As a long-term drug user, unfortunately, I’ve had a few run-ins with law enforcement and the criminal justice system. Many drug users, especially those who suffer from substance use disorder and have for a long time, share these same legal struggles.
In my nine-plus years of regular drug use, one thing I’ve learned is that the average drug user spreads far more misinformation about drugs than they do truthful, accurate information about drugs. Also, laypeople — whether they use drugs or not — don’t know much about the law, generally speaking.
In this article, I want to shed light on a relatively new law codified within the state of Tennessee — the state’s laws are codified within Tennessee Code Annotated, for the record — called T.C.A. § 40-7-124.
Why Should You Know About It?
T.C.A. § 40-7-124 — that’s pronounced as Tennessee Code Annotated, Title 40, Chapter 7, Section 124 — protects drug users from getting popped with Possession of Drug Paraphernalia, a Class A misdemeanor (as much as 1 year in jail, $2,500) as long as they’re honest with law enforcement officers about what they have in their possession.
To best understand T.C.A. § 40-7-124, please read the entirety of this article. It also wouldn’t hurt to google “T.C.A. § 40-7-124” and read what you can about the law elsewhere, too.
You can pronounce this law as Tennessee Code Annotated, Title 40, Chapter 7, Section 124. I struggled with trying to say it out loud after learning about it, but there weren’t any readily-available resources that were easy to understand. Still, to be honest, I am not 100% sure if this pronunciation is correct. If I’m wrong, tell me and I’ll change it — at least we’ll finally have some closure.
What Is T.C.A. § 40-7-124?
This law protects people who are caught with syringes or other sharp objects that have been used as drug paraphernalia from getting charged with being in possession of drug paraphernalia for those objects, though you must inform law enforcement that you’re in possession of such objects before you get searched.
For example, let’s say you’re in possession of a razor blade used to chop up cocaine, heroin, pills, or meth, or a syringe used to inject such illicit drugs. Before you get searched, you inform the law enforcement officer who pulled you over or otherwise apprehended you of your possession of such items. You are not legally allowed to be charged with or prosecuted for being in possession of drug paraphernalia, codified in Tennessee Code Annotated as T.C.A. § 39-17-425, since you informed that officer of the presence of that razor blade or syringe.
Keep in mind that you very much can get charged with being in possession of drug paraphernalia for other drug paraphernalia not covered by T.C.A. § 40-7-124, such as a plate used to chop illicit drugs upon, a straw used to snort illicit drugs, and so on. Also, if you’re in possession of actual drugs and you get caught with them in this situation, you’ll likely be charged with being in possession of such drugs — T.C.A. § 40-7-124 doesn’t protect you against everything that’s drug-related.
What’s the Purpose of T.C.A. §40-7-124?
Politicians and other governmental figures want to protect law enforcement officers from being exposed to used syringes or other harmful objects. Syringes are sharp and, obviously, can cause physical harm, even if they’re 100% sterile. However, people don’t carry syringes for no reason — in most cases, that is — and usually intend to use syringes for the administration of illicit drugs, hormones, insulin, etc.
This Tennessee drug law came about in 2015 with the intention of protecting law enforcement officers — the uniformed public servants who do work tough, dangerous jobs — working jurisdictions within the state of Tennessee from being exposed to objects that are very much capable of spreading blood-borne diseases such as HIV or Hepatitis C.
What Happens if You Get Arrested Despite the Protections Afforded by § T.C.A. 40-7-124?
Most often, we have to drive to where the drugs are or otherwise transport ourselves to them to source them.
Anyways — what happens if you get arrested despite playing by the rules of § T.C.A. 40-7-124?
Let’s assume you only get arrested for being in violation of T.C.A. § 39-17-425. In laymen’s terms, this simply means you got arrested for the misdemeanor possession of drug paraphernalia.
In most jurisdictions, as we frequent fliers of the criminal justice system here in Tennessee know, you’ll likely be given anywhere from six months’ to a year’s probation, along with court fees. You can choose to plead guilty to possession of drug paraphernalia so you can quickly get back to living in the real world. Many of us are forced to plead guilty in such situations to return to our jobs, parenting, and other real-world obligations that we all have to take care of.
If You Can Afford to Bail Out
Bail out as soon as possible. Hire an attorney who is aware of T.C.A. § 40-7-124. If they’re not already aware of this law, hire another one.
With the help of an attorney, you should be okay.
Please keep in mind that I am not an attorney or otherwise legally approved by the state of Tennessee to provide legal advice. Do not take any information listed in this article or on this website as legal advice. The only people who can provide reputable, reliable legal advice are people sanctioned by the state of Tennessee to practice law.
If You Can’t Afford to Bail Out
If you’re willing to sit in jail for anywhere from a week to a month, by all means, do it! With a competent public defender’s help, given that you did comply with T.C.A. § 40-7-124, you shouldn’t be prosecuted for being in possession of drug paraphernalia. After all, T.C.A. § 40-7-124 does prevent people in such situations from being charged with or prosecuted for being in possession of drug paraphernalia.
However, most of us in Tennessee aren’t willing to do this.
Most drug users in Northwest Tennessee (NWTN) are simply too poor to bail out of jail and pay for an attorney. NWTN is simply a greatly-impoverished area. Considering that drug users, as a socioeconomic class, don’t have the same access to financial and other resources, especially here in NWTN, you’ll likely fit under this category — not being able to afford posting cash bail.
That’s Right — Unfortunately, As It Stands, We’re Shit Outta Luck
Again, I’m not an attorney, and I certainly hope I’m not acting like one.
As it stands, even though T.C.A. § 40-7-124 should protect active drug users from being in possession of sharp objects used as drug paraphernalia from getting charged with or prosecuted for being in possession of drug paraphernalia, T.C.A. § 39-17-425, it’s not helping us.
The only thing we can do — by “we,” I mean everybody interested in harm reduction or drug policy, active drug users, recovering drug users, family members and friends of drug users, etc. — is strive to educate laypeople, law enforcement officers, local and state-level politicians, active drug users, and everybody else here on planet Earth about T.C.A. § 40-7-124.
What Can We Do?
Also, anybody and everybody who plans on talking about this stuff to others, whether that be on a public forum like Facebook or Twitter or in real-life conversations with family members, friends, community members, coworkers, peers, or others, make sure to do so in a friendly, calm, welcoming, well-thought-out manner!
Keep in mind that, as far as law enforcement agents are concerned, they regularly hear backtalk and criticism from individuals and society at large. Also, they are the only people who actually enforce laws for a living. They’ve been trained to do this, likely are required to be trained or educated on an ongoing basis, and quite literally put their health and welfare on the line while enforcing laws.
Some, if not many, are generally not willing to listen to people who are not professional law enforcement officers talk about laws and their enforcement in real-world scenarios.
The best way — as far as I know — to get through to pliable, open-minded law enforcement officers would be to first approach friends and family members who are in the field about T.C.A. § 40-7-124 and similar laws.
If you talk to or work with law enforcement regularly, you know exactly how to handle this. For the rest of us who aren’t fortunate enough to be well-versed in educating, informing, or simply being around law enforcement officers, you could benefit from using this harm-reducing brochure — it’s called “Sticks, Pricks & Pokes: a Law That Protects LEO From Needlestick Injury” and is about T.C.A. § 40-7-124 specifically:
Again — and above all else — make sure to be kind, open-minded, well-researched, and nice in sharing information about T.C.A. § 40-7-124 with others. This holds true for talking about other laws, both those in Tennessee and elsewhere, that protect drug users, and otherwise advancing the causes of drug policy reform and the adoption of harm-reduction-related policies and practices.
