The End of Absence: Reclaiming What We've Lost in a World of Constant Connection
by Michael Harris · 6 Aug 2014 · 259pp · 73,193 words
RioCan Complex (a hub of social media, housing outlets of Facebook and LinkedIn, too). He’s a smart, charismatic man. His rationale, surprisingly, matches the harm-reduction argument used to justify safe injection sites: Whether you like it or not, this activity is going to happen, so we might as well mitigate
Radical Abundance: How a Revolution in Nanotechnology Will Change Civilization
by K. Eric Drexler · 6 May 2013 · 445pp · 105,255 words
scenarios that deliver early opportunities for remediation are also scenarios that undercut the value of investments in large, durable, destructive projects. The case for eventual harm reduction sometimes tilts the balance toward avoiding the harm from the start. COHERENT EXPECTATIONS, INTERESTS, AND RESPONSES Again, sound thinking about the prospects ahead requires an
Blank Space: A Cultural History of the Twenty-First Century
by W. David Marx · 18 Nov 2025 · 642pp · 142,332 words
hostility. These efforts gained traction among college students and teenagers on platforms like Tumblr, creating a vibrant, youth-driven movement. Meanwhile, the right mocked these harm-reduction efforts: They derided the woke left as fragile “snowflakes” while simultaneously getting bent out of shape when their own illiberal views weren’t given proper
Fix Your Gut: The Definitive Guide to Digestive Disorders
by John Brisson · 12 Apr 2014
. pylori. Betaine HCL increases stomach acid, deactivating H. pylori. Stomach acid also keeps H. pylori infections at bay if an infection is present. H. pylori Harm Reduction Medication List: Here is a list of believed safer medications that can be used to tackle H. pylori overgrowth or issues; ask your doctor about
Inside the Nudge Unit: How Small Changes Can Make a Big Difference
by David Halpern · 26 Aug 2015 · 387pp · 120,155 words
, the Department of Health insisted we take the section out. We agreed on the basis that the issue would be picked up in their own harm-reduction strategy for smoking. The battle really begins We reasoned that while nicotine was addictive, the evidence indicated that the biggest danger from smoking came from
McMindfulness: How Mindfulness Became the New Capitalist Spirituality
by Ronald Purser · 8 Jul 2019 · 242pp · 67,233 words
said: “Zero!” After a pause in which onlookers laughed, he added: “I appreciate your work. That’s all.”7 Jha defends what she does as harm reduction. “Noncombatant or friendly fire injuries frequently occur when shooters misidentify their target or fail to appropriately inhibit pre-potent responses resulting in unintentional harm to
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from the context of non-violence lest we repeat the same shameful history,” Dyckman warns.36 Proponents of military mindfulness call it a form of “harm reduction.” They say it improves working memory capacity and emotional self-regulation, preventing soldiers in war zones from overreacting. These are not empty statements, and it
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makes them more resilient. If that decreases the chances that they return home and kill themselves, or commit violent crimes, then perhaps that counts as harm reduction. But it is really a very far cry from the Hippocratic Oath, and its principle of starting by doing no harm, which is the context
San Fransicko: Why Progressives Ruin Cities
by Michael Shellenberger · 11 Oct 2021 · 572pp · 124,222 words
a counterfeit five-dollar bill. That doesn’t get brought up at the community meetings. The only people talking to the Board of Supervisors are Harm Reduction Coalition and homeless advocates who paint this very different picture of the homeless being victimized. They point at the politicians saying, ‘You’re all victimizing
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even increase addiction and overdose deaths and make quitting drugs more difficult. Warned a multiauthor review in 2009, “One potential risk [of Housing First’s harm reduction approach] would be worsening the addiction itself, as the federal collaborative initiative preliminary evaluation seemed to suggest.” The authors pointed to an experiment that had
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for the surprising results,” wrote the authors, “may be that aspects of the Housing First intervention, such as the privacy afforded by Housing First and harm reduction approach, might result in slower improvements around substance use and mental health.”46 Researchers have found ways to use housing to reduce addiction. Between 1990
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to alter America’s drug and crime policies than Ethan Nadelmann. I first met Ethan in the mid-1990s when I helped promote decriminalization and harm reduction. It is more due to Ethan than any other individual that America’s most progressive cities and states, including California, Washington, and Oregon, have
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to die down, but in fact, it just kept banging away.”49 Over the next several years, Ethan developed the scholarly case for decriminalization and harm reduction. In 1992 he organized eighteen leading scholars to coauthor a major piece in Daedalus, the journal of the American Academy of Arts and Sciences. Ethan
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summer of ’92 I get a phone call from George Soros,” Ethan said. “We had lunch and hit it off. He didn’t know what harm reduction was. He was coming at this because he saw how open society ideals were being violated. As a businessperson and economist he saw the absurdity
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commodity.” Soros, whose many philanthropic initiatives include drug policy reform, gave Ethan millions in funding to change laws around the country.51 My interest in harm reduction and decriminalization grew after the November elections of 1996 when Californians, myself included, voted to legalize marijuana for medical use. The more I read on
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a mostly African American and Latino neighborhood in Los Angeles, to organize civil rights leaders to urge President Clinton to lift the restrictions. For decades, harm reduction and decriminalization advocates have pointed to Portugal as a model, noting that it decriminalized drugs and expanded drug treatment. In 2013, Portugal’s drug-induced
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Drug use among 15- to 24-year-olds actually declined after decriminalization.61 “All drugs have been legalized,” explained Monique Tula, executive director of the Harm Reduction Coalition. “Their focus is on giving people tools, like job apprenticeships, and the means to support themselves.”62 Progressive cities and states, including California and
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cities have sought to create supervised injection sites in recent years, though such facilities remain illegal under federal law.65 I, like many advocates of harm reduction, compared the death toll from alcohol to deaths from drug overdoses, but the comparison was misleading. Most of the 95,000 people who die from
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by the crack cocaine epidemic, which led to increases in addiction, open-air drug markets, and violence by dealers defending their turf. In the 1990s, harm reduction and drug reform advocates began to argue that doctors were unnecessarily underprescribing pain medications and exaggerating the risk of addiction.110 Over time, doctors began
