One of the most commonly-distributed forms of drug paraphernalia by entities engaged in harm reduction is syringes. Cotton, tourniquets, and alcohol swabs are also commonly given out to help drug users, particularly injection drug users (IDUs), stay safe. Supply distributors often fail to include people who sniff drugs.
Intranasal administration is a common form of administration with many popular drugs, including cocaine, opioids, and amphetamine. People use things like rolled-up currency notes to cleanly transfer drugs to users’ mucous membranes that line their nasal cavities. They also often share these homemade, disposable tooters. Many people don’t know that sharing tooters can spread HCV — Hepatitis C — and other diseases.
Few harm reductionist agencies, organizations, or well-intentioned individuals give out clean tooters, whether they be permanent and sturdy or reusable and pliable.
Meth and Crack Pipes
Traditionally, crack pipes, also known as stems, were made from “glass roses” often available at head shops and gas stations. The roses themselves were simply filler items so that their “vases” — crack pipes in poor disguise is more like it — could be more easily sold. All that needs to be done is buy some steel wool, known by the brand name of Chore Boy, and place a small piece in the smoking end of the pipe.
After this is done, crack pipes are ready for use.
Keep in mind that you don’t have to use Chore Boy — just as cotton swabs are widely known as “Q-Tips,” a popular brand name of cotton swabs, crack users often refer to steel wool as “Chore Boy,” irrespective of the actual brand name or manufacturer.
Meth pipes are also disguised in similar ways in convenience stores, head shops, and gas stations, as well as web-based drug paraphernalia stores.
Lightbulbs can be modified to smoke — technically, you don’t want to cause meth to combust; rather, to get more bang for your back, you want it to vaporize — meth by simply adding a hole and removing their insides.
Just recently, Next Distro began stocking both crack and meth pipes. Now, as one of the largest distributors of harm reduction supplies across the United States, thousands of drug users will soon find it easier to locate new or lightly-used crack or meth pipes that, just like clean syringes, help these stimulant users stay safer.
Fortunately, we’re at a point where harm reduction programs here in the United States are readily able to provide others with brand-new syringes ideal for intravenous drug use. As such, we don’t often find syringe disinfectant aids, such as chlorine tablets that help eliminate all diseases that may be present on and within used syringes.
These chlorine syringe disinfectant tablets, which actually contain sodium dichloroisocyanurate, or NaDCC, are used as follows:
• First, take the chlorine tablet and drop it into a glass of clean water. • The used syringe in question should be thoroughly, fully rinsed at least twice with water. • By now, the tablet should have dissolved. • Flush the syringes at least once with this chlorine solution. • Next, follow up by at least one rinse of only water.
Of course, syringes are used to inject drugs. They consist of a needle, barrel, and plunger. Syringes truly are that simple.
Colored syringes aren’t common in the United States. One benefit of colored syringes to their plain, like-kind counterparts is that it’s easier to differentiate between whose syringes are whose. As long as two or more intravenous drug users set out to each get different-colored syringes for their current using session, they’re going to be at a much, much lower risk of mixing up one another’s syringes and potentially transmitting blood-borne diseases.
Truly Single-Use Syringes
All syringes — at least it seems to be this way — that modern American drug users administer intravenous drugs with are supposed to be used just one time.
However, due to various issues in our modern society here in the United States, people don’t always have steady access to free, clean syringes. As such, they end up reusing them.
A man named Marc Koska, who I do not know and have never met, developed a brand-name syringe known as the K1 Syringe. Put simply, the K1 Syringe is a true single-use syringe, as it is designed with safeguards that render these units unable to be used for second or further administrations.
Although this does encourage intravenous drug users to seek out new syringes, IDUs sometimes put themselves at greater harm by trying to bypass these safeguards and use K1 Syringes again. They might also try to make makeshift syringes, which are inherently more dangerous than reused syringes.
A few other generic names used to describe syringes like the K1 Syringe are difficult to re-use (DTR), lockable, auto-disabled, and retractable syringes.
There are several good reasons as to why these DTR syringes are not provided by modern domestic harm reductionists to drug users, including:
• They, by design, leave a small portion of the drug-containing solution behind. • DTRs sometimes make registering to make certain you’re in a vein difficult. • If the needle itself clogs, drug users sometimes harm these syringes just to use what they already loaded up. • More widespread reliance on DTRs would probably result in non-DTR units being re-used and circulated on second-hand markets more often. • These well-intentioned auto-disabled syringes are roughly three times the price of other syringes. • Leaving IDUs to deal with syringes that do include safeguards assumes that they’re unable to be responsible as a greater social class.
Here in the United States, Ascorbic Acid Is Uncommon
Some American federal agency classified freebase diamorphine as heroin #3 and diamorphine hydrochloride as #4. #3 is typically found throughout Europe and originates, most times, from the Middle East. It’s one step short of being fully-fledged heroin.
Just like freebase cocaine, freebase heroin — aka heroin #3 — doesn’t dissolve in water without the help of ascorbic acid, also known as vitamin C.
There’s not much of a use for ascorbic acid among American heroin users due to the fact the seriously-overwhelming majority of heroin in the country is #4 and readily breaks down in water.
Although ascorbic acid is used by some American users to prepare crack cocaine for intravenous use, ascorbic acid is typically rarely seen among modern harm reductionist organizations’ and agencies’ supply lists.
These Aren’t the Only Rare Ones
Some of these supplies are solid ideas and would do nothing but increase the benefits derived from modern harm reduction advocacy. However, others are proven to be detrimental to our cause as harm reductionist advocates or drug policy reformers.
Can you think of any other rare, uncommon, or outdated harm reduction supplies? If so, please share them in a comment or by reaching out to me directly.
Simply having Narcan, Evzio, or generic injectable naloxone kits around isn’t good enough when it comes to effectively responding to opioid overdoses. Rather, the effective administration of naloxone in cases of likely or certain opioid overdose is more about being educated about such.
In my personal experience, drug users across Northwest Tennessee (NWTN) are typically not aware of what naloxone or Narcan is, let alone how to use it effectively.
As with everything else on this website, this publication is not meant to be perused or referenced as an authoritative source. You should use your judgement in determining to what degrees I’m correct, reasonable, incorrect, and unreasonable.
Without further ado, here are a few ways to use naloxone safely and derive more utility — “utility” refers to happiness or use people get out of things — from educating others about best practices in naloxone administration for opioid overdose and actually carrying out the procedure in real-life yourself.
Naloxone-Reversed Opioid Overdoses Cause Immediate Withdrawal
Opioid withdrawal syndrome, a medical term that might be referred to as being sicker-’n’-shit, is how a rural Tennessean might describe the opioid withdrawal experience.
If you’re not familiar with how opioid withdrawal syndrome plays out, symptoms gradually show up and slowly get worse from roughly 12 to 18 hours after one’s most recent opioid use and typically peak by the third or fourth day of withdrawals.
This type of opioid withdrawal, which occurs naturally, is medically known as spontaneous opioid withdrawal. The “spontaneous” in the phrase refers to the spontaneous cessation of opioid use.
One time, I overdosed on a heroin-fentanyl mixture and was brought back with 0.16 mg of naloxone or less. Despite the fact I should have experienced mild withdrawal symptoms after being revived with naloxone, I didn’t.
