Wednesday, January 17, 2018

A Small Lesson In Harm Reduction

In January 2000, I attended a conference focused on heroin in Seattle, Washington. 

Here's a description:
Heroin overdoses and overdose fatalities are steadily increasing in North America and around the world. Many overdoses are preventable, often with simple and inexpensive interventions based upon scientific research, epidemiological and ethnographic insights, and common sense.
More then 400 participants attended the two day conference, which featured presentations by leading experts from around the world -- scholars, service providers, outreach workers and others who deal with and are affected by heroin overdoses, to discuss:
    • Risk factors and epidemiology of heroin overdose
    • Treatment modalities
    • Outreach and education
    • Naloxone distribution
    • The roles of researchers, emergency medical services, law enforcement, and families and friends of overdose victims
You read that correctly. This is what we were talking about in January of 2000. 

It is now 18 years later. I am hear talking about the same things on a much larger scale. 29 year old me would find it hard to understand how 198 people could die of overdose deaths in one year. One of those was a woman I dated a few times. She was one of the most beautiful people I ever knew in my entire life. Such a warm and wonderful person gone far too soon. I didn't fully understand or even completely embrace harm reduction until I realized that 1. it had saved my life and 2. it wasn't in conflict with the idea of getting "clean" or "sober". A person could not get "clean" if they were dead. My ideas evolved over time. Here I am today. 

I am not sure what the next 18 years are going to be like. While we have made strides in many states (North Carolina has 29 syringe exchanges yay) we are completely fucking up in other places. Rates of Hep C, HIV, and overdose deaths are going up in my own tri county Ohio/KY hometown and many other places. So fucking frustrating. 

I really need something from you, readers. I need information. I need to know what you think would work for you to keep you safe. I need feedback on what goes on in your area. We need to build networks and those networks need information. I also want to strongly suggest seeding your own syringe exchanges. If you can "exchange" them, dispose of them properly. Get a prepaid card, buy a box of syringes from a diabetic supply site, sell a few to friends for a buck a piece to seed a new box, get a new box with that money and keep it going. Before you say "this should be free", it should be but if it can't be, you gotta start somewhere. 

Get naloxone. Period. Stop fucking around and thinking it won't be you or your friends that OD. 

Educate yourself on Hep C. Project Inform in SF has a great informational hotline here:
877-HELP-4-HEP (877-435-7443), Monday–Friday, 9am–7pm EST


I love you and I want you to be safe. 


  1. Luckily for those of us in Maryland, we have access to syringes without a prescription. This is so very important. I believe that the states that require prescriptions should get rid of that law if they want to see cases of Hep-C and HIV reduce. Additionally, the only places I know of to get naloxone are in the city of Baltimore where it's as easy to get heroin as it is to get alcohol. Even easier if you think about the fact that no one is checking ID's for heroin. I would like to see Maryland have more places outside of Baltimore to get naloxone. I don't like the fact that you have to go into the belly of the beast to get a life saving drug.

    Thank you for your work, Tracey!

    1. The other problem is that even in states where it is legal to sell syringes, the pharmacist can refuse to sell them

  2. I also would like to add, on top of providing naloxone outside of Baltimore, that I am clean. My friends know that they can ask me to go to the store and get them clean syringes if they need it. It's one thing I can do. I hope others can do the same. Sometimes I keep a box of 100 in my house so I don't have to go to the pharmacy and ask every time. I hate that sometimes they refuse even though I know they have the syringes I am asking for. Most of the time I have to go to the pharmacy for my friends because I am clean. I do not look like a junkie. If one of my friends that uses goes, they usually have a harder time getting the pharmacy to sell them syringes when clearly they are the ones who need it more.

  3. In NY state where I live a person can buy from the pharmacy counter 10 syringes at a time. I live in the suburbs of NYC on Long Island. They were going to put a mobile needle exchange in one of the towns but residents protested that not in my backyard shit. So now if I want to go to a needle exchange I have to go 20 plus miles into queens. Something needs to be done because where I live heroin addiction has reached epidemic levels. They had a needle exchange in one Long Island town a measley 2 days a week they shut down..but I hear its coming back again..its a start but its not even scratching the surface..2 days a week is nothing. Also rikers island jail has narcan to give out to users if they want upon their release. They need to do that in all jails. I mean jail where 50 percent or more of people are addicts giving narcan out would be a great idea since the addicts tolerance is gone making them vulnerable to overdose. They should give out clean needles upon users release too. They have a medical unit where diabetics get out a few clean needles can help prevent the spread of disease.

    1. People are SO afraid of syringe exchange when they should be afraid of their kids catching Hep C or getting sepsis as the result of sharing and poor hygiene

    2. Exactly. People will protest it meanwhile its their children that are using and they don't even know it. Also I forgot to add in harm reduction they should really methadone accessible to addicts. When I was in jail people were kicking and the ones kicking methadone were the ones the worst off. Rikers island has methadone for people on methadone as well as for people detoxing. Then they set people up upon their release with follow up care so they can continue getting it in the community. So many people go to jail and they are forced to cold turkey from methadone and they hit the ground running and get back on heroin again. Its a crying shame because these people are clean come to jail are forced to detox and then they go out and relapse and are at risk for OD because their tolerance is zilch.

  4. Mississippi.. no needles, no exchanges, lots of people can't get any at all so they share.. ucky. I order mine. I've never done herion I like other things but there was a news article the other day saying herion is starting to invade our town slowly but surely.