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part of government regulators, the overprescription of opioids was equally due to naïve or unskeptical compassion on the part of doctors and the wider society. Harm reduction advocates didn’t create the opioid epidemic, but they were part of the same movement starting in the 1990s urging the softening of restrictions on
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starting in 2009, say some service providers and law enforcement. It was then that California cities stopped making housing conditional upon sobriety. “The ‘Housing First’ harm reduction people said, ‘Recovery doesn’t work,’” said shelter provider Andy Bales. “But it was after that when homelessness exploded.”124 After the passage of Proposition
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including fentanyl. In 2020, San Francisco even paid for two billboards promoting the safe use of heroin and fentanyl, which had been created by the Harm Reduction Coalition. The first had a picture of an older African American man smiling. The headline read, “Change it up. Injecting drugs has the highest
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headline read, “Try not to use alone. Do it with friends. Use with people and take turns.”10 When I asked Kristen Marshall of the Harm Reduction Coalition, which oversees San Francisco’s overdose prevention strategy, about the threat posed by fentanyl, she said, “People use it safely all the time.
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. It’s not cyanide. It’s not uranium. It’s just a synthetic opioid, but one that’s on an unregulated market.”11 Said the harm reduction services director from Glide Memorial Church, “People have used [fentanyl] for years and not come to harm. We can’t be shaming, stigmatizing, sensationalizing.
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2020.13 In 2020, when the city government put homeless people in hotel rooms to prevent the spread of COVID-19, it also pursued a harm reduction approach. That approach included delivering residents prescription drugs, medical marijuana, and alcohol bought by private donors. Tom Wolf tweeted about it, and the program
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aluminum foil and heat the foil with a lighter until the fentanyl turns into smoke, which they inhale with straws. “There’s a criticism of harm reduction,” acknowledged Marshall, “that sometimes we even give them the drugs, but it’s part of a much bigger picture.” The roots of the problem,
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“Oof,” said Zimmerman. “That’s horrible.” “Had you heard that?” I asked. “No,” he said. “I had not.”18 I asked Monique Tula of the Harm Reduction Coalition, “Is there a national, state, or city strategy anywhere to reverse the rise in overdose deaths?” Without hesitating she said, “No.” She then added
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, “One of the things we’ll be working on next year is pulling together a coalition to create a national harm reduction strategy.”19 In late 2020, I asked Supervisor Rafael Mandelman if San Francisco had a strategy to deal with rising overdose deaths. “Not that is
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with Narcan, the person is often put right back into the open drug scene, and not offered drug treatment. “The way our city is doing harm reduction does not work,” said Vicki Westbrook. “It’s not like they give you clean needles and works and talk to you about what it could
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look like to be clean or get your life back. Harm reduction is like life support. It keeps people alive, but it doesn’t give them their life back.”21 Tom says that while
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in 2019 to 1,716 deaths in 2020.23 Like San Francisco, Seattle, and Los Angeles, British Columbia’s most populous city, Vancouver, embraced decriminalization, harm reduction, and Housing First. And most homeless addicts in the United States are destitute and thus already eligible for government-funded Medicaid, so a single-payer
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system might not have mattered. Despite skyrocketing overdose death rates, none of the country’s leading advocates of harm reduction are rethinking their advocacy of decriminalization and harm reduction. Instead they focus on things like promoting Narcan. “It’s really about getting emergency responders to carry [naloxone/Narcan],” said Ethan
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for Vice. “The cause of Bigg’s death, however, in no way repudiates the cause to which he devoted his life.”24 Leaders of the Harm Reduction Coalition agreed. “We can’t end overdoses until we end poverty,” said Kristen Marshall, “until we end racism, and until we end homelessness.”25
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meth, and fentanyl. They propose that cities build special facilities where people can inject or smoke heroin, meth, and fentanyl. Said Glide’s director of harm reduction, “we’re not going to get beyond the opioid deaths until we get to safe consumption sites. There’s really no downside, except for people
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as much as you want.’ ‘There’s no risk of addiction or overdose’ That is just the same rhetoric over again!” Humphreys stressed he favored harm reduction, when appropriate, but that it wasn’t the only response required to addiction. “The first statement by any White House that naloxone [Narcan] should
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be widely distributed was written by me when I worked for President Obama,” he said. “That’s harm reduction. And there’s no contradiction between that and saying, I don’t think a heroin industry would be a good thing. I’m all fine
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and good for harm reduction. I don’t want anyone to die. I work in health care for a reason. I don’t want Purdue Pharma to sell cocaine because
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I am for harm reduction.”44 6 Let’s Go Dutch In early 2019 I traveled to the Netherlands at the invitation of a member of parliament, Dilan Yeşilgöz, to
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and novice users would be discouraged from buying and therefore the market would be constricted.”22 In late 2020, I asked Monique Tula of the Harm Reduction Coalition if drug treatment should ever be mandatory as a sentence for when people commit a crime. “No,” she said. “Bodily autonomy.” “Does that
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eighties, a bunch of us sat around and said, ‘Oh fuck this. I want to sleep in the street.’”7 Said Kristen Marshall of the Harm Reduction Coalition, “The vast majority of people experiencing homelessness did nothing to be out here other than lose their housing, get traumatized, live with over-policing
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semblance of the life of the people we’ve served.”36 Except that they’re not. In fact, some of the harshest critiques of radical harm reduction and drug decriminalization are coming from people like Tom Wolf, Vicki Westbrook, and Jabari Jackson, who suffered from and overcame trauma, addiction, and homelessness.
