S1E57 - Nadia on Harm Reduction

green gas mask among flowers

From Live like the world is dying

Margaret and Nadia talk about harm reduction, what it is, how it relates to community preparedness, strategies for including harm reduction in your preparedness routines, and a little bit of history and legality as relates to different kinds of drug use.

Guest Info

Nadia works with Next Distro and can be found at https://nextdistro.org/

Host Info

Margaret can be found on twitter @magpiekilljoy or instagram at @margaretkilljoy.

Publisher Info

This show is published by Strangers in A Tangled Wilderness. We can be found at www.tangledwilderness.org, or on Twitter @TangledWild and Instagram @Tangled_Wilderness. You can support the show on Patreon at www.patreon.com/strangersinatangledwilderness.

Transcript

LLWD: Nadia on Harm Reduction

Margaret 00:15
Hello, and welcome to Live Like the World is Dying, your podcast for what feels like the end times. I'm your host today, Margaret killjoy. And today, I am really excited about this episode, I think you'll all get a lot out of it. I guess I say that every time but I wouldn't record these episodes, if I didn't think you would get a lot out of them. Today, we are talking about harm reduction. And we were talking about preparedness that includes drug users. Because, if you think you don't know any drug users, you just don't know anyone who is willing to tell you that they're a drug user. And we will talk about that and a lot more. But first, this podcast is a proud member of the Channel Zero network of anarchists podcasts. And here's a jingle from another show on the network.

Margaret 01:01
Okay, we're back. And if you could introduce yourself with your name, your pronouns. And then kind of a little bit about your background about the kind of stuff that we're gonna be talking about today.

Nadia 01:52
Yeah, sure, hey, Margaret. My name is Nadia, I use they or she pronouns. And I am a harm reductionist, a drug user. And I have both worked at in-person syringe service programs, and currently work for an online meal based program, where we ship safer drinking supplies to folks all over the country.

Margaret 02:16
That's cool. So we talked about having you on, because we wanted to talk about preparedness that includes the drug users in your community, whether the person listening to this as drug user, or whether they care about drug users in their community. And I know it's a big open question, but I kind of wanted to ask you that. How prepare that?

Nadia 02:45
Well, you know, I think that when we talk about prepping, disaster prepping and harm reduction, they're really similar, because it's really boils down to a risk assessment and thinking critically, right? The world isn't black and white, it's not really an easy question to answer, for example, should I evacuate or not in a disaster? Similarly, how do I protect myself as a drug user, in a world that isn't concerned about my health or safety? And you know, for people who historically lack access to resources, and healthcare, I think talking about how to prepare or what readiness looks like, is especially important.

Margaret 03:28
So, I guess I kind of want to start with some of the practical questions. It's like, what are the things that one should do that are different from what one would otherwise do? Like I'm like thinking about like, even for my own sake, right. Like, I'm like, like people say, like, carry Narcan, for example, like, how does one access that? What is the shelf life on that? Is that a thing that if community like mutual aid groups or individuals who have like large stashes of things or whatever? Is it like worth having a bunch of. Is it depend on community access? Is it better to just like, specifically coordinate with existing harm reduction and like needle exchange groups in your area? Like, it seems to me that like, like, one of the prepper mindset things is like, "Oh, there's a thing I need, I should go out and get a bunch of it". Right? And my instinct here is that maybe that rather than run out and get a bunch of say, Narcan, it would be more about like, be aware of how people can access that and which groups do distribute that and then maybe have like enough for me to carry around? I don't know. Yeah, like, I guess let's start with Narcan. What's What's the Narcan?

Nadia 04:40
Sure. Um, so for folks that are listening that don't know, Narcan or naloxone is a medication that will reverse an opioid overdose. And you know, it, it should be kept in a relatively temperature stable area, but there's there's been a lot of studies on it. And they have shown that it maintains its efficacy, much past expiration dates and the kind of temperature parameters. So you don't want to keep it somewhere freezing or super hot, but it is more resilient than you think. And having some naloxone is better than having none. And you mentioned, you know, going out and sort of stocking up. And I think that this is a broader conversation about prepping too, the difference between being ready and hoarding, right, yeah, and sometimes that line definitely gets blurry. Do you really need 100 pounds of rice? Are you going to go through it before it gets bad? Do you have a proper place to store it? I mean, you can talk about naloxone in the same way. And you know, just like you can keep Narcan in your bag. If you're going to a show going to a bar, you can also keep some in your gobag, if you have one, to evacuate, for example.

Margaret 06:06
What's the....you know, I usually present myself as sort of the the person who pretends like she doesn't know what she's asking in these episodes, but I actually don't know as much about this as I would like. Alot of my friends are way more knowledgeable about this stuff. Like what is the difference between Narcan and naloxone? And how would I go about getting some to carry around with me?

Nadia 06:29
Sure. So Narcan is really just a brand name, that's the the nasal spray. Naloxone is the actual medication. You can pick it up from certain service programs in your area. If you don't have a needle exchange in your area, you can go just Google Next Distro. We mail Naloxone to folks, so just check the website, see if you live in a state or an area where we do that. But we do try to encourage people to sort of seek out resources where they live. But yeah, there's there's a lot of different organizations, everything from sort of anarchist collectives, running needle exchanges to health departments that are, you know, offering trainings and providing Narcan.

Margaret 07:19
What's the legality of it?

Nadia 07:21
So, as far as you know, carrying it with you, there is what is called a standing order. It's basically a sort of blanket prescription. You can go to the pharmacy, purchase Naloxone, it can be prohibitively expensive, especially if you don't have insurance, which is why I kind of mentioned, you know, needle exchanges and health departments first. But I think, you know, as far as having it on your person, it's not going to be a situation where it's illegal. However, we know that cops like to fuck with people. So if you do happen to have Naloxone, and you have syringes on you, I'm not going to say you'll be fine. However, the law is on your side in that regard. And another piece of that, too, is different states have different Good Samaritan laws. So if you are with someone that is experiencing an overdose, in many states, not all, you can call 911, without the fear or threat of potentially being arrested for small possession, or things like that. They are very narrow in a lot of places. But that's something that you're going to want to look into for your state.

