First Person

Chicago’s South Side Was Covered In Candy Houses. Now They’re Dying Out.

Candy houses are quintessential to Chicago summers. Back in the ‘90s, when I was a child, a kid could go to any South Side community and find local homes that doubled as candy stores. They sold sour and hot kosher pickles, fruit chews, chewy sour balls, Flamin’ Hot Cheetos with cheese and, if you really had the money, with cheese and beef. There was so much to choose from, including the lemon and strawberry cookies that no one could name, but everyone remembers.

“I would buy Flamin’ Hots with melted cheese and ground beef and that was like a whole damn meal. We would buy penny candy, lemon and strawberry cookies, snow cones. We would buy anything related to snacks or junk food now that would be a health hazard,” said Val, a Black South Side native who has lived in Chicago her entire life.

A candy house is a business run by a homeowner who sells candy and snacks. But they were also a source of fun for children and income for women in areas of Chicago the media consistently portrays as violent, unhealthy, and poor, and that have suffered due to policies that hurt Black homeownership, exacerbate segregation, and affect food quality.

According to the Racial Justice Project, Black people have access to half as many grocery stores as whites. Many big grocery store chains avoid low-income spaces altogether.

But we had candy houses. They were symbolic to South Siders.

There are no longer as many as there used to be, though. Growing up, there was a candy house across from my elementary school, then called Myra Bradwell, on S. Burnham Ave. Whenever I had the money, my favorite things to purchase were sour candy balls, specifically the blue ones, and dill pickles. The store wasn’t always open, but when it was, there were always children purchasing candy and running to school. It’s gone now.

In 2006, while I was in high school, another candy house existed for about four months in the summer. I used my money from an after-school job and bought tons of candy and chips to eat each day. But that candy house also closed. I knocked on the door, and the woman simply said that she was no longer selling candy, and that was the end of that.

They provided women money without strings attached.

Traditionally, people on the South Side of Chicago purchased their candy from one wholesaler: L&P Foods, located on 7047 S. State St. And despite median Black household income in the ‘90s being just $21,420, money never seemed like a problem when children and candy were involved.  Depending on the candy house, a child could receive candy on credit, an adult would purchase candy for neighborhood children, or other children would purchase candy for their friends.

This was the case with Etholia, 33, a former Auburn Gresham resident, who with $10 in her pocket shared her wealth with other children. “It had to be third grade and I told everybody that they could get something, all my little friends. We spent that money up and I almost got in trouble. When I came home, they asked, ‘Where’s your [money]?’ I was like ‘Oh, I spent it at the candy store,’” she said.

When children and adults purchased candy for other children it was a way to look out for each other. Doing so built a community of trust and brought people together, because the same people buying candy were also looking out to make sure you didn’t get into trouble, that you made it to school, and that you felt safe. Purchasing candy for children was more than a kind act. It was built on a foundation of Black traditions of acceptance and care.

And the houses were about more than just community building. Economically, they were important to Black ownership, and Black women were the center of the business.

“As far as I knew [it was] women. I never knew any men running it. Also, their older kids too,” Val said. “It was clear that many of those women were much older, and they didn’t have the sort of income that we have now, so candy houses were a way for them to get extra money.” In Chicago in 2016, only 2 percent of businesses were Black-owned despite Black people being 17 percent of the population.

Not only did these businesses provide extra income for necessities, they provided women money without strings attached.

“[My grandmother] loves money. I admired the hustle in her and that was her way to make extra income, because my grandmother was a [stay at home mom]… so she never really had income of her own,” La’Shon, a fourth generation South Side native, said.

The young relatives of these women also received a benefit, because children of candy house owners received automatic “cool” points from their peers.

“It gave me some type of extra street cred because my house was the candy house. If your house was the candy house, it put you on another level because your house was the house,” La’Shon said.

There is no single reason why candy houses are no longer as widespread. But among them are candy house owners growing older and retiring, safety concerns in Chicago’s enclaves due to the small population of violent offenders, and the ease of internet shopping.

“We have different type of community now. A lot of people who were not a part of the community infiltrated the community and made [corner stores] that really were the antithesis to those candy stores,” Val said. “[Illinois] started cracking down on people having businesses in their home, so people would actually get in trouble for it.”

“I think now everybody doesn’t live by the code, which is ‘don’t snitch when it comes to that.’ People are scared of getting shut down,” Etholia said.