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Because different ones work for me in different ways.” “What’s ‘attack therapy’?” I asked. “Attack therapy is behavioral modification,” he said. “It’s not harm reduction. They’ll call you on your shit. They’re going to tell you when you’re doing wrong. When you’re trying to minimize stuff
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justified. Many progressives do something similar with Sanctity, which is to value some things as sacred or pure. When Monique Tula, the head of the Harm Reduction Coalition, insisted on “bodily autonomy,” against mandatory drug treatment for people who break the law to support their addiction, she was insisting upon the Sanctity
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mayors of Seattle, San Francisco, and Los Angeles are all ostensibly moderate, their agendas have either been progressive or a response to progressive demands on harm reduction, Housing First, and criminal justice. In 2021, the San Francisco School Board voted to strip Dianne Feinstein’s name from an elementary school. Her
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people who support him who don’t see the downsides and feel very good about the current policy.”17 The American Civil Liberties Union, the Harm Reduction Coalition, and Housing First advocates exercise significant influence over elected leaders. One of Newsom’s homelessness advisors, Philip F. Mangano, told me that the
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drug use. They prefer homelessness and incarceration to involuntary hospitalization for the mentally ill and addicted. And their ideology blinds them to the harms of harm reduction, Housing First, and camp-anywhere policies, leading them to misattribute the addiction, untreated mental illness, and homeless crisis to poverty and to policies and
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policies alongside a social and cultural progressivism.41 Meanwhile, conservatives ceded the issue of homelessness to progressives. I asked Christopher Rufo, a leading critic of harm reduction and Housing First, why that was. “Most Republican policy makers don’t actually care about the issue of homelessness because it doesn’t affect their
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think the right, if it’s really going to rebuild itself, needs to have definitive answers to those questions.”43 Part of the power of harm reduction, said Stephen Eide of the center-right Manhattan Institute, is that it can be viewed as conservative. “Some people might say it’s just
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we’re doing something similar with criminal justice.”27 Like Mandelman, other elected officials are beginning to stand up to the more ideological advocates of harm reduction and Housing First, and advocating the expansion of temporary shelters. “It’s estimated that it will take till 2035 or 2040 to build enough
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et al., “Personal and Community Characteristics Associated with Unsheltered Status Among Veterans Who Have Experienced Homelessness,” American Journal of Preventive Medicine, 2021. 45. Erica Sandberg, “Harm Reduction in San Francisco: The City by the Bay Has Embraced a New Religion: Drug Normalization,” City Journal, February 14, 2019, www.city-journal.org; Joshua
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s Strategy for the Homeless: Give Them Homes,” NBC, May 3, 2015, www.nbcnews.com. 53. Sam Tsemberis et al., “Housing First, Consumer Choice, and Harm Reduction for Homeless Individuals with a Dual Diagnosis,” American Journal of Public Health 94, no. 4 (2004): 651–56, doi:10.2105/AJPH.94.4.651
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people last year, more than ever before: Coroner’s Service,” CTV News, February 11, 2021, www.ctvnews.ca. 24. Maia Szalavitz, “Dan Bigg Is a Harm-Reduction Pioneer and His Overdose Doesn’t Change That,” Vice, October 24, 2018, www.vice.com. 25. Trisha Thadani, “More Than One Person a Day Died
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Cops Across (Nadelmann), 45–46 COVID-19 California prison population reductions and, xiv, 22 deaths from, compared to overdose deaths, 290 disruption caused by, 267 harm reduction and, 163–164 hotel housing without accountability, 240–241, 244 housing scarcity and, 254 reopening of public schools in San Francisco and, 237–238 social
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, 282 disaffiliation as result of, 13–14, 59–62, 259 displacement, poverty, and racism seen as roots of, 63–67 falling drug prices and, 46 harm reduction approach to, 35–36, 45–48, 56–58, 63–71, 150, 229, 247–249, 274 homelessness and, 7–9, 12–14, 20–24, 35,
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136, 149, 156, 159 Gramsci, Antonio, 214 Grateful Dead, 184 Haidt, Jonathan, 211, 216, 261–262, 284 Haney, Matt, 21, 81, 93, 111, 189, 242 Harm Reduction Coalition, 25, 46, 62, 64, 66, 78, 123, 212 influence on policies, 242–243 Harris, Kamala, 197, 246–247 Hart, Carl L., 70 Harvard Public
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Weiss, Bari, 285 Westbrook, Vicki, 154, 195–196 on California’ missed opportunities for helping homeless, 241 as drug user, 51, 53, 61–62, 124 on harm reduction programs, 65, 149–150 on outsourcing of services, 244 on prison and recovery, 156–158 on probation programs, 201–202 on treatment programs, 77–78
The 4-Hour Body: An Uncommon Guide to Rapid Fat-Loss, Incredible Sex, and Becoming Superhuman
by Timothy Ferriss · 1 Dec 2010 · 836pp · 158,284 words
the #1 bestselling anabolic reference guide worldwide. It features: reviews of nearly 200 pharmaceutical compounds, detailed explanations of the real risks of anabolics, prevention and harm reduction strategies, steroid cycling and stacking sections to take the guesswork out of cycle construction, and approximately 3,000 color photographs of legitimate, counterfeit, and underground