Margaret 08:37
So it's like, this makes sense, like so probably, if I have some drugs on me and my friend has some drugs on me and my friend overdoses. There's a fear of involving the medical establishment because there's a fear of me or the person who's overdosing getting arrested for what we have on them. Is that what you're saying that this law protects? Like, yeah, in some states protects people about?

Nadia 09:00
So you know, there's, there's a lot of stigma, right? And you know, just the the illegality piece. And at the end of the day there, there is an overdose crisis in the United States, in many places. And so these laws are designed to sort of take some of that fear away. And if you are responding to someone who's experiencing an overdose, you don't have to tell 911 when you call that this person is on drugs or that they are overdosing. You can just merely describe the symptoms and what is happening to them. For example, this person is not breathing, they're turning blue. I can't hear a heartbeat, whatever it might be. And you know, if you do have to leave and you have given them Naloxone, you can just leave the vials or or the package next to the person that way when EMS does arrive, they do know "Okay, this person has been given Narcan, "and they can kind of go from there,

Margaret 09:59
Right. Okay, so like if you have reasons that you don't want to interact with emergency personnel and need to leave the scene, okay.

Nadia 10:07
Yeah, and you have options. And that's kind of the whole thing about harm reduction, right? It's a pragmatic approach to drug use and a realistic one. And so, you know, that's why there, there are no hard and fast rules of do this, or don't do this, but, you know, sort of a continuum of human behavior. And, you know, acknowledging the risks at any point of it.

Margaret 10:30
I want to come back to that in a little bit, because I want to have this whole conversation about what harm reduction...like why the work that y'all do is so like, philosophically important, to like disaster preparedness, and probably life in general. But first, I want to, I want to keep talking about some of this stuff, like with, like, you're talking about the, you know, there's an overdose crisis in the United States, I feel like everyone, on some level knows that. And one of the things that's so interesting to me, I would think I was thinking about before we did this episode is that it's like, you know, this is all about like, disaster preparedness, right? The whole show. And it feels like a lot of communities and certainly including drug communities. I don't know the way phrase that.....

Nadia 11:18
You can say, "people who use drugs."

Margaret 11:20
Okay. But so there is a disaster happening right now. Like, there is a crisis. Like there's a reason we call it crisis, you know, it's like a really fucking bad thing. And I'm wondering if, without necessarily going into it, like, too great, but I'm curious, like, what is happening? Like, what is what's happening right now? Why is everyone OD'ing? ,

Nadia 11:44
Well, you know, there's a lot of different facets to the overdose crisis and a lot of different solutions. Some of them sort of more triage, you know, we were just talking about Naloxone, and, and it's a great medication, it saves lives. But ultimately, what we really need is a safe supply of drugs. If people are aware and knowledgeable of what they're taking, how potent it is, if there are any adulterants in it, you know, that's where we would like to go. Obviously, drugs are illegal. Most drugs are illegal in most places in the United States. And, you know, there there has been pushes for access to safe supply in places like Canada in, you know, I believe Oregon has, has I think, legalized some drugs, right? You can purchase I think mushrooms now. Don't quote me on that. I'm not actually familiar with Oregon law.

Margaret 12:46
Anyone listening this, you can go out and buy mushrooms legally. And if the police stop you, you can say "it''s okay. It's not a crime." Don't do that. Okay. Anyway. Yeah.

Nadia 12:57
I mean, you know, philosophically, it's not a crime. It's not a crime to do drugs. And, you know, the, the idea that some of these drugs are illegal, and some of them aren't, really, is sort of goes back to like this puritanical history of our country. You know, why is alcohol legal when we know that drunk driving rates are through the roof, and you know, it can cause incredible damage to your body over time. But then, you know, smoking marijuana is, is still illegal in a lot of places. where I live, for sure, especially in the south. So, you know, I think that there's there's that moral component

Margaret 13:38
So we should bring back prohibition?

Nadia 13:40
Yeah, exactly. And so I think, you know, as far as having access to drugs that are safe, drugs, that that you know, what you're getting, you know, I think that we don't want to short....when I say 'we,' I mean people who use drugs, I mean, people in the harm reduction community. We don't want to shortchange ourselves. I don't want to say, "Oh, well, the overdose crisis would be so much better if everyone had not Narcan." Yes, that's true. But that's a temporary fix,

Margaret 14:11
Right. It's...no, that's such a good point. Because I feel like that's like the...I know I owe came out the gate with like that as the first thing that was on my mind. And I, and I'm, like, kind of embarrassed about that because it's such the like, it's the band aid we always keep getting presented. And it's like a real good band aid. It's more like the tourniquet we keep getting presented. But, it does seem like yeah, what you're talking about decriminalization, it's almost like when you make things illegal, it doesn't make the problem go away.

Nadia 14:40
Yeah, and you know, I think about it in terms of living under capitalism for so long our entire lives, right. And you get to a point where it's hard to think about solutions outside of the current system. We're so focused on kind of again, that that triage, right, how do we make things better within this oppressive state that we live in? But really, ultimately, the goal should be moving past that and moving beyond it, right?

Margaret 15:11
Yeah. Yeah. So to go back with preparedness, I know that you do a little bit of preparedness yourself. We talked before we started recording about, you know, canned vegetables and things like that. How does it impact your preparedness, both that you are a drug user, and also that you, like, care about and take drug users into consideration in your preparedness?