The rise of internet commerce has also played a role in making candy houses a thing of the past. “The internet,” La’Shon said. “It’s definitely the major reason. I couldn’t tell you where a candy house is today… and I can go on the internet and buy chews, Frooties, and all those unique candies that I couldn’t find anywhere else. I can go on the internet and buy it now.”

With so many changes in communities and technology, these Black-owned businesses may never see their former glory. However, what will never change was that they built community and long-lasting memories that bonded communities together.

“Just knowing that we grew up in a time where you had a community, you had people that you could go to, you had people you could talk to, you had places where you could get fresh air and run around and be silly and be a kid,” Val said. “And I don’t necessarily think that a lot of times we think about Black children being children and that was the moment we were not held to this inhumane standard. It makes me think how wonderful it was to at least have some form of childhood and think about happy experiences.”



Minimum Wage Increases Are Great. But Only If Workers Actually Get Them.

New Year’s Day 2020 made history for workers, as minimum wage increases went into effect in 47 states, cities, and counties.

But when cities and states take action to raise wages, they often ignore a pretty obvious problem: across most of the country, employers routinely skirt paying the minimum wage, overtime wages, or contractually promised wages, with little fear of facing consequences.

When the Broken Laws study surveyed 4,387 workers in 2008 across Los Angeles, Chicago, and New York in low-wage industries like hospitality and domestic care, they found that 44 percent had been paid less than the law required within the past year. In 2017, the Economic Policy Institute estimated that employers steal $15 billion annually from workers by paying less than the minimum wage.

Two basic facts add up to create an environment where wage thieves operate with impunity. The first is that most wage thieves will never be caught. Workers often fear retaliation for speaking up or don’t have the resources they’d need to file a complaint or bring a lawsuit. And only a handful of local or state wage theft enforcement agencies have demonstrated an effective strategy for tracking down wage thieves, explaining why in places like Houston, Texas, and Charlotte, North Carolina, a typical year might only bring a single successful wage theft prosecution.

The second is that even when wage thieves are caught, our legal system protects business owners at the expense of workers: wealthy individuals and profitable companies get ample opportunity to claim they just don’t have the money to pay workers what they’re owed. A 15-state investigation by Politico found that workers who won their wage theft lawsuits only ultimately recovered 59 percent of the money that judges or juries had agreed they’d been owed. In New York City, ten delivery workers won a $700,000 wage theft ruling against the restaurant Indus Valley — although these workers started their complaint in 2008 and won their lawsuit before a federal judge in 2014, they say they’ve collected only about 15 percent of what they’re owed.

These are both solvable problems if we’re willing to change a legal and economic system that stacks the deck against working people.

Catching Wage Thieves In the Act

Workers know complaining about unpaid or underpaid hours can mean risking their jobs or getting shunted into a less favorable schedule. According to a 2019 report by the National Employment Law Project, 45 states lack one or more of the provisions of an effective anti-retaliation law.

Undocumented workers are especially vulnerable to retaliation. Speaking about undocumented workers in Houston, Texas, Josef Buenker, a private employment lawyer, said, “I can’t count the number of times workers have told us that that it’s an overt threat used against them, [when bosses say] ‘I’m going to report you to ICE, what are you going to do about it?’” He added, “We regularly meet with people who want to pursue their claim, but then they go home and think about it and decide not to because they’re concerned about their immigration status.” As long as the threat of deportation can be used against workers, wage theft will persist. Aggressive deportation policies undermine labor conditions for both immigrants and for their U.S.-born coworkers, whose bargaining power is undermined by their bosses’ ability to exploit those without papers.

The cost of going to court is another key consideration. Some workers are able to find free legal counsel from a local legal services agency, but these agencies are stretched thin, forced to choose between helping people in poverty avoid eviction, fight wrongful debt collection lawsuits, win wage theft cases, and gain protection from domestic violence. A worker making more than $15,000 per year is often totally ineligible for legal services aid.

Our legal system protects business owners at the expense of workers.

Some legal aid organizations lack the funding to take on wage theft cases at all. In Charlotte, North Carolina, for example, there are two organizations providing civil representation to low-income workers, the Charlotte Center for Legal Advocacy and Legal Aid of North Carolina, explained Ken Schorr, Charlotte Center for Legal Advocacy’s executive director, and he noted that neither organization will represent low-income workers in court for wage theft cases. Schorr explained, “The majority of our funding is grant-based for particular areas.” He added, “We haven’t been able to find funding to do employment law based work such as wage claims.” Our country considers legal representation in civil cases a privilege, not a right — which means many low-wage workers can’t use the court system to hold their employers accountable.

