Google defines “advocacy” as “public support for or recommendation of a particular cause or policy.” Here’s one example of harm reductionadvocacy: creating a brochure that explains the basics of harm reduction, describes examples of it, and tells readers why adopting harm reduction-friendly practices is a good idea; after printing the brochure out, copies are distributed to laypeople throughout the distributor’s local community.
There are countless forms of harm reduction and drug policy reform advocacy. Few are objectively better than one another, though all have unique pros and cons. As such, all forms of advocacy can be better than others depending on how they’re being used — I think advocates should always be situationally sensitive.
Local News Agencies Are Valuable
Keep an eye on local news agencies’ most recent releases. You should keep tabs on at least several local news agencies, preferably those in and around your current area of residence. Subscribing to at least a few elsewhere is also a good idea.
When you find articles or broadcasts that favor the progression of harm reduction and drug policy either on a national level here in the United States, a state level, or even a local level, try reaching out to these agencies and identify whether you think they had a positive or negative effect on advancing harm reduction or drug policy.
To define what I mean by “negative,” negative pieces include those that sensationalize drugs, spread misinformation about them, or damage our collective cause to advance harm reduction and drug policy reform.
Whether you’re looking to (reinforce/punish) the publication of harm reduction-(positive/negative) or drug policy reform-(positive/negative) pieces, you should always seek help from other advocates who you’re connected with. When one of your advocacy group’s members locates a piece that one of you wants to reply to, each of you should write a letter to the news agency in question for added effectiveness.
The person who initially floated this idea to me said it may prove useful to send multiple replies from different identities. Of course, this isn’t illegal, but could very well contribute positively to our cause. Only you can determine if doing so is within your ethical boundaries — honestly, I’m still on the fence about it.
Coming Out as a Person Who Uses Drugs
Although sexuality and drug use are two entirely different things, just as people can out themselves as bisexual — I, too, am a member of the Alphabet Gang — widely outing oneself as a drug user can prove similarly difficult. Of course, there are many downsides to outing yourself as a drug user. If we all out ourselves as persons who use drugs (PWUD) — not that any such widespread, preplanned coordination would be feasible — the stigma associated with drug use is likely to start fading away.
However, you should understand that everything you do will reflect on the other few people who have come out as PWUD. These people have already risked outcast, relationships, criminal justice problems, work opportunities, friendships, and much more.
As such, you shouldn’t come out as a PWUD if you’re not in a good place to do so. Soon enough, fortunately, the stigma surrounding drug use won’t be as strong. The more people who do decide to come out as PWUD will make coming out easier, so, by coming out, we’re helping drug users as a whole.
This should go without saying, but you’ll be less likely to make others look bad if you’re responsible, well thought-out, maintain employment, and so on.
Again — if you decide to do this, make sure you won’t make others look bad in the process.
Realistically speaking, I know at least some drug users would take initiative, but those people would likely be of a more-responsible, go-getter nature. In other words, getting the people who most frequently and most intensively make us look bad — for the record, I’ve made us, as drug users, look bad countless times — would prove difficult, likely rendering our efforts better channeled via another effort.
Befriend or Get to Know the Following People and Places
Some people and entities are inherently more drug-friendly than other people and entities. These include law enforcement agencies, law enforcement officers, correctional officers, wardens, jails, drug rehabilitation facilities, prevention coalitions, churches, libraries, health departments, public defenders, parole boards, etc.
By cultivating relationships with these people and places, you’ll generally be in a better position than most people to influence them.
Understand you’ll get further with those who are already more drug-friendly or drug user-friendly. Still, I’d argue that our collective efforts would be better spent in areas that are more drug-averse or drug user-averse.
Never Spend Time Trying to Change Others’ Minds on Social Media
This is self-explanatory. Arguing with others doesn’t get you far, especially on social media. This is because people on social media are often set in their ways regarding hot-button issues like abortion, gun control, or how society treats drug use.
Trying to advance your cause by attempting to persuade these people either wastes your time and gets you nowhere or results in people thinking worse about your cause.
The unconventional measures that harm reduction-friendly policies propose don’t seem like good ideas upon first glance. Because social media doesn’t lend itself to answering complex, multi-faceted questions — or even hearing them out in the first place — spending time trying to change others’ minds, especially on social media, isn’t a good idea.
If you do try to attempt this, your posts should be placed in highly-visible areas, must be easy to understand, must be non-argumentative, and must not be placed in communities that are inherently or largely against such ideas already — sharing posts in more moderate areas may be a better use of your time.
Ultimately, the only reasons why I post on social media about harm reduction or drugs in general is to expand my network, relentlessly self-promote my writing, or boost my chances of finding gainful employment in this harm reduction space. I believe that posting to social media with the goal of changing others’ minds is nothing short of a waste of time.
Activating Drug Dealers by Giving Them Harm Reduction Supplies
Many people who use illicit opioids via injection, for example, like myself would much rather be able to source syringes from the same place they purchase their opioids of choice from than having to visit syringe exchanges, pharmacies, or — what often happens in rural Tennessee, where I am — elsewhere on the black market.
Dealers who offer clean syringes to customers, whether it be for free or not, can cultivate and maintain a competitive advantage.
In areas where clean, free syringes are available, dealers aren’t likely to source syringes in an above-ground, legal manner. Rather, they’re more likely to accept syringes from below-ground resources, such as from one of their customers, for example. This is something I’ve done, myself.
Activating drug dealers by providing them with syringes, naloxone, and other harm reduction supplies is a good way to advocate for harm reduction because:
People may also more readily familiarize themselves with harm reduction as an ideology.
People who activate dealers in this way should also educate them, if possible, about the basics of harm reduction. Ideally, these aforementioned activators should provide dealers with hard copies of educational material in the form of brochures, pamphlets, or even single, printed-off, black-and-white sheets of basic harm reduction information.
In my experience, dealers aren’t as interested in learning about harm reduction as they are the prospect of building a competitive advantage. I’m not saying dealers are heartless, soulless criminals — I just think humans are more interested in capitalizing on opportunities that benefit them in the now rather than advancing abstract ideologies and the very-potential benefits that may come from them.