I am not an attorney. I am not licensed to practice law in the state of Tennessee or elsewhere within the United States. I have never studied law. I have never worked under the supervision of anyone who was, or currently is, sanctioned by any local, state, or federal government to practice law. The advice given herein is not meant to take the place of advice from an attorney, legal consultant, or anyone else who is licensed to practice law in Tennessee or elsewhere.
If you find yourself in a situation outlined above or otherwise related to T.C.A. §40-7-124, T.C.A. §39-17-415, or other laws, you should consult an attorney who is licensed to practice law in the state of Tennessee.
For the record, we do not support the criminalization of sex work. Arresting sex workers (and buyers) en masse does nothing but push the sexual services market further underground, onto the streets in the form of street prostitution and into the hands of abusive sex traffickers. Founded by a former sex worker, we stand in solidarity with our sex-working brothers and sisters. If you’re a current or former sex worker — or an ally — consider joining the Tennessee Sex Workers’ Union.
Be the first to read our original reporting on all things drug- and sex work-related in the Jackson area by subscribing to Tennessee Harm Reduction — enter your email under the Get Notified of Blog Posts prompt on the left-hand side of this page — or following us on Facebook.
Local law enforcement allegedly carried out a prostitution sting in Jackson, Tennessee, arresting at least one local sex worker in the early morning hours of Friday, Dec. 3. We have reason to believe the sting may have started as early as Thursday, Dec. 2, and could still be going on right now, as of 2:15 p.m. Central Time, Sunday, Dec. 5. Law enforcement allegedly solicited sex workers via the online sex trading platform Skip The Games, posing as legitimate patrons only to arrest at least two women for prostitution (presumably T.C.A. § 39-13-513).
Through our sources, we’ve confirmed that at least one local sex worker attempted to use the sex-trading website Skip The Games to turn a trick in the early morning hours of Friday, Dec. 3. When the sex worker arrived at the client’s residence — it was probably a hotel, though the grapevine didn’t confirm where it happened, exactly — law enforcement arrested them; shortly thereafter, they were booked into the Madison County Criminal Justice Center (CJC) with a prostitution charge.
No official reports of this sex-working sting have been published by local law enforcement as of Sunday, Dec. 5. Multiple women have recently been booked into the Madison County Criminal Justice Center (CJC) with prostitution charges, as mugshots from local news outlet WBBJ show. Owing thanks to the “inside scoop” we received through the grapevine, we’re certain that law enforcement has, in fact, carried out some type of sex-worker sting this weekend.
Whether true or not, we here at Tennessee Harm Reduction don’t support the criminalization of sex work. Web-based platforms for trading sex work such as Skip The Games give sex workers the agency to market themselves, reducing their exposure to serious harms such as violence, sexually transmitted diseases, and abusive clients.
When law enforcement agencies engage in anti-sex-work campaigns via web-based sex trading platforms like Skip The Games, they take away sex workers’ agency to market themselves. Without such websites — such as Backpage, which was taken down in April 2018 after Congress passed controversial legislation (SESTA/FOSTA) into law — sex workers face serious challenges:
They struggle to screen clients, let alone find them in the first place
Sex workers are often forced back into street-based sex work — “street prostitution,” in other words
Upon being pushed back into the street, sex workers are forced to compete with 100% street-based sex workers, potentially resulting in violence or other harmful outcomes
Most importantly, sex workers face much greater risks of being trafficked — isn’t that what law enforcement should be fighting, rather than fucking with independent sex workers who’re just trying to do their jobs — just trying to get by?
On June 18, a news report was released by Huntsville, Alabama’s WHNT 19 News claiming a deputy had overdosed on fentanyl while searching a suspect. After searching a suspect’s pockets, the deputy allegedly caused a powder containing fentanyl to fly up into his face, where he inadvertently inhaled it, causing an overdose.
In the online report, Lincoln County officials released the alleged body cam footage from the incident via WHNT. Only one angle was released of the alleged overdose from the perspective of the officer. It’s dark, nondescript, and short.
Most alarmingly, no suspects were charged with drug possession, assaulting a law enforcement officer, or anything else.
No medical or toxicology reports or updates have been shared. Outside of the aforementioned article and video on WHNT’s website and, no other mentions of Deputy Trent Layman’s inadvertent run-in with fentanyl have been released online. Tennessee Harm Reduction called Lincoln County Sheriff’s Department in the days following the WHNT release, though received no other information about the incident.
Our goal is not to deny Mr. Layman’s victimhood — it’s to obtain more evidence of this alleged incident happening. We have no toxicology reports, medical opinions, or updates from Lincoln County Sheriff’s Department. This currently-unsubstantiated claim has unarguably negatively influenced public opinion even further against drugs. Thus far, the small-town Tennessee sheriff’s department has gone unchallenged on this issue.
We want additional evidence from Lincoln County Sheriff’s Department to support the legitimacy of this May 30 event.
Hysteria Around Fatal Fentanyl Contamination via Transdermal and Respiratory Exposure Has Galvanized America Against Evidence-Based Solutions for the Opioid Crisis
An American College of Medical Toxicology and the American Academy of Clinical Toxicology paper posits that opioid overdose from inadvertent exposure to airborne fentanyl isn’t scientifically feasible as part of a 2017 safety guide for first responders.
Spreading such reports attracts public support for the War on Drugs, often in the form of further criminalizing people found in possession of fentanyl.
Two Republican U.S. Representatives from Ohio, Steve Chabot and Bob Latta, introduced FIGHT Fentanyl Act (H.R. 5771) in hopes of permanently banning fentanyl analogues on a federal level in Feb. 2020. “Fentanyl-like substances” were temporarily banned by the DEA in 2018, which is set to expire in 2021. This would make punishing fentanyl analogs much easier, more harshly criminalizing even those simply in “possession of fentanyl-like drugs.”
“We need to focus on evidence-based harm reduction policies and programs like syringe exchanges and supervised consumption sites,” says Sara Alese, Tennessee Recovery Alliance’s executive director.
39 people in total were arrested. Pulliam, Gary, and Esquivel were each given 12 charges in total; each three share the same list of 12 charges.
The life-saving drug has been legal in the Palmetto State since at least 2016, when the South Carolina Joint Naloxone Protocol was written into law.
These charges are alarming, as the Spartanburg County Sheriff’s Department seemingly doesn’t want to encourage people at high risk of opioid overdose to carry it. Further, a legal precedent to wrongly charge individuals found in possession of naloxone could be established if these charges stick.
We must urge Spartanburg County Sheriff’s Department and South Carolina legislators to reverse these charges.
Criminal Charges for Naloxone — a Bad Look
Naloxone (Narcan) is a life-saving drug that reverses opioid overdose. It’s been distributed across the United States — and the world — in response to opioid overdose deaths. South Carolina, like every state, has legalized naloxone. Why are people being charged for possessing this life-saving drug, one that has no known contraindications outside of naloxone allergy?
