In this chapter, we examine why these people are unable to escape this form of permanent destitution – living in Valdemingómez, homeless, taking heroin and cocaine and amassing numerous health problems. We relate this to a gradual erosion of their emotional, psychological and physical faculties and how this has been facilitated by the meagre forms of support given to them along the way. Personal markers of the self are instead measured against the physical and visual degeneration of other people around them and regulated by the ideological figure of the “machaca”. Because many, we suggest, have spent many years in denial of their situations, when prompted to face up to this, almost all struggle. We point out here that all this collectively interferes with the commitment required of them by the treatment system, which in itself, is snared with further barriers and challenges such as long waiting lists, poor housing placements and substandard work options. The majority then simply return to drugs and to Valdemingómez passing time before their inevitable death. This process we call the “personal surrender”.