Also, even if dealers you come across are interested in the ideology of harm reduction, let alone adopting it and practicing it, they should be — at least I’d hope any business-minded person would be — averse to supporting something that would ideally cut them out of contention (i.e., harm reductionists generally support safe supply, which involves things like allowing doctors to prescribe pharmaceutical-quality heroin; this would unarguably harm any illicit drug market’s bottom line).
Advocating for causes is time-consuming and often frustrating. Further, many people don’t advocate in effective ways. One of the number-one ways that people think is an effective way to be an advocate is by posting on social media. In most cases, this is simply ineffective, if not wholly counterproductive.
These aren’t the only ways to advocate for harm reduction or drug policy reform. However, these five methods are all solid means of advancing our cause as harm reductionists or drug policy reformers — if not both.
We’ve all heard heard dozens of fellow users spout countless inaccuracies, misleading statements, and flat-out incorrect assertions about drugs, drug use, and drug laws as if they were all fact.
There’s no way this article could even hope to cover a half of a percent’s worth of the myths, half-truths, and facts we’ve heard as drug users since 2010 — that’s when I first began using illicit drugs — and address them to help readers better understand them.
Without further ado, let’s get started.
Myth #1 — You Should Disinfect With Alcohol Swabs Before AND After Injection
A few weeks ago, I asked a fellow local intravenous heroin user whether she used alcohol swabs prior to injecting. She told me she used alcohol swabs both before and after injecting. This is actually worse for your health as opposed to just using an alcohol swab immediately prior to injection, no matter the type of injection used: IV (intravenous, or directly into the vein), IM (intramuscular, or directly into the muscle), or SC (subcutaneous, or under the skin).
Put simply, isopropyl alcohol — the active ingredient in rubbing alcohol and alcohol swabs — is an antiseptic, or something used on the skin to shrink the possibilities of infection.
Injections make small holes in the skin through which bacteria and other potentially-dangerous microorganisms can enter. Following an injection, blood rises to the surface and closes the hole made by the syringe. The faster this happens, the less likely foreign objects are to make it inside the human body.
Using an alcohol swab after injection prevents blood from clotting. This is why it’s not a good idea to use alcohol swabs after injection.
Fact #1 — All Adults in Tennessee Can Purchase Syringes Legally
Many injection drug users in Tennessee struggle to get their hands on clean syringes. They usually are forced to hit the black market to source clean syringes, but, unfortunately, due to the underground nature of the black market, market participants can’t be sure that their sharps are fresh.
It’s possible to purchase larger-diameter syringes without a pharmacy’s help — think of veterinarians, vet supply stores, or pet stores. However, these syringes are absolutely not intended for the injection of illicit drugs.
Again, in actuality, injection drug users have one hell of a time trying to purchase syringes from pharmacies. Those who have tried to get syringes from pharmacies, especially in rural areas, often feel discouraged from trying other pharmacies in hopes of getting a “yes.”
I understand the rationale behind not wanting to feel responsible for helping an injection drug user shoot up, but people who inject drugs will get high whether or not they have access to clean, fresh syringes or not. As such, this idea doesn’t make much sense — shouldn’t pharmacists want to help underserved, at-risk persons from reusing sharps or sharing them with other users? Also, even if you purchase syringes off the black market, the only choice for most rural Tennessean injection drug users, there’s no guarantee they’re clean.
Anyway. To wrap this “fact” up, know that it’s legal to purchase syringes from pharmacies here in Tennessee without prescriptions but, in the same breath, understand you’re highly likely to get turned down.
Myth #2 — If You Have a Reliable Illicit Source for Diverted Prescription Medication, You’ll Never Come Across Fakes
Assume you occasionally consume prescription opioids (Norco, OxyContin). It doesn’t matter how often you take them. What does matter, in this scenario, is the source of the opioids.
According to federal government statistics, beginning in 2015, the rate of opioid prescribing in the United States dropped for the first time in some two full decades. This caused major supply chain issues on the American illicit opioid market.
People who were then able to regularly, reliably source prescription opioids from trusted sources had to do things like:
Their counterpart, the big labs mentioned above, are typically operated by Mexican drug cartels. Due to the widespread availability of pill presses, there are hundreds, if not thousands, of clandestine, one-room pill-pressing operations across the United States — but do we really know how active they are? Of course not — I’m just pointing out that pill pressing doesn’t just happen in big-time, Mexican-drug-cartel form.
Both are able to purchase pre-made mixes of inactive ingredients online. In most cases, these counterfeit opioid tablet manufacturers choose fentanyl as an active ingredient. Fentanyl has a lower threshold between the point at which consumers feel its effects — both analgesic and recreational — and the point at which opioid overdose symptoms manifest.
Another factor that makes counterfeit opioid tablets so deadly are “hotspots.” Hotspots are simply clumps of active ingredients. Fentanyl is much more potent than other opioids — extremely so. Because the volume of only a grain or two of salt can cause death in a human adult, it’s easy to understand why fentanyl “hotspots” are such an issue with counterfeit opioid tablets.
Dude, There’s No Way My Pills Could Be Fake
I’ve heard this rationale from countless drug users I’ve been around. I understand the thinking, especially from people who happen to have better connections to the diverted prescription opioid market, though it’s not a valid idea.
As you know, just one run-in with fentanyl-laced counterfeit opioid tablets can cause a potentially-fatal overdose.
How do we spread this message to people who use diverted prescription opioids — that they should view everything they come across as potentially counterfeit? I’m not sure. It’s often difficult to make the case to diverted prescription opioid consumers that their pills could be fake and contain the-super-easy-to-overdose-on drug fentanyl.
I think our best hope is to continually spread this message — that your pills could be fake and contain drugs with higher overdose potential like fentanyl even if you purchase them from trusted sources — to people who use drugs.
Fact #2 — Non-Opioids Can and Do Contain Fentanyl
We’ve all seen reports of non-opioid drugs like cocaine, methamphetamine, and even cannabis containing fentanyl. Although opioids are more likely to contain fentanyl than their non-opioid counterparts, other drugs can and do contain fentanyl — this isn’t just an over-sensationalized narrative pushed by news outlets.
