Lets Talk Substance by mecagdthesis2020

A Thesis Exploration About Harm Reduction in Maine

Ollie McGowan

“ Harm Reduction: We do it in our

day to day lives all the time. It’s not safe to get into a car but we put on a seatbelt anyways. ”

Leo (Episode 1: Homelessness & Ableism)

Table of Contents Preface 2 Preface 1 Introduction 4How I Introduction Became Involved With Harm Reduction Purpose Behind The Thesis

Harm Reduction 10 What is Harm Reduction? 11 Recovery

The Process The Start The16Project Process

19Thesis Process Where My Began

The Posters

Levels of Drugs

Lets Talk Substance 46 The Podcast

Episode 1

16 Homelessness & Ableism Transcript

Episode 2

73 Maine Access Points Transcript

Episode 3 TB Reproductive Rights & Motherhood Transcript

What is Next?

Preface Lets Talk Substance (the process book) is about my thesis project which turned into a podcast. The purpose of starting the podcast was to educate community members about Harm Reduction.

The War on Drugs still continues to divide and uproot people today, especially in relation to the incarceration system. The stigma placed upon people who use drugs still has great impacts.

Not many people are aware of the underground Harm Reduction movements happening everywhere. Coalitions began to rise as the War on Drugs became rampant. The War on Drugs, coined by president Richard Nixon, started in the 1960s and disproportionately affected communities of color.

This epidemic still continues to affect many diverse individuals, and is the reason I wanted to bring attention to it. The intention of Lets Talk Substance is to witness not only the design practice, but begin to understand the depth of what Harm Reduction really means.

Starting with Nixon and continuing with Ronald Reagan, the War on Drugs targeted black, brown, and LGBTQIA+ individuals. They both created mass hysteria, often white hysteria, about crime.

Narcan Saves (Feb 21st, 2020) Ollie McGowan A sign Bangor Needlepoint Sanctuary made for Fridays when they table. This was the day I volunteered with them and interviewed co-founder Leo for Episode 1 of Lets Talk Substance

About Picture

Introduction

Janet Mills Opioid Response Summit (July 15th, 2019) Ollie McGowan Portland Overdose Prevention Society protested Janet Millâ&#x20AC;&#x2122;s Summit based on the Maine syringe law that only allows someone to have ten needles on them at a time.

As every Maine College of Art student knows, senior year is dedicated to thesis. The BFA Thesis is an exhibition that celebrates the hard work and completion of the undergraduate degree. It is a project that allows students to explore whatever topic they want through the art mediums they choose. The big question is How does one choose a topic? or Where does one even start? For me, I started to develop a design practice within my junior year of college. I began to combine my love for social justice with the skills I had learned within my art classes. Social justice and community organizing became very prominent in my life after the election of Donald J. Trump. His transphobic, racist, sexist, classist, ableist mindset has terrorized many marginalized communities including my own. I began to do outreach work with different grassroots nonprofit organizations like Portland Overdose Prevention Society, Maine Access Points, Extinction Rebellion, Planned Parenthood, NextGen America, Maine Youth Justice, Pine Tree Youth Organizing and MaineTransNet.

I saw many disparities, I risked arrest many of times, and I experienced many hardships and backlashes from the government that affected many vulnerable groups of people. I became heavily involved with Portland Overdose Prevention Society and Maine Access Points. The organizers in these groups demonstrated and taught me the best ways to implicate Harm Reduction into my everyday life. As many family members and friends of mine have dealt with addiction, doing Harm Reduction work just felt right. I wanted others to see that people who use drugs are not bad. I wanted people to understand that carrying naloxone wasnâ&#x20AC;&#x2122;t dangerous. I wanted to show people that having compassion for someone using drugs was okay. That we all need to meet people where they are at. This is how I came to the point of dedicating my thesis to educating folks about Harm Reduction. Its not about the drugs, its about the people we care about. Its about compassion, safety, stability and overall love.

Untitled 1-3 (2019) News Photographers This group of photos are of me participating in multiple different Direct Actions. They were about Climate Change and the Concentration Camps on the United States Border. These are only three of the numerous actions I have participated in.

Harm Reduction

Womenâ&#x20AC;&#x2122;s March, Portland ME (Jan 18th, 2020) Angel Melvin Portland Overdose Prevention Society and Maine Access Points tabled at the Womenâ&#x20AC;&#x2122;s March to train people to carry naloxone.

