of a slippery slope to start down. On the other hand, with the winters we do have, how can any decent human being allow another human being to be left alone to endure the elements. It's both cruel and heartless. I think no matter what side of the issue you come down on, it's torturous.

I guess all we can do is do the best we can to help those who will accept it. I know a lot of people say they make a choice to be out there, and in some cases that may well be true, but if you're actually without the means (mentally, financially, physically) to make any other choice, then really what kind of 'choice' is it?
 
BaalsTears
+3 / -1
#7
Strip wealthy progressives of everything except their lives. Let the homeless fill the vacancies.
 
taxslave
No Party Affiliation
+1
#8
It probably would be except for two things.
1) SOme of the homeless are quite content the way they are.
2) The huge amount of graft and mismanagement of funds by the social workers involved. Portland Hotel society comes to mind.
 
captain morgan
Bloc Québécois
+1
#9
Quote: Originally Posted by SLMView Post

That's the really hard question isn't it? And the truth is, there's no good answer to it. On the one hand, I would hate to live in a society that would regularly impose the will of many upon the individual for no other reason that they 'think it's right'. That's one hell of a slippery slope to start down. On the other hand, with the winters we do have, how can any decent human being allow another human being to be left alone to endure the elements. It's both cruel and heartless. I think no matter what side of the issue you come down on, it's torturous.

I guess all we can do is do the best we can to help those who will accept it. I know a lot of people say they make a choice to be out there, and in some cases that may well be true, but if you're actually without the means (mentally, financially, physically) to make any other choice, then really what kind of 'choice' is it?

At some point in time, personal responsibility has to be assessed into the equation
 
mentalfloss
#10
Quote: Originally Posted by captain morganView Post

At some point in time, personal responsibility has to be assessed into the equation

There are claims people out there for that kind of thing.
 
captain morgan
Bloc Québécois
#11
What does that mean?
 
mentalfloss
#12
Quote: Originally Posted by captain morganView Post

What does that mean?

It means personal responsibility is under assessment before giving a handout.
 
captain morgan
Bloc Québécois
#13
Ok, I understand the comment now.

What I am driving at is that the system is finite and at some point, there will be cut-offs that will have dire consequences. At this point, what do we really do?.. Blame society, blame the individual or invoke a systemic approach that cares only for the most vulnerable (think mental illness) and disregards the remainder of those that are homeless.

Head out to the West coast some time and you'll get a bit of an idea as to the nature of the 'personal responsibility' comment
 
mentalfloss
#14
Hey if the end game is profit, then why would a fiscal conservative complain?
 
petros
+2
#15
Build bridges with showers and toilets under them.
 
captain morgan
Bloc Québécois
#16
Quote: Originally Posted by mentalflossView Post

Hey if the end game is profit, then why would a fiscal conservative complain?


What a cop-out.

I take it that your thoughts on this is that more hospitals with even bigger ER depts is the solution, eh?

Stop being such a mindless ideologue
 
JLM
No Party Affiliation
#17
Quote: Originally Posted by mentalflossView Post

Housing The Homeless Not Only Saves Lives -- It's Actually Cheaper Than Doing Nothing

It's cheaper to give homeless men and women a permanent place to live than to leave them on the streets.

That’s according to a study of an apartment complex for formerly homeless people in Charlotte, N.C., that found drastic savings on health care costs and incarceration.

Moore Place houses 85 chronically homeless adults, and was the subject of a study by the University of North Carolina Charlotte released on Monday. The study found that, in its first year, Moore Place tenants saved $1.8 million in health care costs, with 447 fewer emergency room visits (a 78 percent reduction) and 372 fewer days in the hospital (a 79 percent reduction).

The tenants also spent 84 percent fewer days in jail, with a 78 percent drop in arrests.
Housing The Homeless Not Only Saves Lives -- It's Actually Cheaper Than Doing Nothing


I know a better way to cause them to spend less time in jail.............getting food involves a few hours of hard labour every day! -

Quote: Originally Posted by SLMView Post

LHK? (I'm over worked and tired, so I might be missing the obvious here.)



