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Recovery Month Roundtable: Harm Reduction & Recovery

SEPTEMBER IS NATIONAL RECOVERY MONTH

 

 

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The focus of Recovery Month this year is sharing stories and triumphs. In response, Harm Reduction Coalition facilitated a roundtable dialogue with a number of influential people in recovery. The aim was to share stories of recovery and to identify areas of common interest between the harm reduction and recovery movements. The dialogue from this recovery roundtable is published in 3 parts below and is part of an ongoing conversation that will continue at the upcoming 11th National Harm Reduction Conference. We would like to thank all those participated in the dialogue.

ROUNDTABLE PART 1: INTRODUCTIONS

Joy Rucker: Aloha everyone, I’m honored to be a part of such an amazing group of people, I’m Joy Rucker. I currently live in Maui, which has always been my dream, to work, live and retire here, so I can go to the beach whenever I want. So, I’m living my dream! I became involved with harm reduction through working with supportive housing in the Bay Area around 1995 and am still involved in harm reduction through my work with the Housing First model and I train for the State Homeless Program for Hawaii on housing and harm reduction. I’m in recovery.

Joseph Sanchez: Happy Recovery Month everyone. My name is Joseph Sanchez. I am the Co-Founder and President of Recovery ATX, a non-profit organization whose mission is to strengthen the recovery community by providing educational opportunities and support services. Our goal is to unify the recovery community by using the spirit of collaboration as our guide. I am a person in recovery and have not had a drink or a drug since October 2, 2005.  I am a certified Peer Recovery Support Specialist and trainer of Peer Recovery Coaches and Trainers of Coaches. I am looking forward to this roundtable conversation.

Charles Thibodeaux: My name is Charles and I live in Austin, Texas. I work with Texas Overdose Naloxone Initiative (TONI) and recently have been traveling around the state of Texas training individuals in Substance Use Disorder field on opioid overdose prevention and naloxone. I came to Austin for treatment and have been in recovery since Nov 10, 1988.

Lori Holleran Steiker: Greetings! My name is Lori Holleran Steiker and I am an Addiction Recovery Therapist who became a Professor at the University of Texas at Austin School of Social Work.  I am the Faculty Liaison for the UT Center for Students in Recovery and Co-Founder and Board Member of University High School (a UT Charter School), Austin’s first sober high school.

I have been working with Mark Kinzly (with TONI, the Texas Overdose Naloxone Initiative) starting with work to get the Naloxone Bill through the Legislature. I engage UT students from my “Young People and Drugs” course in harm reduction efforts and studies including investigation of pharmacist’s knowledge and attitudes about naloxone. We are working with leaders at UT Austin to raise awareness, train RAs, and keep students and the community healthy and safe from opioid overdoses (read recent commentary). I was honored and moved to be on the committee that planned the Overdose Awareness Day at the TX Capitol. Presently, I am on a Dean’s Fellowship which allows me to focus on these and other harm reduction projects, including starting a UT-specific website associated with GetNaloxoneNow.org. I am a person in recovery and have not had a drink or a drug since August 23, 1987.  I too am looking forward to this roundtable.

Chase Holleman: Good morning! My name is Chase Holleman and I am a person in long-term recovery. What that means to me is that I have not had to use alcohol or other drugs since May of 2013. It means that I am an asset to my family and my community and I share this to advocate for both people in recovery and people using drugs. I am 24 years old and working on my MSW. I am writing you from High Point, North Carolina where I coordinate a new naloxone distribution program within a treatment agency. I have done a little work with underground syringe exchange and with the passage of a syringe exchange bill (thanks to the great work of the North Carolina Harm Reduction Coalition). I am now formally setting up a mobile/fixed/home delivery syringe exchange program here at the agency. My background is mostly in recovery advocacy and I am new to harm reduction, but taking in everything I can from folks who have been doing this for some time now. I am SO EXCITED to be a part of this dialogue as I frequently talk to other about merging these two movements to assemble power.

Mark Kinzly: Good morning folks. Greetings from Austin Texas where I currently work in the arena of harm reduction doing patient navigation primarily for hepatitis C and connecting folks to care and initiatives for Overdose Education Naloxone Distribution (OEND). I have been involved in harm reduction since the early ‘90s when I was fortunate enough to be involved in the early development/running of the New Haven Syringe Exchange Program. I am on the Board of Directors for Harm Reduction Coalition and actively involved in other harm reduction initiatives. I am also a Peer Recovery Coach and active in the recovery community where the interweaving of harm reduction and recovery. I have started a dialogue of the how similar we truly are and not separate. I identify as a person in long term recovery and as the principle states I have been giving many daily reprieves.

Kevin Irwin: Hey everyone – grateful to be sharing with you all and to see so many names of folks I love and respect. Recovery has given me everything good in my life. The benefits of recovery for me have been enabled by sobriety since 1989, but the personal commitment to honesty, humility, gratitude and service have fostered personal growth and opportunities that I never could have imagined in my lifetime. I adopted a harm reduction orientation back in the mid-90s. I didn’t have a name for it. I didn’t go to a harm reduction training or program.  I was a few years in recovery, a single parent, working several jobs and going to school. In my work I was serving custodial grandparents whose families and communities had been shredded by our racist, punitive drug war. I was serving physically disabled folks in their homes who risked homelessness because their only pain and anxiety relief came from smoking modest amount of pot each day. I was working in housing projects that made individuals and families homeless as a result of their symptoms of their illness but offering no alternative options or support. I was working in one of the early “dual-diagnosis” programs as a counselor, and especially learning just how little we understood about, and how little we had to offer most of the folks we serve. At the same time, I was studying as a sociologist, adopting a race-class-gender consciousness about how social and political power operates in our systems. The epiphanies of the origins of the harm I was bearing witness to and the white male privilege I brought to that space smacked me on a daily basis. Soon thereafter I started meeting folks who were giving a name to harm reduction. Made perfect sense to me!