The South Carolina Joint Naloxone Protocol, pursuant to § 44-130-40 of the South Carolina Code of Laws, allows pharmacists to dispense naloxone without a prescription or patient-specific instrutions, making naloxone legal in South Carolina. The most recent iteration of this law was written in 2016.
Marc Burrows, operator of South Carolina’s only syringe exchange, Challenges Inc., says, “This is unfortunate. Naloxone saves lives, and it’s already legal here. Why were these three charged for naloxone possession, of all things?”
Naloxone possession is legally protected by law. You can’t get “high” from naloxone. Rather, it removes opioids from the brain’s opioid receptors, thus reversing overdose. It has no known major contraindications, meaning it doesn’t interact with other drugs. People can be allergic to naloxone, though it’s rarely serious.
“Operation Groundhog Day”
Many law enforcement agencies, especially in rural America, make annual or otherwise regular “drug roundups” where they indict drug-involved people, mainly sellers, on various drug-related charges.
This operation had been in the works for some time, says Fox Carolina, a local news outlet covering the Spartanburg, South Carolina area.
Jane, 52, is a long-term sex worker and often-problematic drug user. She preferred cocaine for some two decades, drifting in and out of jail, rehab, and places to stay along the way. Now, she uses heroin to treat her chronic pain. I believe the unfortunately-illicit opioid satisfies her nearly-lifelong craving for stimulants, although she still uses meth from time to time to scratch that proverbial itch.
Jane, a tried-and-true oldhead, distributes more safe drug use supplies throughout Northwest Tennessee and Jackson-Madison County than likely anybody. Well, I’m sure her numbers are behind Northwest Tennessee’s sole Regional Overdose Prevention Specialist — who only distributes naloxone, might I add — but she’s up there.
How did Jane, a “community guide,” become a leading figure in drug-related public health here in rural West Tennessee, yet still not be employed, commended, or even recognized for her contributions?
The answer lies in the intersection of Tennessee’s painfully-slow response to the opioid epidemic and its unusually-harsh criminal justice-social services alliance. Oh, and the fact that rural communities in the Volunteer State still don’t have a single syringe exchange. Y’know, problems with community buy-in and stuff like that.
Introducing the Community Guide
Other harm reductionists and public health officials have long aligned with well-connected sex work/drug-involved people like Jane to further distribute safe drug supplies and, thus, reduce transmission of blood-borne diseases like hepatitis C and HIV, encourage drug-involved people to improve their lives, and all that good stuff.
Yet, I haven’t seen anybody define the role that Jane plays here in Northwest Tennessee. Or anywhere else. I think “community guide” is a fitting term because, although Jane might not have the glowing reputation of a mayor or city council member, she’s super-integrated in Northwest Tennessee’s sex work/drug-related underworld.
Tennessee, as well as every other government or government-related entity in the realm of public health, needs to begin using — hell, not “using,” but employing — people like Jane as community guides to start reaching the most deprived members of society, those that the criminal justice-social services alliance has done nothing but harm.
I live in Northwest Tennessee, also known as Region 6N by the state (at least as far as Regional Overdose Prevention Specialist jurisdiction is concerned), a nine-county region home to about 254,000 people. 2014 — that’s when I moved here. It’s also when I picked up opioids as my drug of choice. I’ve been using illicit opioids, both heroin and diverted prescription opioids, regularly since then.
Although now I’m “in recovery,” I’m still in touch with people who use opioids around here. I give out syringes, naloxone, fentanyl test strips, and the like. I educate people about safe drug use practices. I inform law enforcement and members of the public about relevant issues and the gospel of harm reduction.
I read countless articles and social media posts about how the novel coronavirus pandemic would disrupt the drug trade. Nothing, really, changed around here. Until now.
A week-and-a-half ago, I came across a report of some strong heroin. People I know claim this stout stuff acts like normal heroin, but another (often strong) wave kicks in anywhere from a few minutes to over an hour later — even if they inject it intravenously.
I came across this same stuff again just five days after my first encounter with it. People around me say they’ve had this stuff before, maybe even as far back as a few months or years ago. But it’s in supply now. If you’re buying opioids, whether it be heroin, diverted prescription opioids, or counterfeit opioid painkiller tablets, there’s a chance you come across this stuff.
I know it’s in Jackson, too, which isn’t technically in Northwest Tennessee — it’s central West Tennessee.
I was told by a regional medical/public health official there were nine fatal overdoses in Northwest TN in the past month. I was also told by a fellow opioid user that there were three fatal overdoses on Mother’s Day weekend alone. I don’t know if these three are included in the nine since the second report came from an unofficial, anecdotal source.
Unfortunately, I don’t know what’s in this heroin. It could also be in counterfeit pain pills around here, if not elsewhere, but I don’t know. I haven’t heard reports of this stuff in Knoxville, Nashville, or North Carolina from sources in these areas.
I think a novel psychoactive substance (NPS) is being cut into heroin because of supply chain issues thanks to the novel coronavirus pandemic. But we don’t know what that NPS is yet. It could be a fentanyl analogue. It could be something like U-47700. But I don’t know. It’s definitely an opioid, that’s for sure.
My purpose in writing this is to sound the alarm and tell people who use drugs, specifically opioids, to be careful. But how, exactly, can you be careful while using this drug — whatever the hell it is?
Advice for Using Opioids During This Time
These tips are gathered from real-world experience with harm reduction in mind. The following tips aren’t necessarily true for all opioids — again, they’re written with this batch of whatever-the-fuck-it-is in mind.
Take It Super Duper Slow
Like I said, this stuff takes anywhere from a few minutes to over an hour to fully kick in. You should always use test doses (called test shots if you’re injecting), but especially with what’s going around right now. Although it’s tempting to use a larger dose at first or even a few minutes after doing a test shot, refrain yourself from dosing again for at least an hour, if not longer.
I know this is difficult. Plus, it’s not practical to assume everyone will take this precaution. A test dose might not be enough to bring someone out of hellish opioid withdrawal. Also, being careful isn’t always synonymous with having fun — I understand the rush this stuff brings is nothing short of sensational.
Cook It First
You can’t do this unless you inject — well, you can, but most snorters don’t want to dissolve their drugs in water; plus, most people aren’t willing to boof, or rectally administer, opioids, even though it’s the next-best route of administration after injecting with roughly 60% bioavailability — but “cooking” your dope refers to heating it up wth a lighter just to the point of boiling (some prefer to heat it to a boil, some don’t) once you dissolve the drugs into water.
Rumor has it that cooking this stuff makes it potentially safer by helping the other active drug(s) kick in faster. If possible, even if you only snort or boof, cook your opioids before using them (I wouldn’t cook pills, but, then again, I wouldn’t recommend injecting or otherwise using pharmaceuticals other than directed, which is usually orally). Here’s how to do just that:
Dissolve some of your drugs (this is possible with other water-soluble drugs, not just opioids) in water. I recommend using less than one milliliter of water, as well as using metal “cookers” as shown below. A metal spoon will work just fine, too.
Mix the drugs until they dissolve. Sometimes, like with black tar heroin, they might not dissolve without heat. Here in Northwest Tennessee, though, powdered heroin that readily dissolves in water is the norm.