What is Harm Reduction? Harm Reduction is an underground movement that has been developing since the mid 1900s. It was provoked by the ideologies brought upon by Richard Nixon and Ronald Reagan. They proposed very discriminatory laws about people who used drugs, and shamed them publicly. Thus propelling the innate stigma that is still festering today. The purpose behind Harm Reduction involves personal autonomy. Giving people who use drugs the agency to make decisions. Meeting people where they are at, in terms of service provision. For example, if someone is in active drug use and chooses to continue, a harm reduction strategy could be to give the

individual clean drug use supplies, a safe professionally-staffed space to use drugs, access to life-saving overdose reversal treatment if needed without stigma or strings attached. Harm Reduction centers around saving lives rather than enforcing laws, using punitive punishment systems, and reinforcing stigma of people who use drugs. It is a set of practical, science and compassion-based strategies aimed at reducing the negative consequences associated with drug use and other potentially risky activities. Harm Reduction, overall is a coalition of people passionate about serving and creating spaces for everyone.

Naloxone (Feb, 2020) Ollie McGowan This photograph was an experiment to see how I could work with the physical materials of Harm Reduction

Recovery In our culture, abstinence or quitting a substance entirely, is often equated to recovery. Being in recovery means something different to everyone, and what may be right for one person is not always the best for another. Recovery can be an extremely personal process and often occurs on a non-linear path. The process of recovery is best supported through mutual aid and understanding relationships. Without the support of a community, an individual can have a harder time recovering; whatever that may look like. It is okay to not understand the path someone else takes, but giving support to people who use drugs is crucial. Stigma and shame can spread when people who use drugs are shunned away from society. Throwing people away can create divides and cause more damage to the drug epidemic. Prisons are

not a form of recovery and can be far more dangerous than they are helpful. They profit off of people who live with addictions, locking them away and claiming that it is a form of recovery. Recovery services need to be flexible, and must not turn those away for reusing. Going â&#x20AC;&#x153;cold-turkeyâ&#x20AC;? can be very dangerous and often causes more trauma to the body due to high withdrawal effects. We must listen to people who use drugs and their needs, rather than what we perceive recovery to be. Slow incremental changes can be highly significant, even if it seems like a small step from the outside.

Recovery is Not Always Abstinence (Jan 2020) Ollie McGowan Recovery is Not Always Abstinence is a poster made for my Independent Project Class. As a class we hung them up in the Maine College of Art Library.

The Process

Never Again is Now Poster (July 18th, 2019) Ollie McGowan While immigrants were being locked in n cages activist group Jewish Activists of Maine gathered together to protest them.

The Start Before I dove into my thesis about Harm Reduction, I took an experience design class that shifted the way I wanted to talk about activism. I decided to pursue a in-depth project about the complexities of Direct Action. Direct Action is a form of civil disobedience with the purpose of disrupting the flow of everyday. Usually organized by grassroots movements, Direct Actions intend to enact change within governmental authorities. For example, Martin Luther Kingâ&#x20AC;&#x2122;s March on Washington is one of the most infamous American Direct Actions known to date.

something for people on the outside interested in looking into the world of activism. I dissected the roles and purposes of each task within a Direct Action. I made timelines, and conducted interviews from peers in the activist community. By creating this educational, yet design based project, I knew that I wanted to continue to do the intersection of the two. Thus the foundation of my thesis was born.

I understood that many people did not know that Direct Actions were a lot more complicated than they seemed to be on the outside. I wanted to create Stakeholderâ&#x20AC;&#x2122;s Map Pieces (Fall Semester, 2019) Ollie McGowan Before we could begin to design our project, we had to do research and map out the different important topics within our overall concept.

After we did research in the topic we wanted to pressure, we then had to make graphics to illustrate what we learned. The purpose of the maps for me was to make them easily readable for people who may not know what Direct Action is or looks like. Within a lot of my work, the intent is to make the work accessible to all people. I want everyone to be able to interact and understand the worlds in which I am amerced in. I want as many people to get involved and to be comfortable getting out of their shell and standing up for what is right.

Stakeholderâ&#x20AC;&#x2122;s Map (Fall Semester 2019) Ollie McGowan The Stakeholderâ&#x20AC;&#x2122;s Map represents the roles that individuals could play during a Direct Action. Including the roles, each role group is assigned when they will participate within a Direct Action.