There are a few reasons why batches of drugs on the American illicit opioid market contain fentanyl — and if you’d like to read more about why fentanyl is so deeply ingrained in the modern American illicit opioid market, check out this previous article of mine. They include the following:
Because fentanyl is much more potent than heroin, distributors don’t have to transport as much volume or weight when they adulterate their heroin with fentanyl. The more fentanyl in an opioid mixture, the easier distribution is.
Fentanyl furthers people’s addictions and dependencies. Once the illicit opioid consumers in an area become dependent on fentanyl in addition to heroin — or another opioid like oxycodone, for example — the less satisfied they’ll be by batches of opioids that are fentanyl-free.
Fentanyl-heavy batches effectively provide free marketing to dealers. Dealers have been known to push exceptionally strong or unevenly-mixed batches of illicit opioids that also contain fentanyl, causing more overdoses than usual — and potentially more deaths. Full diclosure — dealers are people, too, and they often don’t want to see their customers die. However, it’s undeniable that dealers stand to benefit by selling batches of “heroin” — really, almost all American “heroin” is a fentanyl-heroin mixture — that are more likely to cause overdose.
Fentanyl-positive “heroin” hits different. Even though opioid users know how dangerous fentanyl is — at least they should know for the sake of their well-being, and all — many report that they’d rather use heroin-fentanyl mixtures than just heroin, or whatever opioid-fentanyl mixture is at hand.
As you can reason, there are plenty of reasons to add fentanyl to other opioids. But why would anybody include fentanyl in non-opioid drugs?
There’s no question that high-level distributors have made mistakes during the adulteration process that resulted in the cross-contamination of other, non-opioid drugs like meth with fentanyl.
For example, assume a high-level distributor just got done adulterating their heroin with fentanyl. The distributor used a few blank credit cards/gift cards to mix the two opioids together. Rather than cleaning the cards off before attempting to adulterate their cocaine, for example, the distributor inadvertently contaminates their cocaine supply with fentanyl.
A personal anecdote from a Northwest Tennessee man — I’ve referred to him as Jonah before in one other article — is that, after he was court-ordered to go to rehab twice in two or three months, he ended up testing positive for opioids both times. Jonah never uses opioids and doesn’t like them.
The one thing that stayed consistent between the two drug screens is his meth consumption.
Further, other meth consumers in Jonah’s local area have also reported that they’ve tested positive for opioids following their consumption of local meth, despite the fact they didn’t otherwise consume opioids.
Since fentanyl was — and still is — regularly found in the local illicit meth supply to which Jonah has access, I think it’s reasonable to assume that people higher up the supply chain intentionally cutmeth with fentanyl. It’s not very feasible for high-level distributors to continually make the same cross-contamination mistake over, and over, and over, and over again.
Here’s Jonah’s hypothesis as to why his community’s local meth supply contains fentanyl: after a few days of binging on meth, almost certainly bringing no sleep and — in many other methamphetamine consumers’ cases, too — an insufficient nutrient load into the mix, it’s not hard to reason that these people’s bodies would feel sore, worn out, or otherwise bad. Jonah feels as if the distributors who are responsible for adulterating methamphetamine with fentanyl provides the distributors with a competitive advantage because consumers’ aches, soreness, and lethargy would be better dealt with than by consuming methamphetamine without fentanyl included.
Could Jonah be wrong about this idea? Yes. I think it’s a valid idea, however, and I haven’t seen it floated anywhere else.
What’s important to know is that all drugs, not just opioids, are liable to contain fentanyl. The problem with this is twofold: (1) users don’t know they’re consuming fentanyl and (2) since there’s such a low threshold between the amount of fentanyl needed to cause physiological or psychological effects and overdose, it’s easy for people to potentially die from unknowingly consuming fentanyl.
Myth #3 — You Can “Narcan” Yourself
Before Anything Else, Let’s First Understand Naloxone
First off, “Narcan” isn’t technically a verb — it’s a proper noun officially stylized as NARCAN® Nasal Spray — though you’ll inevitably hear it used as such somewhere. Narcan is a pre-loaded, single-use nasal spray that’s available over the counter in pharmacies across the United States. Drugs are available over the counter when they have little to no contraindications, or negative reactions to other medicines or people who have certain health conditions.
Naloxone, the sole active ingredient in Narcan and Evzio — similarly styled EVZIO®, an auto-injector that talks users through the entire process — has no contraindications outside of people who are allergic to naloxone.
Many people who overdose on opioids are opioid-dependent, meaning their bodies need to maintain minimum levels of opioids or else they’ll face opioid withdrawal syndrome, which shares many of the same symptoms of the flu. Although this isn’t a true contraindication — which means, according to Google, “suggest or indicate that (a particular technique or drug) should not be used in the case in question.” — opioid-dependent people experience precipitated opioid withdrawal for an hour or two following administration.
Depending on what opioid an opioid-dependent person is reliant on, the peak of opioid withdrawal syndrome takes roughly 72 hours to be reached. Precipitated withdrawal, on the other hand, causes the full slate of peak opioid withdrawal syndrome symptoms to rear their oh-so-ugly heads in opioid-dependent people.
This is a small price to pay in exchange for having your life saved, though — an hour or two of pain to have another shot at this beautiful experience we call “life.”
Naloxone acts as a powerful public health tool. Whether you think reviving someone who knowingly uses opioids and understands they can die from doing so is a good idea or not, since naloxone is cheap and has no true contraindications, naloxone is an effective tool for preventing death.
And, although off-topic, you may come across people who aren’t supportive of responding to opioid overdoses with naloxone. No matter their reasoning, I think the vast majority of all reasonable-minded humans agree that nobody should die while suffering. Many regular drug users — especially those suffer from drug addiction — use drugs to fill the gaps created by long-unmet needs not being fulfilled. I genuinely believe that every stint of problematic drug use comes to an end, however long it might take; this thinking lends itself to the idea that every addict will has a real, tangible shot at recovery.
Most people will get behind the idea of making sure people in active addiction don’t die in pain. This approach may be useful in educating laypeople about naloxone or persuading them to get on board the naloxone train.
Naloxone has been used extensively to reverse overdoses throughout the United States, especially recently.