Hold a lighter under the cooker just until it boils. The boiling point is reached as soon as you begin seeing bubbles form. You should see black scum forming at the top of the solution. These are likely impurities, if not one or more of the novel psychoactive substances (or one or more of their byproducts), that you don’t want to be consuming anyway. Keep in mind you want to avoid boiling because opioids could be destroyed. Nobody wants that. At least not me.
Use cotton or a wheel filter (good luck finding those; they are available online, just kinda pricey) to draw the solution into a hypodermic syringe or an oral syringe — hell, a turkey baster, if you can’t get either of those. You can get oral syringes from pharmacies without prescriptions. Go ask any pharmacy (I’ve had success at Walmart) for an oral syringe, they’ll usually give one to you for free. You can buy hypodermic syringes online from medical/diabetes supply shops without syringes — I’d recommend pharmacies, but most here aren’t willing to sell needles without prescriptions.
Most people don’t store injection drug solutions for long, as they usually cook just enough for one dose. If you do decide to store an opioid solution, I recommend keeping it in a refrigerator.
Know How to Spot It
Check out these pictures an anonymous source took of this batch. These were taken just a few days ago, around Wednesday, June 10th.
Remember how I said the color of the uncooked solution is often darker? Here’s what that solution looks like before being heated. Note the color of the solution is darker than after it’s been heated.
Although the cooked solution is visible in the first picture above, here’s what the cooked, filtered solution looks like. There doesn’t seem to be much difference in the filtered and unfiltered solution after it’s cooked.
But what does the dope itself look like?
Here’s what the stuff looks like outside of plastic.
This stuff is said to taste just like any other batch of heroin and wasn’t sweet like fentanyl-cut batches sometimes are. Keep in mind that you can’t reasonably identify drugs just by their appearance, though it is important to know what this stuff could look like and how it might behave.
If you come across any opioids that share some or all of these chracteristics, contact me and/or other drug-involved persons, ranging from dealers, fellow users, family members, prevention coalitions, law enforcement agencies (reporting the presence of drug trends to law enforcement ain’t snitchin’), syringe services programs, medication-assisted treatment program administrators and physicians, addiction treatment providers. Don’t do anything that might incriminate you, but there are plenty of ways to go about sharing drug reports without getting yourself or others in trouble.
If you live in Northwest Tennessee and need naloxone (Narcan), contact Region 6N Regional Overdose Prevention Specialist (ROPS) Melesa Lassiter at (731) 819-7603 or firstname.lastname@example.org. You can also contact Martin Housing Authority if you’re around Martin at (731) 587-3186 or the Weakley County Prevention Coalition at (731) 514-7951 or email@example.com.
If you live elsewhere in Tennessee, use this to find your region’s ROPS, along with their phone numbers and emails.
Mitragyna speciosa is the fancy taxonomical name for kratom, a deciduous evergreen* tree native to Southeast Asia that’s in the Rubiaceae family alongside coffee and tea. Unlike these two oh-so-common commodities, kratom doesn’t contain any caffeine. Rather, kratom contains about two dozen alkaloids that are collectively responsible for its pain-relieving, uplifting, and opioid-dependency-satisfying effects.
“Kratom” refers to both the Mitragyna speciosa tree and its leaves, the part of the plant that’s actually consumed. Don’t worry, though — in the United States, kratom trees don’t grow wildly, so “kratom” always refers to the leaves here.
*If kratom were grown in much of the U.S., its leaves would fall off in the winter; it’s native to tropical Southeast Asia, where the temperature never gets low enough for Mitragyna speciosa to go dormant (lose their leaves), making it a “deciduous evergreen” tree.
The Origin of Kratom
Although Mitragyna speciosa grows across tropical SE Asia, it’s only legal in Indonesia. While some kratom might come from illegal sources, it’s safe to say 99% of kratom available to American consumers is from Indonesia.
Indonesia is the fourth-most populated country on the planet with some 270 million residents but has just one-fifth the land mass. The country takes the form of an archipelago, or a bunch of islands; the second-largest of its 17,000 islands, Borneo, happens to be one of the most sparsely-populated spots in the Republic of Indonesia. Indonesia owns about three-quarters of Borneo — its share is split into five provinces: Central, East, North, South, and West Kalimantan.
West Kalimantan is where most kratom comes from. I don’t know how much, but I feel comfortable saying at least 95% of all kratom on the current market comes from Indonesia’s part of Borneo.
The city of Pontianak, (in the province of) West Kalimantan, (in the country of) Indonesia is the largest kratom hub in the country — and, by extension, the world.
Some kratom is grown in the U.S., but almost entirely for personal consumption. I feel confident the U.S. will ramp up its production of kratom in the future, but I don’t know how long that’ll take.
How Traditional Kratom Use and Modern American Consumption Differs
Traditionally, laborers of SE Asia have chewed fresh kratom leaves — in much lower doses than what modern American kratom consumers take — to power through the workday and alleviate aches and pains. They’ve been doing this for at least a few hundred years, if not way longer (I’d think it’d be thousands of years, but I’m not sure if the already-super-lacking body of kratom research supports this). Brewing tea — technically, it’s a tisane, not a tea — has also been common throughout SE Asia.
In the United States, we practically only consume kratom in dried, powdered form. Kratom leaves are milled like flour. Most often, we either swallow the powdered kratom, often done with a liquid, or make tea out of it, though tea-making is much less common. Modern American kratom consumers’ doses vary wildly, though most range between 3 and 12 grams.
The first noticeable wave of kratom came into the States after American soldiers returned home from the Vietnam War. This didn’t cause a permanent surge in kratom demand, though. The modern wave of popularity began within just the last 20 years. No doubt, the ongoing “opioid epidemic” — I don’t like that name, and you probably don’t, either — influenced the botanical’s popularity. The rise of e-commerce played a big role in boosting kratom’s accessibility, as did globalization.
Usually, you’ll find kratom in loose, powdered form. It also comes in capsules for ease of dosing, though capping them yourself is much cheaper. The only way to get fresh kratom leaves is to grow them yourself, have a friend or acquaintance who grows them, or live in SE Asia.
The Unfortunate State of Chronic Pain Treatment
I won’t elaborate on how tough opioid prescriptions are to come by for chronic pain here in modern America, but, just as you guys know, it’s fuckin’ tough. Even if you can get one — good luck finding prescribers willing to give you as much as you need — a constant worry of getting cut off lingers in the back of chronic pain patients’ minds.
The very real potential of having your legal opioid painkiller supply cut off out of nowhere is a big issue on its own. That risk comes in the form of opioid dependency. Wouldn’t you want a magic bullet to make opioid withdrawal syndrome go away once it rears its ugly head? It’s bound to happen in every CPP’s doctor-visiting career.
Kratom does just that. Yup, no bullshit, it satisfies our brains’ opioid receptors enough to stop withdrawal dead in its tracks. And it’s not that kratom has some limitless recreational potential or something — that couldn’t be further from the truth. There’s debate on whether kratom is an opioid or not, but, come on, it sure as hell acts like one!
But not when it comes to euphoria.
It acts like an opioid in terms of analgesia, say countless thousands of anecdotes online, but not when it comes to causing dependencies of its own.
We haven’t even got to the legality aspect yet. Mitragyna speciosa, at least in its raw form, is legal in almost every jurisdiction across the U.S.