The Pot Book: A Complete Guide to Cannabis
by Julie Holland · 22 Sep 2010 · 694pp · 197,804 words
-BY-STATE (AND FEDERAL) CANNABIS LAWS AND PENALTIES Chapter 9. On Ending Prohibition Ethan Nadelmann, J.D., Ph.D. PART TWO Risks of Use and Harm Reduction Introduction to Part Two Chapter 10. Medical Risks and Toxicology William Holubek, M.D. TERMINOLOGY PHARMACOKINETICS AND PHARMACODYNAMICS DRUG TESTING GENERAL TOXICITY MANAGEMENT OF MARIJUANA
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, M.D. Chapter 18. The Collateral Consequences of Cannabis Convictions Richard Glen Boire, J.D. EXECUTIVE SUMMARY CONCLUSION POLICY RECOMMENDATIONS Chapter 19. Harm Reduction Psychotherapy Andrew Tatarsky, Ph.D. HARM REDUCTION ACUTE HARMS CHRONIC HARMS FINDING YOUR HEALTHIEST RELATIONSHIP TO MARIJUANA CONCLUSION PART THREE The Clinical Use of Cannabis Introduction to Part Three Chapter
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its harmful impact. Most useful medications have recommended doses and toxic doses, as well as methods of ingestion that minimize harm and maximize therapeutic results. Harm-reduction strategies should include not only utilizing vaporizers to diminish pulmonary disease, but also a careful reexamination of our drug laws. It is illogical that the
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of what it is in America (Degenhardt et al. 2008). (For more on the Dutch, please see chapter 39.) It is quite possible that a harm-reduction-based drug policy could keep our country healthier. What I hope to outline in the pages that follow is a comprehensive assessment of cannabis, its
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fears and actively fight for drug policies grounded in science, compassion, health, and human rights. Thank you very much. PART TWO Risks of Use and Harm Reduction Penalties against possession of a drug should not be more damaging to an individual than the use of the drug itself, and where they are
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not smoke cannabis. The following chapters delineate not only the acute and chronic harms inherent in cannabis use, but provide options for diminishing these harms. Harm reduction is a philosophy that accepts the inevitability of drug use and does not insist on abstinence. It is a practical, pragmatic framework upon which to
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build a therapeutic structure. Seatbelts, motorcycle helmets, and condoms are all good examples of harm-reduction products. They make risky behavior a bit safer and reduce the potential for harmful outcomes. In the case of cannabis, one of the most important
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harm-reduction tools available is the vaporizer. This is a device that heats cannabis to the temperature required to release the psychoactive components of the plant into
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sanctioning it, it is more likely to normalize in frequency. It is important to analyze the pattern of use and its effect on your functioning. Harm-reduction psychotherapy can help to balance the benefits and harms, and adjust the use for the best functional output and outcome. One more important thing about
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cancer in marijuana smokers who do not use cigarettes is comparable to the rates in nonsmokers, but lung function impairments and respiratory symptoms are possible. Harm-reduction techniques, including a switch from smoked to vaporized or edible cannabis, appear to be worth the effort for regular users. LUNG CANCER As public service
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completion of the sentence or probation. Section 11361.5 of California’s Health & Safety Code serves as a workable model for such a provision. 19 Harm Reduction Psychotherapy Andrew Tatarsky, Ph.D. Marijuana has been charged with the power to induce insanity and proposed as the gateway drug to all things evil
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more than thirty years that informed my understanding of why substance use becomes problematic for some, and how others make positive changes in their use. Harm-reduction philosophy frames and influences the approach. An integration of strategies to deepen awareness and facilitate change provides a variety of tools to use in your
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answer for everyone; many concerned marijuana users are not ready, willing, or able to stop. They need an alternative approach that starts where they are: harm reduction. HARM REDUCTION Harm reduction is an alternative to the traditional abstinence-only approach to problem substance use. It began as a response to the failure of traditional treatment to
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address the explosion of serious drug and alcohol use in Amsterdam and Liverpool in the 1970s. The essence of harm-reduction philosophy is the acceptance of the fact that people use mind-altering substances. The focus is shifted from only trying to stop drug use to
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reducing the harms associated with substance use, acknowledging abstinence as one among many possible ways to accomplish this. Harm reduction seeks to support and empower users to make conscious, responsible, healthy choices regarding their drug use and other aspects of their lives. All positive changes
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use and the loss of control it predicts. Clarify What You Think of Yourself as a Drug User You might begin working on your own harm-reduction process by spending some time trying to make explicit what you think and feel about yourself as a drug user, why you use drugs, and