For example, I had at least two opioid overdoses — I say “at least two” because I was given naloxone a third time when I was potentially just a few minutes away from experiencing overdose; I’m not sure if I can definitively count that as an “overdose” — in 2019. Both times, fortunately, I was revived with naloxone. Would I have died or experienced permanent brain damage without naloxone’s help? There’s no way to know.
Knowing when to administer naloxone is the same thing as knowing how to recognize an opioid overdose.
Bluish lips, fingertips, and toes are one of the most widely-reported symptoms of opioid overdoses, according to friends, family members, peers, first responders, physicians, nurses, and other medical professionals who’ve seen people experience opioid overdose.
The skin will turn a different color, though what color it turns depends on the person’s regular skin tone. Lighter-colored people, such as most White and Asian people, skin may begin turning hues of blue and purple. For darker-complected people, like most Middle Easterners and Black people, skin tones may start to become any one of a range of gray colors. Keep in mind that these aren’t scientific facts — just concerns we should play with.
If you’re unsure of what to look for or think you might not be good at recognizing these color changes, always first look to the lips for help. They’re the easiest to read, generally. Also, fingertips and toes may be of help, too.
Assume you’re not sure of what to do. You see someone exhibiting one or more of these opioid overdose symptoms, but you also see that their current cohort of symptoms could very well be caused by another drug’s pattern of overdose symptoms.
Here’s what we’re going to do. I’ll explain how to administer naloxone, as well as what signs you should look for to know when it’s an appropriate time to “Narcan” somebody.
Now, it’s time to administer Narcan. Don’t worry about getting their body in a certain position; simply spray one spray in each nostril. Make sure the nozzle is firmly inserted inside each nostril before spraying.
If you’re using injectable naloxone, draw the naloxone solution into the syringe and inject it into the thigh or upper arm. To bridge the gap from now until paramedics alive, perform rescue breathing. There are several other best practices to follow in responding to opioid overdose, though I won’t list them here — I’m just trying to give you an idea of what administering naloxone is like, if you didn’t already know.
That’s how the naloxone administration thing works. But can you revive yourself with naloxone?
But Can You Revive Yourself With Naloxone?
Let’s Cover a Real-World Example, After Reading Which You’ll Determine the Answer Yourself
Opioid overdoses can happen anywhere from a few seconds to a few hours after opioids are taken; the fastest overdoses usually happen with intravenous administration, since no absorption barriers have to be passed.
Oral consumption, on the other hand, is sure to take the longest in terms of causing an opioid consumer to experience opioid withdrawal syndrome. One time — and it’s not like I’m proud to admit this; not at all — I experienced an overdose in 2014 that involved oral administration.
It was early June 2014. I won’t get into why, but I was angry at the time — very angry. I had almost never, ever used drugs in direct response to my emotions. I first took oxycodone — relative to my opioid tolerance at the time, I just took a standard dose; nothing special. Then, maybe 45 minutes later, I took alprazolam, and, relative to my benzodiazepine tolerance at the time, it wasn’t a large dose, either.
I had actually combined alprazolam (Xanax) with oxycodone before several times, not to mention in larger doses than I did on this super-humid evening. About an hour after I took the Xanax, I decided I wanted to walk back to my room, as I wasn’t having any fun with the people I was hanging out with.
Keep in mind that pretty much all students at this school had left a week or two prior, as the spring semester had just come to close.
On my way back to my room, I passed out. The only thing I remember is leaving the room. The room was no more than ~40 steps away from where I’d passed out, including a small flight of stairs.
Here’s what ended up happening: I stayed that way, collapsed in a lump on the carpeted hallway floor. All by myself. With nobody to help me. Not a soul.
Everybody else had left campus just a week or two prior. I ended up coming to about three to four hours after I’d passed out. I was extremely disoriented, dehydrated, and confused. I felt more confused than I ever had in my entire life for about 15 minutes. I puked, and I puked, and I puked. And then I puked some more.
I’m very lucky to be alive.
Could I Have Administered Naloxone Myself and Prevented That Overdose?
Again, I don’t remember anything about falling out. Even if I knew what naloxone was and I had it with me, how would I have recognized the “point of no return”?
Therein stands the central issue with the prospect of naloxone self-administration in response to opioid overdose — you don’t know when you need to hit yourself with the life-saving drug.
I very well suspect that some opioid users could successfully prevent an impending overdose via naloxone self-administration. However, if you miss the mark just one time, game over!
Also, keep in mind that opioid users often can’t afford to ruin their high, which is exactly what naloxone does. Or, they might just not want to blow their high.
Put simply — and if you want to read more about my take on naloxone self-administration, check out my article on it — you can’t rely on yourself to administer naloxone in the event of overdose.
One last thing about naloxone — after I’ve been given naloxone, I’ve never experienced precipitated opioid withdrawal syndrome. This is because I just happened to be given enough naloxone to resume consciousness, though not enough to forcefully remove the opioids that were occupying my noodle’s opioid receptors from those receptors — that’s what causes precipitated withdrawal, if you didn’t know. I also still felt high after all three of my run-ins with naloxone.
Fact #3 — Kratom Is an Opioid
Many advocates of kratom, including the American Kratom Association, argue that kratom is not an opioid despite the fact it causes effects oh-so-remarkably similar to opioids, mitigates opioid withdrawal syndrome, and acts on the brain’s opioid receptors as its mechanism of action.
I wholeheartedly disagree — I think kratom is, in fact, an opioid.
What Is Kratom?
Kratom (Mitragyna speciosa) is a deciduous evergreen tree — the tree would lose its leaves if grown in a non-tropical area, though, since it’s found in tropical areas, kratom trees don’t ever shed their leaves for the winter, making it both deciduous and evergreen — that is native to Southeast Asia. People have used kratom for at least hundreds of years, usually by laborers to power through workdays thanks to its stimulating and analgesic effects.
Kratom contains a couple dozen alkaloids, or psychoactive compounds, that are responsible for its effects. People typically use kratom by swallowing ground, powdered kratom leaves, making tea, or chewing fresh leaves raw a la chewing tobacco.