And did I mention how cheap it is? Fair market value (FMV) of a kilogram of kratom is currently between $80 and $130; with doses ranging from 3 to 12 grams, a fair-market-value dose’ll run you ~$0.25 to ~$1.50. When I took kratom regularly, I dosed anywhere from 3 to 6 times daily.
Kratom holds its ground as a stand-alone pain reliever. Pharmaceutical companies hold several patents on alkaloids that are in kratom; patents don’t always indicate worthwhile or commercially-viable ideas, but early research indicates these alkaloids are worth their salt in healthcare contexts.
Mass Mis-Marketing in the Modern Mitragyna Market
We know almost all kratom comes from Borneo. Then why are there so many “strains” that come from other islands? I’ll tell ya why — ‘cuz it’s a marketing ploy.
Don’t pay much attention to “strain” names. Just find what works for you. I already wrote about this issue in full here, if you want to learn about mass mis-marketing in the modern Mitragyna market.
Problems With Kratom’s Mainstream Marketing
One thing that hurts kratom’s stock is how it’s marketed like the rash of legal highs that exploded in head shops, gas stations, and even “legal high” specialty stores in the early 2010s across the United States. It’s often sold in eye-grabbing packaging and, while I can’t be mad at store owners trying to put roofs over their heads, I most definitely am upset with the way kratom is sold at gas stations, head shops, etc.
I wrote about why buying kratom at stores like this is a bad idea here, if you’re interested.
Where to Find Kratom
Local in-person, non-ecommerce kratom markets are not very competitive. Where I live, a town of 10,000 and a county of 30,000 in the South, kratom never costs ≤ $0.50 and usually doesn’t go for ≤ $0.75. Shopping online is how you get kratom for the FMV of ~$80 to ~$130 — don’t expect to find kratom for this cheap at a gas station!
I don’t want to promote any vendors. Seemingly EVERY kratom resource online either’s hosted on a vendor’s page or has affiliate links to one or more vendors’ websites. Who am I if I fall guilty to the same lack of objectivity? I’m trying to teach you to fish here rather than just give you the fish, too, as that old-as-dirt proverb goes; here’s the steps I would follow:
Look for American Kratom Association Good Manufacturing Processes (AKA GMP) certified kratom-selling outfits in the United States — this is, of course, assuming you’re in the U S of A like me. You can find a list on the AKA’s website. Only the largest kratom businesses can afford getting this seal of approval. Buying from nobody but AKA GMP-certified vendors would leave countless more-than-suitable, way-cheaper alternatives.
AKA GMP This stamp of approval is the safest way to find a legit source of kratom, but I’ve never done it myself. I’ve always received kratom from non-certified sources. Here’s the thing — every single bit of kratom that any AKA GMP-certified company imports comes from non-AKA GMP-certified entities. Buying directly from Indonesia is ideal for getting the most value (lowest price); it’s also likely to be fresher coming straight from the source.
I got into kratom because of my problematic non-medical opioid use. What I mean is, even though I wasn’t opioid-dependent, kratom improved my ability to abstain from the use of “real” opioids, in turn boosting my quality of life. I’m not a chronic pain patient (though I am a CPP advocate) and want to be clear about how I got involved with kratom. This is relevant because I was always used to buying unregulated drugs (yes, kratom is a drug). CPPs are used to buying regulated goods and services; veering away from AKA GMP-regulated kratom sources could ultimately delegitimize our shared interest of giving CPPs more tools to handle chronic pain.
If I had to leave you with three ways to find good kratom sellers online, it’d be these:
The more legitimate the social media presence, the better.
The longer they’ve been around, the better.
The more (legitimate) reviews, the better.
How to Use Kratom
You can toss-n-wash — that’s short for “toss and wash” — powdered kratom with a liquid fairly easily. Put the kratom in your mouth and take a few swigs of chocolate milk (my favorite), orange juice, or, hell, just water. Trust me, though, this shit tastes rank.
You can also mix kratom into a drink, like a chocolate milk, for example. That’s what I always did.
Of course, you’ve got the capsule option. I don’t think capsules are good for dosing upwards of three or four grams; for me, personally, it always felt like the capsules rose to the top of my stomach — I could feel them inside of me for, I dunno, 30 minutes or so after dosing. And I didn’t like that feeling. But you might not have the same experience — that’s the big thing here, you won’t know which mode of administration is best until you try them out for yourself.
And then there’s tea — or tisane, is the right name, so I understand. Boil kratom powder or crushed leaf — I think crushed leaf is better for tea, personally — for a few minutes or even 30, 45 minutes. Add some lemon juice to extract some more alkaloids into the final product. I don’t know how it works, but it do.
Don’t worry about the specifics of how you toss-n-wash or make tea out of kratom. Just experiment and find out what works best for you. Don’t buy into any bullshit guides online — all of them come from places of personal experience. What works for Billy Joe might not work for Bobbi Sue.
To Tell, or Not to Tell… Your Doctor?
No… just, no. Let’s think — what’s the upside? Your doctor is cool with it and points out potential drug interactions.
What about the potential downside? Your doctor tells you kratom was responsible for X deaths in a recent year and that it’s bad. He identifies drug interactions that aren’t there and uses this excuse to cut back on your other meds or even not prescribe them at all.
Although there’s a blatant lack of empirical, academic-type research about kratom, there’s tons of anecdotal reports from fellow kratom users that can easily be found online. This includes other kratom consumers’ experiences with telling their doctors or other healthcare professionals about their kratom use. Just don’t do it — it’s sad I have to say that, but keeping your trap shut about kratom use is a very real concern in the modern American healthcare space.
Right off the bat, let’s get shit straight. Not everybody in harm reduction (HR) is unwelcoming. Not everybody in HR has shut out me or my opinions. Not everybody in HR has been uninclusive. Many people in HR have been good to me — or, at the very least, fair. I hope to be involved in HR until we’ve achieved the fair treatment of drug users across the United States. This is the only thing I’ve ever had a passion for.
When I say “harm reduction isn’t inclusive,” I mean this: Because some of my opinions haven’t fit the mold of the average American (or Canadian) harm reductionist, they have been written off by some or even most of the HR community. Not only that, I fear my reputation has been irreversably damaged by well-known community members — particularly one community member — speaking out against me. I worry this may also happen to others who wish to get involved in HR, especially those in rural, largely-right-leaning America. These areas, which make up the bulk of the United States, currently aren’t well-represented within HR.
Let me be clear:
The primary goal of this article is to ignite the discussion that the HR community might not be as inclusive as it wants to be.
Ultimately, I want to de-homogenize HR. In other words, I hope more diverse viewpoints will enter the fray, particularly those of people from rural, largely-right-leaning America; this will result in the tenets of harm reduction being adopted (1) more widely and (2) more extensively (in other words, people will adopt more of our views as opposed to just one of our views) by people in rural, largely-right-leaning America.
I’m choosing not to call anybody or any organization out by name — I don’t want to play into “call-out culture.” If I did, I’d be guilty of the same convention I’ve fallen victim to. Even if I were okay with calling others out and causing harm within my own community, that’s not my goal here. I also don’t want to identify those who have treated me well out of fear they, too, might face pushback from the community or its members.
Most of this article doesn’t chronicle my subjective experiences in harm reduction. Rather, the first several sections investigate the nature of HR, commonly-shared characteristics among harm reductionists, problems newcomers to all communities face, issues with entering communities online (specifically on social media), and human nature in general.