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judgmental moralizing and shaming and blaming yourself. These reactions tend to close down exploration. Compassionate, pragmatic self-acceptance of where you are, the essence of harm-reduction philosophy, is a powerful alternative to the self-condemning tendencies that are supported by internalized stigma. Recognize that your desire for change reflects positive motivation
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and chronic harms associated with using marijuana, as well as tips for reducing the possibility of experiencing these problems. It introduced a framework based on harm-reduction philosophy that I’ve been using in counseling people grappling with substance use problems. This framework can be used as a guide for evaluating your
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self-assessment of one’s current relationship to marijuana, setting the internal stage for change, embracing ambivalence to change, and setting harm-reduction goals. A variety of strategies to evaluate and pursue harm-reduction goals was offered. Change is a work in progress. As you develop new goals and strategies, see what works for
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agree with Donald that vaporizers are much better than joints or pipes. JULIE: There’s a chapter in this book by Mitch Earleywine talking about harm reduction and the use of vaporizers,*19 which I think is really important. ANDREW: It’s a much better way to use it. JULIE: And I
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, I look at the vaporizer as a device that reduces the negative effects of smoking the material. JULIE: Right, it’s what I would call harm reduction. MAHMOUD: The point is, all you really need to do is get the THC to go through and come out of the vaporizer so you
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by using cannabis. From a medical and psychiatric perspective, the substitution of cannabis for other more toxic and addictive drugs is a good example of harm reduction. A recent examination of postmortem brains of alcoholics showed alterations in endogenous cannabinoid levels in key brain areas thought to be implicated in alcoholism (Lehtonen
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of other conditions including ADD, ADHD, asthma, autoimmune diseases, brain trauma, cerebral palsy, diabetes types 1 and 2, dystonia (muscle spasm), severe menstrual pain, epilepsy, harm-reduction management of addictions and substance abuse (including alcohol, tobacco, cocaine, benzodiazapines, amphetamines, heroin, etc.), inflammatory bowel diseases, mental disorders (including post-traumatic stress disorder, anxiety
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marijuana laws in the United States (and most other countries) cause vastly more harm than they prevent. The Marijuana Policy Project (MPP) advocates for commonsense, harm reduction–based marijuana policies through state and federal lobbying, ballot initiative campaigns, public education, and grant support of local activists. All policy decisions come down to
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. Common Sense for Drug Policy www.csdp.org Common Sense for Drug Policy (CSDP) is a nonprofit organization dedicated to reforming drug policy and expanding harm reduction. CSDP disseminates factual information and comments on existing laws, policies, and practices; provides advice and assistance to individuals and organizations; and facilitates coalition building. Community
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to Cannabinoid Content in Relation to Other Plant Characters.” Euphytica 62 (1992): 187–200. Denning, P., J. Little, and A. Glickman. Over the Influence: The Harm Reduction Guide to Managing Drugs and Alcohol. New York: Guilford, 2003. Denson, T. F., and Earleywine, M. “Decreased Depression in Marijana Users.” Addictive Behaviors 31 (2006
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at the State University of New York, Albany, February 13, 2006. Earleywine, M., and S. Smucker Barnwell. “Decreased Respiratory Symptoms in Cannabis Users Who Vaporize.” Harm Reduction Journal 4 (2007): www.harmreductionjournal.com/content/4/1/11. Accessed April 29, 2010. Edery, H., Y. Grunfeld, Z. Ben-Zvi, et al. “Structural
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.” Frontiers in Human Neuroscience 3 (2009): 53. Looby, A., M. Earleywine, and D. Gieringer. 2007. “Roadside Sobriety Tests and Attitudes toward a Regulated Cannabis Market.” Harm Reduction Journal (2007): www.harmreductionjournal.com/content/4/1/4/abstract. Accessed November 24, 2007. Lopez, H. H., S. M. Goldman, I. I. Liberman, et al
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forAnti-inflammatory Diseases.” Journal of Neuroimmunology 166 (2006): 3–18. Lucas, P. “Regulating Compassion: An Overview of Canada’s Federal Medical Cannabis Policy and Practice.” Harm Reduction Journal 5 (2008): 5. Lucas, P., H. Black, and R. Capler. “Roadmap to Compassion: The Implementation of a Working Medicinal Cannabis Program in Canada” (2004
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, et al. “An Examination of the Central Sites of Action of Cannabinoid-induced Antinociception in the Rat.” Life Sciences 56 (1995): 2103–9. Martlatt, A. Harm Reduction: Pragmatic Strategies for Managing High Risk Behaviors. New York: Guilford, 2002. Matthias, P., D. P. Tashkin, J. A. Marques-Magallanes, et al. “Effects of Varying
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. Meissner, Bruno. Wissenschaft und Bildung: Die Kultur Babyloniens und Assyriens. Leipzig: Quelle and Meyer, 1925. Melamede, R. “Cannabis and Tobacco Smoke Are Not Equally Carcinogenic.” Harm Reduction Journal 2 (2005): 21. www.harmreductionjournal.com/content/2/1/21. Accessed April 29, 2010. Melges, F. T., J. R. Tinklenberg, L. E. Hollister
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in FEV1 with Age.” American Journal of Respiratory and Critical Care Medicine 155 (1997): 141–48. Tatarsky, A. Harm Reduction Psychotherapy: A New Treatment for Drug and Alcohol Problems. Northvale, NJ: Aronson, 2002. ———. “Harm Reduction Psychotherapy: Extending the Reach of Traditional Substance Use Treatment.” Journal of Substance Abuse Treatment 25 (2003): 249–56. Taura