That’s why, as Tallulah Knopp, a staff attorney at Boston’s Volunteer Lawyer Project, points out, it’s so important for states to have clear “fee-shifting” statutes: in many states, when a worker wins a wage theft lawsuit, the employer will have to pay their back wages, but not necessarily their legal fees. A strong “fee-shifting” statute, like Massachusetts’, sets a standard where, if a worker wins their case, their employer pays the legal fees, instead of the worker having to pay the lawyer out of their recovered damages. That encourages private lawyers to come to the table on behalf of workers, Knopp explains. In a state like Texas, where filing fees are $400, and many attorneys bill at $100 per hour or more, there’s no real way to get your wages back if you’re owed just $500. That’s why Knopp and Nick Wertsch, of Texas’ Workers Defense Project, both point to fee-shifting statutes as a critical part of fighting wage theft.

But Jennifer Lee, associate professor at Temple Law School, argues that relying on workers to come forward against their bosses can’t solve wage theft by itself, even in the presence of fee-shifting.

As Lee explains, the information barriers and risks for workers to report their own wage theft remain high, even when states try to protect workers from retaliation. “The number of workers who are suffering violations versus the number of people who come forward is miniscule,” says Lee.

After investigating 141 state and local anti-wage-theft laws, she concluded that we can’t rely on workers to file complaints or lawsuits: while a worker’s “private right of action” can be part of the solution, we also need strong wage theft enforcement agencies that don’t just react to workers’ complaints, but are on the lookout for abuse.

Funding is part of the problem in some cities and states, says Lee, but she also points to cities whose enforcement agencies are dramatically underutilized. Many agencies, Lee says, wait for workers to file complaints, rather than entering the community to inform workers of their rights, and to find bad actors.

The most promising approach, says Lee, is collaboration between government agencies and workers’ centers. Although workers in the industries susceptible to wage theft often aren’t unionized, many are organized through local worker’s centers like the Domestic Worker & Day Laborer Center of Chicago and Houston’s Fe y Justicia. “Agencies aren’t always in the best position to identify which workplaces have issues or to build trust with workers,” says Lee, adding that worker’s centers are often more embedded in the community. The cooperation of worker’s centers gathers useful information about labor conditions and can encourage more workers to come forward. Lee pointed to Seattle as an example of a city that has effectively partnered with local community groups — their Office of Labor Standards selected ten community organizations to receive $1 million contracts to provide education and outreach to workers. Reporting by the Philadelphia Enquirer found that, in 2018, Seattle’s Office of Labor Standards received 10 times the number of wage theft questions and complaints than Philadelphia received, a larger city that lacked such a strategy.

Making Them Pay the Bill 

But even once wage theft is brought to light, workers don’t always get paid. Across the country, nominally “successful” wage theft lawsuits often result in empty judgments: just because a judge or jury agreed that a worker experienced wage theft, it doesn’t always mean that the worker will be able to collect her back wages.

A report by the National Center for Law and Economic Justice found at least $125 million in unpaid wage theft judgments and orders within New York City alone. Carmela Huang, a supervising attorney at New York City’s Legal Aid Society, says “it’s just far too easy for employers to transfer their assets.” As an example, Huang explains, a restaurant owner faced with a high-dollar wage theft lawsuit will recruit a friend to create a new corporation and transfer the restaurant to the new corporation. That makes the original corporation facing the lawsuit nominally unable to pay its wage debts. “For more than a decade employer-side attorneys have been advising clients on how to hide their assets — it is definitely a part of the practice to advise clients on how to make themselves judgment-proof,” says Huang. That’s why the Legal Aid Society called on New York Governor Andrew Cuomo to sign the SWEAT Act, which would have allowed workers to place a lien on their employers’ assets while wage theft litigation was ongoing, stopping bad companies from using suspicious transfers to hide assets. Cuomo vetoed the SWEAT Act on January 2.