Nadia 15:40
Yeah, I mean, I think a lot of it is planning, right? I'm gonna use the example of of evacuating, I lived in the Gulf South for a very long time. Hurricanes were a yearly occurrence. And so I had to think about it a lot. But, you know, just in terms of what your risk is, and making a decision based on that, for example, if you are evacuating, do you bring drugs with you and sort of chance getting pulled over? Or do you try and score in a new place? And you have to decide what the bigger risk is for you. For example, if I'm driving with five of my friends in an unregistered van with acab stickers all over it, I might not want to be riding dirty, I might not want to have drugs on me. Versus, you know, if I am going somewhere completely unfamiliar to me, I'm not sure if I'm going to be able to score when I get there. It might be worth the risk, right? And so thinking of those things in advance is really important. And the longer you wait in an emergency situation, the longer it's going to take you to get out of that cone of impact, right? If you wait to the last minute, there's going to be you know, traffic on the road, it's harder to to get out, it's harder to find a hotel room, for example. So really, that thinking of it in advance, you know, I think can save you a lot of critical time when you need to act.

Margaret 17:10
Yeah. Yeah, like, I don't envy a lot of my friends who live in the Gulf South, are like, "What do I need?" And I'm like, I don't know, a house in the mountains somewhere. And then I'm like, No, that doesn't. That doesn't help. You know, I can't just tell people that.

Nadia 17:26
Well, and I mean, you know, we're talking about preparedness, we're talking about disaster prep. And, you know, a lot of places that haven't had to deal with disasters, like hurricanes or flooding, or wildfires are seeing more and more of that now. And there's a greater impact on bipoc, queer and trans folks, disabled people, you know, marginalized groups whose access to resources is already more limited. And, you know, I think we really need to look towards communities that have been repeatedly harmed, especially by structural and environmental racism, I think they're best informed as to how to survive and how to support each other. And I don't want to say just in the Gulf south, but I'm talking about Flint, Michigan, I'm talking about, you know, Jackson, Mississippi, there's a lot of places where, you know, people are painfully aware that no one is coming to save you. It could be weeks or months for FEMA to arrive. In many places, local governments rely on mutual aid networks and charity groups to provide support. And so that kind of vacuum speaks to the importance of building dual power. Because it leaves the field open, I think for kind of any group that wants to become entrenched or inevitability, to sort of step up, right, whether that's a homophobic church group, right wing militias, especially in rural or remote areas, because, people remember who took care of them. You know, that's one of the reasons why the Black Panthers were such a threat with free breakfast programs and community care, is why Food Not Bombs is illegal in some places. There's just there's a lot of power in community sufficiency.

Margaret 19:23
Yeah. I mean, and so you, you mentioned that there's like lessons that you draw from these specific places, especially bipoc. communities that are under like constant threat. What are some of the lessons that you feel like you draw from that? I mean, besides the one that you just pointed out, maybe that's the answer to the question, what you point out that like, building mutual aid networks and stuff like that, but....

Nadia 19:45
Yeah, absolutely, figuring out who is in your support network. Also in a disaster or crisis situation, how will you communicate with that network is really important. You know, do folks know where you're staying and vice versa? Yeah. Also, you know, we're talking right now and 2022, almost 2023, the COVID pandemic isn't over. So figuring out how you can shelter places safely, you know, do you have masks on hand? That sort of thing. And then going back to prepping for people who use drugs, stocking up on drugs, you know, you might be thinking, "Oh, well, after the fact, I can just XYZ," whatever your plan is, but what if your dealer evacuated? You know? And, you know, the, as far as staying with other people, how do they feel about drug use? Does everyone know where the naloxone is and how to use it, you know, disasters are stressful, you might be dealing with extreme temperatures, hunkering down with people and their different temperaments, and, you know, for most of us to, stress impacts drug use, and it's important to keep that in mind. If you're, you know, for example, trying to cut back or regulate your use. I think all of these things, you know, are useful for people who use drugs, but ultimately, I think they're all skills or at least, you know, aspects of preparing that are beneficial for anyone.

Margaret 21:14
Yeah. Well, so interesting, because it you know, normally we think of like, okay, if you can get more of a medication that you need ahead of time, right? That's great. And, you know, there's this limitation, it's actually very similar limitation, the limitation is legality. In this case of like, you know, it's, it's sometimes very hard for people who even have a prescription to get more than, you know, a month's worth of supply or whatever, at a time of any given prescription. And it's, it's something that people run up against a lot. And then obviously, with, I don't know, whether the way to phrase it as street drugs or not, or like drugs that are not being bought through the pharmaceutical networks or whatever, you know, there's an accessibility that is hit and miss. And then there's also an increased danger of stockpiling, because it seems like the the level of risk that you're carrying for getting busted changes a lot based on how much of any given drug you have on you.

Nadia 22:11
Yeah, definitely. And I do want to kind of speak to one of the pieces you talked about, as far as having medications, you know, if you're on prescription medications, you know, you can check in with your provider, see, if you can get a larger refill than normal say, you know, instead of 30 days, can you get a 60 day supply, especially for people who use drugs, who might be on, you know, medication assisted treatment, they might be taking methadone, naltrexone, and, you know, these are highly effective in terms of either regulating your use, or perhaps, you know, not using it all. But they can be difficult to access. And in some places, it's harder to pick up the prescription for Vivitrol or suboxone because of stigma, because pharmacists, you know, have this idea of, of drug users, or they just might not know the the regulations and laws in their area. And you might not know them either, because you're new. So, I think that checking in, like I said, with providers ahead of time, if that's possible, and you know, doing what you can in terms of stocking up, but this, that whole plan needs the assistance of people in the medical field. And even they have, you know, that kind of stigma, unfortunately,

Margaret 23:33
Yeah, yeah. To self insert this, I got refused a COVID shot because I was wearing a harm reduction shirt once.