Again, I don’t want to push us apart. I want to bring us closer together. In order to become more inclusive and improve the adoption of HR across the country, we must examine ourselves and HR at large.
Understanding the Nature of Harm Reduction and Commonly-Shared Characteristics Among Harm Reductionists
The American mainstream has long written off drug users. Of course, alcohol, coffee, and tobacco are okay, but anybody who uses anything else is nothing short of a dirty, degenerate dopehead!
Of course, I don’t believe this, but the American mainstream long has — and, in large part, still does.
Harm reduction, although there isn’t a single widely-accepted definition, has included people who’ve long been cordoned-off from society — particularly people who use drugs (PWUD). PWUD who are interested in HR or who’re active in the field often fit the bill of “long-term, often-problematic drug user,” just as I do.
I became interested in HR after learning about it on Reddit’s r/Opiates subreddit some three or three-and-a-half years ago. I often visited r/Opiates and other drug-related subreddits because I felt as if I couldn’t talk about drugs IRL (in real life); further, there wasn’t enough solid information about drugs IRL, nor was there enough of it.
I love that HR welcomes people who’ve long been considered worthless or who’ve otherwise been unwelcomed by the rest of society.
However, when opinions that even kind of resemble those of the mainstream — those that people have faught against for decades, literally decades, before I became interested in HR — are floated in HR, they’re sometimes (if not often) met with disagreement, if not hostility.
The divisiveness of the modern American political landscape doesn’t help, nor does the fact that many (if not most) discussions about HR take place on social media. I don’t know how social media lends itself to divisiveness, but it unarguably does. Further, the fact we’re still living in the times of “cancel/call-out culture,” which arose around 2014, doesn’t help. If you’re not familiar with call-out culture, people get career prestige points by calling out others who don’t share similar opinions — so, even if someone doesn’t like the idea of dogging someone online (or IRL), they’re incentivized to do so; even further, further, it’s not just the missed opportunity of career prestige that’s at stake — not calling someone out can implicate a community figurehead (or even an average community member) as being complicit in fostering “uninclusive” or “microaggression-friendly” or otherwise-bad environments.
Many — I’d go as far to say most — harm reductionists have faced substantial drug-related harms in their own lives. Who else would be pushed to openly supporting “radical” things like syringe exchanges or supervised consumption sites? Again, I don’t consider these things radical, but it’s safe to say most people do.
Harm reductionists are sensitive to people, organizations, government agencies, and groups that could take away what they’ve worked so hard to secure. Wouldn’t you exercise caution, yourself? Or distance yourself from people who claim to be down with the cause but seem to have ulterior motives?
The Very Real Disadvantage of Being a Newcomer
This goes without saying, but newcomers to any community are discouraged from sharing unpopular opinions or sticking up for anybody — especially those who’ve been “canceled.” This is especially true online.
Newcomers to communities are likely to be scrutinized before being embraced. This makes newcomers less likely to share their opinions on hot-button topics or that are otherwise potentially-controversial than established community members.
Even then, established members are unlikely to speak out on topics for which they hold views that differ from the average community member. For example, in HR, a field that has little funding or employment opportunities, people who lead or work for funded organizations are unlikely to challenge popular opinions or otherwise “break the mold” out of fear they’ll lose funding, have their pay docked, be put on administrative leave, or outright fired. This can result in reduced community participation. Socially-astute individuals will “play the game” — they’ll unquestionably embrace widely-held opinions, avoid rearing hard-hitting questions, or even tolerating important conversations that seek to change long-held group norms.
We all “play the game.” In our lines of work, whether HR-related or not, we put our heads down and do what’s best for self-preservation. Well, at least anybody with half a brain would “play the game” (whatever that means). My dad has told me that dozens of times — “Just play the game, son, you’ll get farther in life. I’ve done it. You need to do it, Dan, just get with the damn program!”
Note: My dad is awesome and I love him very much. Rhetoric like this comes from nothing but the best place; he wants to see me succeed, and we all need people in our corners who’ll tell us shit that might be hard to listen to — shit that damn near nobody else is willing to tell us.
Newcomers Are Especially Disadvantaged in Online Discussions and Largely-Web-Based Communities
Like I said earlier, newcomers to any community are likely to go through an informal probationary period where established community members judge whether they’re worthy of inclusion. This isn’t an HR-specific thing — it’s a humanity-wide thing.
Online, we can actually quantify how well community members are supported in the form of post engagements, favorites, likes, reactions, shares, retweets, replies, followers, friends, and so on. Even if nailing down precise community support figures is difficult, it’s easy to gauge where community members stand on the proverbial totem pole.
Assume a newcomer shares an unpopular opinion in good faith on Twitter, Facebook, or in an email-based Google Groups community. The opinion has been developed over many months or years and was shaped by the newcomer’s real-life experience. The newcomer tries to be friendly, respectful, and level-headed in how they approach the issue. Do you think the newcomer’s idea will be taken seriously or given merit? How about if a well-trusted, long-established community member shared the same idea? Which one would get more community support for the same idea?
Almost certainly, the community figurehead — they don’t have to be a true figurehead for this example to work; just a well-trusted member of the in-group — will find more support for the same idea.
Newcomers are likely to get discouraged from sharing their off-kilter ideas after just a few unsuccessful tries — hell, maybe even after just one try!
If community support is the goal — of course, social inclusion is a basic human want, so doesn’t everyone operate with community support in mind? — community members are incentivized to discuss safe topics rather than veering off the well-trodden path.
“Just play the game,” right?
Isn’t that something we all do? Especially when we first get a job or start hanging out with a new group of friends — don’t we all do things to promote or, at the very least, protect our perceived value?
Don’t get it twisted — “playing the game” isn’t bad. It shouldn’t be frowned upon. Doing tried-and-true things in the interest of self-preservation is as old as humanity itself. If I knew what’s good for me, I’d play the game myself. That’s actually how I got into writing: I wanted to do something from home and travel to work, wear uniforms or adhere to dress codes, punch time cards, or put up with potentially-asshole bosses — I could make much more if I just played the game.
The “Rock-Star Effect”
Again, many people who’re active in HR have long been mistreated. They haven’t been included elsewhere. Wouldn’t you be protective of the one place you call home? I would, that’s for damn sure.
Some people in harm reduction have amassed relatively large, loyal followings over the years. I don’t think any of these people got into HR because they saw an opportunity to become a “rock star” — rather, they got involved because they’ve personally been adversely affected by drugs and wanted to spur change.
HR is one of the few spaces former/current drug users and sex workers can be accepted in — at least be accepted for who they truly are. These “rock stars” are largely responsible for gatekeeping, or deciding who can become bona fide members of the HR community and who can’t.
Calling people out for their mistakes — hell, even their unpopular opinions, even if they were expressed in good faith — is a form of fodder for HR rock stars. Do all harm reductionists with substantial followings or in-group clout “cancel” fellow community members? No. However, “cancel culture” has piqued the interest of countless pop culture fans over the past few years. Emotionally-dense social media posts involving “cancellations” disproportionately elicit likes, shares, responses, and other interactions from interested community members.
Of course, no “rock star” would turn down a chance of openly, harshly criticizing someone. After all, it drives social media engagement like wildfire. Further, as mentioned earlier, community figureheads can be held responsible by other community members if they have a chance to “cancel” — or call them out, in other words — someone and choose not to.