Experience Map (Fall Semester 2019) Ollie McGowan This Experience Map illustrates what the Jail Support role might do during a Direct Action. It takes the viewer through each moment the Jail Support has to make a decision for themselves and for the team.

Process After taking the Experience Design class, I obtained a lot of new skills in which I used throughout my thesis. What I learned during this class was how to take what I love and make a project out of it. Since I knew I wanted to create a thesis that was educational, interactive, and political. I took from what I learned previously and applied to here.

foundation of my thesis, propelling me to start my own Harm Reduction podcast.

As I began the exploration of research and creation, I found that there were so many things to discuss. I started to reach out to people and create different types of messaging. I tested a lot of things out with not only my design peers, but with my Harm At first, I was unsure on how Reductionist friends. I wanted to communicate the world of Harm Reduction to I want to make sure that I was not the public. Harm Reduction is only making my work accessible very vast and complicated con- to all, but also not stigmatizing cept, and I knew I couldn’t tackle any group that I was discussing. I everything. However, I knew that needed to make my work attainI wanted to create something able, but also heartfelt, serious, that did address a lot of different and dynamic. sectors within Harm Reduction. The process was intense, but the Although I had a lot of knowledge outcome of the whole project has on the topic and experienced the given me opportunities to conHarm Reduction community, I tinue work after thesis. still did not know everything. Naloxone Saves Print Design Then I thought... “Why not bring (Feb 2020) Ollie McGowan the voices of the Harm Reduction community to the public.” This In a Fashion and Textiles class I learned how sparked the to print on fabric. For my project I designed a illustration of a Naloxone vial with flowers for merch like tote-bags, shirts, and bandannas.

Goals Create an empathetic environment for People Who Use Drugs Create an education tool for all To bring marginalized voices to the forefront Visually consistent designs

People Anna McConnell (EP2) Skye Gosselin

Elements

Cait Vaughn (EP3) Lizzy Handschy Leo (EP1) Uncle Sean Winifred Tate

Interview Transcripts Tabling Supplies

Podcast Name Naloxone Kits

Podcast Icons Harm Reduction Merch Thesis Book

Ideas & Topics

Website Mothers Who Use Drugs Harm Reduction in Reproductive Justice (EP3) Homelessness, Ableism, and Drugs (EP1) Why is Harm Reduction Healthcare? Maine Access Points and Naloxone Distribution (EP2) Race and the War on Drugs What Does Recovery Look Like? The Importance of Safe Consumption Spaces People Who Use Drugs Are Not Bad

Throughout my thesis process I recorded all my thesis thoughts, discussions, and critiques in a small notebook. I labeled it by each date and now have a timeline of my process. These two pages from my notebook mark the beginning stages of my thesis. One of them outlines the first steps I had to take in regards to what medium I wanted to pursue my thesis with. The other one outlines the many ideas I had for creating a poster.

01/16/2020 (Jan 16, 2020) Ollie McGowan This page outlined the goals I wanted to accomplish for that week, along with the ideas that I wanted to do for my thesis.

01/30/2020 (Jan 30, 2020) Ollie McGowan This page discussed the direction I wanted to go in, regarding my thesis poster. It also reveals the my first attempt at my thesis statement.

Posters At the beginning of my last semester at Maine College of Art, the graphic design majors were given and exercise to create a poster about their thesis. At first I struggled, I did not know what direction I wanted to take my posters in. There are some many intersections within the Harm Reduction community I just did not know what to tackle first.

There are so many important topics to discover in Harm Reduction, but I ultimately landed on messaging around recovery. Many people perceive recovery as abstinence but that is not alway the case.

I had to think about the ways in which I wanted to communicate to an audience that many not have the experience with the Harm reduction community, that I do. I started by composing multiple different posters with varying messages. I tested them out on my peers to see which one was grabbing peopleâ&#x20AC;&#x2122;s attention, while also educating them. Recovery (Jan, 2020) Ollie McGowan This was the first attempt at my poster about Recovery. although it is very graphic, it did not evoke the compassion that I was going for.

Narcan Saves (Jan, 2020) Ollie McGowan This was an apart of a quick exercise to make posters about my thesis. The intent of this piece was to create something very simple yet meaningful.