Light housekeeping.-
 
Cliffy
Free Thinker
#18
Simple solutions to major problems:

www.jovoto.com/projects/300house/ideas/12576

DIY recycled pallet house with IKEA-style assembly instructions - YouTube

 
mentalfloss
#19
Quote: Originally Posted by captain morganView Post

What a cop-out.

I take it that your thoughts on this is that more hospitals with even bigger ER depts is the solution, eh?

Stop being such a mindless ideologue

I'm asking a legitimate question. There are conservatives out there supporting this study because it saves money.
 
Tecumsehsbones
+2
#20
You'd think something that improves life for the needy and saves money would get widespread approval.

That, alas, turns out to be a trifle naive.
 
SLM
No Party Affiliation
#21
Quote: Originally Posted by captain morganView Post

At some point in time, personal responsibility has to be assessed into the equation

Personal responsibility can't be legitimately assessed for an individual if they have a deteriorated mental condition though. Someone who refuses to come in out of the cold because they don't want to be told what to do and someone who refuses to come in out of the cold because the voices in his head tell him not to really can't be assessed on the same scale. Which brings us back to the question of what society should do when someone is prevented from making choices because of mental defect.

Another question is, where does our own personal responsibility end? With just our own selves? From an ethical and moral perspective, do we bear any responsibility for or to each other? Does a person with a strong sense of personal responsibility turn their back on a fellow human being in distress and asking for help? What if we recognize them being in distress and, for whatever reason, they are incapable of asking for that help? I'm not suggesting that there isn't a line where intervention becomes interference, but where does that line really begin, that is the question.

Quote: Originally Posted by mentalflossView Post

I'm asking a legitimate question. There are conservatives out there supporting this study because it saves money.

I'm sure there are many on the extreme left side of the spectrum that support measures irrespective of any financial considerations too. It's only a legitimate question if you're aim is to maintain the status quo and limit this issue as a strictly political one.
 
Tecumsehsbones
#22
Quote: Originally Posted by SLMView Post

Another question is, where does our own personal responsibility end? With just our own selves? From an ethical and moral perspective, do we bear any responsibility for or to each other? Does a person with a strong sense of personal responsibility turn their back on a fellow human being in distress and asking for help? What if we recognize them being in distress and, for whatever reason, they are incapable of asking for that help? I'm not suggesting that there isn't a line where intervention becomes interference, but where does that line really begin, that is the question.

For more than 100,000 years, humans have banded into societies for mutual protection, aid, and support. But we're past that now.
 
mentalfloss
#23
Quote: Originally Posted by SLMView Post

Another question is, where does our own personal responsibility end? With just our own selves? From an ethical and moral perspective, do we bear any responsibility for or to each other? Does a person with a strong sense of personal responsibility turn their back on a fellow human being in distress and asking for help? What if we recognize them being in distress and, for whatever reason, they are incapable of asking for that help? I'm not suggesting that there isn't a line where intervention becomes interference, but where does that line really begin, that is the question.

There are medical (both physical and psychological) and financial assessments that can accurately measure one's capability. That's part of what determines entitlement to some benefit, like disability pay or housing.

Quote: Originally Posted by SLMView Post

I'm sure there are many on the extreme left side of the spectrum that support measures irrespective of any financial considerations too. It's only a legitimate question if you're aim is to maintain the status quo and limit this issue as a strictly political one.

This is an idea that would seemingly benefit everyone as far as I understand it.
Last edited by mentalfloss; Mar 28th, 2014 at 06:30 AM..
 
captain morgan
Bloc Québécois
+2
#24
Quote: Originally Posted by SLMView Post

Personal responsibility can't be legitimately assessed for an individual if they have a deteriorated mental condition though. Someone who refuses to come in out of the cold because they don't want to be told what to do and someone who refuses to come in out of the cold because the voices in his head tell him not to really can't be assessed on the same scale. Which brings us back to the question of what society should do when someone is prevented from making choices because of mental defect.


