I stumbled into harm reduction by accident. In 2010, I was a struggling writer, trying to figure out how to translate a passion for words into paying the bills. I came across an unusual job posting on Craigslist. The job had some unusual duties: among other things, whoever they hired would have to take a life-sized rubber vagina behind Home Depot department stores to educate migrant day laborers about safe sex.
Well, that sounds interesting, I thought. As a writer, I was always looking for a good story, and what better way to find an interesting story than to live one? I applied right away, and miracle of miracles, got the job.
I spent a few months lugging rubber genitalia behind department stores for show-and-tell with day laborers. But after a while, I learned that my employer, the North Carolina Harm Reduction Coalition, did much more than just sex education. We brought syringes to people who injected substances and hormones for gender transition; we taught violence prevention techniques to sex workers; we trained incarcerated people on how to reverse a drug overdose.
To someone from my sheltered background, this kind of work was fascinating. I admit that my first forays into harm reduction were for all the wrong reasons: more morbid curiosity than understanding or respect for the autonomy of people who use drugs.
From the beginning I felt compassion for people impacted by drugs, but I saw them as victims of poor choice and powerful substances. I considered it my job to scoop them up in my rescue boat and steer them towards abstinence. All I needed was a hero cape.
But after months, and then years, working in harm reduction, up close and personal with people with substance use disorder and the policies that impact them, all my previous beliefs were challenged, tested, and flipped around. I started to see how broken mental health and criminal justice systems contribute to addiction. I saw how sometimes well-intentioned efforts, like assuming that everyone who uses drugs should go to treatment and stop, can be just as stigmatizing and harmful as criminalization. I started to understand the hypocrisy of demonizing heroin and prescribing its sister drugs, opioid pain relievers. I started to realize that the entire way that we approach addiction is based on stigma and lies.
Can someone explain to me why it is illegal to smoke marijuana but not to cheat on your partner, which arguably, causes a lot more pain? Can someone explain why there are 11 million people addicted to illicit drugs and 14.7 million people addicted to sex in the United States, yet no one suggests we imprison people for having sex? Can someone explain why, even though there are 15.1 million adults addicted to alcohol, instead of prohibiting it, our cultural obsession with the substance borders on worship? Or maybe, someone can explain why we declare the exact same drug (such as fentanyl) legal or illegal depending upon who makes money off its sale.
No one can provide a good reason for these policies, because there isn’t one. Our drug laws are arbitrary, based on stigma and politics rather than science and sense.
After years working in harm reduction and advocating for more sensible drug policies, I am starting to realize that addiction is not a disease, it’s a symptom. The disease is that we, as people, don’t know how to treat one another. It’s all the fronting and posturing, the building ourselves up by tearing others down, the judging others’ flaws while justifying our own, the loneliness we refuse to admit, the pretending to be people we aren’t, the swallowing of pain so we appear strong, the dividing into ‘us’ and ‘them’ so that ‘us’ can dominate and ‘them’ can be shamed.
For these reasons and many more, we are all broken in some way. We all search for ways to heal the brokenness. For some people, those methods are socially acceptable. For others, they are criminalized.
I think it’s important for people like me, who have not been personally impacted by addiction, to nevertheless become involved and advocate for reform. It will take collaboration across all fronts to address the root causes that fuel addiction: poverty, unemployment, loneliness, mental health issues, grief, lack of self-love, and many more.
We can start by trying to break down the barriers that divide us. We must realize that no matter our political, ideological or religious beliefs, or where we born, we all want to feel happy, safe and loved.
So let’s start by making our brothers and sisters feel happy, safe and loved, even—no, especially—if they struggle with addiction.