Our country arrests 1.5 million people for burglary and larceny per year — but workers facing stolen wages are routinely deprived of justice. Businesses can dial 911 and expect the cops to show up to arrest a shoplifter, while millions of Americans work for poverty wages, as victims of theft from their employers, with little hope of recourse. To end wage theft, we should lift the threat of deportation, guarantee workers access to the legal system, build strong wage theft enforcement agencies, and close the loopholes that allow employers to shirk responsibility to pay owed wages.


First Person

Laws Aren’t The Only Barrier To Abortion Access. So Is Cost.

When thinking of abortion access challenges in the United States, waiting periods, mandatory ultrasounds, biased pre-abortion counseling, bans on federal and some state funding, and a dwindling number of independent clinics come to mind. These challenges delay abortion care, increase medical risks, and especially hurt minors. After navigating extreme restrictions and logistical needs to get to the clinic, another problem may arise for some patients: additional fees, which can range from $50-250 (on top of an average cost of $500 for a first trimester abortion), for factors entirely out of the patient’s control, such as having a negative blood type, being over a certain weight, or having a twin pregnancy. Although additional fees are common among various medical procedures, the lack of public and private coverage for abortion costs makes them difficult for some to afford — especially in places where the rate of uninsured people is high.

I have firsthand experience with one: Rhogam. Like 15 percent of the population, I lack the Rhesus factor in my blood, which means I have a negative blood type. If your partner has a positive blood type (or if their blood type is unknown), the fetus can inherit their factor, causing problems with the pregnancy. Pregnant people in this position can be given an injection of rho(D) immune globulin, such as Rhogam, to create antibodies that desensitize our physiological response if our blood comes into contact with the fetus’ blood, should it be Rhesus positive. Without the injection, it could be problematic for not only the health of the pregnant person and developing pregnancy, but the development of future pregnancies. Normally, Rhogam isn’t given during pregnancy until the 28th week, but abortion providers still routinely provide it at earlier gestations.

I had the privilege of using insurance when I delivered my two children, including one through a cesarean section. Unexpected fees weren’t something I anticipated when I needed an abortion while living uninsured — and I live in Texas, where in 2017 a bill passed prohibiting insurance plans from providing coverage for abortion unless the pregnant person has a separate premium they’ve purchased specifically for abortion. And for most people, Medicaid won’t cover it, either. I learned I’d need to pay $100 because of my blood type, on top of $450 for a surgical abortion. My local abortion fund helped, but it wasn’t enough for me to afford Rhogam and sedation. So I experienced my surgical abortion completely aware, which wasn’t comfortable for me. Nor what I wanted, since medical settings give me anxiety.

Some clinics have taken measures to address the challenges of added fees. And abortion funds, such as the Mississippi Reproductive Freedom Fund, also provide financial assistance. Some abortion providers combine what would typically be additional costs with the price of the abortion, or try to be up front about these fees on their websites. But not everyone has access to the internet, or if they do, it isn’t always easy to find accurate information. Crisis pregnancy centers often use similar names to trick people, who may not realize they’re on a site that isn’t legitimate. So it isn’t unusual for us to learn — for the first time — that we have to pay hundreds of dollars upon visiting the clinic.

“We’ve had patients who choose our clinic specifically because we don’t charge for Rhogam,” one clinic told me. Other clinics may waive the fee for those who need help paying for it, when resources are available to do so. “We received a grant that allowed us to provide our patients with financial assistance for things, and at the time we decided to use it on Rhogam, so people wouldn’t have to miss their appointment over an unexpected thing,” another clinic said. “We recognize the hardship this creates for many people, especially when a lot of people have no idea what their blood type is to begin with.”

Our right to choose means nothing if we can’t access it.

The extra cost of Rhogam increased the time one patient needed to pay back a loan they took out on their car in order to afford the procedure. “I had to travel to a different state because it was closer than the clinic where I lived. I had the money from a loan I took out already, but when I found out I’d need to pay $100 more because of my blood type — in addition to the barriers I was already facing — I realized I’d be stuck in this cycle of debt longer than I hoped for,” they said.

I also spoke with Desiree — whose name has been changed to protect her privacy. “I remember standing at the window and being told it would be an extra $100 because of my blood type. It had already taken me weeks to get the $400, and I needed an abortion a few days before rent was due. I had to step aside and really think about what this could mean for my living situation,” she said, since she’d already needed assistance from a local abortion fund.

Laurie Bertram Roberts, co-founder and executive director of the Mississippi Reproductive Freedom Fund, told TalkPoverty: “We hear from many callers that struggle more because of these extra costs. It’s already hard as it is to raise hundreds of dollars for the procedure, especially for our callers who are experiencing homelessness and other barriers related to accessing abortion.”