I understand drugs from a real-world perspective shaped by my tenure as a long-term drug user, having grown up with a super-problematic drug user for a mother, and my experience from having served Northwest Tennessee as an active advocate for harm reduction. I say this because you might pharmacologically understand opioids, opioid dependence, and naloxone use in opioid-dependent persons in response to opioid overdose symptoms — that’s something I don’t understand at all!
However, Usually Only If It’s in Doses That Are Small Enough
Traditionally, generic vials of naloxone, Narcan, and Evzio have carried various naloxone dosages. Generic naloxone vials typically carry 0.4 milligrams. Narcan nasal spray carried 4 milligrams of naloxone per dose. The rarely-used voice-assisted auto-injector known as Evzio contains either 0.4 or 2 milligrams.
All of these doses are high in terms of what’s typically required to reverse opioid overdose in typical modern cases. A recent study carried out by the American College of Emergency Physicians reported that, when median intravenous doses of 0.08 mg naloxone administered in just short of 10 separated bursts in stop-and-go fashion, it was easier to not overdo it on naloxone, resulting in more favorable outcomes, often entirely avoiding opioid withdrawal symptoms — this was even true for opioid-dependent persons.
Which one is better:
• (1) Using just enough naloxone to bring someone back from an opioid overdose without causing precipitated withdrawals, though with higher risks of death?
• (2) Or using plenty of naloxone despite patients almost certainly suffering precipitated opioid withdrawal for about two hours — as far as naloxone administration is concerned?
I think we’d much rather have better outcomes if we stuck with number two. However, opioid use scenarios that are more controlled and better supervised, especially in the presence of a confident, experienced, and well-researched partner.
Also, as far as reliable-and-gentle average intranasal naloxone doses go — including both Narcan and with atomizer-equipped syringes filled with injectable naloxone — ideal doses have been shown to usually be around 2 milligrams naloxone administered intranasally. In such cases, per the aforementioned American College of Emergency Physicians study, researchers have found an 83% successful response rate with this dosing approach.
Knowing About It Isn’t Enough; Trainees Need Practice
Most people aren’t required to take prescription medicine that necessitates the use of syringes and injections into muscles, veins, or under the skin. Further, most people also aren’t intravenous drug users.
Although both SC and IM administrations are easier and straightforward, people are prone to experiencing issues when administering naloxone without having physically practiced the motions of intramuscular, subcutaneous, or intravenous use. This is even true for naloxone kits that contain step-by-step, picture-based charts that inform people how to use naloxone to bring people back from excessive opioid doses as they read it — not requiring prior experience for most people, that is.
Get your hands on sterile water or, if that’s not available, cold tap water that has been boiled for 5 to 10 minutes immediately preceding its use.
Now, you’ll need to find one or more guides or other information sources for intramuscular administration. Peruse their steps, make mental run-throughs of carrying them out, and practice at least two intramuscular injections before considering yourself or someone else as being able to carry out the administration of naloxone for opioid overdoses. Also, since you should have more than plenty of vials of naloxone in your possession just to be on the safe side, you should be able to burn through anywhere from two to a few vials of naloxone in practicing how to draw up solutions into syringes from vials.
Real-world practice and having an army of tips built up from many academic sources form the ideal combination to serve as the foundation that supports the home of reversing opioid overdoses with naloxone.
Check Out This Unconventional Concern to Consider Regarding Injection Naloxone Use
The Internet is packed to the brim with helpful content regarding harm reduction and staying safe while using opioids.
However, one thing that I picked up from the real world that I’ve never seen mentioned online is that injectable naloxone is prone to causing syringes’ needles to break of as the result of opioid overdosers’ having regained consciousness. To better explain, as you might know, people brought back from opioid overdoses are often confused and sometimes don’t take well to waking up to being essentially pinned down and hovered over by one or more people who are usually strangers (e.g., emergency medical technicians).
Since you’ll never know exactly how people will respond to understandably-disorienting naloxone-aided opioid overdose reversals, intranasal uses of naloxone are safer than those involving syringes because of their potential spread of blood-borne diseases from getting poked by the syringe used to administer naloxone or the possibly-yet-unlikely incidence of hypodermic needles breaking off inside people’s bodies.
Should this be a central reason in determining best practices for naloxone?
No! It’s more of a novel, though very real, practically-minded idea that was presented to me by Melesa Lassiter, Tennessee’s Region 6N — Region 6N is one of 13 regions that the state’s 21 Regional Overdose Prevention Specialists are assigned to — Regional Overdose Prevention Specialist. She covers all of Northwest Tennessee, a nine-county area home to roughly 250,000 people.
I haven’t since heard or seen this idea anywhere else and, although it shouldn’t be a central factor in determining how we use naloxone, I feel responsible for fleshing it out for the World Wide Web to see.
Always Use Around Others
Without being supervised by someone who fits all three of the categories below, you’re setting yourself up for an increased risk of suffering permanent damage or death as a result of opioid overdose:
• Aware of your opioid use. • Trained in administering naloxone during opioid overdose. • Well-versed in spotting opioid overdose very quickly after happening.
Unfortunately, not all of us are actually able to regularly use opioids around someone else. Some of us are forced to use without hardly ever being supervised by someone who knows what’s going on.
Others, especially in NWTN, where stigmas are high and people are particularly incentivized to retain information regarding their drug among themselves and keep it away from most others, are able to regularly consume opioids around other people except those people aren’t trained in the use of naloxone or spotting opioid overdoses, let alone being aware when their drug-using counterparts consume opioids.
Of course, this is another important reason why you should avoid using opioids without active, ample supervision.
Just a Few
Depending on how you classify things, this text covers either four or five tips — just a select few — for using naloxone in response to opioid overdose. Either way, there are many other tips worth reading that will improve various factors regarding this application of naloxone — in other words, this article just scratches the surface.
If you learned something, carry it with you and try to spread the word to other people. Even if you didn’t, being exposed to how different people explain things is a good way to improve your efforts in educating others about harm reduction.
When we think of harm reduction, most people rarely think of helping people who sell drugs. Rather, helping general drug users out pops to mind.
In actuality, many illicit drug users sell drugs to others or otherwise facilitate the exchange of illicit drugs through one another. This includes acting as a “middleman” and using connections that your drug-using partners make available when you attempt to source drugs together by piling both of your money together, for example, among many other types of facilitation, harboring, or furthering.
Either way, no matter how many people actually sell drugs on occasion, it’s important for us harm reduction advocates to activate vendors as harm reductionists.
How Might You Activate a Dealer as a Harm Reductionist?
There are many ways to get dealers involved as harm reductionists. Unfortunately, they have historically been drastically under-utilized as assets in advancing our cause as harm reductionists. Here, I’ll be covering a handful of practical ways to get your sources of illicit drugs to engage in harm reduction practices and spread such ideas with others.
Make Sure to Build Tight Relationships First
Establish relationships with sellers first before attempting to establish them as harm reductionists. Doing so without having first established tight relationships, especially in rural Northwest Tennessee (NWTN), where people are largely unaware of harm reductionist’s ideas, practices, and policies, is less likely to be welcomed by your targets.
