#harm redux

it's a good thing when someone shoots up with a clean needle.

it's a good thing when someone carries Narcan, whether they use drugs themselves or not.

it's a good thing when someone switches from using laced drugs to clean drugs.

it's a good thing when someone starts using only one drug at a time.

it's a good thing when someone goes on medication assisted treatment like suboxone, methadone, or amphetamines.

it's a good thing when someone reduces their spending on substances, or the frequency of their drug use.

it's a good thing when someone gets regular tests for STIs.

it's a good thing when someone is using with friends instead of using alone.

It’s an unrealistic frame of mind to have. It is unfair to the people you are discussing.

Harm reduction is, for some people, the end goal. Not "full recovery", not abstinence; the end goal is sometimes a state of existing with a lowered risk of harm.

It is a fantasy to believe that everyone can aim for sobriety/abstinence/"full" recovery. It is not realistic. Unless you can fix every system of harm in the world, and magically undo trauma and severe health issues and chronic pain and mental illness; and then erase all trace of the past harm done to every single person alive? Total abstinence for everyone is not on the table.

Substance use isn’t a one-size-fits-all type of thing!! People are complex. Addiction is complex. The situations that form people’s addictions are also complex. You cannot realistically expect every addicted person to be able to quit cold turkey and instantly be abstinent + coping with that.?? It's honestly unhelpful.

Abstinence is not the only form of recovery. AA/NA doesn’t work for everyone. Sometimes people choose to use instead of meeting other needs, which is valid. Some people use for recreational purposes. Some people use for medicinal purposes. Some people who use have substance abuse disorder. Treatment looks different for everyone. Not everyone needs or wants treatment, for various reasons. The only thing Naloxone enables is breathing. Active use is not shameful. People who use drugs often also deal drugs. People in recovery should not shame active users. Active users deserve love. Active users deserve someone to check in on them, get them safer use supplies, and get them pizza. Active users deserve to be listened to. They deserve better than to have that be the first time anyone ever treated them as human since they began using.

Hi anon.

So, in my most recent post where I was talking about reversing overdoses, I was talking about Narcan (naloxone).

Narcan is a medicine that can reverse opioid overdoses. It works on any opioids, including fentanyl, heroin, oxy, vicodin, etc. It isn't effective in reversing other kinds of drug overdoses, but would still work to reduce an overdose if your coke has fent in it, for example. It functions by blocking the opioid receptors in your brain and helps restore breathing. Narcan is not a dangerous medication, and it is not harmful to your brain, which means you can be dosed multiple times without increasing harm to your body. The experience of being Narcaned can be pretty fucking shitty, because it basically puts your body in withdrawal super super fast, and you might experience some of the effects of withdrawal like vomiting, body aches and chills, fatigue, etc. But there are not other harmful side effects outside of that. Narcan is safe to give to people of all ages, including children.

Narcan comes in both an nasal spray and intramuscular injections, but it's usually easier to get access to nasal spray. This is what Narcan looks like:

[ID: Someone holding a narcan nasal spray, which has a nozzle that can be placed into someone's nose, and a plunger underneath the nozzle that can be pushed up to administer a dose. Text on the image says: Do not test nasal spray device before use. Each device contains 1 dose of medicine. Each device sprays one time only.]

How to Use Narcan

Identify signs of Overdose

Check for Responsiveness

Administer Narcan

Support (other friends/911/medics)

To administer Narcan, you first need to identify if someone is overdosing. Signs of an opioid overdose can be when someone is unconscious, unresponsive, not breathing or slowly breathing, no pulse or erratic pulse, has pinpoint pupils, and/or has blue lips.

If you see some of these things and think that someone is overdosing, the next step is to check for responsiveness. You can do this by loudly calling the person's name, saying that you are going to Narcan them, gently shaking them, and by performing a sternum rub, which is where you rub your knuckles into the place in someone's chest where their ribs meet. If they're breathing and they respond, even if it's just making noises in response to you or physically pushing your hands away, that can be a sign that you don't need to administer Narcan right away. Still, in that case, it's a really good idea to stay with that person in case that changes. If, and only if, the person is completely unresponsive, you should administer Narcan.

Once you've determined that someone is unresponsive and overdosing, the next step is actually administering Narcan. Narcan comes in packs of two nasal sprays. Take the first nasal spray out of the box, put the nozzle in the person's nose, and press the plunger. If the person is still not responsive after 2-3 minutes, take the other nasal spray out of the box and give them another dose. I try to use the lowest number of doses possible to try to reduce the withdrawal experience, and I stop giving Narcan once someone is breathing and responsive. If they still are not responsive or breathing, and you know how to give rescue breaths, you can start administering rescue breaths. If you have to step away for any reason, turn the person on their side in the recovery position first.

After someone's overdose is reversed, it's really important that whenever possible, someone stays with them for at least an hour afterwards. Narcan is active in the body for about 30-90 minutes, so depending on what someone's original amount of opioids was, they might start overdosing again and need you to give them Narcan again. This is also why it can be important to try not to use again right away, which is really fucking shitty when you're trying to use cause you don't want to be sick, but unfortunately using right away can also put you at risk of overdosing again. When people come back after getting Narcaned, it can be a pretty disorienting and uncomfortable experience. You might not know who Narcaned you or why they're in your space, might be feeling really fucking shitty because of withdrawal, and might want to be left alone. If you've just Narcaned someone, introduce yourself and explain that you just gave them Narcan, listen to what they tell you, empathize with their feelings, respect people's boundaries, and give them space if they ask for it. Understand that they're probably feeling pretty fucking shitty in their body, that it fucking sucks when your high gets ruined, and they (justifiably) might not feel happy about the fact that you Narcaned them.

Pretty much all Narcan trainings will tell you that it's "recommended" to always call 911, but we all know that this is not always actually possible in a lot of situations and that cops always fucking make the situation worse. My policy is that I always, always ask for consent before calling 911 and if someone says no, then we brainstorm other ways of keeping safe and we don't fucking call the cops. If there's a situation where I do need to call 911, I never tell the operator that someone overdosed, because that usually gets them to send out the cops alongside ambulance, which can cause delays to care, put a lot of people at risk, and also put people, including bystanders, in legal danger. If I have to call 911, I say that my friend has collapsed/fainted/isn't breathing and keep it more vague, and when paramedics actually arrive on the scene, that's when I tell them more information about the overdose, what drugs someone took, and how many times I've administered Narcan.

You can get free Narcan a lot of places. Next Distro has resources for getting free Narcan by mail for almost every state. If there's harm reduction orgs in your area, they will have free Narcan. There's also a lot of Department of Health programs for free Narcan. Most pharmacies now also have Narcan available over the counter, but that's usually really fucking expensive and often pretty hard to shoplift cause they keep locking it up.

Even if you don't use drugs and you think that your loved ones don't use drugs, it's super important to have Narcan as a part of your first aid kit and learn how to use it. You never know when you're going to need to use it, and it's super good to be prepared ahead of time, in case your friend/family/neighbor/classmate/coworker ends up overdosing while you're there. Or in case you end up overdosing and having Narcan on you means that bystanders can help support you through it.

Here's a guide that goes a little more in depth into how to use Narcan.