Are most HR “rock stars” aware of their “rock star” status? I don’t think so. However, we can’t deny the influence of social media engagements over our actions. We all do things on social media with the intention of eliciting attention from others in the form of sweet, sweet post engagement. Even though I like to think I’m better than that, I’m no different.
Reliving Trauma When Facing Viewpoints That Our Oppressors Have Used to Keep Us Down
Trauma, contrary to popular opinion, isn’t tucked away in the mind; rather, we physically relive trauma when triggered. Once a spouse is undeservingly yelled at or beaten, they relive the horror of seemingly-inescapable domestic abuse every time someone yells at them. I’m not a psychologist, so I can’t explain the mechanisms behind this phenomenon, but it’s true — trauma is stored in the body, for lack of better words.
HR community members aren’t used to seeing opinions that break the mold. When they are, they’re especially averse to idly letting them pass by without openly criticizing those views — and oftentimes their creators in ad hominem fashion. Even though damn near all of us know that personal attacks aren’t logical or cash money, we’re still prone to insulting people, rather than reasonably deconstructing their ideas, particularly when sensitive topics are at play.
If I say drug users should take more responsibility for their actions, it’s easy to understand why harm reductionists might take offense. This sounds like something a police officer would say to someone arrested for drug possession while transporting them to the local jail, or a loved one — y’know, one of those who thinks doing anything for someone in active addiction constitutes “enabling” behavior? — might offer up to a drug-addicted family member.
I better understood such outlash once I learned that trauma was stored in the body — and our emotions can easily overtake reason, which is even more likely when such a super-sensitive topic is at hand.
Why Are Most Harm Reductionists Left-Leaning and Seemingly Not Familiar WithRural, Largely-Right-Leaning America?
Admittedly, I don’t have any research to back any of this shit up — I think all of my assertions and postulations are well within reason, though — but most harm reductionists aren’t just left-leaning, they’re largely-left-leaning. They’re used to hearing accusations of being “radical,” whether or not they actually are. This long-term mmmmmm-blockin’-out-the-haters (Brandon Bowen’s Vine, remember this one?) is conducive to not accepting differing viewpoints now or in the future, especially when surrounded by fellow harm reductionists.
But, seriously, these people are used to fighting opposing viewpoints. That’s how they got here to harm reduction. They’re still used to fighting opposing viewpoints. Can you see how this would breed intolerance, despite how inclusive people in this space strive to be?
Many, if not most, people in HR are from areas that are left-leaning and already have HR-type resources in place. Whether or not these resources were in place when they started isn’t relevant, in my opinion, because you can’t draw parallels between ass-backwards rural Tennessee and, I dunno, fuckin’ Massachusetts 20 years ago.
Here’s My Point
It’s been difficult for me to share my opinions within HR. Just to put a timeline on things, although I’ve been giving out supplies and educating people about drugs for much longer, I started writing about HR-related issues as Daniel Garrett (that’s my government, in case you’re wondering) around November 14, 2019. I did so to let others know that I’m out here putting in work. How else would people know I’m here? The grapevine ain’t that long.
When I try to stick up for Poor Whites or say that shit really is that different here in the rural South… it’s difficult. Because some of my opinions — like we often-problematic drug users should, in fact, try to be more responsible for our actions — I’ve been widely unwelcomed to the space of harm reduction.
I thought this space was inclusive — but I gets no clout tokens for growing up bisexual in rural Tennessee, being involved in sex work for some four years, having used drugs in an often-problematic fashion for a decade, nun-a-that. And that hurts. It’s so tempting to give up this HR shit. To give up being the only motherfucker in Northwest Tennessee giving out syringes and shit, which I’m doing on an unpaid and unfortunately-illegal basis. Don’t forget I’m on two probations. I often hear people say they’re willing to go to jail for this shit — have fun with that! I went to jail for the first two times in 2019 and I’m too much of a pussy for that shit. It’s in my best interest to never illegally distribute another syringe, but I know I’ll be doing this for a while — no matter how difficult it is for me to spread my unconventional opinions in this space.
And hopefully, one day, I’ll be able to help some other youngblood find his footing in this very space. Maybe even for sharing unpopular, somehow-controversial opinions.
Here marks the end of the article. If you’d like to learn more about my subjective experience, keep reading.
My Experience With the Harm Reduction Community
I’ve been giving out safe drug use supplies for about two years now. Much of the syringes, naloxone, fentanyl test strips, etc. I’ve given out have come from a mail-based supply distributor based in New England. I don’t want to name them here because the outfit isn’t supposed to mail supplies outside of the state they’re located in.
In the past few months, two individuals — one in Washington, one in Indiana — have sent me a collective 3,000-or-so syringes, not to mention single-use bacteriostatic water containers, tourniquets, cookers, cottons, fentanyl test strips, antibiotic ointment, and even condoms (I’ve never really given out condoms, as they’re already widely available here; I’m primarily interested in giving out supplies that aren’t often available active drug users in rural West Tennessee).
I haven’t paid a dime for these supplies.
I’ve had long, rousing, stimulating chats with dozens of harm reductionists online and over the phone. I only came across these people on social media — I’d “cold messaged” them on social media or via email and, luckily for me, they were willing to entertain my requests for help. I still keep in contact with some of these folks today.
Through Facebook, I reached out to a lady in East Tennessee, some six hours away from me, who I heard was involved in HR. Over the past 15 months or so, she’s taken me to two HR-related conferences and given me other opportunities that I wouldn’t have had otherwise. In a field that’s full of organizations “held together with twigs and bubble gum,” as a more-experienced counterpart told me in late 2019, I’ve found several diamonds in the rough who’ve done a whole lot for me.
Don’t mischaracterize my words and say I hate all harm reductionists and they’re all pieces of shit — that’s not at all the truth. Like all humans, most people have good intentions.
However, due to several factors already mentioned — not all of which are HR-specific, as you might recall — as well as the fact that most American (and Canadian) harm reductionists are largely-left-leaning people, I think the modern HR community isn’t as inclusive as its membership thinks it is.
Here’s an Anecdote
Back when I first got active in HR circles on social media, I challenged someone who said something I didn’t agree with.
The other person was a panelist at a rural-oriented, HR-related speaking engagement at November 2019’s International Drug Policy Reform Conference in St. Louis, Missouri, which was put on by the Drug Policy Alliance. They shared some solid advice at the event and I looked up to them. On Twitter, they quoted an article in which a licensed social worker and state public health official stated that “[Naloxone] is not meant to be the solution to a person’s overdose.”
The state official was more or less saying that, while naloxone should be readily-accessible and is a useful tool in reversing opioid overdose, it shouldn’t be the cure-all for dealing with opioid addiction or otherwise-problematic opioid use.