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Canadian AIDS Society since January 2004. She sat on Health Canada’s Stakeholder Advisory Committee on Medical Marihuana. Lynne also works on issues related to harm reduction, drug policy, housing, and community-based research. She can be contacted at LynneB@cdnaids.ca. Chris Bennet is coauthor of Green Gold the Tree of
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. Andrew Tatarsky, Ph.D., is a clinical psychologist and psychotherapist in private practice in New York City. He is codirector of Harm Reduction Psychotherapy and Training Associates and is the author of Harm Reduction Psychotherapy: A New Treatment for Drug and Alcohol Problems (Lanham, MD: Rowman and Littlefield, 2007). He can be contacted at
Raising Lazarus: Hope, Justice, and the Future of America’s Overdose Crisis
by Beth Macy · 15 Aug 2022 · 389pp · 111,372 words
could see the bags better in flophouses and other low-light areas. Unhoused recipients especially loved the crocheted bags—they reminded them of home. Harm-reduction activists might have dismissed the crochet circle for being uneducated and overly timid, but Mathis felt it best to meet the crafters where they were
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, I don’t like the dirt from my poor neighbors splashing over onto me,’” said Lesly-Marie Buer, a Tennessee-based medical anthropologist and harm-reduction worker. In 2005, Buer attended the funeral of an old friend who’d overdosed—and noticed how poorly rural drug users were treated compared to
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SUD, then literally pick them up from jail when they’re released and drive them to housing. Like the outreach workers in Peoria and other harm-reduction programs I followed, Lovitt’s nonprofit continued operating full steam when COVID hit. In the beginning there were bureaucratic wrinkles to smooth out—communication
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vape pens. At the center of the storied atrium, she led a staccato call-and-response: We want their money For safe-consumption sites, For harm reduction, For treatment. It’s time, Guggenheim! To take down their names! The Guggenheim had received more than $9 million from the family between 1995
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named museum wings, from the Smithsonian to the Louvre to the Temple of Dendur. She also sold limited-edition prints of her work to fund harm-reduction innovations, from a mass spectrometer to test the strength of illicit drugs in Greensboro, North Carolina, to a center that provided sterile syringes and
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of overdose deaths rising among people in their teens, twenties, and thirties. Which is another strong argument for making bupe more widely available, along with harm-reduction supports like clean needles and fentanyl test strips—especially in rural communities where stigma is most entrenched. In Surry County, North Carolina, you can drive
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Narcan to the trailer park in nearby Patrick County, Virginia, where her daughter died. She expanded to other nearby communities with the help of harm-reduction supplies donated by a coalition based out of nearby Winston-Salem and a small cavalry of people in long-term recovery who knew where the
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in Odum’s nature to wait. “Change has always been driven by people with boots on the ground,” said Sam Snodgrass, a nationally known harm-reduction activist in Arkansas. “People who realize that saving lives is more important than getting arrested.” Stroud and Odum were following a tradition started by Chicagoan
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Services Administration (SAMHSA) and/or the drug czar’s office under Trump taken an active evidence-based stance to provide low-barrier bupe and other harm-reduction approaches—like reversing the federal ban on funding needles—many drug-related deaths could have been prevented, most experts believe. “One way to think
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largest drivers of life-expectancy decline in recent American history. “The blame is just so disproportionate,” said Corey S. Davis, director of the national Harm Reduction Legal Project. “I think advocates should push the notion that fat-cat billionaires who started this thing are getting off scot-free. But your cousin
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sometimes the therapy team won, sometimes probation. When I saw the title of her doctoral presentation, “Changing What’s Possible,” I thought of the late harm-reduction guru Dan Bigg, who would have said of the small-town culture wars: Any positive change… Nikki King proved that, with enough community effort,
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bigger jails. Best to get what she could from them while she could still control it. Chapter Six Good Criminals Joe Solomon (center) handing out harm-reduction supplies, Charleston, West Virginia. As Purdue’s bankruptcy case lumbered toward a seeming conclusion in late 2020, I trailed an underground needle exchange operator in
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to school (which he doesn’t love), narrating the injustices they witness. “This rail is flimsy,” Jagger said. We were getting pizza following a harm-reduction event in Charleston, and he was pointing out the instability of the outdoor dining rails. Prosperino quietly said into Jagger’s ear: “You know, they
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sideshow finally gaining traction among politicians, reporters, and Hollywood producers, Goldin, Quinn, and their friends had already gotten further than they’d imagined, as had harm-reduction activists and supporters of decriminalization. And they were not resting now. But neither were the criminals, good or bad. Chapter Seven Weaponizing Addiction Trail of