In areas where the local or regional cohorts of drug users and sellers alike are more likely to be aware of the availability of clean supplies and safe drug-using strategy education, you won’t be forced to develop such close relationships.
Unfortunately, this isn’t true here in NWTN. This ultimately slows how quickly harm reductionists can engage in the distribution of supplies to dealers throughout Northwest Tennessee.
Encourage Sellers to Share Supplies and Education Between One Another
Dealers might develop a competitive advantage by having regular access to clean, suitable harm reduction supplies, especially if those objects are provided at no cost. As such, they would be incentivized to keep such information quiet and to themselves to maintain that advantage.
However, dealers often work in loosely-fitted organizations known economically as cartels — for the record, I’m not referring to what we think of as “drug cartels,” but the true economic use of “cartel” — that operate through participants adopting like principles to protect common interests.
One example is a group of dealers fixing their prices at market-wide lows on the local drug market.
These groups of like-minded competitors, in the name of preserving the welfare of their long-term operations and reducing competition between individual cartel members, are also likely to share resources among themselves such as ideal sources of harm reduction supplies.
Keep in mind that in your exposing of people who sell drugs to such free harm reduction supplies, they’re going to be inherently incentivized to stock them in the name of more effectively attracting customers. The more people you establish such trusting, working relationships with, the more likely you’ll eventually stumble across members of such cartels who are more likely than other dealers to share harm reduction supplies among their drug-vending counterparts in a peer-to-peer fashion.
Putting Dealers On to the Utility of Standardized Drug Checking
Experts in the modern world of drug checking have mentioned that, once one major dealer in most towns, cities, or other relatively small areas regularly check the contents of drugs through chemical means when selling them to resellers and end-users alike, all other dealers are forced to also adopt the practice or be forced to compete with such a massive competitive advantage.
Even though some customers might not be interested in drug checking, most will either appreciate it from the jump or come to develop positive opinions about drug checking pretty early on.
Mandelin, Marquis, and Meckereagent tests are the three most popular such reagents used in drug-checking. Using them simply requires chipping off a tiny amount of the drug in question. Separate the drug sample into three roughly equal parts, dropping one of each flavor of reagent on each sample. By simply reading the colors of these tests’ results, dealers can prove the contents of what drugs they’re selling to customers in real-time.
Instant urine drug screens use one or more paper strips to determine whether drugs or their metabolites are present in urine samples. One particularly sensitive such strip-based drug test is that of modern fentanyl urine screens.
Fortunately, these fentanyl test strips can also readily be used for detecting fentanyl in drug samples within anywhere from a few seconds to a couple of minutes. Simply dissolve a tiny bit of a drug in question in water, dip the strip in the solution for a few seconds, then read the strip’s results shortly thereafter.
These are both — the reagent tests and fentanyl test strips above — easy to understand and therefore useful among potential buyers, they are cheap to purchase and implement, as well as easy to source, whether they come from for-profit drug-testing-supply resellers or their non-profit counterparts.
Seek Out “Community Guide” Services From Well-Connected Individuals
This particular piece of advice also applies to drug users or people who are otherwise involved with drugs who don’t use or sell them.
Harm reductionists, both individuals and organizations, have experienced success in activating people who sell drugs as harm reductionists by building bridges between themselves and well-connected individuals among local or regional illicit drug markets.
These people are widely respected and trusted by dealers when they tell inform them about harm reduction. Also, dealers are more likely to welcome offers of being given free syringes, naloxone kits, and other drug-using supplies.
Although it’s not always possible, this is arguably the most effective and highest-valued approach to activating a market’s vendors as harm reductionists.
Know that, as you might imagine, these people will likely not be willing to share the identities of local dealers or introduce dealers to such harm reduction advocates directly. People who are fortunate enough to find such “community guides” should be thankful for having their help in any capacity, form, or fashion.
Making Sense of It All
Although I know it’s especially true particularly in Northwest Tennessee, there aren’t any established infrastructures for carrying out harm reduction activities on a large, state-approved scale. I’m sure it’s also like this many other places throughout the United States.
Since the contemporary drug-related roots of harm reduction only date back to the 1980s, I feel the general domestic realm of harm reduction is largely unexplored. It’d be nice if we could follow tried-and-true, already-tested guidebooks that include pictures for better understanding and step-by-step guides.
However, this is nothing more than a pipe dream.
Just know that it’s normal to not experience even moderate levels of success in activating drug dealers as harm reductionists. Be patient, street-smart, and don’t ruin individual relationships that must be based on trust.
Please report any strategies or approaches that you’ve found to be successful in activating dealers as advocates for our cause to me, directly, or elsewhere online, such as in popular, active web-based harm reduction and drug advocacy forums.
The idea that any one person can have an impact on the world is nothing short of a cheesy cliché. We often feel that, since just one person’s labors aren’t worth the minute overall benefit to society that they could yield, we shouldn’t even bother with them in the first place.
However, no matter where you live, there are things that you — yes, you — can do to advance the society-wide adoption of harm reduction-positive policies, practices, and ideas.
I’m in rural Northwest Tennessee (NWTN). People in Tennessee are relatively inactive in social causes like voting, for example, the state securing 49th place for voter turnout rates in the 2016 presidential election. The Volunteer State’s 2014 midterm election turnout came in 50th place at just 28.5% voter turnout.
With this in mind, it’s easy to understand how this commonly-held fallacy — that individual efforts are not worthwhile — leads to people not being involved in efforts such as harm reduction advocacy.
On the bright side, however, the less progress that’s been made in an area harm reduction-wise, the greater the impact that individual harm reductionists have.
Before listing off a few real-world things that anybody can do to become a real-life, true-blue harm reduction advocate, here’s one more thing to consider:
Forward-thinking, progressive ideologies are often unwelcome in the Southeastern United States. This is especially true in rural NWTN, as locals are more likely to view practicing harm reductionists and the cause’s supporters as “less” than people who don’t advocate for the better treatment of drug users.
This is one of many issues preventing the implementation of harm reduction infrastrcuture in the Volunteer State.
What Can You Actually Do to Advocate for Harm Reduction?
It’d be great if more people spent time advocating for drug users. Our efforts would yield fruit much quicker if this were true.
One thing’s for sure — you aren’t helping advance a social movement unless you, personally, are involved. You can have a material impact on society by advocating for this cause, given you do so in an effective, open-minded, fair, well-thought-out way.
Without further ado, here are several real-world, practical ways to actively advocate for harm reduction.
Share Information With Others in Support of Harm Reduction
Technically, sharing a supportive article or crafting a positive post from scratch on social media — whether it be Twitter, Facebook, Google+, or YouTube — is a form of advocating for harm reduction. However, in actuality, simply sharing things on social media in the modern world of mass social media use is one of the weakest forms of advocating for this cause.
When this activity is carried out, seemingly most social media users fail to present their opinions in warm, caring, open-minded, welcoming ways. Rather, they do so in a mean-spirited, off-kilter, rude manner. How can you possibly expect someone else to adopt your way of thinking by being mean?
You really do, in fact, catch more bees with honey than vinegar.
So, if you do share this information with others, make sure to do so in a fair way in which you understand the merits of both or all common arguments for or against such practices.
Keep in mind that you’ll need to study up on how to most appropriately share such information in your social media advocacy efforts. It’s most definitely not as simple as making a run-of-the-mill post as you normally would on Facebook or Twitter!