This point is, in many regards, ground zero in this discussion... The contemporary bible for assessing mental illness is: The Diagnostic and Statistical Manual of Mental Disorders v 5 (PsychiatryOnline | Diagnostic and Statistical Manual of Mental Disorders, 5th Edition | Table of Contents).

Not exactly light reading, but from what I recall, one of the interesting elements in said publication is that there is no definition of 'normalcy ' outlined in the manual.

That said, according to the manual, we are all 'suffering' from mental illness and all in the same boat (to one degree or another)... The point that I am really hitting upon here is that if we were to truly assess the situation in recognizing the true numbers of those individuals that simply are not able to care for themselves, the proposed needs of this part of the system would be very different from the existing requirements we see today.

I believe that the number of folks that won't come in out of the cold because of 'the voices' are a slim percentage of the overall (homeless) population.

Case in point; ask yourself why the problem of homelessness in Canada is essentially regulated to major cities more so than small towns and communities?


Quote: Originally Posted by SLMView Post

Another question is, where does our own personal responsibility end? With just our own selves? From an ethical and moral perspective, do we bear any responsibility for or to each other? Does a person with a strong sense of personal responsibility turn their back on a fellow human being in distress and asking for help? What if we recognize them being in distress and, for whatever reason, they are incapable of asking for that help? I'm not suggesting that there isn't a line where intervention becomes interference, but where does that line really begin, that is the question.

That is an excellent point, but where the opportunity for introspective analysis is lost is the moment that gvt admin decisions legislate a solution that impacts you and I directly.

While I fully support any and all assistance for those that suffer from significant conditions, I also differentiate those from the 'victims' mental illnesses that are a result of (poor) personal choices and my belief is that a substantial % of those relying on homeless shelters fall in this category.

This over representation in the personal choices sector is, in my opinion, costing everyone, especially those that truly need the help.
 
SLM
No Party Affiliation
+1
#25
Quote: Originally Posted by TecumsehsbonesView Post

For more than 100,000 years, humans have banded into societies for mutual protection, aid, and support. But we're past that now.

Now, that I don't really buy, we're not past or beyond that. I think we still retain both the capacity and the need for community for just the reasons you've stated. I think that, probably since the industrial revolution predominantly, societies both geographically clustered and globally as a whole, have under gone rapid and in some cases very drastic changes. This instinct to band together requires recognizing our surroundings, our communities, our society and that's a difficult thing to do whilst still dealing with rapid change. I can't even count the number of ways society has changed just in my lifetime alone. But I think we still strive towards banding together, we are just facing different hurdles to that. Whether you think we'll clear those hurdles ultimately comes down to whether you're an optimist or a pessimist regarding mankind's fate, I suppose.

But make no mistake either, through out those 100,000 years there have always been those on the fringes of society, who were ostracized and had no place within the community. And if I had to guess, I'd assume that there were always large numbers of mentally ill amongst them.

Quote: Originally Posted by mentalflossView Post

There are medical (both physical and psychological) and financial assessments that can accurately measure one's capability. That's part of what determines entitlement to some benefit, like disability pay or housing.

Of course we can, but the question was, should we and, if so, in what circumstances? Take for instance, those that admit they want the help. Seems pretty cut and dried, they want help, we have the ability to help, so we help them. What if they squander that help? What if they squander that help continually? Is there a point where we say, enough is enough? Financially that would be a fairly easy assessment, numbers are cold, hard and strictly logical. But from a moral and ethical standpoint, it's not so black and white. But that doesn't mean from a moral and ethical standpoint we should make assistance a bottomless well either. This is where an expectation of personal responsibility comes in to play. Both for those being helped and those doing the helping.

And amongst those unwilling or unable to admit to wanting or needing help, what do we do? Should we be force feeding an individual medication for a mental condition just because they're homeless? If we do it to (for) them, do we do it to (for) others in society?