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’s words went on to influence how Google curated and monitored information around treatment in the United States. But the northern Virginia mother’s DIY harm-reduction notions remained on a periphery that was equal parts geographic and philosophical. A few years earlier, a therapist had introduced her to Ginny Lovitt,
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, the glue doesn’t always hold. But the peers persist, focusing on the hope that something, eventually, will stick. The Fairfax model of integrating harm reduction and bupe is rare for a jail setting, some of which provide twelve-step and other abstinence-only approaches, while many offer nothing at all
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preachers don’t want to help, I find the parent who secretly has the kid struggling, and we work with them.” Citing Canada, where harm reduction comes in the forms of safe-consumption sites and treatment of OUD with pharmaceutically dispensed heroin, one researcher credited middle- and upper-middle-class influencers
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been at it for two decades—dogging Democratic and Republican administrations alike—and they were just as exhausted as the besieged peers, parents, and harm-reduction workers. It reminded me of an exchange I witnessed in 2016 between Los Angeles Times investigative reporter Harriet Ryan and Obama’s first drug czar
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and hepatitis C cases in the city—sending the work of Prosperino, Solomon, and their peers underground. While Gupta has said repeatedly that he supports harm reduction, his record is mixed. He remains under attack for providing cover for needle-exchange opponents in Charleston during the 2018 shutdown after criticizing the program
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litter. “There was an opportunity for Gupta to lead, but he took the opposite approach,” said Robin Pollini, a West Virginia University epidemiologist and harm-reduction expert. “And I personally feel like we are still living with the wreckage of those decisions.” The volunteers at SOAR continued to run their needle
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so people can pick the pathway that works for them.” As tempers flared and politicians fanned the fury, Pollini publicly warned officials that, unless immediate harm-reduction measures were enacted, the outbreak would prove to be worse than the 2014 outbreak in Scott County, Indiana. “People are going to want to
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was San Francisco, where fentanyl was finding fertile ground among that city’s skyrocketing homeless population. In most blue states and big cities, to have harm-reduction cred was not only scientifically proven; it was cool. Still, in rural places where the overdose crisis first broke out, Purdue’s neediest victims continued
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to enter treatment, and that, absent intervention, these were the people most likely to end up in Johnson’s handcuffs again. Previous efforts to offer harm-reduction services in Surry County had backfired spectacularly. When a public health department worker suggested in 2017 that Mount Airy open a needle exchange, the outcry
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in rural America without Jesus, or without talking about the value of self-sufficiency,” she said. “In some ways that’s the rub with harm reduction versus abstinence. With abstinence, you’re supposed to be pulling yourself up by your bootstraps, but actually it’s all based around mutual support—which
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shot to death as retribution after allegedly giving her killer HIV through a shared needle. A severe national naloxone shortage struck hardest in communities where harm-reduction services were least supported, not coincidentally in the same places where bystanders were the least likely to call 911 for an overdose because they feared
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overdose in 2014 and spent nearly every moment since agitating for accountability, fighting against tough-love/drug-war narratives, and doing gritty, on-the-ground harm-reduction work. As he did for the first SACKLER Act hearing, Mike Quinn helped Maloney’s staffers line up speakers, including Pleus. Pleus fields so
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live an hour south of Charleston and grew up in Appalachia. Coyne and other reporters told me that Charleston mayor Amy Schuler Goodwin was pro–harm reduction but too politically astute to say so publicly now in city council meetings because, they assumed, she was plotting her next campaign. One city
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the West Virginia ACLU, a federal judge in Huntington issued a restraining order against the enforcement of a new state law which effectively banned most harm-reduction programs in the state. Charleston-based ACLU lawyer Loree Stark filed the lawsuit in the jurisdiction of a Huntington judge, arguing that the law
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than solve them they create new problems they claim to have the solutions to,” Kyle Vass said. The political legerdemain of Charleston’s anti-harm-reduction elected officials echoed the government’s early inaction on HIV/AIDS. When ACT UP occupied Grand Central Station in 1991 and held up signs demanding
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progressive than Charleston. When the new statewide needle exchange restrictions went into law, PROACT and Harmony House served as a buffer for local efforts against harm reduction. Also, the shock of twenty-six overdoses happening in one day in Cabell County—and making international news for it—ensured that most of