Become Active in Looking Out for News That Supports Harm Reduction
Letters to the editor go a long way, especially when done so in accordance with contemporary best practices. The best way to support such articles, programs, news segments, or radio broadcasts is promptly. If you don’t respond within a few days of publication, the potential utility of your efforts drops quite a bit.
News that packs a punch moves people to consume it and talk about it with others in a rapid way. Make sure to keep up with articles like these in real-time to get the most from telling such publications’ editors or other people of importance that you strongly support them. News agencies will be more likely to continue writing like-kind pieces soon with the more positive reports they receive.
Community members not aware of or big on harm reduction will become more familiar with its basic principles and real-world applications through running harm-reduction-related content more frequently.
After all, local news sources are trusted quite more than publications active on broader levels. Local publications often set the tone for topics of concern across communities throughout the United States, too.
Regularly Attend Local Governments’ Community Meetings
Municipalities value the input of residents regarding important things going on in communities throughout the Northwest Tennessee area — however, this further goes for everywhere throughout the United States.
When you regularly attend these events and become active in them in a positive, constructive way, others will grow familiar with you and come to value your role as a wanted community member. Put simply, your words will carry a higher exchange rate than your peers.
You’ll learn what’s going on around you. Without understanding where harm reduction currently is, appropriately selecting the means of becoming active in such advocacy efforts is difficult.
Educating others about your community’s harm-reduction-related issues is more possible when you keep up with these municipal get-togethers. If you don’t know what’s going on, how can you hope to teach others important local-level things in a reasonable way?
Donating to Harm Reduction Organizations
Let’s take Next Distro, for example. The highly-active distributor of harm reduction supplies like syringes, naloxone, and other clean, high-quality drug paraphernalia is unable to provide fentanyl test strips to all of their patrons en masse. They’re too expensive to afford, for them, in this example.
This happened earlier this year in my dealings with Next Distro, a provider of free supplies that I’ve trusted for a while.
To be fair, I’ve fnever donated to the organization. I’m not able to afford giving away money to any good cause. Either way, what I’m trying to say is that I’m as guilty as everyone else insofar as having not donated to Next Distro.
If more people donated to Next Distro, for example — the New York-based harm reduction supply distributor founded by Jamie Favaro, who has personally helped me gain regular access to free harm reduction supplies — fentanyl test strips, which are highly useful among opioid users — specifically street heroin consumers — in today’s domestic heroin market. This drug checking would ultimately help people stay safer, as well as potentially accomplish a few other goals.
Other harm-reduction-related causes that are good to donate to also take the form of government agencies and community-based organizations. Treat them in a similar manner.
Not Moving Our Cause Backward
One way that you can harm the greater cause of harm reductionists is to give us a bad name by being uneducated regarding the harm-reduction-related positions you discuss with others and doing so in an unfair, illogical way. Being an asshat won’t get you anywhere, especially in today’s dicey American political landscape — it’s one side versus the other.
We don’t need to talk about harm reduction in such a manner. Always try to see the merits in other points of view opposing those held by contemporary harm reductionists. Engage them in a curious, level-headed, nice way. Don’t ever insult others or talk down in a condescending form.
The last thing any of us should be doing is chipping away at the growing, cinderblock foundation upon which our proverbial home of harm reduction will be erected upon.
Give Out Syringes, Naloxone, and Other Supplies
If possible, you should consider distributing such supplies to drug users. Naloxone should also be distributed to laypeople, not just drug users.
Doing so may be illegal where you live. Always check state and local laws regarding the distribution of naloxone, syringes, tourniquets, glass pipes, drug-checking tools such as fentanyl test strips, and so on before doing so.
Even if it’s illegal where you live, you can often bypass such laws by becoming approved by your state or municipality to distribute such supplies or otherwise engage in harm-reduction-related activities.
Educate Others About Safe Drug Use Best Practices
Naloxone can’t, in practice, be self-administered by opioid users who experience overdose. Although research has outlined a handful of cases of naloxone self-administration during opioid overdose, it rarely happens in the real world.
Tell others that opioids should never be used unless users can be accompanied by at least one non-drug-using person who is willing to keep a constant eye on you for signs of opioid overdose. This person — or people, ideally — should be informed regarding the administration of naloxone, as well as what to do following administration.
These are just a few important best practices in drug use. Inform real-life peers about these things, or feel free to do so online.
If you don’t know things well enough to explain them in your own words, you’re not in any kind of spot to even attempt to educate others about such things — in this case, it’s harm reduction as related to drugs.
This Isn’t an Exhaustive List
By no means is this an all-out, full list of practical things anybody can do to engage in harm reduction advocacy.
However, these are a few good places to get started.
Do what you’re best suited to do! Please don’t resign to just posting about this stuff on social media, as it’s so ineffective relative to the other practices mentioned above. Wouldn’t it be a shame to be passionate enough about a subject like this to do advocate for it only to not engage in effective strategies?
It certainly would be a shame nothing short of a complete, utter waste of your time.
There are several other issues with posting opinions on social media and attempting to advocate for things you believe in. Just know that you should try to do other things, given that you feasibly can.
What Should You Take Away From This?
If you don’t know what to do, reach out to trusted organizations like the Harm Reduction Coalition and the Drug Policy Alliance, as well as smaller, locally- or regionally-focused non-profit organizations and government agencies like Middle Tennessee’s Street Works and East Tennessee’s STEP TN both of which are syringe services programs, and ask for help becoming an active advocate for harm reduction or drug policy reform. Individuals who are also passionate about this stuff are also willing to help you do so. You can meet reliable, well-versed, reputable people who know their stuff and who are willing to provide mentorship to eager, open-eared beginners like yourself by becoming active in harm reduction groups on social media and elsewhere online.
Forums such as Reddit’s Opiates subreddit, also known as r/Opiates, can be useful in finding this kind of help, as well as seeking out references and vouchers for various individuals, organizations, and agencies across the U.S. — and the world at large, for that matter.
No matter what, each of these four means of administering generic naloxone requires between two and three separate, freely-moving pieces that aren’t as easy to use as one-piece formulations of naloxone, such as Narcan or Evzio.
The United States Food and Drug Administration indicates that the average invoice price of a naloxone kit is $29, on average, here in the U.S. “Average invoice price” refers to the total cost of getting together suitable syringes, naloxone, and instructions for on-the-spot reference.
These are more difficult to use than Narcan or Evzio, for example. Many people who administer naloxone are anxious, even to the point of full-blown panic attacks. Simplicity is key insofar as best practices for naloxone administration are concerned.
Naloxone kits, in my experience, are the second-most popular naloxone formulations in Northwest Tennessee and likely elsewhere across the U.S.
The Average Cost of Narcan
Narcan is a name-brand version of naloxone that comes in the form of a nasal spray. The sprayer comes loaded with naloxone and ready for immediate use. It’s also foolproof, unlike generic naloxone kits.
It’s only used intranasally — sprayed into the absorbent mucosal membranes of the nasal cavity — via the nose.
The U.S. FDA reports that the average retail price of Narcan in the United States is $142 per two-unit packages. This equates to $71 per dose.
