Yesterday a man who has been in our program several times without success called and asked for help. Each time we've discharged him it's because he's been using drugs, usually on the property. On one of these occasions he was actually working for us as a manager. Another manager noticed that his eyes looked funny and he was asked to give a urine sample. He declined, and of course was discharged him for refusing a drug test.

Over the past 10 years he's been back in our program four times. For a period of time he'll do well and then he'll be asked to give a drug test, which he usually fails. After he leaves he goes on a long run of using until he is near death. When he calls, we usually take him back.

But where we draw the line? For some reason the man always has the humility to ask for help. When he calls he's usually broke, sick, and demoralized. Our inclination is to not help him. But then we have to look at our mission which is to "help recovering substance abusers rebuild their lives." So in pursuit of this mission, we generally take the man back into the program.

And these days we're more inclined to help people in this situation than to not help them. Over 10 years ago we turned a man down who had a similar history. We learned a few days later he died in the streets of Phoenix while drinking. Though he made the choice to drink and drug we always wonder if maybe we'd let him in one more time it might have helped him change.

There is a term that seems to apply to this situation. It is called "harm reduction." Maybe all we can do for a man in his situation is to help him stay sober for a period of time, that period of time being while he was with us and sober.