Since then I have been afforded unending privilege and opportunities to serve in the harm reduction field as a practitioner, trainer, program builder, evaluator and advocate around the US and abroad. Most recently we relocated to New Hampshire where I am fortunate to work in the public health in my region. Here the “opioid crisis” draws massive attention yet the infrastructure and policies lag far behind. Lots of need, lot of opportunities, lots of catching up to do… for example we still have no syringe services enabling legislation or programs. Grateful see some expansion of access to naloxone through various programs, and I am especially grateful to be contributing to the growth of a great Recovery Community Organization (SOS) in my region comprised of super-committed and highly mobilized folks.

Heather Edney: I live in LA and work for Homeless Health Care Los Angeles (HHCLA) – I hustle money for the people accessing services at HHCLA’s harm reduction center on skid row. I’ve been in recovery for 13 years and worked in drug treatment for 12 of those years. Prior to that, I ran the syringe exchange in Santa Cruz for about 12 years. I grew up in the harm reduction movement. Harm reduction definitely came first and kept me hepatitis C and HIV negative for the 15+ years I was using.  My involvement in harm reduction also afforded me access to naloxone and prevented countless near fatal overdoses.  But at a certain point, harm reduction stopped working. I’ve never explained it like that but for those of you on the roundtable who knew me then, you probably know what I’m talking about. At that time, the recovery community and the harm reduction community were at opposite ends of the spectrum (I guess they still are which is why we are doing this roundtable). That polarization (which I contributed to because I didn’t know any better) was a huge obstacle to having the kind of life I wanted for myself. Sterile syringes and naloxone are amazing, but being homeless, turning tricks, and scaring the hell out of the people who loved me wasn’t and unfortunately, that’s where my involvement in harm reduction kind of ended and the deep dive into recovery began. I have so much love for both communities — and when we are at our best, we are one and the same. But in my experience, when we get super dogmatic (and recently I’ve noticed that this is often perpetuated by non-users), we aren’t effective and everyone suffers — namely the clients we are paid to serve.

Phillip Fiuty: Hi all, joining the roundtable from here in New Mexico. I’m currently the program coordinator for the Santa Fe Mountain Center’s Harm Reduction Program providing services in rural Northern New Mexico’s Espanola valley. My adventures in harm reduction began as a damn proud drug user way back in 1990 when AIDS suddenly appeared in the isolated community in which I lived and we lost one of our best friends, and then others began to get ill. My friends and I began figuring out ways to take care of ourselves, including distributing new syringes and getting a hold of and using naloxone successfully in our community. We had no idea there were people doing the same things in other places.

I first decided that maybe I wanted to try life without drugs in 1996, so on the heels of a few Ayuhuasca ceremonies I left New Mexico and went through my first couple of rehabs. After the second one I was able to hold onto my first five years of recovery, during which I began an amazing career in harm reduction. I guess I felt I had an obligation to the world to share the knowledge and experience that had helped me survive my years as a meth and heroin user relatively unscathed, and rather than develop an attitude about harm reduction, drugs, and the people who use them, sharing my experience became a mission. I’ve had more than a few successes and slips, and am now coming up on three years sober again.

Five years ago, I had to admit to myself that after all was said and done, the happiest, healthiest and most successful time of my life was during those five years in recovery, and when I decided it was go back to meetings or die, I somehow fell in with a group of “Big Book thumpers”, and am now farther along in the recovery process than I have ever been, doing some of the best work I’ve ever done, and am generally experiencing the most success I’ve ever had acting like an adult, father and son. Trust me when I say that no one is more surprised than me!

I have an unfortunate addendum to this narrative. My friend Aaron who worked for the ARCW syringe exchange when I first encountered them, who I later met in the rooms and who then convinced me to volunteer with them, thus starting my “overground” career in harm reduction, succumbed to an overdose yesterday in Milwaukee. He was a good friend and awesome support early in my recovery… we laughed a lot and rocked out to the Cramps. Without his insistence that harm reduction was a valid movement and sorely needed people with my experience, I probably would never have gotten involved. He will be missed.

Gary Langis: Hi Folks, Happy to be taking part in the round table with so many of my recovery and harm reduction heroes.  I’m Gary Langis from Gloucester, MA. I came into recovery on Feb. 5, 1990 after surviving many years of drug use, a sketchy life, and raising 3 kids. During the last couple of years of using (’88 and ‘89) I was introduced to syringe exchange by medical staff at Boston City Hospital, this person explained the importance of using new sterile syringes to avoid infection and HIV, he also encouraged me to share them with other fellow users. I continued to use and share and exchange syringes within my using network. My wife had already contracted HIV so I completely understood and appreciated what this person was doing for me and my friends. I began to feel empowered and part of a positive change. One of my friends that I shared syringes with entered treatment, after watching his life change and attending a couple of meeting’s myself I took the suggestion to go into treatment. Shortly after leaving treatment this same friend met me and took me to a meeting.