Narcan is easier to use than naloxone kits. It’s also more widely-known than Evzio or Narcan’s active ingredient itself, naloxone. Also, people are more willing to accept Narcan from active harm reductionists than naloxone kits because kits contain separate syringes.
This is due to the stigma that surrounds the use of syringes for illicit drugs across the United States.
Narcan is, in my experience, the most popular and widely-used version of naloxone in modern NWTN.
The Average Cost of Evzio
Evzio is an auto-injector, name-brand form of naloxone that talks people through the administration process. Evzio is rarely seen in practice due to its exorbitant cost.
The FDA reports that each single-dose unit of Evzio costs $2,321. The average retail price of two-packs of Evzio, in other words, are $4,641.
Out of these three forms of naloxone, it’s the least common by far.
Which One Is the Most Valuable?
Narcan is the most valuable — here’s why:
When people return from being unconscious thanks to opioid overdose, they sometimes have an urge to resist whoever administered whatever form of naloxone was used — in practice, naloxone is naloxone is naloxone, as it all has the same medical effect.
With naloxone kits, people who administer the injectable form of the opioid overdose drug are prone to stabbing themselves, other people who are present, or the person being revived themselves with the syringe that was used during administration.
This can result in the spread of disease and development of infection. Needles could get broken off inside the recipients. The syringes they use also pose much more of a threat than Narcan or Evzio if not properly disposed of.
Evzio may help especially-nervous people through the process of administering naloxone, but it’s simply too expensive for how much value it delivers.
Narcan is roughly between three and five times the average cost of naloxone kits that use injectable, generic vials of naloxone.
However, the value derived from Narcan, which exists on multiple other levels, at this price is simply worthwhile for many buyers of the drug. They can also receive government assistance in paying for naloxone, as well as specifically for name-brand Narcan.
At the end of the day, some naloxone is better than none. However, Narcan is a cost-effective formulation that offers several real-world benefits to generic naloxone kits and Evzio.
Naloxone is the active ingredient in Narcan, a nasal spray formulation of the drug that reverses opioid overdoses nearly instantly. You may have heard about Narcan or naloxone in recent news headlines related to the rash of opioid use that culled 47,600 Americans in 2017.
Naloxone most often comes in two forms: intramuscular naloxone kits and the more convenient name-brand Narcan nasal spray. Narcan is easier in that it only requires the nasal spray unit itself which is fool-proof and comes loaded with ready-to-go nasal sprays from the time they’re manufactured.
If you aren’t already familiar with intramuscular naloxone administration, it requies drawing naloxone solution into a syringe for injection is time-consuming and may prove difficult during the panic that witnesses might feel immediately after friend, family member, or running partner experiences opioid overdose. This is the main reason why Narcan is superior — it’s hard to mess up administering the drug with this name-brand nasal spray.
How Long Does Opioid Overdose Take?
Opioid overdoses can take place anywhere from seconds to hours after an opioid user’s last dose. Intravenous use (shooting up) typically manifests overdose symptoms most quickly, followed by intramuscular use. After that, intranasal (snorting) and rectal (boofing, booty bumping) overdoses happen pretty quickly, though not as quick as with injection use. Oral administration usually takes the longest to result in an overdose.
“But how long, exactly,” you may ask, but there’s no set-in-stone time frames during which opioid overdose can be expected.
I’ve overdosed some 10 minutes after injecting opioids intravenously, which is supposed to cause overdose instantly — at least that’s what many people think, both users and laypeople.
About two hours after I took a combination of oxycodone (Percocet, OxyContin) and alprazolam (Xanax), I experienced my first overdose. Most people think that OD’s never take this long to manifest — think again, as they very well can.
In Practice, Only Others Can Reliably Use Narcan
Most opioid users don’t want to forego the high that their expensive opioids bring them. Most of us, especially those in rural Northwest Tennessee, are not able to readily afford opioids to our liking. This makes us not want to waste the high that disappears when naloxone is administered.
Despite its life-saving capability, still some people are averse to using it at the risk of spurring precipitated withdrawal, a beefed-up version of opioid withdrawal syndrome caused by administering naloxone.
Many users whom I’ve distributed supplies to here in Northwest Tennessee weren’t familiar with “naloxone,” let alone how to use it. Those who are familiar with it tend to think self-administration is both feasible and reliable.
This couldn’t be further from the truth.
As a four-time opioid-overdose-experiencer who’s been given naloxone thrice, opioid overdose feels like going to sleep out of nowhere, often with no sense that an overdose is imminent.
Self-Administration of Naloxone Isn’t a Reliable, Feasible Option
Most people fall unconscious before they can prepare themselves to administer naloxone. Once you’re unconscious, it’s kinda hard to do anything, let alone revive yourself. For this reason, self-administration of naloxone isn’t possible.
Besides, even if you could walk that thin line, just know that you don’t get any second chances — the first time you fail, you die.
What Opioid Users Should Do
Always use around someone else who isn’t also using drugs, at least not those that can cause deadly overdose. Inform them when you’re using, make sure they know where naloxone is, and ensure they understand how to spot overdose symptoms and administer naloxone.
People who are prescribed opioids should also be aware of the risks of opioid overdose. They should follow the same protocol that I’m covering right here.
Learn how to spot signs of opioid overdose and how to administer naloxone via an online training course like this one to help others improve their OD response efforts.
Look for more insight on administering naloxone and spotting overdose by googling the topic. I implore you to always research things — at least things of importance, which I hope you consider administering naloxone to be — you find online.
Both opioid users and laypeople should strive to educate themselves about naloxone and how to use it, which can easily be done online.
Where to Find Naloxone
In most places across the United States, it’s relatively easy to find free naloxone around close or online. Here are some resources for people in
Government agencies provide naloxone and related training on local levels, such as the municipal-level, Tennessee-based Weakley County Prevention Coalition.
State-level Narcan provision is also done, such as by the state of Tennessee’s Department of Mental Health & Substance Abuse Services, which is carried out by 20 Regional Overdose Prevention Specialists (ROPS) responsible for various regions throughout the Volunteer State. Melesa Lassiter, for example, is Region 6N’s ROPS, which covers the nine-county spread making up the entirety of Northwest Tennessee.
Non-profit organizations such as NEXT Distro of New York City, New York, are even active on a national level, which spreads harm reduction supplies and education across the 50 states.
See my other article, “Accessing Naloxone in Martin, Tennessee,” to learn one effective, reliable means of sourcing Narcan in Martin, Tennessee, one of many small towns in Northwest Tennessee. If you’re not in Martin or Weakley County, Tennessee, google your local area’s services. Find more general drug-related resources here.
Martin, Tennessee, is in Weakley County, which borders Western Kentucky. Martin was home to roughly 10,543 people in 2017, says the United States Census Bureau, whereas Weakley County is likely currently home to some 33,400 residents.
Fortunately, the Volunteer State allows syringe services programs (SSP) as long as they’re first sanctioned by the state to act as such. On the other hand, there’s no fully-fledged SSP — they’re generally referred to as syringe exchanges, though the Tennessean government identifies them as SSPs — in West Tennessee.
Memphis, the second-largest city in the state, is home to an active syringe services program, though it’s in the far southwestern extreme of the state, meaning people in Northwest Tennessee aren’t reasonably able to visit. Other Tennessee cities that are home to SSPs include Nashville, Knoxville, and Chattanooga.
