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We Gotta Start Associating Harm Reduction With Tobacco and Vaping More

The phrase “harm reduction” is most often associated with drugs and, to a much lesser extent, sex work — specifically, street prostitution and escorting as opposed to web-based, non-contact sex work — here in North America.

So much of our struggle as harm reductionists comes from trying to get our fellow laypeople rolling with SS Harm Reduction. Really, most of us who want to help drug users are interested in drug policy reform, drug user advocacy, and harm reduction, but most of us tend to lump it all under the umbrella of “harm reduction.”

Like damn. Those three are wayyy too fuckin’ long to say together just to identify ourselves.

Anyways.

I live in a rural, largely-right-leaning area that has virtually no HR infrastructure. You can imagine how few people are on board with harm reduction in bum-fucked-Egypt — in this case, BFE is Northwest Tennessee; my fellow injection drug users aren’t used to being able to source syringes in an above-ground manner. We’re used to the social services-criminal justice alliance not treating us right — why would we trust anything that seems too good to be true?

When it comes to my efforts in “drug stuff” — the aforementioned trio of things that help drug users — I feel like I’m responsible for making sure HR itself (i.e., mentioned by name) and HR-positive ideas thought of by people who don’t label their actions “harm reduction.”

We Gotta Normalize HR

People in the largely-right-leaning areas that dominate the United States by land mass are averse to ideas that seem overly left-leaning or excessively politically correct.

The modern American political landscape is more divisive than ever — check out this minute-long video that uses imagery to show just how discordant (yes, fancy word, I have big brain) we are in these times.

Social media also contributes to divisiveness among Americans. I don’t know what characteristics of social media lend themselves to this gross argumentativeness, though I know it’s true.

Also, I think largely-right-leaning people are all but averse to “radical,” high-level harm reduction applications like supervised consumption sites or safe supply; however, they are, in my opinion, likely to see the merit in switching to vaping largely-harmless nicotine solutions from smoking tobacco, which exposes smokers to dozens, if not hundreds of carcinogens. Hell, I’d think that many Americans wouldn’t even be down with syringe exchanges.

With such barriers in mind, it’s absolutely essential that we actively start involving tobacco and vaping in general harm reduction messaging. And, I’d go as far to say that harm reductionists, as individuals, should strive to associate entry-level harm reduction applications — or low-hanging fruit on the proverbial harm reduction tree, in other words — like switching to vaping from smoking or making sure to pace alcohol consumption and drink water in between every alcoholic drink, for example, with the phrase “harm reduction.”

In other words, if it’s appropriate for you to mention these entry-level ideas alongside “harm reduction,” do it! If more of us adopt this habit, we’ll undoubtedly improve the spread of harm reduction.

Not-So-Guilty by Association

Although tobacco so reliably causes cancer and other often-fatal health problems, since the drug is legal and has long been socially accepted by Americans from Fairbanks to Miami, it’s viewed many times more favorably than just about all illicit drugs.

The most widely-recognized application of harm reduction here in the United States is — and this is whether people actually think of it as “harm reduction” or not — switching from dip, chew, or another form of tobacco in favor of vaping.

Already, I can see how some people might not want to mar together the two worlds of (a) “hard” drugs that are viewed as inherently bad or high-level, “radical” ideas like supervised consumption sites and (b) basic, common-sense strategies that the American public is generally already on board with. Admittedly, it does seem disingenuous to associate non-radical, non-“hard”-drug-related ideas with what we’ve come to accept as “harm reduction.”

However, isn’t our cause as harm reductionists to help as many drug users as we possibly can to the greatest extent achievable? I think it is. Wanting to actively avoid easily-achievable, entry-level applications of harm reduction in favor of their way-more-advanced counterparts isn’t based upon solid reasoning — there’s nothing wrong with working smarter, not harder.

Well, at Least a Little Guilty

Vaping doesn’t have a smooth, buttery-soft image, unfortunately. Throughout 2019, people across the country developed often-serious pulmonary injuries, dozens of which died. News reports incorrectly linked the injuries to regular-ol’ vaping — the vaping smokers and dippers use to get clean of tobacco, that is — to the lung injuries. In actuality, the bulk of the injuries, if not all of them, were caused by counterfeit cannabis concentrate cartridges.

With legalization and regulation, states’ cannabis industries have become just like any other consumer goods market. Rather than, for example, cannabis concentrates being made in unregulated, illegal, often-unsafe makeshift labs and packaged in whatever’s convenient, these legal state markets offer branded products to customers.

You likely know that legal cannabis markets’ wares are often super duper pooper scooper mooper super fuckin’ expensive. Many people have eschewed the legal, well-regulated state cannabis markets in favor for the black market cannabis they’ve grown up with. With these two factors comes a perfect storm for tons of counterfeiting — and that’s exactly what caused the 2019-2020 vaping lung illness outbreak (that’s not my name for it; I ripped the name from Wikipedia), or so we think.

Admittedly, I’m not a vaping expert — I’m pulling this info essentially straight from Wikipedia. Centers for Disease Control and Prevention believes that patients who presented symptoms of vaping-associated pulmonary injuries were often exposed to cannabis concentrate cartridges that used abnormally-high proportios of vitamin E acetate, a thickening agent that’s regularly used in cannabis concentrate cartridges.

Usually, such cartridges wouldn’t contain more than 20% vitamin E acetate. Many illicit cannabis concentrate cartridge sellers were using vitamin E acetate to the point that cartridges were made up of at least 50% vitamin E acetate.

Vitamin E acetate is used because, to the untrained eye, it closely resembles THC oil, the most common cannabis concentrate.

Most Americans, so it seems, aren’t aware of the fact that counterfeit cannabis products were widely associated with observed vaping-related pulmonary injuries.

Ultimately, the vaping lobby ended up taking a net loss in terms of reputation. Still, it’d be beneficial to us to associate our cause with entry-level HR applications like this.

Associating Harm Reduction With Protective Measures Against COVID-19

Of course, global pandemics don’t come around too often. Like all of us, I hope the threat of catching COVID-19 goes away super soon.

However, while the pandemic is still very much in full swing, we should seize the opportunity to associate “harm reduction” with any and all entry-level, common-sense applications (e.g., wearing face masks or respirators, offering free novel coronavirus test facilities) that virtually everybody will recognize as effective.

And, just so we don’t get confused, potentially-controversial measures like forced stay-at-home orders shouldn’t, in my opinion, be linked to “harm reduction” — it seems like right-leaning people are responsible for much of the stay-at-home order protests; since we already desperately need to involve right-leaning people (especially those in rural areas) as harm reductionists, distancing ourselves from supporting such stay-at-home orders might be a good idea.

In Other Words, Let’s Make Harm Reduction Not Necessarily Drug-Related

If we could collectively brand “harm reduction” as a collection of common-sense, practical strategies for reducing all sorts of harms — not just drug-related harms — we’d be so, so much better off.

And, to be clear, I’ve already seen people associating the phrase “harm reduction” with the measures mentioned herein. But these harm reductionists are the exception, not the rule.

Lastly, since the vaping/smoking thing isn’t exactly in most harm reductionists’ wheelhouse, a lot of us — me included — might have to educate ourselves before we start making these associations publicly.

I want to hear what you have to say on this issue. And, no, this isn’t some generic call-to-action I close all my articles with; I really, really do value the community’s insight on this issue.

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.

2 replies on “We Gotta Start Associating Harm Reduction With Tobacco and Vaping More”

Hii Daniel,

“switching from dip, chew, tobacco, or another form of tobacco for vaping.”

Not sure how familiar with tobacco research you are but you should check out this video:

Like

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