I threw myself into the 12 Steps, built a support network, many of the folks in my network were HIV+ including my sponsor. My sponsor was working at an outreach program doing HIV prevention, mainly bleach and teach. One day he asked me to work with him because his wife was sick and couldn’t go out with him, that was it I had found what I was looking for in life and haven’t stopped. I was working as an attendant at a therapeutic community treatment center and doing volunteer outreach for about a year when I was hired as a case manager for an HIV advocacy group, sat on Mayor Manino’s needle exchange program advisory committee, and became active in my community. It had been 4 years in recovery and during these four years my sponsor and his wife passed, my wife passed and I was raising three young teenage children, I survived.

In 2002 after having a successful career and finally arriving at a comfortable life, nice savings, new cars, a great job (as a HIV program manager in a large agency) and many years of desensitizing myself to drug use, I decided to chew up a couple of Oxys. After a two-year research study, a wicked heroin habit, a drained bank account, empty 401K, a hallow existence, looking into the blank eyes of my now adult children, I was finished and with the help of my harm reduction, recovery and biological families I was nurtured back to a new life. Since that day in 2004 I have been living my life seriously one day at a time. If I can get through the day and lay my head down at night I’m cool. I continue to dedicate my life to my family, my work, my peeps, my friends from all walks of life. I’m grateful to celebrate Recovery Month, honor those we have lost to overdose on August 31, walk or participate in the annual AIDS Walk, attend one more National Harm Reduction Conference, go to a meeting when I feel like it or when I don’t feel like it, and live one more day. Thanks for including me in the roundtable.

Mark Jenkins: Hello everyone, greetings from the great state of Connecticut. My name is Mark Jenkins and I am an addict, you can make that statement as politically correct as you like; I have not found it necessary to use illicit drugs or alcohol since April 6th 1997. I mark the date because it is a reminder of the accumulation of 11 years of merry-go-round inpatient treatment centers (17) and countless other detoxes, psych and outpatient programs and jails before “I” decided to surrender and realize that ‘I’ could no longer use safely.  It took me a while to incorporate the ‘we’ (recovery) process in my life, but I feel my path is what allows me to unconditionally without judgement connect today to the people I serve. The past 19 years have not all been fun but I wouldn’t trade the experience for anything in the world. I am the Founder and Executive Director of the Greater Harford Harm Reduction Coalition and I am a harm reductionist. The title, I am 100% positive, I would not have, and the work I would no longer be doing had it not been for a degenerate I know and love who now lives in Texas—Austin to be specific since Texas is so damn large. He introduced me to a cherry picker that now lives in New Hampshire who also happens to be one of the smartest men I have ever met, there’s a clam digger in Gloucester, then there’s one who is sleepless in Seattle (and it ain’t because of insomnia) and now my life will never be the same. Recovery has blessed me to have these men and so many others in my life that continue to show me how to live, and not tell you what I’m really thinking.

ROUNDTABLE PART 2: HARM REDUCTION & RECOVERY

  • September is Recovery Month. For someone who had never heard of recovery, how would you explain it to them?

Joy Rucker: You have to decide what if there is something you want “recover” from and what you are willing to do to get there.

Mark Kinzly: I try and explain recovery in both the principle of harm reduction and what has been my path regarding any positive change as defined by the individual that is seeking it making sure that folks understand that we have many different journeys and the greatest determinant for recovery is the ability to remove as many barriers to one’s individual health and wellbeing outcomes.

Chase Holleman: I am a fan of SAMHSA’s current working definition of recovery, “A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential”. I would explain the many different pathways to recovery and the very individualized and personal nature of recovery.

Phillip Fiuty: A lot of damn work. When I was totally loaded on speed and heroin, I would fall asleep in my super cool post-apocalyptic fortress in the desert, with my fellow warriors, well-armed and organized, waiting happily to take on the end of the world. Then I would wake up in an abandoned windowless mobile home in the middle of winter, sick and dirty with mice and rats in and under the bed, surrounded by thoroughly dangerous, criminally insane weirdos like myself, and totally paralyzed with the fear that this was never going to end. It is a whole hell of lot easier and quicker to figure out how to get some more dope and get loaded again than it is to get a whole new life.

The biggest mistake I think people make is minimizing that change. Every day I hear people who have been deep in the life say “all I need to do is not do all of the things that I do, and I’ll be OK”. Just staying away from this person or that bar, or just getting through the withdrawals and everything will suddenly become normal (whatever that means!) …. I don’t really believe in the “mechanical model” of addiction, that the mere taking of some drug hijacks the brain and we go from pills to heroin, etc. If that were the case then everyone who was given pain meds at the hospital or after some dental work would be automatically engaging in drug seeking behavior when it was over, and that’s just not the case. Something, or a lot of somethings, need to, or at least seem to be rectified or solved by the ingestion of a substance. Pretty much nobody gets to the point of having withdrawals unless the conditions summed up as “addiction” are already present. This is difficult for non-users to understand. Looking in from the outside, one is hard pressed to see what issues are being solved for someone in the depths of a crack binge.

Recovery for me is the taking on of all of the somethings that have made me want to get loaded or die most of my life. Getting over all of the actual substances is the easy part. So easy I’ve done it a thousand times. Changing my fundamental relationship with myself and untangling the layers of fear and loathing I have somehow been programmed with is the hard and scary part. I have to be willing to change everything, and honestly, a lot of my defects have served me well. I have to make it fresh every day because my experience has shown me over and over that every day that I’m not moving forward just a little, I’m sailing backwards a lot. What kept me sober on day one is no longer sufficient at one week, is no longer sufficient at one month, is no longer sufficient at one year, etc. The difference today is that the little bit of work that it takes to move forward is an energizing and invigorating process, whereas in the beginning, the mere thought of any one of the somethings was overwhelmingly exhausting.