Even if Memphis were home to an SSP, it’s too far away from NWTN to help my fellow drug users in the further-north portion of Northwest Tennessee. From Martin, for example, it’s about two-and-a-half hours.
While we don’t have any syringe exchanges here in West Tennessee, we do have Regional Overdose Prevention Specialists who are put to work giving out naloxone throughout the state, as well as educating people about using it safely, in a legally-sanctioned manner.
Want Free Naloxone in Martin?
Melesa Lassiter of the Weakley County Prevention Coalition is a registered nurse who works as one of the state’s 20 active Regional Overdose Prevention Specialists. She serves the nine-county region the makes up Northwest Tennessee, classified by the state as Region 6N.
Regional Overdose Prevention Specialists such as Melesa Lassiter primarily work with first responders, people at risk for opioid overdoses, laypeople who might find themselves around people who are at high risk of opioid OD, and “organizations that provide treatment and recovery services or community resources,” according to the official website of the state’s Department of Mental Health & Substance Abuse Services.
You can access Melesa Lassiter’s free services by reaching out to her by email or phone.
Narcan (naloxone) is a name-brand version of naloxone, a drug primarily used to reverse cases of opioid overdose. It is legal to possess in the state of Tennessee.
Its use carries absolutely zero contraindications, or negative side effects, outside of its use in people who regularly use opioids — both pharmaceutical and illegal forms — and are physically dependent on them.
The only contraindication is that using it will cause immediate opioid withdrawal symptoms known as precipitated opioid withdrawal. Precipitated withdrawal symptoms are worse than those from normal opioid withdrawal. Experiencing precipitated opioid withdrawal is a far, far, far more desirable outcome than facing opioid overdose, a now-common form of death that has ravaged the American population over the last few years.
As long as Narcan is given to someone experiencing an opioid overdose within a few minutes, they’ll be brought back to life.
Better Understanding Narcan
All pharmaceutical drugs have name-brand versions. At least they did at a given point in time.
There are multiple name-brand versions of naloxone, though the most widely-recognized one is Narcan. In fact, in my experience working with drug users on a peer-to-peer level throughout Northwest Tennessee (NWTN), I’ve found that “Narcan” is a more commonly-recognized term than “naloxone,” though both are still largely unrecognized by contemporary NWTN-based drug users.
Narcan is a nasal spray that can be purchased in pharmacies and sourced at no cost from government agencies, non-profit organizations, and grassroots harm reduction supporters across the United States.
Naloxone refers to Narcan’s active ingredient itself, as well as generic formulations of naloxone. Outside of nasal spray, naloxone is also common in a generic injectable form that comes in one-milliliter vials.
In the past few months, I visited a local chain pharmacy in Martin and requested a price check on their two-packs of Narcan — the price was $80! This was the cheapest variety they had. I’m not sure if they stocked another name brand of naloxone, Evzio, which costs thousands of dollars per unit — the American average is said to be some $3,854.
Why Bring Back Drug Users to Life?
Since the idea that opioid use is dangerous is widely known, many of us feel that opioids shouldn’t be used in the first place. People who do use them shouldn’t be brought back to life, some of us think.
Although drug users know what they’re getting themselves into, I don’t think anybody wants to see a friend or family member die when they could have been revived. We’ve all lost people to drugs. One reason why is because too many people aren’t aware of naloxone or how to use it; further, most people don’t have steady access to the safe, life-saving drug.
Society benefits in several ways from making naloxone more widely available and making people more aware of its existence and how to use it properly.
Despite these facts, let’s say you still think people shouldn’t use illegal drugs or their legal counterparts (e.g., alcohol, tobacco, coffee).
People can’t use naloxone or Narcan recreationally. It offers absolutely zero recreational effects. You can’t overdose from naloxone, either.
People who are prescribed pharmaceutical opioids by physicians also overdose from opioids. Family members and friends who take their opioid medications on accident, including children, are also liable to experience opioid overdose.
Would it be fair to these chronic pain patients whose lives are ravaged by day-in, day-out pain — as well as their family members and friends — to not have access to naloxone or Narcan and reverse accidental overdoses?
Who Is Narcan For?
Narcan isn’t just for illegal drug users. It’s for people who are prescribed opioids both on a long-term basis and on an acute, short-term basis (i.e., after having wisdom teeth pulled by dentists, after experiencing surgical procedures such as for spine or knee problems). It’s also for laypeople, including family members and friends of known opioid users.
People who aren’t even aware of anybody who takes opioids in any capacity should still keep Narcan around and know how to use it properly. First responders should always have it. All law enforcement officers should possess the drug while they’re on duty. Physicians, pharmacists, and government agencies should make it easier and less worrisome to possess and obtain Narcan.
Do You Oppose the Use of Naloxone and What This Article Talks About?
We should all know about Narcan, at the very least — even if you’re against drug use and against the idea of Narcan in our society, despite the countless benefits associated with its promotion and the few, if any, negatives tied to Narcan. Personally, I recognize how otherworldly the views that I express on this website might sound to others. As such, I genuinely believe that my views, as well as the opinions expressed in this article, are not objectively true.
In other words, that means I don’t believe it’s my way or the highway.
Tying Everything Together
However, I do believe that you should thoroughly give my way of thinking a shot before writing it off. Please try to learn about Narcan and its merits before disagreeing with its use.
If you still don’t support Narcan or naloxone and are passionate about this topic, I encourage you to share your opinions with others. We need more informed people who care about things in our society.
Kratom trees, scientifically known as Mitragyna speciosa, are indigenous to Southeast Asia. Their leaves have been consumed by locals for hundreds, if not thousands, of years primarily for helping laborers work harder, longer, and more effectively. Kratom, which refers to the leaves of Mitragyna speciosa trees, has also been relied on for various medicinal and social applications by people indigenous to Southeast Asia.
More recently, in the past couple of decades, the Western world has grown fond of kratom. The United States is currently the world’s number-one national consumer of the drug. I believe that the recent climb of opioid use throughout the United States is responsible for kratom’s uptick in popularity in the past two-or-so decades.
Just like cannabis, kratom contains a few dozen alkaloids that are responsible for its effects. Unlike cannabis, kratom’s alkaloids have not yet been studied very well. We know that these alkaloids act on the brain’s opioid receptors. Some, particularly advocates of keeping kratom legal, backed by the American Kratom Association, argue that kratom is distinct from other opioids and should not be classified as one.
I will not be differentiating or comparing kratom and opioids in this article. Rather, I will simply address the utility of kratom in replacing traditional opioids among people who suffer from opioid use disorder, as well as how kratom can be used to dampen the effects of opioid withdrawal syndrome among people who are physically dependent on opioids.
Also, I will refer to kratom as an opioid in this article because, put simply, it acts very much like an opioid. It stops opioid withdrawal for most people suffering from opioid use disorder. It provides pain relief in the same fashion as traditional opioids. I understand that there are differences between traditional opioids and kratom — however, for all practical purposes, they are largely the same.
Opioids Are Known for Causing Dependency
One of the most common reasons why people suffering from opioid use disorder find quitting to be difficult is that they don’t want to face the effects of opioid withdrawal syndrome. As you likely know, after using opioids daily for even just a couple of months, users experience physical withdrawal symptoms that can be particularly rough.