Nadia 23:41
Wait, why what was the excuse that they gave you?

Margaret 23:45
I went in, I was like this dirty punk wearing a Steady Collective shirt, which is the harm reduction group in Asheville, North Carolina. And I, it's funny, I feel like it's like Stolen Valor that I wear this shirt. Because people like when I wore in Asheville people were like, I love what you do. And "I'm like, thanks. What I do is I designed the logo." And the reason I wear the shirt is because I designed the logo for it. So I'm very proud of...and it's just crossed hypodermic needles. And

Nadia 24:13
It's a cool logo.

Margaret 24:14
Thanks. Thanks. And I was in like, rural fucking right wing California. And I wanted a COVID booster. And so I went into the pharmacy. I found out ahead of time that this particular pharmacy did walk ins. And I walked in, and the the pharmacist at the counter was talking to a doctor who was in line in front of me. And they were both just complaining about drug users. And they were just both sitting there being like, "Oh, these damned, you know, junkies," or whatever. I don't remember how they phrased it, but it wasn't polite. And then like the person finally leaves and I walk up and I'm like, Yall take walk ins? and she's like, "No." And I'm like, "Can I make an appointment? And she's like, "Not for today."

Nadia 24:59
That is wild. I mean, also you have a lot of people in the medical community that don't really believe that COVID is a thing or that vaccines are effective. I mean, you can have an anti Vaxxer pharmacist, which is, yeah, I mean,

Margaret 25:16
And, like, this is such a, like, I face stigma once....I so it's like, it's really easy for me to imagine after that, that like, of course, people face stigma coming in and picking up their fucking medications, if they're like, the kinds of medications that are, like methadone and stuff like that. That's fucked up. I don't know, that sucks.

Nadia 25:40
Yeah, and I mean, you know, we're talking about COVID. And I think harm reduction is a huge piece of you know, how we can kind of move through the world right now. People are continuing to die and be disabled by COVID. And, you know, we were talking a little bit before, before we started about, you know, kind of the beginning of COVID. And I was really optimistic at first kind of seeing mutual aid networks spring up and more people coming to the realization that the government will kill us for the sake of the economy. But you know, now I think even in radical spaces, that sort of care and community level protection has given way to the more mainstream sentiment or desire to return to normalcy. And that's just something that isn't possible. And it's not desirable to many, many people for whom normalcy was oppressive and a danger. Yeah, you know, I think that, especially as anarchists or folks that consider themselves radical, preppers, as well, we know that we keep us safe, right? That's kind of the tagline. But, that should also apply to immunocompromised people as well, and disabled folks. And, you know, now, I think it's a really great time to take stock of your existing protocols, and safety measures and sort of ask if those things that you're doing or not doing are still in line with what our current risk is. And right now, going into winter, you know, nationally, over 10% of tests are coming back positive. And we know that we're severely under testing, and we know that COVID reinfections, wear down your immunity. That increases your risk for long COVID or kind of lingering COVID symptoms, and, you know, makes people more susceptible to things like the flu, RSV, or Strep A, all three of which we're seeing a surge of in this winter.

Margaret 27:43
Yay. Yeah. I think about it, like the fact that...I don't know how to put this. Like, I wear a mask for the same reason I carry a gun. And it...and not that I want everyone to carry guns, that is a very personal decision based on the legality and the threat models that you're facing. Bu,t I carry a gun, so that it is harder for someone to murder me and it is harder for someone to murder the people I care about who are near me, right? I wear a mask, so that I am less likely to die, and other people around me are less likely to die. This seems like such a, like the idea that there's people who are like preppers or prepper adjacent, who are anti mask, and then anti vaccine is just so nonsensical to me. And I mean, I do think that like protocols do like, they do need to shift, we do need to realize it as we realize that this is endemic, and you know, we can't...like we probably can't just say no more live music in the course of human history. Right?

Nadia 28:58
I would hope not.

Margaret 29:00
But I especially like, when I walk into the grocery store, there is literally no cost to me to wear a mask. There is just, there's only positive effects of me wearing a mask minus social stigma.

Nadia 29:17
You know, I think that we need, if we're going to survive, care, kindness, and a lot of grace. Which requires us to acknowledge that there's a huge cognitive dissonance people are dealing with right now. We're three years into a global pandemic that's killed six and a half million people around the world, the rise of fascism, I mean, there's a lot and people's responses are going to vary wildly. Kind of the metaphor I like to use is, it sort of feels like a house fire. And we've all just gone through this traumatic experience, and we've run out of the house in the middle of the night, and everyone is sort of behaving in a trauma informed way, some people are trying to run back into the house, some people are claiming that there was never a fire. And, you know, it's, it's trying to take care of each other, and hold ourselves accountable to being, you know, I think responsible for our communities, but while also acknowledging, you know, this is a weird fucking time. You know, I think too, this kind of goes back a little bit to our Naloxone conversation. You know, when we talk about masks, when we talk about boosters, these are sort of individual steps we can take, right? But ultimately, that's, that's only a piece of it, right? We need a societal shift. We need proper air filtration in schools, we need access to rapid testing, we need the working class to have the money and ability to take time off of work when they're sick. I mean, all of these things are sort of interconnected to this larger struggle. And one way that capitalism and our sort of overlords here and Imperial core, are able to shift blame is by you know, kind of making everything this individual choice and individual responsibility when it's not at all.