Kevin Irwin: I would share that my own conception of recovery is unique and personal to me, as I believe it should be to all who seek to pursue recovery on their own terms, as they define and redefine it for themselves, towards their own goals, in their own way, at their own pace. It seems to start with developing an awareness of that from which we are hoping to recover. That aspect alone has been a long evolution for me, about which I would describe very differently at any given point in my life. Substance use/misuse itself is but one piece of a much larger puzzle for me.

Charles Thibodeaux: I explain that recovery is any positive change.

Gary Langis: During September, Recovery Month is a time I can join with the recovering community to march, lobby, visit the state house and advocate. So September is a full month of work, advocacy, fellowship and change. In Massachusetts we have a strong organization that unite people in recovery to advocate for treatment monies and other causes that impact both the drug using community and the recovering community. Over the years we have restored the right of drug defendants to retain their right to driver’s licenses that at times would be taken away for years, change CORI laws (criminal record checks) that would many times hinder someone with a drug record from getting jobs and securing housing, the organization has also teamed with the harm reduction folks in efforts to make naloxone more available, start a statewide stigma campaign and introducing and passing a Good Samaritan legislation.

  • What came first for you – recovery or harm reduction? Was it hard to go from one to the other?

Joy Rucker: When I was introduced to the concept of harm reduction I was in recovery and had been for several years, it was a struggle to embrace the concept because I didn’t understand it, but I compared the principles of the 12 step program and the principles of harm reduction it became easier to embrace. Then after years of being in recovery and running a Harm Reduction center in Oakland, I started using again. I found it very easy and acceptable to use in the harm reduction world. After about 10 years of using, I needed to be in recovery again and I needed to distance myself from the day to day environment of active users. I still do the work but in a different environment, and it would be too hard for me to go back to being involved the way I was when running HEPPAC.

Mark Kinzly: I was fortunate that the two came fairly simultaneously as I began doing harm reduction work just prior to finding long term recovery. The opportunity to serve/help others in my early recovery allowed me to get outside of myself and realize at that time that for me the best form of HR was abstinence, but also knowing that was not everyone’s journey. It wasn’t difficult for me it felt right and still feels right.

Joseph Sanchez: I would say that harm reduction came first for me.  Although at the time I didn’t consider it harm reduction nor did I receive the support and services that are included in today’s harm reduction organizations. I tried to minimize my use to weekends and not drinking or using as much.  But as I mentioned before, I didn’t have the adequate support or guidance to even consider that part of my life in recovery successful. It was only until substances were completely removed from my body, thanks to clinical detox, that I was able to consider complete substance use a pathway of recovery. But once I even considered it, I was given support services and a community that wrapped me with the hope that I needed to believe that I too could do it.  Was it hard, thinking back, it was one of the easiest decisions to make, but one of the most challenging things to maintain. But I love a challenge, now.

Chase Holliman: Note: I understand the point of this question, however, I would not separate harm reduction and recovery as I believe they are one in the same, based on the former definition of recovery. However, to answer this question, when I started my change process there were not many harm reduction options available in North Carolina (that I knew of). I tried medication assisted therapy (Suboxone) and it did not work well for me, however the prescriber offered nothing other than a script and some shaming. The next time I tried positive change was at a treatment center based on a traditional peer support mutual aid model. Abstinence was preached and self-determination was out of the question. While perhaps damaging, this model did work for me. Through the culture of these groups and ill-informed guidance from my mentors I disdained harm reduction. However, after furthering my education and becoming more public about my recovery I began to learn about other pathways and evidence based practice. The process was painful, embarrassing, and tumultuous to say the least. I am still on a journey to loving and appreciating harm reduction, and I think that process may never be complete. However, what I have learned is that I will support ANYONE at any point in their journey of drug use.

Phillip Fiuty: Harm reduction came way first, though again, we didn’t call it that. We didn’t call it anything because we didn’t think we were doing anything other than taking care of ourselves, and as I mentioned in my introduction, we certainly had no idea that anyone else was doing these things, at least not in America. My personal mission with what has since become known as harm reduction was really solidified when I was 18 and watching Ron and Nancy on TV, and realizing that they were declaring war on my friends and I, and I thought “oh hell no… this is bullshit” and the mission began.

In 1996 I left New Mexico and went back home to Milwaukee and failed my first trip through rehab. I found myself on the streets up there, way out of my element, buying dope and trying to bum syringes off of people, and they kept telling me that there was a program in town that would give you syringes, an exchange. I looked it up in the phone book and sure enough there was, but I refused to go, even though I had been doing similar stuff for years in New Mexico. I was sure there had to be a catch. They were going to coerce me into treatment or hit me over the head with a Bible and I wanted nothing to do with it, but eventually things got bad enough that I called them and got their schedule. Early one Saturday morning I went to the corner and staked out their van, watching the activity before deciding it was cool to go talk to them. I got into the van and the two people in there said hi and asked me a few questions, my zip code and stuff, asked me how many syringes I needed and if I wanted any other supplies, then asked if there was anything else they could help me with, and when I said no, they said “OK, see you next week”. I sat there for a minute waiting for the other shoe to drop, and when it didn’t, I suddenly blurted out all of my pre-programmed obligatory responses with regard to my drug use… “I’m going back to treatment, I’m gonna do this, I’m going to stop that…”, etc. They just looked at me and when I finished they were like “OK… let us know if we can help”, and that was it. I got out of the van and had to sit on the curb and process what had just happened. It was like I had vertigo from ten thousand pounds suddenly lifted off of my shoulders.