Without getting into the problems that opioid users in Northwest Tennessee and elsewhere in rural Tennessee face in seeking out methadone or buprenorphine in place of their current opioids of choice, what’s important to know is that we — I say “we” as a long-term opioid user myself; fortunately, I’m currently on Suboxone and have been for a little over two months now, as of mid-November 2019 — often struggle to afford to pay for these MAT programs or the medication they prescribe, let alone have access to resources like reliable transportation to be able to visit them.
The Utility of Kratom in Addressing Opioid Use
Kratom isn’t only useful in serving people suffering from opioid use disorder as an alternative to other, often-illicit, expensive, not-always-available opioids. However, this article only addresses kratom in this light — just so you know.
Put simply, kratom relieves the symptoms of opioid withdrawal, both physical and mental. The Internet is flooded with anecdotal reports of regular opioid users who have used kratom in place of other opioids, having completely molly-whopped their expected opioid withdrawal symptoms from rearing their ugly heads in true Whack-A-Mole fashion. Personally, kratom has done just this for me.
However, for others, kratom only reduces the severity of opioid withdrawal symptoms.
Either way, kratom does a good job at eliminating or reducing the gut-wrenching effects of opioid withdrawal syndrome.
In Southern Middle Tennessee, for example, according to personal experience and reports of fellow drug users who are from the area, the standard price of 30-milligram, instant-release oxycodone tablets — aka roxies or blues, as they’re often called — have risen to $50 to $60 per tablet! That’s up from a standard rate of roughly $20 per tablet in this same area around 2011 or 2012, when I first got into opioids.
Reason Number One
Kratom is far cheaper than other opioids. Although some blessed — or not-so-blessed, depending on how you look at it — individuals are able to secure ultra-high-dosage prescriptions from legitimate physicians and cover the cost of both their medication and doctor visits with insurance coverage or source low-cost prescriptions from family members in such a fashion, the vast majority of us are forced to pay lots of money for illicit opioids.
Currently, standard-quality, unadulterated, powdered kratom costs as little as $80 per kilogram from U.S.-based vendors. It goes for as little as $40 to $50 per kilogram from Indonesian-based vendors, where the vast majority of kratom consumed by American users originates.
For reference, when I used kratom more often, I would usually dose between 6 and 12 grams, taken up to five or six times per day, if not more. Kratom doses for others usually range between 1 and 15 grams per dose.
Reason Number Two
Kratom is more readily available than other opioids. Back before the contemporary opioid epidemic, when the United States was home to fewer street heroin users, the domestic population of people suffering from opioid use disorder consisted of a greater proportion of those who sourced prescription opioids (including prescriptions diverted to the black market) rather than heroin to fuel their addictions.
In these days, even though the supply of legitimate prescription opioids was saturated, dealers ran out of opioids because of the problems related to sourcing prescription opioids. Of course, this persists today, just in far more prevalent fashion than before.
What’s more important is that kratom doesn’t cause people to lose consciousness — respiratory depression isn’t, actually, the main cause of opioid overdose deaths. Rather, sedatives sometimes cause people to lose consciousness and the ability to keep their airways open.
Considering that kratom isn’t as likely to cause the single-most dangerous side effect of traditional opioids, it’s loads safer!
I should note that some studies claim that kratom does cause respiratory depression. However, widely-supported kratom reseach such as the AKA’s 8-Factor Analysis of kratom indicates that such concerns are blown out of proportion by federal government agencies such as the U.S. Food and Drug Administration (FDA).
Make your own determination regarding whether the FDA is unbiased in pumping out research that unfairly, untruly portrays the facts about drug use. One major incentive for the FDA to do so is to maintain the War on Drugs waged by the U.S. government against drug users and, by extension, society at large.
Also, another way that opioids cause overdose is through asphyxiation. Opioids sometimes cause vomiting. They also cause people to lose consciousness. Combined, opioid overdoses sometimes manifest themselves by users choking on their vomit.
In my experience — and according to countless thousands of anecdotal reports spread far and wide across the World Wide Web — kratom isn’t prone to making people pass out. While kratom may make people barf, at least they won’t spill their guts while unconscious, further separating kratom from traditional opioids in terms of safety.
Another way to look at safety is, because of kratom’s legality in both Indonesia — the overwhelming majority of kratom unarguably comes from Indonesia, specifically West Kalimantan, part of the Republic of Indonesia’s legally-owned stake of the island of Borneo, a large Southeast Asian island — and most of the United States, kratom is less likely to be cut — another word for “adulterated” or “made impure” — with other unwanted active ingredients or unknown adulterants.
I’ve heard that some batches of kratom are adulterated with “matcha,” or powdered green tea leaves. They taste largely the same as kratom and are the same color as ground, powdered kratom. Batches are rarely adulterated with active ingredients other than matcha (which contains caffeine, if you didn’t know), according to my experience with close, personal relations with Indonesian kratom vendors and processors (to read more about my relationship with these two people, skip to the section below about it).
All considered, the market status of kratom also makes it safer than many drugs sold on the black-market economy many common psychoactive drugs are sold on in the United States. Cannabis is largely safe, even in illegal states, for example, though many other popular drugs, such as heroin, are often loaded with adulterants.
Compare the relative safety of kratom to traditional opioids, then combine it with the above, to understand the full picture on kratom’s safety-related utility on opioid users.
Reason Number Four
Of course, in both my experience and the minds of countless other regular illicit drug users throughout the world, the illegality of drugs isn’t stopping hardly anybody. We’re still going to use drugs, whether or not they’re legal.
The primary reason why I enrolled in a MAT program is that heroin, my now-former drug of choice, is illegal. Everything about it is illegal. People who sell it are often engaged in other criminal activities — not because they’re bad people, in most cases, but because of a combination of other factors that are too lengthy to get into in this article.
I grew tired of the bullshit associated with heroin thanks to its illegal nature.
Although some drug users are disciplined in avoiding run-ins with law enforcement, inevitably, the vast majority of us will face legal trouble at some point in our drug-using careers. I’ve known this from the start, but, of course, it wasn’t enough to stop me from using drugs.
Without getting into too much detail, I wasn’t willing to risk getting in legal trouble any further, and, just a couple of months ago, I turned to a medication-assisted treatment program for help dealing with my regular use of heroin and other opioids.
The criminal justice system ultimately turned me to Suboxone. I’m grateful for that today. No more worrying about dying every fucking time I want to get high.
Whether you’re on probation/parole, or if you simply are too scared to use illicit drugs because of potential negative outcomes stemming from run-ins with law enforcement — which includes potentially harmful interactions with law enforcement officers, such as unlawfully being shot or physically struck, however unlikely that may be, or having large amounts of cash seized as “drug money,” even if they’re not related to drugs in the slightest, among other things — or sentences placed upon you by the criminal justice system, kratom is a fine alternative to other drugs.
By the way, there’s nothing wrong with being scared of law enforcement. I am, that’s for sure! I hate that so many of us drug users have to feel that way.