Margaret 31:33
No, that's such a good point. And there's it, it shows that there's even like, some of those things are small scale community, things can be done as well, like, it would be a shame for a small scale community to have to suddenly like come up with the resources to provide rapid testing to everyone constantly or whatever, right. But like, I don't know, like, helping your local venues get real good air filtration systems, you know, or like, expanding outside infrastructure in climates that allow it, and like, there are the steps that we can take that are sort of medium. They're not....And I think that's actually where anarchists and radicals actually do best is not at the individual level. And frankly, if I if I'm being honest, not necessarily at the systemic level, but like this sort of in between level, this community based this community size level of like, how do we? Yeah, I mean, we can't....the punks or the anarchists, or whatever is can't pass a mask mandate, but like, we can create, like, cultures where, when there's no reason not to, we wear masks, and we work on our air filtration. And this is really just me thinking about COVID instead of the whole point of this conversation was drug use stuff, but...

Nadia 32:54
Well I mean, they're, I think they're interrelated. You know, if you are putting on a punk show, is it accessible, right? Does that mean, you know, for folks in wheelchairs, folks with, you know, mobility aids, as well as immunocompromised people, and ensuring that you know, this is a place that they have access to? Or if it's not, saying that. I at least want you to say, "Hey, this is a dangerous place for you. And, making it accessible is not our priority or isn't possible in this situation. Therefore, you can make your own decision about whether or not you want to attend."

Margaret 33:36
I've been in like, an now I can't remember if it was France or Montreal, somewhere where people spoke French. I've been in places where like any anarchist event will put on the fliers the accessibility or lack of accessibility for wheelchair access. And that's such an interesting, good point, right? Because if you have to flag on it, "This is not wheelchair accessible." It means you have to think about it when you do it, right. And like, Which isn't to say you shouldn't...I don't know one way or the other about what I'm about to say, which doesn't mean like you can't put on an event if you can't find it, accessible space, but you should have to own it, and you should have to be working on making the space more accessible. Is that, uh??? I'm really talking about my ass here. I haven't I haven't been part of these conversations. But.

Nadia 34:21
I mean, as someone who is struggling with long COVID still a year in, you know, I am also new to the disability conversation. And I definitely feel grateful for the folks who have been activists and have been organizing around these issues for you know, forever, honestly. And it really was shocking to me, even though I'm fairly realistic about how our society treats folks they deem unworthy or undesirable, but it was really shocking the level to which you become invisible. All. And you know, I think, to sort of shoehorn a little segue back to our orginal conversation, people who use drugs also live in that sort of liminal space, right? There's so much that is invisible about drug use. But also, this kind of caricature of drug users is sort of trotted out anytime people want to talk about society's ills, right? When people are talking about folks without homes, inevitably drug use comes up as if people aren't sitting in their houses doing drugs. They just have walls and you can't see them.

Margaret 35:38
Yeah, well, and then one of the things that I really appreciate about this conversation with you is that you're talking about the implication, or the the inference that I'm picking up on, is that basically saying, It's okay, if people use drugs, that is their choice, it seems to be like, like a lot of the conversation that I've feel like I'm exposed to is this, like, we should have pity for these poor drug users, and everyone is trying to stop using drugs. Whereas, it seems like you're trying to present an alternate case where people can choose whether or not they want to engage with drugs in different ways?

Nadia 36:17
Yeah, I mean, you know, harm reduction is the sort of set of principles or tenants that allows for autonomy and allows for people to make informed decisions about what they do. You know, abstinence doesn't necessarily work or isn't feasible for everyone. And so, you know, giving people the space and acknowledging that there's always going to be some risk in the things that we do, you know, helps us kind of approach it with clear eyes. But the I think the moral question around using drugs really does us a disservice. Doing drugs is fun, and cool. And that is, I think, an important message to have out there because, you know, so often, we're just inundated with all of the terrible things that can happen to you. And again, this is normal human behavior. This is normal behavior in other other species, you've got monkeys eating, you know, fruit that's gone, gone bad and getting drunk, you've got bears eating psychedelic honey. We do this because it's enjoyable. And to deny it that, I think, sort of leaves us on our back foot in terms of "Okay, well, how do we do this safely?"

Margaret 37:41
Yeah, presenting as this is a bad thing that someone shouldn't have done and now we have to deal with the bad parts, as compared to being like, every animal on the planet wants to do this, we should figure out ways that people can have freedom to do it as safely as they want or to not do it, if they don't want.

Nadia 38:07
Right, and you know, both are fine. It's also cool to not do drugs. I do want to put that out there. But as a drug user, you know, this touches on our conversation about safe supply, right? When you're buying and you don't know the quality or if there's cross contamination, obviously, a lot of folks are very concerned about things like fentanyl right now. There's also you know, other sort of fillers or things people can use. Xylazine is something that is sort of making the rounds right now that can have potential, like negative health impacts. So yeah, I think this, this goes back to sort of those bigger picture solutions as opposed to the band aids.

Margaret 38:55
Okay. And then, how useful is it? You know, like, as you pointed out earlier, right....Again, before, we had a long pre conversation. We knew each other back in the day for, now, people can know that about us, I guess. You know, pointing out because like, I mostly don't do drugs, but I do drink sometimes, right, and that is a drug and alcohol is absolutely a drug. It's a very dangerous drug. And it's one that I engage with very rarely, but I do engage with, and it does seem like a fairly useful comparison for talking about other drugs. Like cause there's this drug that is socially acceptable while also being massively destructive, right? And it seems like that actually maps fairly well to most of the other drugs that are like, problems for people. I don't know is that too simplistic?

Nadia 39:51
No, I don't think so. You know, and that's also not to say that people don't struggle with their drug use that people you You know, might be really unhappy with their relationship to drugs. And, you know, the more openly we can talk about it and the more access to different options people have, that sort of allows them to, you know, find the most comfortable place for them. Right, there is this, you know, kind of individual piece to it, even though we're talking a lot about sort of community care,

Margaret 40:24
Right. No, that's what I mean, that, in some ways, is part of why alcohol feels like such a good comparison. It's not even a comparison, it's literally a drug. It's a drug that is somehow held into a different class than the others, is that I think we all know people who....for whom alcohol is a problem. And we all know people for whom alcohol is not a problem. And then we all know, people who completely abstain from alcohol, who are in one of those two camps, if they weren't abstaining, you know? Hmm. I don't know, I'm having this like, epiphany, that should have been obvious a long time ago, I think about this.