It was the first time that I had been treated like a human being instead of a piece of shit by the world at large, and to this day, was probably the single most influential experience of my recovery, like maybe I was worth something after all. At least more than the sum total of the drugs I did. Shortly after that I did get back into treatment, and after that began volunteering with The AIDS Resource Center of Wisconsin, the first legal exchange I had ever had contact with. It has since been my goal to provide as many people as possible with that same experience.

Kevin Irwin: I have never understood this as an either/or proposition. To me these are mutually supportive. Harm reduction is recovery. Recovery is harm reduction. At their core, both are about resisting stigma and discrimination, building resilience, cultivating hope, supporting any positive change towards one’s own self-actualization of health and wellness and for those in our various communities. I have come to realize that I have been engaged in developing and applying personal principles and approaches in each of these conceptual areas all my life. What varies, relative to this conversation, is the degree to which those experiences and practices may include or apply to substance use. That is, I have always been recovering from or reducing the harmful consequences of one experience or another. We all experience threats to our psyche and wellbeing throughout life. The intensity of trauma, the recurrence of trauma, and our available resources to contend with trauma are all different. The use of substances plays a different role for different people, based on their expectations and countless other factors. We build our resistance, resiliency and coping mechanisms any way we can. Yet eventually for some of us, the inability to modify or stop using despite the desire to do so, while experiencing and witnessing the accumulation of negative consequences and wreckage in our lives… that becomes every day trauma unto itself. From this space, this lived reality, any positive change is harm reduction AND recovery.

Charles Thibodeaux: Actually I believe harm reduction is an element of recovery.  I got clean/sober in 1988 and was introduced to harm reduction around 1990. I feel fortunate that from the beginning from when I heard about harm reduction it was easy for me to believe in it.

Gary Langis: As a drug user I would have to say harm reduction. From my earliest days of drug use in the 1960s I was taught by older drug users best practices in injecting i.e. using cottons to filter my product, cleaning syringes with alcohol and water, not using alone, rotating injection sites and practices to reduce abscess and wounds. Even at Woodstock we were advised by Wavy Gravy not to take the tainted “brown acid”, I also carried a large supply of Thorazine to that concert and dispensed it to many of the folks suffering from a “bad trip”. During the waning days of my heroin use I was introduced to using clean syringes and sharing them in my drug using network. I was introduced to recovery by one of those in my network who accompanied me to 12 step meetings and eventually helped me get into a detox.

Upon release from detox I attended meeting regularly and refrained from associating with my former drug using network, fearing relapse. During the late ‘80s and early ‘90s the halls were pretty full of people in recovery who were also battling HIV infection. There was much discussion on how this impacted our recovering and drug using communities. Several of my friends in recovery were taking part in HIV activism, education and advocacy. I had some hesitation in getting involved because I feared doing outreach to drug users but had the feeling of doing the right thing that my heart was telling me to do. With this burning desire and guidance and support from my recovering network I began to accompany friends conducting outreach in the community.

As I said earlier I would put both in different compartments, participating in my recovery and doing community service by providing low threshold health care. I wouldn’t share about harm reduction at meetings and would not do 12 stepping while doing outreach. My approach got me in some trouble later on in my recovery when I relapsed after 12 years. I never walked away from my harm reduction world but did walk away from the 12 steps and recovery. After a 2-year absence I returned to meetings and continued with my work. Over the 12 years I have been back to recovery I have had some rough times including the loss of my 25-year-old son in 2005 at which time I was supported by both my recovering family and my harm reduction family. My 12 step family would surround me and be waiting on my doorstep and during the whole next week when I was supposed to be in Tacoma at the NASEC I received phone calls, letters, packages and even a call from Dave Purchase whop provide the comfort that only he can provide.

So yes there were some difficulties going from one to another but I feel at this time of my life I have a healthy prospective of both. I usually identify myself as an opioid researcher or opioid historian when doing my work or in public, I hold my recovery as a personal mission and identify as a recovering person at 12 step meeting’s. when doing advocacy in public or at the statehouse I believe it more about the people we serve and less about me. Some in the audience may think I a geeky research or historian nerd and some folks will read right through my smokescreen.

  • What misconceptions about harm reduction do you hear from people in recovery? What misconceptions about recovery do you hear from people in harm reduction?

Joy Rucker: I don’t hear the same kind of misconceptions about harm reduction from people in recovery like I did when I first got involved in providing trainings for sober/recovery based programs. What I hear a lot of is value judgments, class judgments, which on some level can be harder to “train” on as opposed to harm reduction strategies and models. What I have experienced in the harm reduction world, is it appears harder for people to talk about the harm they see happening to others (colleagues) and offer help, so it often saddens and baffles me when our colleagues are not using in safety and overdose. Do we practice what we preach? I know everyone makes their own choices, but isn’t it part of the principles of Harm Reduction that we talk about our concerns for someone’s wellbeing?

Mark Kinzly: The common thread from both sides of the aisle is the lack of accurate information and most times the willingness to find out and have open dialogue. The enabling argument from the recovery community regarding syringe access and access to lifesaving medications is embedded in misinformation and the harm reduction community has done a poor job of educating. The harm reduction community have felt misunderstood and not heard from the recovery community and we have done a poor job educating the harm reduction community regarding recovery. Harm reduction folks often feel judged by recovery community feeling like they are being viewed from a higher spiritual hilltop. The opportunity to have conversations to define and discuss each other’s perspectives are mostly met with resistance. This must change.