One question leads to another which leads to another.
 
Tecumsehsbones
#26
Quote: Originally Posted by captain morganView Post

While I fully support any and all assistance for those that suffer from significant conditions, I also differentiate those from the 'victims' mental illnesses that are a result of (poor) personal choices and my belief is that a substantial % of those relying on homeless shelters fall in this category.

This over representation in the personal choices sector is, in my opinion, costing everyone, especially those that truly need the help.

Undeserving Poor - YouTube

 
mentalfloss
#27
Quote: Originally Posted by SLMView Post

Of course we can, but the question was, should we and, if so, in what circumstances?

Take for instance, those that admit they want the help. Seems pretty cut and dried, they want help, we have the ability to help, so we help them. What if they squander that help? What if they squander that help continually? Is there a point where we say, enough is enough?

To begin any claim you need to have a willing party to that claim. For example, if Joe gets into a car accident and he is injured, then he would go to an insurance company for medical coverage. That insurance company will refer Joe to independent medical assessor if they need assistance in determining a reasonable extent of medical coverage. They can also refer him to forensic accountants if Joe loses work as a result of the accident and they need an appropriate measure of Joe's income.

All this is predicated on Joe's willingness to co-operate.

He can voluntarily choose not to make a claim or accept any benefits offered to him.

The same, real world circumstances apply to this situation.


Quote: Originally Posted by SLMView Post

And amongst those unwilling or unable to admit to wanting or needing help, what do we do? Should we be force feeding an individual medication for a mental condition just because they're homeless? If we do it to (for) them, do we do it to (for) others in society?

One question leads to another which leads to another.

Again, there are reasonable ways of determining someone's capability.

If that person does not have a diagnosable dilemma, then it can be assumed they will not be granted some form of aid. The system is not perfect of course, but private and public organizations are constantly refining their methodologies to reduce fraud.
 
SLM
No Party Affiliation
#28
Quote: Originally Posted by captain morganView Post

This point is, in many regards, ground zero in this discussion... The contemporary bible for assessing mental illness is: The Diagnostic and Statistical Manual of Mental Disorders v 5 (PsychiatryOnline | Diagnostic and Statistical Manual of Mental Disorders, 5th Edition | Table of Contents).

Not exactly light reading, but from what I recall, one of the interesting elements in said publication is that there is no definition of 'normalcy ' outlined in the manual.

That said, according to the manual, we are all 'suffering' from mental illness and all in the same boat (to one degree or another)... The point that I am really hitting upon here is that if we were to truly assess the situation in recognizing the true numbers of those individuals that simply are not able to care for themselves, the proposed needs of this part of the system would be very different from the existing requirements we see today.

I believe that the number of folks that won't come in out of the cold because of 'the voices' are a slim percentage of the overall (homeless) population.

Yes, those hearing the voices are an extreme example I admit, although they are out there and the ones in most need of intervention, but it still illustrates that the notion of choice can sometimes be a matter of perspective.

Quote:

Case in point; ask yourself why the problem of homelessness in Canada is essentially regulated to major cities more so than small towns and communities?

A good part of that probably is just percentage of population in that there is a typical X number of individuals within every group that falls outside of the mainstream. But also, the plain fact is that it's difficult to become a nameless face in a crowd when you are in an area where everyone knows each others names.


Quote:

That is an excellent point, but where the opportunity for introspective analysis is lost is the moment that gvt admin decisions legislate a solution that impacts you and I directly.

That's true however we really need to stop making government a third party in society. Government is supposed to be us, it's supposed to be society's collective hands for getting things done. And no matter what, all collective decisions will impact the individual. What we need to strive for, in my opinion, is an acceptable cost factor, one that recognizes that humanity is an important part of decision making but doesn't disregard the economic impact either.

Quote:

While I fully support any and all assistance for those that suffer from significant conditions, I also differentiate those from the 'victims' mental illnesses that are a result of (poor) personal choices and my belief is that a substantial % of those relying on homeless shelters fall in this category.