Nadia 41:02
Well, and, you know, thinking in terms of alcohol, and using that as an example of how constrained we are in terms of our choices, you know, if if you are someone that struggles with drinking, really the the options that are given to you are abstinence, right? 12 steps, complete sobriety, and the message that that is the only way that you will be able to, you know, become a functioning member of society. And the fact is that that's simply not true.You know, abstinence really doesn't work for many, many people. You know, I think most of us can remember the "Just Say No," campaigns of the 90s, or maybe the 80s, depending on how old you are. And we know those didn't work. It don't work for children, it doesn't work for adults. And, you know, I think I don't want to get too far down the rabbit hole. But I think it would be important for folks to sort of think about, "Well, why is alcohol illegal? And all these other drugs aren't?"And I think it all goes back to capitalism. It goes back to money. It goes back to social control.

Margaret 42:22
Yeah. Well, ironically, one of the reasons that alcohol is legal, is that a bunch of people fought the KKK to the death to make alcohol legal. I only learned as kind of more recently when I did a bunch of....one of my other podcasts is a history podcast. And I didn't realize that the second incarnation of the KKK was like, one of their main things is that they were the foot soldiers of prohibition. They were like the Proud Boys of the prohibition era. And it was this whole thing where it was like Protestants versus everyone else, including reasonable Protestants. It was white Protestants against Irish Catholics, Italians, all of the people who were, you know, bootlegging, and all of that other stuff. And there were these like massive violent street fights. And I mean, mostly, it was massive violence, street fights about fuck you, you're the KKK, we want to...you can't run our town. But, what they wanted to do was run the town on a prohibition model. And there's this like, really interesting tie between white supremacy and prohibition. And it? I don't know, I mean, like, I know, I know how to immediately draw the same thing between the outline of weed and anti blackness. And I'm suspecting that if I dug very hard, I would find similar things with like, drugs, period. I don't know. I just got really excited about people beating up the KKK and that's why we're allowed to drink.

Nadia 43:59
Yeah, that's always a win, both of those things.

Margaret 44:06
But, what anyway, sorry, I got lost in rabbit hole thinking about that. Okay, so you've brought up this topic a couple times: harm reduction. And I suspect most people have at least an idea of what harm reduction is, but I'm wondering if you could kind of introduce it because, one, it feels very relevant to this specific conversation. But it also feels very relevant to conversations around disaster preparedness in general, because it seems to be implying that there is no perfect and that in some ways perfect is the enemy of good. And that we should just like, figure out what can go wrong and do the best we can rather than expect to succeed in everything. Maybe that's a misunderstanding.

Nadia 44:51
That's, that is I think, a really core piece of it, you know, and I don't want to belie the the history behind harm reduction too, you know, this was a movement that was created in platformed by people who use drugs, by sex workers, especially during the HIV AIDS crisis. And again, you know, from groups of marginalized people that realize that they are the only ones looking out for each other. And you know, that many behaviors carry some form of risk. And so talking about that honestly, and figuring out how to mitigate that risk is far more helpful than shaming people and that is connected, you know, directly to the criminalization of HIV and AIDS too, you know, there's the sort of moralizing, right, when folks become sick. There's this idea, I think, that is rooted in very, like old school, Brimstone Christianity, that, you know, it's some form of punishment. And I think that the way our society looks at people who use drugs, and the potential risks are viewed as appropriate punishment for the behavior, which is wrong and fucked up.

Margaret 46:06
Yeah. Okay, so. So what is harm reduction?

Nadia 46:12
So, you know, I think that if we're specifically talking about drug use, that can be, you know, practical tips, anything from making sure that you're using sterile supplies, making sure that you have syringes, and you don't have to share them, to prevent the transmission of diseases, you know, that can be, you know, figuring out different routes of administration. So for example, if you're someone that likes to snort a lot of drugs, maybe you want to give your nostrils a break, and, you know, smoke or boof. There are a lot of things that you can kind of adjust, right? You don't even have to necessarily be adhering to this strict set of rules as far as your drug use, but really being sort of flexible based on your own needs.

Margaret 47:09
Okay. And then, what are some of the ways that harm reduction either applies to other things besides drug use, or like has been successfully applied, or like some of the ways that like harm reduction, as jargon, has been, like, kind of co-opted by other things?

Nadia 47:32
Yeah, I mean, I feel like especially after 2016, the the idea that voting is harm reduction really picked up speed. And I personally disagree.

Margaret 47:47
Okay.

Nadia 47:48
For the most part, because harm reduction is something that you know, you can use for yourself, for your drug use, and so when we say voting is harm reduction, my question is, "Whose harm is being lessened?" You know, we currently have a Democratic president, and there's still concentration camps on our southern border, you still have Democratic mayors and city council's introducing regressive anti homelessness laws, throwing more money at more cops. And so I just think the notion that we can affect the kind of change necessary to liberate us by voting is....it's short sighted. And I think it can be an excuse for people to not have to invest so much in their allyship. Yeah, I think at its very base, most like literal definition, voting potentially reduces harm, but most of that is going to be in the immediate or short term.