Chase Holleman: The misconceptions I hear most is that people utilizing harm reduction methods are not in recovery. Note: Those utilizing harm reduction methods may not identify themselves in recovery, which I respect and will try not speak for them. I hear that harm reduction methods enable drug users to continually ruin their life. I hear that harm reduction methods do not work. I’ve also been told that “I am helping people kill themselves.” On the flip side of the coin, I have heard people in harm reduction say that traditional models of recovery are ineffective, which can be argued all day. The evidence would show that they do not, but I would contend the methods of most studies that demonstrate that. I have heard disdain for other methods from all pathways.  All this being said, I hope to see more hands reach across the aisle on both sides.

Joseph Sanchez: I have heard that harm reduction isn’t a part of recovery, or even a pathway of recovery, and I hear the defensive argument from such statements from people in harm reduction.  I believe recovery is all too personal and so it should involve a personal perspective. And since it is personal should include a self-guided recovery plan with access to the adequate resources to achieve healthy living. From some lowering their drinking from being habitual to social and light at that, might consider themselves in recovery. I consider that making a healthy change in one’s life, part of being in recovery. I have heard die hard 12-steppers say that maybe that person who can moderate or “drink like a gentleman” may not be the “real deal” or “real alcoholic”. Comments like these further separate a community of recovery and can be damaging, in my opinion.

Phillip Fiuty: The first fellowship I was involved with was full of people who had an attitude of intolerance towards this kind of work, mostly that we were enabling people to not change. I used to think it was pretty disheartening that people who had struggled in this manner themselves accepted the status quo opinion that suffering, disease and death, or that “jails, institutions and death” were acceptable alternatives for people who could not figure out how to get “clean”. People would talk about having a disease, and then ridicule people who couldn’t or wouldn’t stay that way. I used to get livid when members who were not doctors pontificated and harassed other members about medications or methadone, challenging their desire or right to participate.

This nonsense is what people in harm reduction usually refer to when pointing out that recovery doesn’t work, or at least didn’t work for them. And some of the other points, like the God thing, seem to really offend some people. And these are exactly the things that I pointed to when I went back out after 5 years. That, and at one point during my first divorce I was coerced into going to meetings. I even wrote and performed poetry about how much I hated the fellowship and the weak people in it.

When I came back five years ago, I landed in the original fellowship. I hadn’t used a needle or really done any drugs for four years at that point, but alcohol had fucked me up worse than all of the other things combined, and I got involved with the Big Book people. As annoying as they were to me, I was desperate enough to try anything. I eventually decided that I wasn’t cool anymore and that I would be a Big Book dork, too, and that was when my life really began to change. This time around the people in recovery that I associate with are very tolerant and supportive of harm reduction work.

I always inform people who are considering meetings, or new to them to keep in mind that sometimes the culture of recovery fellowships can be very different than the actual programs themselves. Wherever there are groups of people, you’re guaranteed to find assholes, and don’t let anyone tell you or make you feel that you don’t belong.

As for the God thing, well, I don’t believe in God, and boy did I struggle with that when I came back this time. But again, I was desperate, and I decided that I would just do what was being suggested and learn how to pray. What I have found is that I have grown so much more by not having a problem with it then I ever did by trying to have a problem. If I was invited to a church, or synagogue, or a mosque by a friend for some reason I wouldn’t have a problem participating, so why do I think I am all sensitive when it comes to my recovery? Today it’s about the celebration.

Kevin Irwin: Certainly I observe and hear many expressions of recovery or harm reduction that aren’t well-aligned with my understanding or practices. But I think it’s important to understand these first as “different” conceptions rather than misconceptions. In either area I reject any kinds of proclamations that there is “one right way,” or that one belief or practice is more valid, more correct or more conforming to some universal standard. Even the expressions that are furthest from my understanding or reality are still opportunities to engage in productive discussion. In the end, my primary objectives are not to change people’s opinions/beliefs. All the data and evidence in the world is just as likely to reinforce people’s existing beliefs, no matter their positions or educational background. To me the pathway to productive dialogue isn’t in being right or wrong, but cultivating curiosity, finding our common humanity, and seeking pathways to a healthier community for everyone, whether that gets labeled as recovery, harm reduction, or both.

Charles Thibodeaux: Some People in 12 step recovery programs feel that harm reduction is “enabling” (I hate that word). Some people in harm reduction feel they are not welcome in some recovery aspects such as 12 step programs. Many times I have seen people on Medication assisted treatment such as methadone not be welcomed in 12 step meetings. People in harm reduction feel that people in 12 step recovery harshly judges them. Where do you see the common ground between the recovery and harm reduction movements? Are there shared values or goals? I do see the treatment field moving a little more towards harm reduction—Texas actually encourages medication assisted treatment (MAT) however some folks work in field are still not convinced that MAT is the way to go. 

Gary Langis: The important thing here is my conceptions of both. I have heard the stories from people in recovery that harm reduction is a strategy of using in safety, enabling, endorsing drug use and other misstatements. In my early years I use to hear that 12 step programs didn’t really work for people and felt separation between both in the harm reduction movement. But after my own relapse I really embraced the just for today approach, if I can lay my head down at the end of the day without regret, I’ve had a good day. We also have so many people in our movement that practice recovery in one form or another that bring so much energy that we need to focus on our similarities. I believe forums such as this roundtable and maybe workshops at our conferences and places of employment focusing on these issues. I would hope we enhance each other rather than water each other down.

  • Where do you see the common ground between the recovery and harm reduction movements? Are there shared values or goals?

Joy Rucker: I believe there are shared values in both harm reduction and recovery. Both have the value of being the best and healthy beings we can be, whether that is not using at all or reducing the harm related to your drug use while using. Both models ask the person using what do you want to do about your problem and how can we help and there are no rules about when and how long you have to either get sober or reduce your harm.