Note the idea of “toxic masculinity,” whereby men have been raised by parents or society — usually both — to not be scared of or admit being scared by real threats such as those posed by doing illegal things. People who hold such ideas, which are especially prevalent in NWTN and the rest of the Southeast, are seemingly more likely to engage in adopting common harm reduction practices to some degree, however how small. This is of my personal opinion and experience spending my short lifetime in rural Tennessee, particularly Southern Middle and Northwest Tennessee.
Reason Number Five
People who face the threat of employment-related drug screens also use kratom for this very reason. Keep in mind that some state- and federal-level government agencies acting as employers are typically more likely than other employers to engage in the expensive, wide-ranging drug tests that are more likely to detect kratom as opposed to mainstream, run-of-the-mill urine and saliva drug tests.
This can be largely related to the drug screens often required by probation and parole requirements referenced above.
Reason Number Six
Kratom was illegal in the Volunteer State as recently as 2016. Since kratom isn’t illegal, it’s more on par in terms of social acceptability à la alcohol as opposed to largely-illicit drugs that are not societally considered as acceptable.
Just for the record, and in the interest of being fair to the American Kratom Association (AKA), I should also mention what positive work the AKA has done for kratom.
I feel like the differentiation between traditional opioids and kratom has harmed my efforts of promoting the normalcy of drug use, particularly opioid use. Opioids have consumed the bulk of my attention in being an active advocate for harm reduction (i.e., giving out free and clean syringes, providing naloxone to users and laypeople alike and educating them best practices in preventing opioid-related deaths) because of opioids having been my drug of choice for about five-and-a-half years as of now, mid-November 2019 and the ongoing opioid epidemic.
The FDA has argued against kratom advocates by say it should be grouped into the category of traditional opioids as a tool to keep kratom illegal throughout the United States.
I should mention that the AKA claims that kratom “is not a drug,” which is wholly false. Drugs, put simply, are things that change how we feel. Kratom very much changes how people feel, with the exception of long-term users who’ve built up tolerance to the leafy green psychoactive drug.
The AKA also says, per its “Follow the Science” web page, that it’s “not a synthetic substance” or “an opiate.” First off, synthetic substances aren’t inherently harmful; also, just because something is natural doesn’t mean it’s safe. Second, opiates — a more appropriate, all-encompassing term is “opioid,” as opposed to “opiate,” which refers only to drugs that are found naturally in the opium poppy — aren’t inherently bad, either.
However, I understand that avoiding labeling kratom as a synthetic substance or opioid helps the American Kratom Association in its efforts to keep kratom legal throughout the United States. I’m torn between praising the AKA for doing a great job of keeping kratom legal and damning them for piling even more stigma onto opioids — and kratom is pretty darn similar to opioids, might I add.
However, seeing as I have used kratom regularly over the past three years when I couldn’t afford illicit opioids — something that often happened quite frequently throughout my time as a drug user when focused on opioids as my drug of choice — to make keep me happy, away from anxiety and depression, and feeling “normal,” the AKA has sure helped my outlook of experiencing serious outcomes from my almost-six-year period as a concurrent traditional opioid and kratom user.
Put simply, AKA good bc provide legal & cheap alternative to opioid use.
IMO, AKA bad bc didn’t advocate for all drugs.
Doing so would have obviously made it so much more difficult for the kratom advocacy community and the AKA to successfully reverse many near-decisions to make kratom illegal on several levels of state and municipal governments.
This is especially true in backwards-thinking areas of the United States, such as in Northwest Tennessee.
Kratom has many benefits to illicit opioids in modern America. Keep in mind that kratom definitely isn’t a cure-all. Also, there’s a lack of research — of its commercial market and on an academic, a pharmacological, and a medical level — that makes understanding truly how much kratom improves the long-term outcomes of modern American illicit opioid users.
My Relationship With Two Indonesian Kratom Vendors/Processors/Harvesters
Most Americans don’t talk to native Indonesians very often. Personally, I don’t know any languages but English. I’ve never been out of the country and travel very little. I am not well cultured myself and am not trying to seem that way or brag about my time being connected to the industry in this way.
Since the kratom industry in Indonesia isn’t regulated and kratom trees grow wild there, making it easy for anybody to visit public lands that contain wide ranges of rainforest, which is what the island of Borneo consists of.
The U.S. Dollar goes far in Indonesia. The number-one national consumer of kratom, again, is the United States. Indonesians capable of harvesting, processing, and selling kratom are incentivized to do so.
Some privately-owned kratom trees exist in both small-time residential capacities and large, farmed capacities. However, you should understand that most kratom is not farmed, no matter what the majority of American kratom consumers might think.
Because of the nature of kratom in Indonesia, commercially speaking, it makes sense why Indonesians would want to keep industry-specific information — admittedly, they’ve done a good job of securing these details among themselves — within their own country and out of the lexicon of American kratom users.
Here’s How It Happened
I offered to write articles for about 10 kratom vendors active on the Internet via email. One of them was based in Indonesia. We’ll call them KootaBang, or KB for short.
KB was operated by a pair of young Indonesian men. They had been selling kratom shipped from Indonesia for a few years and worked with at least two other individuals they met online in the United States. I was the third that I know of. Even if they have to risk someone running off with a shipment of kratom — the largest single incoming shipment, in my situation, was less than 200 pounds, which was lasted about a month — it was worth taking the risk (see USD exchange rates with the Indonesian Rupiah, etc., above) for their potential reward.
I simply performed customer service, as they weren’t fluent English speakers, and shipped the already-packaged kratom throughout the U.S. via my local post office. I paid nothing for the kratom shipments. It was all loaned to me. They paid for all shipping, too. The customer service function of my job work was something I offered to do after shipping kratom for a little while.
So, I didn’t own KootaBang, but I pretty much ran it myself — operations-wise, that is.
I bring this up to explain why they would have been incentivized to share some industry insider information — keep in mind that kratom is largely new across the U.S. and that we grow absolutely none used on a commercial scale here — with me rather than hide it. Any of the now-four people who have run KootaBang’s United States-based operations could have run away at any time with current inventory stores worth a few thousand dollars. Doing so also would have taken KootaBang out of business due to how long finding a new suitable U.S.-based vendor, including shipping kratom some 7,000 to 9,000 miles away from Indonesia to the United States, takes.
Did I Learn Everything There Is to Know?
Absolutely not! All of the stuff I learned — the stuff that most other American kratom consumers wouldn’t know about — didn’t scratch the surface of what there is to know.
I don’t know how the various drying or curing methods affect the alkaloid concentrations and their proportions to one another. I don’t know how to grow kratom myself. I didn’t ever go there, let alone participate in the industry myself.
I didn’t get the gig with them because I was good — I got lucky! I can’t pretend that I earned it myself. I was very small-time and my experience spanned just four months of hands-on kratom selling.
Also, as time goes on, these “trade secrets” will become more widely known across American kratom consumers. I think this is great, by the way, in the name of better understanding kratom.
I share this stuff not to seem like I’m special and holier than thou — I just want to share what should be common knowledge across the world of kratom. I wish I, and everybody else, knew it from the jump.
If you visit the Kratom subreddit on Reddit, you’ll see that ignorance is common across the community, but that’s only because Indonesian kratom industry participants benefit from keeping it that way and withholding information that only people who have hands-on experience with kratom harvesting and processing possess.
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.
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!
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.
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.