Although the pro-kratom advocacy organization American Kratom Association considers kratom not to be an opioid, I disagree. There’s no single, widely-accepted definition of “opioid,” which makes arguing whether kratom is an opioid or not difficult — without agreeing on a definition, you can’t reasonably discuss whether kratom is, in fact, an opioid or not.
Why does morphine — and, of course, other opioids — relieve pain, cause analgesia, and potentially lead people to addiction or dependence?
We’ve got a few different kinds of opioid receptors. One of them is the mu-opioid receptor.
A 1996 study found that, by comparing humans to mice that lack the mu-opioid receptor, the mu-opioid receptor is responsible for both the “therapeutic and the adverse activities” of morphine. Mice without the mu-receptor gene are more sensitive to painful stimuli, don’t pull as much reward from drugs of abuse, and lack the same dependence, reward, and analgesia from morphine that mice with the mu-receptor gene.
Here’s Why Kratom Is, in Fact, an Opioid
Two of the most prevalent and powerful alkaloids in kratom are mitragynine and 7-hydroxymitragynine (7-OH). Primarily, the effects of these alkaloids come from partial agonism of the mu (µ) opioid receptor.
Some kratom fans may argue that, since kratom is only a partial agonist, it can’t be considered a true opioid. LSD and THC, for example, are both partial agonists of the 5-HT2A and CB1 receptors, respectively. LSD is still considered a classic psychedelic based on its effects; THC is defined as a cannabinoid for the same reason.
Myth #4 — Kratom Is a Deadly Drug
The other ideas I’ve addressed so far are likely more familiar to you than this one. While this might not be a widely-held misconception, I’ve come across a handful of people who think kratom is a deadly, dangerous drug.
The only people I’ve heard say this in real life were all involved with a medication-assisted treatment program in Jackson, Tennessee — two of them were physicians and the other was the program’s director and a registered nurse. I’ve seen people online say the same things, too.
These two physicians and the director-cum-registered-nurse told me kratom causes worse opioid withdrawal symptoms than buprenorphine (Suboxone). That could be the single most ignorant thing I’ve ever heard. I’ve taken kratom for three-plus years. Never did I have serious withdrawal symptoms.
Now, since I’ve been on Suboxone, I can’t even begin to feel the effects of kratom, even in high doses. Also, before enrolling in the MAT program, I never had a material physical dependency to opioids. Now, I do.
Comparing Kratom to Other Opioids
Opioids are notorious for causing respiratory depression, the most common direct cause of death stemming from opioid overdose.
The Centers for Disease Control and Prevention (CDC) have published research that fingers kratom as a direct cause of death in about 100 people after examining some 27,000 accidental drug overdoses across a 17-month stretch in the United States.
I feel that the three aforementioned medical professionals — although they’re obviously incentivized to slam alternatives to opioids other than buprenorphine, considering they work for a medication-assisted treatment program, and all — may have been led astray by FDA and CDC reports.
Also, these reports have spurred news agencies around the country to write about kratom as a potentially-harmful or definitely-deadly drug, further pushing people to view kratom negatively.
Here’s the Verdict
Yes, kratom is a drug. Like all drugs, kratom can prove harmful. However, kratom doesn’t pose much of a threat because:
It’s less likely to cause respiratory depression — or vomiting, for that matter.
Kratom is much, much safer than classical opioids, especially those sold on the black market, not to mention readily available and cheap.
Kratom, which is often used to curb anxiety, depression, chronic pain, and other health problems, can be used irresponsibly, especially by people who are self-medicating to deal with anxiety or depression.
Also, because the kratom market is largely unregulated, there’s no way to reliably enforce manufacturers to prevent kratom from being contaminated with pathogens, heavy metals, other active ingredients, bulking agents, or any other adulterants. Kratom needs to be regulated — at least if we want the kratom industry to be safer, that is.
Tying Everything Together
I hope I’ve been able to shed some light on commonly-held myths, misconceptions, and half-truths that are common among people who use or are otherwise involved with drugs.
Please do reach out to me if you think I got anything wrong.
People like San Francisco’s Tracey Helton and organizations like New York City’s NEXT Distro have long distributed syringes, naloxone, and other harm reduction supplies via mail.
Mail-based supply distribution (MBSD) is so very helpful for people who live in areas where there isn’t much, if any, access to harm reduction supplies, drug-related education, or drug user health support. Although MBSD isn’t an equal substitution for in-person syringe services programs and other resources that help drug users like me, they’re unarguably the next-best alternative.
I regularly distribute supplies like these from mail-based supply distributors to fellow drug users and dealers here across rural Northwest Tennessee in an underground, unfortunately-illegal, grassroots fashion. Here, syringe access is nonexistent and finding naloxone is like pulling teeth.
Here are some insights on MBSD that I’ve gathered during my time as a harm reductionist.
Drug Users Often Lack Access to Necessary Supplies
Across West Tennessee, there are only two syringe services programs (SSP) overseen by the Volunteer State. Both of them are in Memphis, which is in the far southwestern extreme of Tennessee. No matter where you’re at in Northwest Tennessee, a nine-county area home to 254,000 people, Memphis is at least a solid 90-minute drive away, rendering legal syringe access essentially impossible.
Pharmacies can legally sell syringes, though pharmacists routinely turn down customers without prescriptions for syringes. The only access we have to syringes here in rural West Tennessee is the black market.
Here, there’s an objective, pervasive lack of access to supplies like syringes.
Even in areas where there is syringe access, many drug users get left behind for reasons like not having reliable transportation, having to work during program operation hours, not wanting others to know about their drug use, and fearing incarceration because they have outstanding warrants for their arrest.
Mail-based supply distribution circumvents these barriers and many others — though, just to be clear, MBSD isn’t a panacea.
At Least Here, We’re Trained to Exercise Discretion in Everything We Do
As drug users, we’ve been trained to avoid new people or things that seem too good to be true. In my own efforts to distribute syringes, naloxone, and other supplies to people who use drugs, I’ve been turned down countless times by people who simply don’t trust me.
The people of rural West Tennessee aren’t used having access to syringes, let alone getting free syringes — we’re used to buying them illegally from other users, family members, or dealers — which has made reaching out to people who use drugs and could stand to benefit from what I do difficult. As you might imagine, many here aren’t comfortable with the idea of receiving syringes through the mail, either.