Mark Kinzly: So being that SUD is often described as a condition of separation from society from community from many things the common thread that I often see is the connection with others in both the recovery and HR community. Isolation breeds dangerous behaviors often in either so the more connected we are with the common goal of physical, mental and spiritual health the more we see how alike we are and not how different we are.

Chase Holleman: I see the common ground in the simple fact that we care about our own. We are all people who have and do experienced stigma, consequences, and discrimination for our drug use. We all have a common purpose to push for drug policy reform, increased intervention options, and better conditions in a society that hates us. Our common ground is also our purpose to create positive change in our own lives and to be allowed our freedom to live lives that make us happy.

Joseph Sanchez: I feel there should be more conversations like this, in both circles. Perhaps cross training and participation in each other’s professional conferences. I would also say that most change will need to come from those in the front lines. Both recovery and harm reduction front line workers are passionate about what they do and what has saved their lives and the lives of their friends, so to have a conversation with them to invite them to see a difference perspective or a broader approach is difficult. This can be super difficult, but if we continue to have these conversations and also encourage our front line workers to cross train, we would see a change in the landscape for both advocacy movements.

Phillip Fiuty: In my opinion, sobriety is overrated. Upheld as a value or a moral to be achieved and sustained by everyone is totally meaningless. None the less, I’ve come to understand that it is entirely necessary in order for me to participate with, and enjoy this life I have. This is a deeply personal understanding and as far as I’m concerned, there are as many measures of success and ways to achieve it as there are people. I am occasionally dismayed by the seeming number of people who have managed to escape a life of addiction who don’t automatically turn around and lend a hand to the next person. It’s kind of like “well, I got mine”. There really are very few of us who turn around and get involved with harm reduction, be it the hands on work or the policy, politics and advocacy. I like that the sponsorship trip is built into the 12 step model of recovery. I am of the opinion that this extends beyond our rooms and goes back into the world at large. I recently had one of my clients ask me how long it has been since I did heroin and I told him nine years. He nodded and said “you give us hope”. As far as I’m concerned all of the ground is common. We are all working for the same things.

Kevin Irwin: At their core, it seems to me that both movements are about supporting pathways that center people’s humanity as agents of change, not subjects of problems to be solved, any more than drugs, per se, are the problem to be solved. To me, both are about cultivating awareness, both self-awareness and social awareness, that substance use/misuse, speaking particularly to the harmful consequences, are symptoms of deeper or larger internal or external issues. To me, both are about building resources to enable, or removing barriers that constrain people’s ability to make positive changes. Those resources come in many forms, and yet at their core each is about providing the information, materials and support for people to identify and work towards self-directed goals. Whether our work is to provide direct services, or create programs that provide or improve services, or we advocate for policy changes to remove barriers to positive change or bring critical resources to these spaces, or all of these… we are supporting recovery and harm reduction.

Joseph Sanchez: Stigma. I believe this is what we are up against and if we are ever to get more funding for the work that we do to save lives the stigma needs to be addressed. Both recovery and harm reduction movements have champions and organizations that work towards breaking the stigma and I feel that whenever we advocate for change there are values and goals that are shared. An example of a common goal maybe more funding and access to services.

Gary Langis: During my pre-contemplative stage when I was still using I was introduced to the harm reduction philosophy through needle exchange. Harm Reduction had acted like a bridge for me, connecting me with people that exhibited true caring for the health consequences of my drug use. As I began to take more interest in being as safe as I could when injecting to avoid infections, I also started to examine other negative practices that were causing both legal and relationship troubles. It was at this point that I began to contemplate recovery, shortly afterwards I entered treatment. When I began to practice abstinence and 12 steps I distanced myself from harm reduction because I was conflicted but as I continued to watch friends and family succumb to HIV infection and having a sponsor that was both HIV positive and an activist in the AIDS movement, I was soon drawn into HIV prevention and education work, at times I would be conflicted but soon realized how much I was committed to the work. By stepping back and forth from recovery to harm reduction I started to see similarities between both. I also realized that I needed to keep both in separate compartments at times. But the similarities gave me an opportunity to bring my activist role into my recovery by attending rallies at our state house calling for expansion to drug treatment, calling for policy change, meeting treatment and recovery lobbyist and law makers. At the same time, I was advocating for syringe exchange expansion and HIV funding.

ROUNDTABLE PART 3: BUILDING BRIDGES

  • What does Recovery Month mean to you? Is it a time for celebration? A time for reflection?  A time for advocacy?

Joy Rucker: I think it is all of the above and happens every day not just in a month out of the year, you know like Black History month is one month a year or Gay pride once a year, the reflection, celebration and advocacy goes on every day. We should pay tribute to the struggle every day and not take it for granted.

Mark Kinzly: I believe it’s all of the above however most important to me is coming together with common goals and human interaction to see the hope in the eyes of another, with that the rest just kind of happens. 

Chase Holliman: For me, recovery month means a lot of work, lol. It is a time that I celebrate, reflect, and advocate. I believe it to be my responsibility to be visible and vocal and advocate for others. Our society still puts people in a cage for drug use. As far as I am concerned, it is my duty to do everything I can to ensure that people are not stripped of their human rights by an oppressive society because of drug use. Recovery month is a great opportunity to work alongside others who are also empowered and passionate during this time of celebration and reflection.

Joseph Sanchez: Yes! I feel it’s a time for Celebration a time of remembrance and a time to raise our voice for change. Recovery Month, albeit jam packed with events and pretty stressful for me personally, is a time to come together in unity and show that change is possible. People no longer have to suffer in silence and help is available. People in recovery who raise their voice and come out of the closet about their recovery give something to people who feel that they are trapped in a helpless cycle.  They give them hope.

