Categories
Harm Reduction The Volunteer State

Accessing Naloxone in Martin, Tennessee

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.

Her email is melesa@martinhousing.org.

Her phone number is (731) 819-7603.

You can also visit Martin Housing Authority here in Martin at 134 East Heights Drive to receive naloxone.

What’s Narcan?

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.

Categories
Chronic Pain From Personal Experience Harm Reduction Kratom

Kratom’s Utility in Addressing Opioid Use

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.

Although opioid withdrawal is not typically known to cause death, the Internet, rehabs, medication-assisted treatment programs, and general drug culture are all littered with anecdotes of how harsh opioid withdrawal symptoms are.

In general, non-prescription drugs and prescription medications alike — the latter often known by prescribers as “comfort meds” — are used to ease opioid-dependent persons from opioids.

12 name-brand Suboxone films, commonly used as opioid replacements, stacked on top of one another.
Wikimedia Commons

Drugs such as methadone and buprenorphine (e.g., Suboxone, Subutex, Bunavail) are often used by medication-assisted treatment (MAT) providers to help opioid-dependent people from experiencing withdrawal symptoms and help them maintain neurological normalcy, two things that such opioid-dependent people would otherwise experience if they were to entirely cease the use of opioids.

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.

Why Use Kratom in Place of Other Opioids?

Opioids are expensive for the overwhelming majority of opioid users in Northwest Tennessee — and elsewhere throughout the United States. Since prescribers have cracked down on their once-liberal opioid prescribing practices, causing the available supply of prescription opioids diverted to the domestic black market for sale to drop, the price of available opioid tablets — and other less-common formulations, such as Actiq fentanyl lozenges or hydromorphone rectal suppositories — has skyrocketed for most of us.

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

Mitragyna speciosa (Kratom) tree in the wild.

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.

Some people pay much more for kratom, such as in gas stations, convenience stores, or head shops, with prices ranging upward of a dollar per gram — that’s $1,000 per kilogram!

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.

Heroin — I often refer to heroin as “street heroin” or “illicit street heroin” because heroin is used in pharmaceutical applications elsewhere, such as Diaphin, a brand-name, pharmaceutical version of heroin… in practical local use, though, nobody calls it that — does not fall short to this “prescription problem.” Due to its black-market nature, heroin is more consistently available than pharmaceutical opioids.

Reason Number Three

Kratom doesn’t cause respiratory depression like traditional opioids.

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.

In other words, people find themselves unable to breathe during opioid overdoses.

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.

In other words, the ongoing War on Drugs isn’t working.

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.

Suboxone is super expensive, but at least I’m safer.

Anyway.

Kratom, at least here throughout the state of Tennessee, is legal. You can’t get in trouble for kratom, legally-speaking, that is — well, at least you’re not supposed to, as some people in the Volunteer State very much have gotten in trouble for kratom possession or sale.

Most — most, not all — drug screens do not test for kratom’s alkaloids or any of their metabolites. Therefore, people in drug court, on probation, or on parole may find utility in turning to kratom as a substitute for other drugs.

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.

Someone, assumed to be an employer, offering a urine drug screen and clipboard with disclosure form to the viewer.

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.

Official logo of the
PRNewsfoto / American Kratom Association

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.

A Side Note

With this in mind, I consider the AKA’s efforts over the past few years as being detrimentally influential to my largely-opioid-related harm reduction efforts.

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.

Tying This All Together — Here’s the Skinny

Modern American illicit opioid users are plagued by countless major market-wide issues, such as a lack of regulation and policing as the sole mode of industry administration.

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.

Categories
From Personal Experience Harm Reduction The Volunteer State

Area-Specific Challenges in Northwest 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!

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

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

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

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

That’s a lot of laws to learn!

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

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

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

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

There Aren’t Many Programs That Help Drug Users Here

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

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

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

In Conclusion

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

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