In full disclosure, I’ve tried to turn people on to mail-based supply distributors, many of which offer supplies for free, but nobody’s taken me up on this offer. Once syringe access expands and rural Tennessean drug users become familiar with it, I know they’ll slowly come to trust such opportunities as legitimate.
Even if we did have open access to syringes here in rural Northwest Tennessee, the most vulnerable drug users likely wouldn’t be able to visit syringe services programs’ outlets or be comfortable with showing up in person. MBSD would help reach some of these people, assuming they’re housed or otherwise have an address to accept mail at.
Last thing — there will be a transitory period following the expansion of syringe services programs here in rural Northwest Tennessee in which drug users will slowly come to accept such resources as legitimate. Abruptly shaking us out of our discretionary habits, which, again, are so prevalent here in rural Tennessee, isn’t possible. During this period, I predict that some people who stand to benefit from access to syringes and other harm reduction supplies may only be comfortable participating in supply distribution programs if they can receive supplies via mail.
MBSD may prove useful during this transition. Maybe not.
Well-Served Drug Users Are More Likely to Support Harm Reduction Than Those We Haven’t Helped
It doesn’t take much thought to reason that a well-served drug user is more likely to aid in harm reduction than an underserved counterpart.
This is just an anecdote, but I only became active in harm reduction after I was given syringes, naloxone, and other supplies — they came by way of mail, too. We don’t have much access to things like that here.
Although you could, in theory, purchase syringes from pharmacies, pharmacists rarely sell syringes without prescriptions here in rural Tennessee — I’ve heard pharmacists are more lenient in cities, such as Memphis or Nashville — this rarely happens. Those who have tried to buy syringes without prescriptions usually don’t bother after a few tries, anyway.
One more anecdote — I’ve only been able to welcome aboard other drug users or dealers as secondary distributors after giving them supplies myself.
If We Drug Users Demonstrate Responsibility, We Stand to Gain More Support
Despite researchthatshowsotherwise, most Americans — at least this is true for rural Tennesseans — don’t support expanding syringe access.
Many people think opening up syringe access simply enables injection drug users. While I understand this reasoning, the fact that regular injection drug users by the boatload who only have black-market syringe access suggests this idea falls short.
Let’s face it — often-problematic drug users like me have often lived up to the stereotype of “junkie” or “druggie.” I know this is true for me. And I’ve been around so many others who fit the bill, too.
If we drug users can prove ourselves responsible in handling syringes given to us, views toward improving syringe availability may brighten.
Of course, I’m sure syringe access will be portrayed negatively by local news agencies if syringe litter becomes prevalent or complaints arise even if most of us are, in fact,responsible with the supplies we receive. Still, we stand to improve our overarching reputation as drug users through proving responsibility. But this is something we should strive for, anyway.
For the record, if I wasn’t already clear, I’ve made myself — and all drug users, by extension — look bad countless times before. And, even though I try to act more responsibly now, I still find myself giving drug users a bad name from time to time.
Is it reasonable to expect everyone who uses drugs to act responsibly? No. Actively making drug users like me aware of this responsibility will, inevitably, encourage at least some of us to shape up.
Mail-Based Distribution Can Promote Safety During Pandemics
Times of pandemic don’t rear their ugly heads very often, to be fair, but MBSD reliably reduces pathogen transmission.
Although this is a very real benefit, I feel it’s auxiliary to other points expressed herein. Despite this, I think we harm reductionists could benefit from making the public aware of this benefit before the ongoing novel coronavirus pandemic slows down. Maybe not — admittedly, I’m not well-versed in communications or public relations.
Providing Opportunities to People as Potential Secondary Distributors Gives Them Purpose
I know a handful of people, one currently-incarcerated dealer and a few active drug users, who are willing to distribute the supplies I provide to others who use drugs.
The dealer, of course, was motivated by the prospect of selling syringes or increasing sales by offering supplies customers might not have access to. However, the others, I believe, are motivated by the prospect of helping others.
Long-term, often-problematic drug users like me often have less to live for than the general population. We are also less likely to actively pursue passions and hobbies. We lose interest in things we used to like.
Activating current drug users as secondary supply distributors gives them purpose, which can very well lead to outcomes like ceasing or decreasing drug use, securing gainful employment, or enrolling in college or trade school. Put simply, by giving people purpose, we improve their quality of life.
Just to be clear, I don’t think MBSD should be solely reserved for people interested in community distribution. Mailed harm reduction supply access certainly got me engaged in secondary distribution and harm reduction in general, though I think I’d have been less likely to seek out supplies if the senders considered me responsible for further distributing them.
In my time distributing supplies to other drug users and, less commonly, dealers, I’ve found that most recipients haven’t been interested in distributing syringes, naloxone, and company themselves. I do think, however, that people who seek out supplies from mail-based distributors are more likely to engage in secondary distribution than their counterparts.
They Help Kickstart Harm Reduction Efforts in Underserved Areas
I live in Northwest Tennessee. The closest syringe services programs are each two-and-a-half hours away. Syringes currently aren’t available anywhere else, as pharmacists — the only other legal source here — don’t usually sell syringes to people without prescriptions despite being legally able to do so.
I’ve only ever received harm reduction supplies from out-of-state, mail-based sources. These suppliers effectively advanced efforts to improve the treatment of people who use drugs by activating me as a harm reductionist, whether or not they had this in mind.
Mail-based distribution can inspire recipients to support future harm reduction-positive measures in grassroots form or, as in my case, encourage them to actively practice harm reduction in a tangible, hands-on manner (i.e., distributing supplies, educating others about safer practices in drug use).
One of the major challenges that American harm reductionists face, in my opinion, is expanding resources that help drug users to rural areas. MBSD is one of our most valuable resources in doing just this.
Tying Everything Together
MBSD isn’t just for reaching people in underserved areas. I think mailing syringes, naloxone, and company to people in areas where there aren’t currently any available resources is an effective way to reduce HIV and hepatitis C transmission, prevent injection drug users from potentially harming themselves by using worn-out syringes or other supplies, and connect people in active addiction with much-needed resources.