This over representation in the personal choices sector is, in my opinion, costing everyone, especially those that truly need the help.

In all honesty I think homelessness itself is a significant condition, one that's extremely difficult to get out of without any kind of assistance. One does need something to build upon after all.

Also, I get where you're coming from as far as personal choices go. I don't think assistance should always necessarily be blanket with no questions asked or even, in some circumstances, expectation and demands made. But at the same time, I'd hate to think that we only have the one shot to get everything right, particularly when there are definitely some situations where the beginnings of poor personal choices can be outside of our control. Just take kids for example, there are numerous kids and young adults out on the streets that are there because they've fled abuses. They can easily become the lifelong homeless when they compound what could be called a 'desperate' choice with continued poor personal ones, like criminal behaviour or substance abuse.
 
Tecumsehsbones
#29
Quote: Originally Posted by SLMView Post

In all honesty I think homelessness itself is a significant condition, one that's extremely difficult to get out of without any kind of assistance. One does need something to build upon after all.

Also, I get where you're coming from as far as personal choices go. I don't think assistance should always necessarily be blanket with no questions asked or even, in some circumstances, expectation and demands made. But at the same time, I'd hate to think that we only have the one shot to get everything right, particularly when there are definitely some situations where the beginnings of poor personal choices can be outside of our control. Just take kids for example, there are numerous kids and young adults out on the streets that are there because they've fled abuses. They can easily become the lifelong homeless when they compound what could be called a 'desperate' choice with continued poor personal ones, like criminal behaviour or substance abuse.

Yeah, but then you miss out on the fun of sitting in judgment on those who fail to meet your standard of personal excellence!
 
SLM
No Party Affiliation
#30
Quote: Originally Posted by mentalflossView Post

To begin any claim you need to have a willing party to that claim. For example, if Joe gets into a car accident and he is injured, then he would go to an insurance company for medical coverage. That insurance company will refer Joe to independent medical assessor if they need assistance in determining a reasonable extent of medical coverage. They can also refer him to forensic accountants if Joe loses work as a result of the accident and they need an appropriate measure of Joe's income.

All this is predicated on Joe's willingness to co-operate.

He can voluntarily choose not to make a claim or accept any benefits offered to him.

The same, real world circumstances apply to this situation.

Not necessarily. The ability to make a true voluntary choice requires an ability to accurately self-assess, and the ability to accurately self-assess is impacted by things like mental illness or low self-esteem or addictions, etc, etc.


Quote:

Again, there are reasonable ways of determining someone's capability.

If that person does not have a diagnosable dilemma, then it can be assumed they will not be granted some form of aid. The system is not perfect of course, but private and public organizations are constantly refining their methodologies to reduce fraud.

Although some fraud does occur, I don't think fraud is really the issue. It's not about whether or not someone needs food, clothing and shelter. Human beings need food, clothing and shelter for survival. It's not that difficult of task to determine who has that and who doesn't. The issue is how far do we go with someone who does not have the capability to make that distinction for themselves, where does it being and where does it end? It's not necessarily a diagnosable mental illness like bipolar disorder or schizophrenia, it's also about those that are so far gone into addiction that there is no way they can make any kind of choice without help.

All I'm trying to speak to is that there is no black and white, cut and dry solution,like an assessment and ticking all the right boxes or attributing it all to personal choice, because both the problem and the solutions are multifaceted.

Quote: Originally Posted by TecumsehsbonesView Post

Yeah, but then you miss out on the fun of sitting in judgment on those who fail to meet your standard of personal excellence!

I don't think that's what he's doing, in fact I know it isn't. And it is a very reasonable and important talking point. Personal responsibility has to become part of the equation at some point. For anyone I know or have ever heard of that has gotten beyond a cycle of abuse or beaten an addiction, a key factor in doing so was their embrace of personal responsibility for life choices. I think it just becomes a question of when in this process of recovery or healing that becomes a factor.
 

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