This issue also affects those who don’t have a negative blood type. “I wasn’t even Rh-negative, but the clinic I went to gives everyone Rhogam,” said another patient. She said the additional cost caused her to drive home on “fumes,” because she had to use her last $50 that was originally intended for gas after driving out of town for her abortion.

When it comes to the extra cost associated with Rhogam, fortunately, things are changing. In Contraception Journal, the National Abortion Federation (NAF) recognized last year that testing for the Rhesus factor in abortion care has become a barrier. They refer to Dutch guidelines, which say the injection is unnecessary for pregnancies less than eight weeks — and Sweden also recommends against the injection for early medical abortion.

NAF recently updated its recommendations regarding when Rhogam is required. They no longer recommend it for early abortions less than eight weeks, most of which are medical abortions and account for two thirds of the abortions performed in the U.S., according to the Guttmacher Institute. Now, people with a negative blood type — who find out about their pregnancy early on — may have the ability to forego Rhogam at NAF-member clinics. Some experts say it isn’t necessary for a first pregnancy at all.

Dr. Alice Mark, NAF’s Medical Director, told TalkPoverty: “We know giving the Rhogam injection at 28 weeks decreases the risk of sensitization, but what we don’t know is that any intervention before that has any impact on the outcomes…The studies [on sensitization] use methods that are outdated, and we were doing this intervention without knowing whether or not it benefited patients.” They drew heavily on data from Europe, where not providing Rhogam early in gestation has “no appreciable impact.”

Dr. Mark stressed that some clinics may want to follow American Congress of Obstetricians and Gynecologists (ACOG) recommendations to protect their patients, and that’s not wrong. “But because we’ve made this change, it’s been taken to ACOG to be discussed on their committees,” said Dr. Mark.

One clinic I spoke with told TalkPoverty that, “We’re going to follow the [NAF] recommendations, and we should be updating the guidelines in the next month. All of our physicians are really excited to follow these guidelines — there’s a lot of research on it. It’s an extra barrier for patients.” Patients are also growing more aware. “I didn’t need it because I’m less than eight weeks,” said one person I spoke with before her abortion.

This isn’t the fault of clinics. It is the result of the systemic issues related to extreme abortion restrictions. After all, paying for abortion could be a lot easier if there wasn’t a federal ban on public funding. Independent clinics perform the majority of abortions in the U.S., but they receive absolutely no support from our government. Use of state dollars for Medicaid reimbursements for abortions is highly restricted in Texas and a number of other states, so while some providers may combine these additional fees in the cost of the abortion, it’s inevitable not all would be able to in order to sustain the operation of the clinic. In eleven states, including Texas, most people can’t use their private health insurance for their abortion, either.

And with providers across the country facing closures due to medically unnecessary restrictions, accessing a clinic becomes less of a reality for many even without these additional costs. Next month, Missouri will give a final ruling in the case of the state’s only abortion provider shutting down. Six states currently have only one clinic, and Missouri could be the first with zero. In Texas, we have the most cities more than 100 miles away from an abortion clinic. For some of us, there is no choice: we’re forced to continue a pregnancy we don’t feel ready for.

Because even though we have a legal right to have an abortion, lawmakers continue to remind us that our right to choose means nothing if we can’t access it.



Jail Isn’t A Drug Treatment Center. Stop Promoting It As One.

Kathleen Cochran is no stranger to the term “enabling.” These days, she manages 11,000 acres of ranchland in the lush Santa Ynez Valley, just north of Los Angeles. Her daughter, who has struggled with heroin addiction for 15 years, is stable. But those 15 years were a tumultuous ride, riddled with harmful advice from fellow moms and accusations that she was “enabling” her child by preventing her from suffering the worst consequences of drug addiction. Some of the most prevalent advice Cochran was given was to call the police on her daughter, or otherwise allow her to become and remain incarcerated. Common refrains included a false belief that she was safer behind bars where she could not get drugs but would be provided three hot meals a day, or that people who do the crime deserve the time, and that it might give her the space to think critically about how she was living. What these families fail to understand is that incarceration leads to a host of problems for people struggling with drug addiction, both immediate and long-term.