I also think health departments and state-sanctioned syringe services programs (SSP) can find utility in mailing supplies to areas that aren’t currently served. Mailing things isn’t free, plus, governments that allow SSPs to operate often require them to dispose of participants’ used syringes — mail-based distribution doesn’t lend itself to direct used syringe disposal by such programs.
Like all things in life, mail-based distribution isn’t problem-free. The altruistic distributors who send syringes and other supplies out of state often worry about legal action being taken against them. Some funding sources might not allow organizations to send supplies to out-of-state recipients, either, potentially resulting in loss of funding. There may be other issues, such as safety concerns.
All considered, mail-based supply distribution is a great thing—and something we need more of.
One of my few hobbies is picking up litter around my community. I’ll go litter-picking, as I call it, anywhere from once a month to three or four times a week. In just the past year, I’ve found used syringes in my small, rural area on at least five occasions.
After posting about my most recent run-in with irresponsibly thrown-out used sharps on Facebook in November, a local resident commented and claimed they, too, found a used syringe less than a mile away from me.
Why Don’t We Increase Police Presence and Clamp Down on Prosecuting Syringe Possession?
This is a common response from people who I’ve told this story to. Small-town Martin, Tennessee, a low-key college town with great public schools, is a great place to grow up, say residents. Every local resident I’ve told about my run-ins with used syringes is baffled.
They usually respond by sharing sentiments that wholeheartedly disapprove of drug use. After all, people who inject drugs (PWID) know what they’re getting into ahead of time. Why tolerate such tomfoolery?
Police Are Already Harsh on People with Syringes
Police are already unforgiving of people found in possession of syringes. Judges aren’t fond of these “criminals,” either. Possession of syringes without a prescription often results in criminal charges.
Here are two recent, local examples of how law enforcement typically isn’t fond of people found in possession of syringes.
A young, 25-year-old who lives in Martin named Zack — that’s not his real name, of course — got pulled over about a year ago here in Martin. A naloxone kit I’d given Zack was in his truck’s glovebox. The officer(s) found the naloxone kit and immediately thought the packaged, unopened, 25-gauge syringe was intended for injecting drugs. This kit, which included the syringe, two vials of naloxone, and a sheet of instructions, was in a bag clearly decorated with a large, white sticker that read “Intramuscular Naloxone Kit.”
Zack was not in possession of drugs at the time he was stopped. He also wasn’t under the influence of any drugs. Fortunately, he wasn’t arrested on any criminal charges.
It surprised me that the presiding police officers weren’t aware that 25-gauge, Luer-Lok, 3-mL syringes are almost never, ever used by injection drug users.
In September 2019, I was pulled over by a sheriff’s deputy for speeding in Madison County, about an hour south of Martin. The deputy asked to search the vehicle. I refused. Before a K9 was called to the scene, I informed that deputy that I was in possession of syringes. I said nothing else and was not in possession of drugs or other paraphernalia.
The K9 alerted to drugs that weren’t there, giving the deputy and his crew probable cause to search the vehicle. Only the syringes I reported were found.
T.C.A. 40–7–124, a 2015 law, prevents Tennesseans from getting charged with possession of drug paraphernalia, a Class A misdemeanor punishable by a year in jail and a $2,500 fine, if they inform law enforcement that they’re in possession of sharps that have been used as drug paraphernalia prior to getting searched.
Further, syringes that haven’t been used as drug paraphernalia cannot be construed as evidence for charging someone with possession of drug paraphernalia, a violation of T.C.A. 39–17–425.
No matter what, I shouldn’t have been charged with possession of drug paraphernalia.
Here’s Why Criminalizing Syringe Possession and Use Won’t Work
Why do people throw syringes on the ground? Why don’t they properly dispose of them like self-respecting human beings? Here’s why:
Injection drug users (IDU) are scared of catching criminal charges from syringe possession.
People who inject drugs (PWID) around here haven’t been educated about how to safely dispose of syringes. The most appropriate, 100% free option is to dispose of used syringes in a 2-liter bottle, empty laundry detergent bottle, etc. The bottles should then be marked as “biohazard,” “sharps,” or “syringes.” It’s also a good idea to secure the top with tape once full.
PWID are scared of coworkers, loved ones, friends, and even fellow drug users finding out about their injection drug habit.
Benefits of Instituting Safe Syringe Disposal Locations
Improves local residents’ relationships with the communities they live in.
Reduces criminal charges incurred by drug users, the majority of whom aren’t violent.
Many people in active addiction struggle from mental health problems that need to be dealt with via evidence-based mental health treatment providers. By creating areas in which IDU feel safe, they’re more likely to be interested in, seek out, and ultimately enroll in treatment.
Prescription Drug Take Back Day is an event held annually throughout Tennessee. These events are often manned by law enforcement officers, public health workers (e.g., physicians, nurses), and social services employees (e.g., counselors). By accepting used syringes at these events, PWID would: grow closer to the community; feel better about themselves since community leaders are accepting of them, even in active addiction; be more likely to seek out help from law enforcement, social services, and public health sectors; and encourage PWID to be more trusting of resources provided by cities, counties, and the state.
What Can We Do to Hasten the Adoption of Safe Syringe Disposal Locations?
Here are several things everybody can do to effectively encourage politicians, stakeholders, and laypeople alike to support the adoption of safe syringe disposal locations:
Talk to people you know in person — not on social media — about potentially crossing paths with used syringes in unexpected places (e.g., public bathrooms, sidewalks).
Write, call, and talk to local judges, police chiefs, sheriffs, state representatives and senators, health departments, and prevention coalitions about the benefits of safe syringe disposal locations.
Get involved with community-based organizations and local meetings such as those held by chambers of commerce and city boards. Befriend people who regularly attend them and share your ideas with them in a friendly, open-minded, understanding, well-researched manner.
Find brochures and pamphlets about syringe exchanges, for example, online or from harm reduction peer educators like myself, print them out, and distribute them to laypeople in your community — even if you don’t know them personally.
Connect with entities that deal with addiction treatment and drug use prevention such as rehabs and prevention coalitions. Share your ideas, such as expanding syringe access, with them.
Oftentimes, when people try to advocate for causes via the Internet, other people aren’t willing to listen. Neutral parties and opponents alike are likely to argue with proponents of adopting safe syringe disposal locations, ultimately causing rifts between those who do support the idea and advocates’ target audience members.