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Division of Addiction Sciences. She suspected that most complaints about needle litter had been trumped up by naysayers—including people running for office on anti-harm-reduction platforms. The new restrictions weren’t ideal, but they were politically necessary to keep the doors open. “Cabell’s health officer played the game
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continuing to jail people in the name of morality. But too many stone-rollers still divide themselves between tough-love twelve-step models and the harm-reduction model of meeting people where they are with medicine, compassion, and tiny packets of triple-antibiotic ointment. Too many still universalize their own personal
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Tami Olt, author interview, August 20, 2021. “the only thing that kept assholes”: Chris Schaffner, author interview, September 17, 2020. (sites established in Canada): Canadian harm reduction: See: Garth Mullins interview; also Mottie Quinn, “Safe Drug Injection Sites Are Coming to America. Canada Has Had Them for Years,” Governing, April 10, 2019
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Odum, author interview, October 28, 2020. hatchet wound: Amy Gecan and Erin Shafto, author interviews, October 29, 2020. “they always treated her like shit”: Virginia Harm Reduction Coalition director Lawson Koeppel, author interview, November 25, 2020. nodding out in drug court: Fairfax County Judge Penney Azcarate, author interview, March 2, 2021. “tidal
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Reports, July 31, 2020. “This rail is flimsy”: Witnessed outside of Pies and Pints, following an author talk I gave with novelist Robert Gipe about harm reduction on November 7, 2021. “I’ve overdosed”: Kelli Keen, author interview, December 6, 2020. I interviewed the needle-exchange operator the same day and
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Services, September 16, 2021, https://oeps.wv.gov/hiv-aids/documents/data/WV_HIV_2018-2020.pdf. “mini-mall for junkies”: Kyle Vass, “Politics of Harm Reduction,” Dragline, April 3, 2021. ample evidence: “Needs-Based Distribution at Syringe Services Programs,” Centers for Disease Control and Prevention, December 2020, https://www.cdc.gov
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author interview, March 29, 2021. “so fucking tired”: Ann Livingston, author interview, March 20, 2021. hit a snag: Gordon Katic and Sam Fenn, “In Surrey, ‘Harm Reduction’ Drug Approaches a Hard Sell,” The Tyee, September 26, 2014. Chapter Nine “worst mistake”: Norah O’Donnell, “Former FDA head: Opioid epidemic one of ‘great
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[the law] in an attempt to catch other people breaking the law.’” recent estimate: Jill Kriesky, “Saving Lives and Saving Money: The Case For Harm Reduction in Kanawha County, WV,” West Virginia Center on Budget and Policy, (n.d.; report analyzes data through 2020), https://wvpolicy.org/wp-content/uploads/2021
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/03/Harm-Reduction-Report-Final.pdf. recommended by the CDC: “Needs-Based Syringe Distribution and Disposal at Syringe Services Programs,” Centers for Disease Control and Prevention, September 2020
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November 26, 2019. Barbecue and Sweet Tea: Donnie Varnell, author interview, February 16, 2021. less likely to get stuck: Max Blau, “Southern states slowly embracing harm reduction to curb opioid epidemic,” PBS NewsHour, April 17, 2019. changed their tune: Dr. William Cooke, author interview, July 15, 2021, and “Boone County Jail becomes
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Radio, July 17, 2020. most of the illicit: Michael Sinclair, “The wicked problem of drug trafficking in the Western Hemisphere,” Brookings Institute, January 15, 2021. harm-reduction work: Alexis Pleus, author interview, August 3, 2021. crippling fear of the ringer: Alexis Pleus, testimony, “The SACKLER Act and Other Policies to Promote Accountability
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T. Allen, “Understanding the public health consequences of suspending a rural syringe services program: A qualitative study of the experiences of people who inject drugs,” Harm Reduction Journal 16, no. 33 (2019): 4–5. eight to ten times: Christine Teague, as quoted by Kyle Vass, “HIV in the Mountain State: Mike
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Kentucky. Photos Karen Lowe (left) and the Rev. Michelle Mathis, co-founders of Olive Branch Ministry, run the nation’s only biracial, queer, faith-based harm reduction group, offering low-barrier needle exchange and medicationassisted treatment. As an Olive Branch volunteer, nurse practitioner Tim Nolan (right) signs up new patients in western
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traveled the county in their cars, passing out syringes and vital connections to care. Wendy Odum Harm reductionists Joe Solomon and Lill Prosperino (below) delivered harm-reduction supplies in Charleston, W. Va., and elsewhere in the overdose-plagued state as legislators worked to outlaw needle exchange during an HIV outbreak. Lill Prosperino
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County Jail. Tiffany Riley Kristy Howard (above) and Brittany Roberts worked as peersupport specialists for The CAF, helping inmates with reentry issues and handing out harm-reduction supplies in the region, including at area methadone clinics. Brittany Roberts Abbie Setzer hangs out regularly at Olive Branch Ministry in Hickory, N.C., where
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she volunteers and uses the harm-reduction facility’s services, located behind a church. Mary Jo Silver (below) got treatment for Hepatitis and her addiction through Olive Branch andmwent on to
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