Margaret 48:50
Well, so that's really interesting to me, right? Because I think that I had a kind of misunderstanding of harm reduction in some ways, because from my point of view, I mean...voting as harm reduction just seemed to be the rephrasing of vote for the lesser evil. Because in my mind, voting for the lesser evil is acknowledging an evil, right, it is acknowledging like Like, like, Biden is an evil, the Democratic Party is an evil, that does evil things in the world. And so for me, there's a there's a sensibility to the argument of thinking that voting is how we make systemic change is terrible. And I actually thought that the kind of concept of, but they always lose their meaning, right, in the 80s. and 90s It was vote for the lesser evil and people were like, yeah, that's how we make things better. It's like, no, it's clearly not how to make things better. It's how you make things evil. You're just controlling the amount of evil. And then with harm reduction argument, the reason I bought it at first was because it was like, "Oh, yes, because it's, it's saying there is going to be harm, but we want to do less of it." But, with what you're talking about, about how drug use or sex as two of the spaces that we talk about harm reduction a lot, right? Like those things can rule, right? Like sex and drugs, there's a reason that people talk about them positively. They're very dangerous activities sometimes, right. And people should go into them as clear headed as...well, maybe not clear headed depending on their preferences, but you know, people should should be aware of the risks, but then go and have all the sex and drugs and rock and roll or whatever that they want, as compared to... and so this is where the metaphor to the political system seems to fall apart to me is because like, well, the existing political system that we have is just doing bad. And it's really about what tiny little bits of mitigation or picking, something's going to kill. It's the trolley problem, right? You're still killing people. And that's not fun and cool. That's not sex, drugs and rock and roll. I don't know. That's what I got.

Nadia 51:01
Yeah. And, you know, I think that you really laid it out very well there. You know, yes, I can reduce the harm to myself if I am using drugs or having sex, but I can't get these politicians that I voted in to reduce the harm that they are causing. Because, you know, if you're voting for one of the two dominant political parties in the United States, I think you're just asking yourself, if you want to get to fascism, the short way or the long way, because I think, you know, voting in Democrats does make a material difference when it comes to some social services, and some environmental protections. But ultimately, both of these parties work at the behest of the ruling class. And capitalism requires ceaseless consumption and growth. And neither of those are sustainable. And they require the subjugation of working class people. So I think, you know, if, you know, it's, it's a question of capacity, if you and the people in your community that you organize with have the time and resources to engage in electoral politics, while simultaneously building dual power, and fighting encroaching fascism, like, go with God. There's space for a lot of tactics, and you gotta find where your skill set is and where your comfort lies. And I do just want to say this one last piece, too, when we talk about voting as harm reduction in the United States, that often I think tends to overlook the international implications of maintaining the current political system here,

Margaret 52:36
Right, which is, that's where it becomes even more of the same as like, yeah, it's never...the solutions don't lie in the ballot box, and like, Oh, whatever. I'm just like, speaking cliches or whatever. But it's like, even if we can make things like slightly better, like, because like, literally, if someone was like, "Well, do you want fascism tomorrow? Do you want fascism in five years," I'd be like, "Five years, please, that gives me a little bit more time to try to fight it." But of course, the problem, obviously, we're way off topic, but the problem is, of course, then people think that like, oh, that's the solution. The solution is engaging with this political system that has no fucking reason for existing besides driving us closer to Ecocide and fascism.

Nadia 53:21
Right. That's, that's the band aid. That's the triage. You know, there are so many different things that I think harm reduction principles can be applied to whether that's sex work, you know, mental health issues, eating disorders, tobacco use, I think there's a really natural evolution of the harm reduction philosophy to extend it to other health risk behaviors and to a broader audience in that way. I just, I think that, again, using harm reduction to sort of Pantious Pilate wash your hands of a lot of things and just say,"I voted and that's enough," is it's not going to work. It's not.

Margaret 54:00
Okay. No, and now I'm thinking, I'm like, Oh, shit, is my like, I just carry around naloxone. Is that my, like, wash my hands of addressing the larger systemic things and like, well, it doesn't affect me, it clearly affects me because it affects people I care about and it like, I don't know, is the takeaways. Okay, wait, I'm gonna try and some of the takeaways I've gotten from you, is that carry Naloxone, but it's a band aid. And it is a useful one, but the larger systemic problems have to do with criminalization and they have to do with access to safe supply. And so working on the kind of pressure involved to fight for that is good having mutual aid networks....Oh, okay. One of the questions that kind of had actually is, in your experience existing mutual aid networks, how well do they get along with existing harm reduction networks? Does it tend to be the same players and everyone's excited, or do you run across some mutual aid networks do they kind of like to step up their game about actually care about, you know, drug users? Or like, How's that look right now,

Nadia 55:09
In my personal experience, and I can't really speak to, you know, places I haven't lived or, you know, different communities that I'm not a part of. But there is a great deal of overlap. You know, a lot of folks that are working in harm reduction, people who use drugs and sex workers are sort of use to you know, fending for ourselves, we're used to creating these these networks of care that exist outside of the current system. And, you know, that's not to say that, when disaster strikes, it can sort of hit some folks harder than others. If the needle exchange in your town closes down, because there was a disaster. You know, there, there might be some time before they opened back up. And that's not going to stop people from using drugs. It will just create a situation where people have to use drugs more dangerously. And so, you know, yes, I think that there's a lot of overlap. But also, it shouldn't be this sort of jerry rigged, you know, last line of defense, the folks that have just experienced a disaster now having to turn around and all care for each other. Because again, no one is coming to save you.

Margaret 56:28
Yeah. Yay. That's

Nadia 56:32
that's the real point of it. Yes.