Phillip Fiuty: Honestly, I only learned that there is this thing called “Recovery Month” last year when my current employer asked me if I would like to help run a booth advertising all of our harm reduction and recovery focused programs at the local recovery fair. I guess if I had to attach some meaning to it, it would definitely be about advocacy. I am a notorious malcontent and am rarely satisfied with things the way that they are, and there is always more work to be done. And definitely a celebration. If we aren’t having any fun, why on earth would anyone want what we have?

Kevin Irwin: This Recovery Month in particular has been a fairly intense time of reflection for me, which has also included more advocacy than usual. There is an impressive burgeoning recovery movement in the region where I live. I also have the privilege of speaking in front of large crowds on a regular basis, often about community responses to challenges we are observing in substance use, mental health and social supports and resources. While I am perfectly comfortable speaking to almost any subject to any size audience, my recovery has always been very private to me. My early recovery was very much about getting re-centered in the world. It was about massive amounts of meditation, and living in the moment as a parent and in the workplace. Yes, I rebuilt social connections, but not through fellowships and not through public speaking about my recovery. My recovery was built on a three-legged stool of maintaining humility, a commitment to honesty, and a pledge to “just do the work,” and not get caught up in public dialogue, especially those that devolve into ownership of definitions or receiving credit for the hard work of others. So here we are, after so many years, in the midst of this so-called “opioid crisis,” and I live in a state where lots of folks are keen to get in front of any crowds and media available to proclaim their heartfelt concern and dedication to addressing the negative consequences of substance use. I applaud everyone who is working to make recovery visible and give recovery a voice. I’ve been talking about harm reduction in public for so many years, it’s second nature. Likewise, I am comfortable advocating and speaking to anyone about our Recovery Community Organization, Centers, Coaching, and all things recovery… but I remain discomforted speaking about my own recovery process or giving the impression that the legitimacy of my voice stems from that experience. So yes, lots of recent recovery advocacy, yet lots of reflection on how and where my own lived experience fits into that space.

Charles Thibodeaux: I think it brings more awareness to the general public.

Gary Langis: I practice my personal recovery on a daily basis by attending the meetings and talking to folks in my recovering network.

  • How can we continue to build dialogue, understanding and partnerships between the broader harm reduction and recovery movements?

Joy Rucker: I think having more workshops at the National Harm Reduction Conference where we bring people together to talk about the challenges people face, like the workshop some of us did in Austin, Texas several years back, that workshop was packed and we ran out of time because people who had started using again felt like they had nowhere else to share their struggles or people who were considered the “poster child” for harm reduction decided to be in recovery and didn’t feel supported. I think we have to model what we want to build in the broader movements.

Mark Kinzly: Continued dialogue and respect for the dignity of each other’s positions on what their beliefs are even when we disagree. Truly meet people where they are at not where we want them to be at. Talk talk talk to one another

Chase Holleman: I believe dialogues like these are vital to build relationships between harm reduction and advocacy. I think it’s easy not to talk about the divide. It took courage from myself to just mention to Daniel Raymond when I met him that the divide was disconcerting to me and I wish there were more conversations about it. It is because I mentioned that to him that I was even able to join in on this discussion and I am grateful for that. I believe that we need to be open to having our assumptions and biases challenged. I think a good common ground are the Universal Declaration of Human Rights laid out by the United Nations.

Education is also super important. When I had disdain for harm reduction, it was because of my lack of knowledge. My ignorance and closed mindedness. Even when the movements find disagreement and conflict (which we will), we still have common purpose. A vast majority of people in both movements can agree that current societal conditions are oppressive to drug users. Working together is the only way we can change that.

Joseph Sanchez: I feel there should be more conversations like this, in both circles.  Perhaps cross training and participation in each other’s professional conferences.  I would also say that most change will need to come from those in the front lines.  Both recovery and harm reduction front line workers are passionate about what they do and what has saved their lives and the lives of their friends, so to have a conversation with them to invite them to see a difference perspective or a broader approach is difficult.  This can be super difficult, but if we continue to have these conversations and also encourage our front line workers to cross train, we would see a change in the landscape for both advocacy movements.

Phillip Fiuty: There is a quote in the back of the Big Book attributed to a Herbert Spencer that says “There is a principle which is bar against all information, which is proof against all arguments and which cannot fail to keep a man in everlasting ignorance… that principle is contempt prior to investigation”. No one corners the market on suffering or solutions. I started on my journey of recovery in 1996, and 20 years later I’m only claiming 3 years of sobriety. I believe that for most people this is a very long process and it would be beneficial to all involved if we keep challenging ourselves to redefine our goals and how we know when we’ve accomplished them. I hold onto a vision that someday, every single person who wants help with something might just find exactly what they need. To me both of these worlds are deeply intertwined, build on top of, and support one another. This is totally necessary for the long journey people like me find themselves on if we are to survive ourselves and work with others to do the same.

Kevin Irwin: To me, the “how” always comes down to physically getting folks in the same space. Social media, email, websites, comment sections, papers… none of those substitute for face to face dialogue, and in many respects these forms of communication undermine the depth and value of our communication. Being very intentional about inviting and promoting dialogue about recovery in traditionally harm reduction spaces, and vice-versa – to me that’s the only way to cultivate better understanding and clarity, and to forge partnerships that advance our mutual aims of individual and community health and wellness.

Gary Langis: As I mentioned above I think it’s important to continue roundtables like this and create space where we can delve into this at future trainings and workshop.

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