“I understand the sheer panic of not knowing what to do, and you want to get your kid off the street because you really honestly believe they’re going to die,” said Cochran. “But I had a thought that, you know, if my daughter gets arrested, she’s gonna have a record.”

The concepts of “enabling,” “rock bottom,” and other punitive approaches toward addiction are mainstays of the 12 step programs that continue to dominate recovery culture despite a lack of scientific evidence backing their efficacy. It’s not uncommon for parents of people in the throes of addiction to feel compelled to call the police on their loved one, pray for their incarceration, or feel relief when their loved one gets locked up. Cochran still encounters the mentality frequently in “Moms for All Paths to Recovery,” an arm of her nonprofit “Heart of a Warrior Woman,” dedicated to disseminating the harm reduction tools and tenets she wished had been more available when she was desperate for ways to help her child.

“In that moment, [parents] say nothing else is working,” explained Cochran. “They need a reprieve and somehow they think no matter what anyone has told them, [their child’s incarceration] gives them a reprieve.”

Parents, however, are not the only people who uphold the myth that incarceration benefits people struggling with addiction. Many people in recovery credit incarceration with their turnaround. It’s not uncommon to hear people say they would never have stopped using if they hadn’t gotten locked up, or that detoxing felt psychologically easier in jail, where they knew they couldn’t get a hit. Amanda Mansur, a restaurant server and mother living in Massachusetts, told TalkPoverty over the phone that, in retrospect, being incarcerated was a “positive experience.”

“It taught me…about gratitude. You don’t realize how good you have it until you lose everything,” said Mansur.

But incarceration is highly traumatic and embedded with both short- and long-term negative consequences. In the long term, convictions, especially felonies, can follow people for years after their release from jail or prison. People with felony drug convictions face difficulties renting homes, gaining employment, and even accessing public benefits.

Most states no longer enforce a lifetime ban on public benefits like food assistance and cash benefits for families with children, but many still impose temporary bans or reinstatement requirements outside of their criminal sentence. That can mean drug testing, which is costly, invasive, and not always accurate; the more common, less expensive urine drug tests, for example, are prone to false positives, which can result from the use of over-the-counter medicines or even edible poppy seeds.

If my daughter gets arrested, she’s gonna have a record.

The negative consequences of incarceration are compounded for people of color. Members of Black and Latinx communities are more likely to be incarcerated for drugs, and one in nine Black children has an incarcerated parent, as opposed to one out of every 57 white children. One study conducted in New York City found that Black men with criminal backgrounds faced harsher employment discrimination than white men with similar convictions. One out of every 13 Black Americans will lose voting rights in their lifetime due to felony disenfranchisement. Over 250,000 immigrants have been deported as the result of drug charges since 2007, according to data compiled by the Drug Policy Alliance.

But all of these consequences hinge on the assumption that a person survives the ordeal of incarceration. For people who are addicted to drugs, survival is not guaranteed.

“Any time someone has to use drugs in a way that’s secret, that’s hidden, that’s rushed, that’s not around people, that’s not in a safe secure network where you can get help, you see increased harms,” said Kim Sue, the medical director of the Harm Reduction Coalition, who also performs clinical work at Rikers Island Correctional Facility and recently published a book titled “Getting Wrecked: Women, Incarceration, and the American Opioid Crisis,” that examines the use of methadone and buprenorphine within jails and prisons. Those harms can include increased rates of infections and diseases like HIV and Hep C that can result from sharing syringes and other equipment.

Those harms can also manifest as death due to withdrawal. Although opioid withdrawal is not conventionally considered fatal among otherwise healthy adults, a number of people have been found dead in cells across the country. In 2017, Mother Jones reported that although nobody is tracking how many of these deaths are taking place, 20 lawsuits were filed against United States correctional facilities between 2014 and 2016 in response to alleged opioid withdrawal-related deaths. Withdrawal-related dehydration is often cited as a primary factor in these deaths. In more than one of these cases, distressed inmates reported concerns for their life to family members over the phone, or begged staff for water and medical care in earshot of their cellmates. Surveillance cameras caught the excruciating withdrawal and death of a 32-year old Michigan man who was in addiction treatment when he was arrested and sentenced to 30 days in jail for failing to pay a driving ticket.

“If you’re doing a lot of vomiting or a lot of diarrhea…[that] can lead to different electrolyte disturbances which can affect cardiac function, leading to cardiac arrest,” explained Sue, who also noted that many times, medically untrained guards are the only people available to assist incarcerated people in withdrawal. She added that even when inmates are transferred to medical units, most facilities do not have doctors on site full time.