I agree with this statement. Although I’ve been revived from opioid overdoses thrice with naloxone and even though I give the life-saving drug out to fellow drug users and laypeople throughout West Tennessee, I think we should invest more in programs that intervene early on in children’s, teens’, and young adults’ lives; schools should expand sports programs to include more than basketball, football, and baseball (which seem to be the Holy Trinity here in the South); and so on. Will this solve drug addiction or otherwise-problematic drug use? Of course not. However, I think such measures will reduce problematic drug use. These solutions resonate with me, particularly, because I wasn’t involved with any social programs in school outside of basketball for one year (I wasn’t good enough to make the team again), I wasn’t engaged in many healthy activities, I didn’t have a mom for the latter half of my childhood (the full list is rather lengthy; I’ll stop here for the reader’s sake). I picked up drugs because they satisfied otherwise-unmet needs in my life. I actually ended up attempting suicide at 16, almost certainly due to a many-layered combination of intersecting issues in my life at the time.
Note: The article doesn’t specify what is meant to be the solution to opioid overdose, but I assume medication-assisted treatment and improved early-life social involvementare both fine alternatives — though they aren’t alternatives for reversing opioid overdose (that’s naloxone’s job), exactly, we’d rather not have people experiencing overdose in the first place. I do agree that naloxone should be the first-line reactive (rather than proactive) treatment for opioid overdose.
I piped up — this was on Twitter and I had, like, literally zero followers at the time; I just made my account a few minutes prior — and argued the state official’s ideas were worthy of merit. I was shamed for not understanding (illicit) opioid use here in the United States and also advised not to speak to women if I wasn’t spoken to first. The Twitter user got several favorites, retweets, and co-signs from fellow harm reductionists and other people who’re interested or active in public health, medicine, pharmacy, and related fields.
Of course, I got zero.
Some More Anecdotes
I won’t explain these as extensively as the story above — it’s just not necessary. Just know that sharing off-color opinions within this community has proven difficult for me.
Even though I’m openly bisexual, I’ve been called a “cis White male” by people who know I’m bisexual at least a dozen times, likely more. And this isn’t in general — this is only within the HR community. If these people weren’t aware of my sexuality beforehand, once I made it clear, they still denied that I could take the title of “queer.”
Sometimes, when I share opinions that unarguably fit that of the average harm reductionist, I’m shot down just because people recognize that others have said bad things about me. This holds true when others share my writing or interact with me.
I’ve been told several times that people won’t associate with me openly because of the bad reputation I’ve picked up for myself. So, they feel like shooting down my viewpoints are necessary to avoid being viewed as guilty by association.
In my time as a harm reductionist, I’ve never heard anybody talk about Poor Whites — actually, yeah, I heard one talk of Poor Whites at a conference/convening back in March. Outside of that, it’s only been about racial justice.
I don’t like dwelling on this shit. I don’t wanna think about it anymore. There are dozens, if not hundreds of times where others in HR have wrongly slighted me or not given me the chance. I haven’t yet mentioned that time that one popular harm reductionist called out my writing and got hundreds of comments and hundreds of likes on her posts for “canceling” me. I still face the fallout of that today. Just for having a different fucking opinion.
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I grew up with a super-problematic drug user of a mother. For her, someone who couldn’t ever use drugs responsibly, being in “recovery” meant not using drugs.
For most of us, however, using drugs without going completely overboard is possible. And, even though I’ve also proven myself to be a long-term, often-problematic drug user, I consider myself to be “in recovery” even though I still use drugs.
Due to mounting drug-related legal issues, I turned to medication-assisted treatment — a.k.a. Suboxone — in September 2019. My reason for seeking an alternative to illicit opioids was strictly legal in nature — I was tired of the legal consequences associated with drugs and drug paraphernalia like syringes.
Although I only used illicit opioids once in my first two months of medication-assisted treatment (MAT), I eventually returned to using heroin and diverted prescription pain pills more often. Since January or so, I’ve been reducing my illicit opioid use and the resulting problems that often follow my drug use; I’ve also improved my life in various other ways, such as cleaning my house and brushing my teeth more often.
But, still, most of modern America wouldn’t consider me as being “in recovery.”
What’s the deal? Why can’t we consider this ongoing transition I’m going through as being “in recovery”? And, even if I don’t end up quitting drugs in the long run, we should still consider this change I’m currently going through as being just that — recovery.
Changing What Recovery Means
My purpose here is to ultimately attract more long-term, often-problematic drug users and their less-problematic counterparts into bettering their lives, specifically by decreasing their drug use and any resulting drug-related problems.
I think we can go about doing this in several ways. Here are some ideas I’ve got.
Note: Even if you don’t think some or all of these ideas hold water, I hope you agree that we should, in fact, want to actively change the definition of being “in recovery” from drug addiction or otherwise-problematic drug use.
Addiction Treatment Outfits Shouldn’t Require Patients to Have Substance Use Disorder
Though I’m just an MAT program enrollee, not a provider, I understand that Suboxone programs and methadone clinics across the Volunteer State can only treat people who have opioid use disorder or are dependent on opioids. This might not be true — the state’s opioid treatment program (OTP) and office-based opioid treatment facilities (OBOT) guidelines can be found but are difficult to read through; also, since I’m not a provider, I don’t have any real-world experience with state or federal regulatory agencies and their enforcement of such guidelines. However, generally speaking, MAT programs don’t accept people unless they meet the diagnostic criteria for opioid use disorder — and, yes, they treat people with alcohol use disorder, though, since I’ve got no experience with alcohol addiction treatment, I don’t want to speak on the issue.
What if Suboxone and methadone clinics accepted patients who didn’t have substance use disorder? And, more importantly, what if they still allowed patients to test positive for other drugs without potentially being fired?
Then, I wouldn’t have to worry about refrigerating “clean” urine in anticipation of drug screens. Programs wouldn’t have to waste as much money drug testing me, either, if abstaining from drugs that you’re not prescribed wasn’t a requirement — I should note that most, if not all, programs around here allow patients to test positive for THC and its metabolites, so we are able to smoke weed as an alternative to other drugs (or just smoke weed for the hell of it, for that matter).
Addiction Treatment Facilities Should Also Offer Less-Intensive Outpatient Services
Here in rural Middle and West Tennessee, the only addiction treatment outfits we’ve got are full-fledged rehabs, methadone clinics, and Suboxone programs — and I’m sure we’ve got halfway houses and sober living facilities. There might be a few facilities lingering around that don’t fit any of these five labels. Oh, and you can’t forget Narcotics Anonymous (NA), Alcoholics Anonymous (AA), and other 12-step-based programs.
All of these outfits inherently support complete abstinence from drugs — yeah, Suboxone (buprenorphine) and methadone are both very much “drugs,” but usually aren’t “abused” with the intention of getting high — and don’t have much lenience for being “in-between,” like I am right now.
Also, I think addiction treatment providers — which can include plain-Jane mental health practices, as counseling proves helpful to many former often-problematic drug users — should offer less-intensive services that provide an added sense of structure in patients’ or clients’ lives. An example of this could be life planning.
And, yes, I recognize that this section doesn’t include many concrete, well-defined examples of “less-intensive outpatient services.” I usually don’t like writing about things unless I offer concrete, well-defined recommendations for fixing the problems I point out. However, simply sparking the conversation about redefining recovery is my primary goal here — and that’s something you can help me with.
I’m Asking You for Help
Even if you’re not involved with any addiction treatment outfits or drug user-oriented organizations, I encourage you to take to social media and ask people who are in recovery, involved in addiction treatment circles, or otherwise interested in or active with any drug-related entities to reconsider what “recovery” means. You don’t have to share this article with them — it’d be great if you did, but it’s most certainly not necessary.