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Area-Specific Challenges in Northwest Tennessee

A run-through of the specific challenges I’ve faced here in Northwest Tennessee as both a drug user and a practitioner of harm reduction.

To my knowledge, very few people in Northwest Tennessee (NWTN) are either familiar with harm reduction or supporters of it, let alone active in distributing supplies or educating others.

There are no programs engaged in harm reduction in this region, with the exception of programs that engage in the distribution of naloxone, usually in the form of the name-brand, nasal-spray formulation known as Narcan. That’s all they do, unfortunately.

The More Rural the Area, the More Discretion That’s Exercised

In my experience, this holds true in NWTN. Everyone who has ever lived in a small town knows all too well that community members know about your business before even you are keyed in to what’s going on! At least, it seems to be that way.

Discretion, according to the Oxford English Dictionary, refers to “[the] quality of behaving or speaking in such a way as to avoid causing offense or revealing confidential information.” If I exercise discretion in telling you something, for example, I simply won’t come out and say it.

Due to the fast spread of information in tight-knit, rural communities, illicit drug users are particularly more likely to exercise discretion than the general population. The more risqué their drugs of choice, preferred routes of drug administration, and lifestyle choices are, the less likely NWTN residents are to share socially-frowned-upon information about themselves.

This makes it particularly difficult to reach the people who need help most, such as injection drug users (IDUs) or those who regularly consume illicit street heroin. I say these people need help most because they are statistically shown to be more at-risk than most other portions of the greater drug-using population.

In my experience, and in my opinion, a principal issue related to drug use that currently plagues NWTN is the unwillingness of drug users and all others involved in the world of illicit drugs — as well as their family members, friends, and other associates — to share their habits with others.

Most Drug Users Aren’t Aware of Basic Harm-Reduction-Related Things

Drug users, ostensibly, just like any other group of people, would be in favor of doing or supporting things that improve their quality of life. One of these many possible things is understanding how and when to administer naloxone, whether or not their drug(s) of choice are opioids. Another one might be regularly sharing harm reduction-related information with one another so as to improve their peers’ health.

Unfortunately, in my experience, most NWTN drug users — including opioid-primary or opioid-exclusive users — are not even aware of what naloxone is. Some are familiar with Narcan — it’s naloxone, but most here can’t tell you the differences or similarities between Narcan and naloxone — though few of these people even have access to the opioid overdose reversal agent.

Such as Syringe Availability

The same goes with having clean, legal access to hypodermic syringes. The majority of injection drug users in NWTN source syringes through one of two means:

• A friend, family member, or associate who has diabetes and a prescription for injectable insulin. Typically, these people don’t pay for syringes.
• A friend, drug dealer, or associate who sell syringes via a black-market manner.

There are obvious disadvantages to sourcing syringes through secondary sources, such as not knowing whether they’ve been used or not. Already-used units obviously increase the chance of developing infections, spreading blood-borne diseases, and otherwise causing soft-tissue damage.

In Tennessee, fortunately, it is legal to receive syringes without a prescription. Tennessee residents can readily purchase syringes suitable for injection drug use online from medical or diabetes supply stores either in or out of state. They can also source syringes from organizations such as the Harm Reduction Coalition — for free, too!

Further, there are syringe exchanges here in West Tennessee, for example, but only in Memphis, the only city in the region. There are a few syringe services programs in East Tennessee, too, but only one is in a rural area. That happens to be the only rural-based SSP in all of the Volunteer State.

Law Enforcement Officers Aren’t Well-Versed in Laws That Protect Drug Users

No law enforcement officer wants to handle hypodermic syringes in their line of duty. Unfortunately, in reality, they’re likely to cross paths with used syringes on a reasonably-frequent basis.

In Tennessee, our state book of laws is known as Tennessee Code Annotated. It contains 71 individual titles, each of which is broken down into several chapters, which are further broken down into sections.

That’s a lot of laws to learn!

I can’t expect every Tennessee law enforcement officer to be aware of all state laws. However, they should be well aware of all those that protect themselves from things like not knowing where apprehendees’ used syringes are, should they be in possession of them.

One such example is with T.C.A. § 40-7-124 — Tennessee Code Annotated Title 40, Chapter 7, Section 124 — which protects people in the possession of syringes used as drug paraphernalia from getting charged with being in possession of drug paraphernalia.

Here’s how it works: after getting pulled over or otherwise approached by law enforcement and before being searched, as long as you inform the officer(s) that you’re in possession of syringes and point them toward the general location of said syringes, you cannot get charged or prosecuted with violation of drug paraphernalia statutes for those syringes.

Unfortunately, many law enforcement officers in NWTN — also, presumably, elsewhere around the state of Tennessee — aren’t aware of laws that help or protect drug users such as T.C.A. § 40-7-124.

There Aren’t Many Programs That Help Drug Users Here

Of course, there are some programs that help drug users in rural West Tennessee, but there aren’t many.

Just like everywhere else, we have rehabs, which are designed to help drug users get over their struggles with substance use disorder. We also have our lovely Regional Overdose Prevention Specialist, Melesa Lassiter, who distributes naloxone to community members and trains them in using naloxone.

Outside of this, there aren’t really any programs designed to help drug users here in Northwest Tennessee.

In Conclusion

Obviously, I didn’t include any solutions to the issues identified in this post. The purpose of this document is simply to explain to outsiders some of the issues that plague drug users in NWTN.

Please reach out to me with any questions or concerns. I don’t know too many people who are down with the cause in Northwest Tennessee, so, if you are — or even if you don’t live in NWTN — please reach out.

By Daniel Garrett

I'm a self-employed writer, long-term drug user, and resident of rural Tennessee. Find me on Twitter at @DanielGarrettHR or email me at danpgarr@ut.utm.edu.

9 replies on “Area-Specific Challenges in Northwest Tennessee”

[…] Here in rural Tennessee, people who especially averse to anything that’s been singed by superfluous political correctness. This isn’t geographically specific, though — aversion to political correctness is common among all largely-right-leaning people regardless of location. I should mention that even some left-leaning people aren’t fans of PC, either. […]

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[…] Here in Northwest Tennessee, most fellow drug users aren’t familiar with rapid fentanyl test strips — or, I should say, at least they weren’t familiar with them before I put them on game. These test strips are the most popular, in-demand supply I give out. I wish I had more, as they get more people interested in harm reduction in general. Hell, they make people more interested in taking care of themselves. […]

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