There is a growing awareness among criminal justice authorities that medications used to treat opioid use disorder, like methadone and buprenorphine, are essential for people struggling with opioid addiction. Often prompted by lawsuits, several facilities have begun inducting incoming inmates who are addicted to opioids, or allowing people already prescribed the medications to continue taking them. Regardless, the majority of facilities do not allow the use of these medications, except for people who are pregnant (even then, patients are typically tapered off after pregnancy, sometimes while still recovering from childbirth).

This means that most people who are incarcerated while addicted to opioids will undergo forcible detox. In some cases, even when people are given methadone or buprenorphine as a withdrawal aid or for maintenance while inside, they are not given adequate referrals on the outside. In some areas of the country, these medications are difficult to access or too expensive to pay for out of pocket. For people addicted to opioids, being forcibly detoxed without adequate access to evidence-based treatment like methadone or buprenorphine can be dangerous upon release because it leaves them at risk of relapse, but without their former tolerance. Opioid-addicted people who have been released from incarceration are at significantly heightened risk of overdose in their first several weeks back in the community.

Even in facilities where evidence-based treatment is offered, the risk of trauma remains ever-present. “[People who are incarcerated] get killed by staff, they get killed by other inmates…they get raped, they get sodomized,” said Dinah Ortiz, a vocal harm reductionist and parent advocate at a New York defense firm. “You don’t know how many rapes I saw, you don’t know how many women I saw sodomized during my little six months in Rikers.”

“If you’re the kind of person who needs to take a walk when you’re feeling stressed, you cannot do that [while incarcerated]. If you’re anxious around other people who are loud or fighting, you can’t avoid that. The environment is not therapeutic,” said Jonathan Giftos, who worked as the clinical director of substance use treatment for the Division of Correctional Health Services at Rikers Island. “A lot of the health side works hard to mitigate the harms of the environment, but you can only do so much.”

Even when formerly incarcerated people praise their experience behind bars, they also often share stories of trauma and relapse that didn’t end with jail or prison, but with evidence-based care that they accessed in the community. Mansur, for example, admitted that she relapsed shortly after her release, and continued using for three years before achieving sobriety with the help of a self-referred buprenorphine prescription. She detailed that she’s had difficulty renting apartments because of her conviction, which was for theft that she committed in order to pay for drugs. She’s also unable to work in the medical field or with vulnerable populations like children or the elderly, which she finds disappointing because she had studied psychology in college.

“Maybe if I had been introduced to medication-assisted treatment previously from going to jail, maybe that would have prevented [the need to be arrested],” Mansur stated, before acknowledging that her addiction became “much worse” after she was released from jail.

“If your [child] is out of control there are ways to go about [helping them] that do not involve incarceration,” advised Ortiz. “If you have that mentality that I prefer they be in jail, then that’s the mentality that they are going to have, too.”


First Person

I Was Ready for College. College Wasn’t Ready for Me.

The upstairs toilet is wobbly. It’s been this way for a few months. Whenever someone sits on it or shifts their weight, it makes an unsettling clunk. Strangely, that’s not the upsetting part to me. See, I know how to fix it; in this age of YouTube and WikiHow, you can find and teach yourself how to do almost anything. I know what tools I need, where to get them, and I even have the funds available to take care of it. What I don’t have is time, and that is largely due to my decision to continue my education as an older, non-traditional student. According to the American Council on Education’s “Post-traditional Learners Manifesto,” as many as 40 percent of undergraduate students nationwide are non-traditional, defining non- or post-traditional as over the age of 25 with varying factors such as financial independence, number of dependents, high school graduation status, and military experience.

Like many of my cohorts, I was sold the line that higher education was the golden ticket to a successful life. Off I set at eighteen to Eastern Michigan University, sure of what I wanted and what I would do. But life being as it is, and plans going the way they often do, I didn’t graduate. I dropped out to have a baby, joined the Navy, was medically discharged, and left drifting without tangible purpose. This is at least in part due to my husband’s active duty status, taking us overseas. This is not unusual, as the same manifesto notes that as of 2017, 60 percent of non-traditional students are women. At least I had my Post-9/11 G.I. Bill, a college payment incentive offered for military enlistment after the 9/11 attacks, and since my life became more stable in my late 20s and early 30s, the time seemed right: I enrolled at the University of Hawai’i at Mānoa.