Margaret 56:35
But I mean it's really liberating. I think that like, I'm not super into political nihilism, personally, a lot of my friends are and I don't mean to slight it. But, the thing that reminds me of what like my like nihilist friends get out of like hopelessness, not hopeless, whatever, out of nihilism is comparable to the like, I find something joyous and liberating about the realization that no one's coming to save us. Because it's this like concept, one of my favorite cliches from like, when I was a baby anarchist was just like, "We are the ones we've been waiting for." Because it's less about, no one is coming to save us, we're doomed. And it's more about like, it is up to us to build the power and capacity necessary to bring about the changes that we need to see in this world. And there's a lot of us, and there's a lot more of us all the time, and the problems we're facing, seem to be getting bigger and bigger, depending on the position you're coming from, right, the problems facing me have gotten bigger and bigger as all the anti trans stuff comes through, or whatever, you know, but there's also more of us. Even to just continue the trans thing as a metaphor. It's like, the reason there's all this anti trans shit is that we all came out of the fucking closet. Like, there's a ton of us. And like, there always were a ton of us, but we were all fucking scared. And like, and what they want to do is make us afraid and get back in the closet. And so I get a lot out of, 'no one is coming to save us.' Because of the flip side being. We're going to save us.

Nadia 58:16
Yeah, I mean, I think it's really liberatory. That's something that I love about anarchism, too, you know, yes, that means that, you know, the system isn't here for us, because it's never been here for us. But ultimately, we have to take responsibility for our lives, for our communities, and for the future that we want, as opposed to sort of being handed these these goals and expectations, the rules that were supposed to have, the lives were supposed to lead. And you know, it can be scary to not have that safety net, but I think through, you know, both political discourse, but also just, you know, having lived a life, you quickly become aware that that safety net never actually existed in the first place.

Margaret 59:05
Yeah. Well, are there any last words on preparedness that you want to, you want to shout out? Everyone should fill their basement with needles? I don't know.

Nadia 59:22
Well, I mean, don't do that. Or if you do that, make sure that they are, you know, safely kept somwhere that only you have access to, or the folks that need them. You know, I know I've kind of hammered this home a lot. But, it really, when I say 'it,' I mean harm reduction. And I think what we're trying to do for ourselves really comes down to community and it comes down to having these bigger goals and not taking, 'no,' for an answer or taking, you know, half measures for an answer. The overdose crisis is very real. And there are pharmaceutical companies and families that have directly caused a lot of pain and death, and they should be held accountable. And that is slowly happening over time. But, I just want to keep clear, you know, who are the folks in our community who are doing the work? And who are maybe the people that are sort of preventing us from living our best lives?

Margaret 1:00:34
Yeah. All right. Well, is there anything you want to shout out here at the end of like, what people...I don't know it was anything you want to draw attention to any projects? Any of your work?

1:00:47
You know, support your local needle exchange, support your local sex workers. You know, if there is a call to fight back against fascists, or show up at your local library, because people are doing some fuck shit against trans people, you should be there. That's my shout out. Yeah.

Margaret 1:01:05
That's a good shout out. Well, thanks for being on...it's funny as like, every now and then I do these episodes where I'm like, it like challenges my own like weird....I don't want to say puritanical upbringing, I didn't have a puritanical upbringing. I was around a lot of people, you know, all my friends did a lot of drugs when I was in....whatever. And it's just like, interesting to every now and I'd have these episodes like, it's like the first couple times I did firearms episodes. I was like, It's not that I was like, Oh, I'm being so edgy. It was just being like, Oh, right. Information is dangerous because I and then I'm like, that's true about everything. I don't know where I'm going with this. Basically, thanks for coming on to talk about something that I feel like doesn't get talked about because people are afraid to acknowledge it, because we all walk around with this, like, 'drugs are bad,' and then we just secretly all do drugs. And so it's just better to just actually be like, drugs are complicated.

Nadia 1:02:03
Yeah, and people are complicated.

Margaret 1:02:05
What? Not me. I'm a paladin. I adhere to my moral code. That doesn't sound great. Okay. Yep. All right. Well, thank you for coming on this episode.

Nadia 1:02:15
Thanks for having me.

Margaret 1:02:17
All right. Bye.

Margaret 1:02:25
Thank you so much for listening. If you enjoyed this podcast, please tell people about it by whatever means that you prefer to tell people about things, like skywriting, please sky write Live Like the World is Dying above a beach. Ooh, get one of those banners that goes behind the like little plane that flies by the beach and usually advertises auto insurance. And instead it should just say, "Live Like the World is Dying." Don't tell people it's a podcast. Just tell people to live like the world is dying and become a cool, no future punk or a only a future if we imagine it....Okay, I'm off track. So, yeah, you can tell people about it. You can also support us. This podcast is published by pa...not by Patreon, it's supported by Patreon. It's published by Strangers in a Tangled Wilderness, which is a publishing collective that I'm part of along with a bunch of other people. We put out books we recently put out Cindy, Barukh's Milstein's "Try Anarchism for Life" and soon possibly, actually, I don't know when this episode is gonna be released. February 1st, 2023, we are releasing my book, "Escape from Incel Island." If you're listening to this before February 1st, 2023, you can pre order it at tangledwilderness.org. If you're listening to it after February 1st, 2023, you can buy it wherever books are sold, or go to the library, or steal a copy from Barnes and Noble. I don't care. And but, don't steal it from an info shop. That's just, it's just mean. Why would you do that? Get a library to carry it and then get it, or steal it from a big corporate place. Whatever. You can support us on patreon at patreon.com/strangersinatangledwilderness and your donations, go to pay the transcriptionist and pay the audio editor to keep all of this stuff happening. And in particular, I want to thank Aly, and Paparouna, and Milica, and Boise Mutual Aid, Theo, Hunter, Shawn, SJ, Paige, Mikki, Nicole, David, Dana Chelsea, Kat J, Staro, Jenipher, Eleanor, Kirk, Sam, Michaiah, Chris, and Hoss the dog. I really appreciate all of you and I really appreciate that there's enough of you that I read your names fast and maybe that's like really rude. But, I just like I don't know, I'm kind of like humbled by the support that Strangers gets and I hope that you who are listening well I only hope you support us if you can afford it. If you can't afford it, just continue to get our shit for free. And that's the whole point of supporting, is it helps other people get our shit for free. Anyway I'll talk to you all soon be as well as you can

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