The best way to avoid this is to simply avoid using the Internet to spread this cause. It’s okay to organize advocacy efforts with like-minded advocates using the ‘net, as well as to perform research. Otherwise, avoid using the Internet, especially social media!
Most of us have heard about the dreaded, oh-so-evil “dark web,” as well as the seemingly-interchangeable term “deep web.”
The dark web is the collection of websites that require advanced, specialized configurations and setups to access. The deep web is simply all websites that cannot be found on Google, which includes companies’ in-house web-based tools and applications. To help you better understand them, remember that the dark web fits within the greater deep web — kinda like how rectangles are squares but squares aren’t rectangles.
Using Tor Browser itself isn’t enough to protect your identity while browsing the dark web, though it’s a great start. Downloading the Tor Browser Bundle is as easy as making a quick google search — better yet, it’s a quick download.
One of the most common websites on the modern dark web is those that help people sell and purchase illicit goods and services. These operate similar to eBay, in that such sites simply act as an intermediary between buyers and sellers. AlphaBay Market, for example, was one of the largest online darknet markets before being shut down in mid-July 2017.
Drug Users Benefit From Exchanging Illicit Drugs on Tor-Based Websites
In real life, very, very few drug users are familiar with any local area’s list of dealers. Buyers often know anywhere from one to a few local dealers, but usually never all of them. Assume that you know all the dealers in Joshuatown.
You can shop among this network of dealers and potentially leverage one dealer’s offer against another. However, while you, personally, might be able to peruse your fully-unlocked menu of illicit drug salesmen, almost everybody else in your locality will not.
I bring this up because if they were able to, they’d likely pay less for drugs due to increased competition among vendors.
Provides Access to Legitimate Forms of Drugs That Are Sometimes Hard to Get
Darknet markets make it easy for drug users around the world to get their hands on drugs of higher quality than they could get among their real-life drug connections, drugs they couldn’t otherwise purchase within their localities, and to shop for the safest, most highly-reviewed goods on such digital storefronts.
Wider competition forces vendors to offer up their most potent, least-adulterated substances. Also, because people in other parts of the world who str able to access drugs that are hard to find in other people’s lives, they’re incentivized to register on these illicit eBay-like websites and capitalize on their valuable sources of sought-after drugs.
Many drug users who are familiar with dark web markets know how seriously useful they are in obtaining these harder-to-find psychoactive substances. Since only people with legitimately high-quality sources are likely to even begin to succeed on the market, they’re not likely to proffer illegitimate drugs.
Reviews Form the Backbone of E-Commerce-Based Illicit Drug Markets
Reviews mean the world to the participants of the dark web’s drug markets. Just two or three bad reviews in a row can mean significant business declines for these Internet-based dealers.
On these types of markets, since users’ identifies are safeguarded, the only way to gauge how much users mean to others is by turning to their reviews and other means of gauging reputation.
What’s so good about these reviews? Most sites anonymize identifying information about reviewers, such as the exact times that they made purchases, their usernames, or the exact amount of dollars spent. As such, in most cases, they can freely leave reviews on vendors without having to worry about facing repercussions.
Reviews are typically posted within a few minutes or hours of their publication. This is done for user safety.
Less Violence Is Associated With This Mode of Purchasing and Selling Drugs
Drug dealers and other criminals engage in violence to assert dominance over competitors. One such application of violence by a drug dealer or a group of like-minded dealers is to perform a drive-by shooting if a member of a rival gang or group of drug dealers. The intended result of such violent activity is to dissuade those rival gang members or dealers, ultimately resulting in more business for the party who shot.
This is one way drug users can find themselves on the receiving end of violent crime.
It’s safe to say that everybody who has used drugs for any stretch has been robbed of or taken advantage of for drugs at least once. We know all too well that users and dealers alike are prone to gather up weapons and other criminals’ help to rob others of money or illicit drugs.
If someone does, in fact, manage to get over on you in real life, you may be inclined to act violently to the perpetrator(s), ranging from a sucker punch to point-blank sprays of gunfire. That’s right — violence here, violence there, violence everywhere in the world of drugs.
Purchasing drugs without having to leave your home — or wherever you order them from — is safer than having to drive or otherwise meet your dealer and venturing back to your place of residence.
Life is risky. You never know when a car accident could take place, for example. Not having to get out reduces the risks of such real-yet-unlikely threats.
Law enforcement agencies stress the importance of carrying out traffic stops to the best of their government-given abilities. Pulling drivers over leads to so many other things for law enforcement officers, such as finding drugs or drug paraphernalia. This is a risk that drug users like me have to face.
Eventually, we’ll all get pulled over or apprehended by law enforcement. Put simply, the less you drive in sourcing your drugs of choice, the less likely you are to experience interference from law enforcement.
If Done Correctly, Curious Government Officials Will Almost Entirely Be Unable to Intercept Mailed Packages Containing Illicit Drugs
When it comes to mailing things within and outside of the United States, the three couriers that we Americans have access to are FedEx, UPS, and USPS.
FedEx and UPS are both private businesses. By paying for postage, you’re agreeing to several terms and conditions that ultimately give workers employed by UPS or FedEx, to look inside any and all packages that make their way through these two companies’ facilities.
I’m not an attorney, so I don’t know exactly how many more years in jail that buying or selling drugs online might bring as compared to doing so in traditional, face-to-face form; however, it’s safe to say that, in most cases, using the mail and the Internet to engage in these activities hold serious sentences.
Also, because darknet markets are relatively new, U.S. law enforcement agencies are more than willing to make examples out of people caught up in this stuff.
Bringing All the Loose Ends Together
Am I telling you to purchase or sell illicit drugs online? No!
I am simply recognizing the handful of very real benefits to drug users that can be derived from using Tor-based websites to purchase and sell illicit drugs.
People who are unwilling to come out as drug users, such as how I have, due to the obvious potential consequences associated with it, might find utility in Tor-based markets that oversee the sale and purchase of illegal drugs. In other words, they might prefer to engage in advocacy on this level as opposed to being active in the real world.
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.
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.