As a disabled veteran and mother of a teenager, I knew some of the challenges awaiting me after admission. Being significantly older than my peers and being mistaken for a graduate student or instructor were odd blows to my self-esteem. There were numerous others I’d not considered. But as I sit here three weeks from graduating at the time of this writing, I’ve realized that I’ve succeeded despite higher education institutions failing to understand the needs of non-traditional students.

The university experience in the United States is designed to pipeline high school graduates through it and into the workplace as fast as possible, even with the reality that financial success is not necessarily waiting at the other end. Our campus is full of eye-catching signs encouraging undergraduate students to finish in four years, encouraging a fifteen-credit course load if you mean to finish within four years, instead of a full-time load of just twelve. Each syllabus reminds us that we should expect three hours of outside class work per week per credit hour. A fifteen-credit schedule alone starts with fifteen hours a week under instruction. If each class sticks to only that three hours per week outside of class, you’ve racked up forty-five hours of homework. Being a full-time student is more than full time. If your only responsibility is class, and you budget your time well, that may just be doable.

As a theatre major, like many other majors, it’s also not unheard of to have to fit in many outside-of-class activities. I study stage management and playwriting, and that requires me to run shows. I am lucky to have instructors who help me find alternate routes to these requirements, but not every department is this accommodating.

Class and homework are not always the only things people are balancing.

In addition to family duties and disability status, I’m an author, which is a demanding job that comes with irregular hours, most of them unpaid. My time is valuable. My work and financial circumstance allow me to put projects on pause, to the frustration of my ambition. But I still find it difficult to keep up with the amount of self-promotion being an author requires. I was asked to choose between my GPA and my income.

40 percent of undergraduate students nationwide are non-traditional.

My share of the responsibilities of my home life doesn’t stop for my school day, not if we want things like packed lunches and clean underwear. Even with on-campus services like the Student Parents at Mānoa (SPAM), who help to fill in gaps in childcare, there are limitations. Families need fed. Meals need planned. Perpetual chores pile up each and every day, even if you did them the day before. My family is great about sharing chores, but they have school and jobs too. Of course, traditional students often have to deal with this, as a record number of young people currently live in a household with at least one other generation, which only further emphasizes the need for more support.

And commutes! My commute of twenty miles one way is over an hour. By the time I get home, with a mountain of homework or paperwork, those languishing piles of laundry and cat boxes in need of scooping make me want to cry. Plus, between commuting, family care, instruction time, homework, paid and unpaid non-school work, sleep must happen.

As a person living with chronic pain and mental illness, I often find the demands on my time challenging. My mobility is largely unaffected, which is good, since several of the buildings I frequent lack elevators for my second and third floor classes. With chronic pain often comes chronic fatigue, and while I can make it up and down all of those stairs, it takes its toll.

Managing disability and mental health requires appointments. Appointments take time out of home, work, rest, and class since they tend to be during standard business hours. Going to school for me means staying on my medications. Keeping that medication requires monthly appointments. Many classes penalize overall grades — some as much as one-third of a letter grade deduction — for missed instruction time. If you maintain attendance and miss appointments, health issues inevitably arise, requiring more missed class hours. My teenage child also has appointments, which my spouse and I must take turns with so neither of us miss too much work or school.

Most campuses now have disability services, like UH Mānoa’s Kōkua office. For many students, knowing what accommodations to ask for is daunting. What help can they offer for missed meds and bad traffic? Even if you know what to ask for, it needs to be documented by a qualifying medical professional, which is more outside-of-class time, and the hours per week are reaching untenable.

Universities could take great steps, including encouraging communication with instructors or eliminating graded attendance, in order to address some of these issues. Integrate more one-stop offices to help non-traditional students navigate enrollment and registration. Place non-traditional students on your student governments, boards of regents, and other organizations empowered to enact policy change. Create liaison positions for non-traditional students to direct their needs. Even small things, like eliminating assignments that are little more than busywork, can be an amazing reprieve.

Like I said, I’m in the final days. I would have to try to fail at this point, and even then it may not be enough to undo what I’ve accomplished. At the end of the term, many non-traditional and later-in-life students will graduate, but our successes are in spite of these circumstances. So, I guess that toilet is going to need to wait a few more weeks.