â&#x20AC;&#x153;We are completely changing the ways in which our communities are thinking and talking about drug use and about drug user health.â&#x20AC;? Anna McConnell (Episode 2: Maine Access Points)

Healthcare (Jan, 2020) Ollie McGowan This was an apart of a quick exercise to make posters about my thesis. The intent of this piece was to bring attention to Naloxone and how it is a form of healthcare.

War on Drugs (Jan, 2020) Ollie McGowan This was an apart of a quick exercise to make posters about my thesis. The intent of this piece was to inform people about the history of the War on Drugs.

Decriminalize (Jan, 2020) Ollie McGowan

Recovery II (Jan, 2020) Ollie McGowan

This was an apart of a quick exercise to make posters about my thesis. The intent of this piece was to address my feelings about the incarceration system in regards to the War on Drugs.

This was the revised version of Recovery. My intention with this piece was to explore the notion of recovery not always be abstinence. I do this by pairing the words with a Naloxone kit.

Since a majority of people assume that recovery equates to abstinence, my posters that addressed this misconception really caught peopleâ&#x20AC;&#x2122;s eyes. The intention of Recovery is Not Always Abstinence was to transform the views others had about drug use. Not only that, but the coffee iconography was to push this narrative that not everyone person who is using drugs is addicted to opioid. Drugs come in many forms, and less stigmatized drugs are often looked over. The purpose of the coffee was to ultimately have viewers question the way they see drug use. The affects of coffee withdrawal is the same of many other regulated drugs. The fact is, coffee is just more socially acceptable.

How is an avid coffee drinker different than a person who uses drugs? The answer is that they aren’t really different at all. For many, “cold turkey” seems like the best solution for resolving the drug epidemic, but how willing are you to completely cut out caffeine? It may not be as easy as it seems. Coffee, like drugs, causes withdrawal symptoms when immediately and abruptly taken out of a diet. Many people feel fatigued, irritable, nausea, and even feel a lack of focus; symptoms that directly relate to the effects of a drug withdrawal. Before you think about people who use drugs as less than, remember that not everything is as simple as it seems on the surface.

– Recovery is Not Always Abstinence (Jan 2020)

Levels of Drugs

Level of Drugs Pattern (Feb 2020) Ollie McGowan In my Fashion and Textiles class we had a project where we needed to make patterns. I took all my Level of Drugs icons and created one big drug pattern

Levels of Drugs As I grappled with my poster concepts on recovery versus Abstinences, the process gave me new ideas. The purpose of the Level of Drugs was to place different types of drugs on a scale from least to most stigmatized socially. I wanted to break the stigmatization of drug use by comparing opioid with drugs like caffine. Many people may not consider sugar or caffine as a drug, but our bodies can have similar addictive reactions to these substances. The same way someone may be using alcohol or opioid.

list can be a controlled substance to treat many diagnostics. The stigma that is then placed upon people is based off of if they were given the drug by a doctor or not. Creating not only a stigma on drugs, but on lower income individuals.

Many doctors will withhold prescriptions based on income, race, sexuality and gender. Also, if someone cannot afford a drug that can potentially elevate issues, it is very likely that they will seek out more affordable avenues. This doesnâ&#x20AC;&#x2122;t mean that they are a bad person for needing something that can This is not saying that the drug help them. It is just to say that categories in the icon set all because someone uses one drug work the same, but they are all over another does not make more similar than people may them any better, we are all equal. perceive. Just like opioid or even The purpose of placing these cigarettes, caffine and sugar can drugs on a even playing field create similar withdrawal affects. is to show that no one is any better or any worse for using Not to mention that many what they choose. Harm Reducpeople use caffine or sugar to tion and drug use is about body boost mood or productivity. autonomy. It is about meeting These substances are used as an people where they are at and not aid, same as opioid, marijuana, judging them based on if they or even prescription medicaare using caffine or opioid. tions. Most of the drugs on the

Sugar

Sugar is a commonly used ingredient in the kitchen made of soluble carbohydrates. Sugar can increase Weight Gain and Acne. It can also increase risks of Type-2 Diabetes, Depression, Cancer, and Heart Disease. About 184,000 people die each year from sugar overdoses, many of them being affected by Type-2 Diabetes.

Caffine

Caffine is considered a psychoactive stimulant drug that mainly affects the nervous system. It is the most commonly consumed, unregulated substance that prevents the onset of drowsiness. Caffine takes about 1 hour to set in, and has a duration of about 3 to 4 hours. About 5,000 people each year have overdose symptoms from caffine, with about 10% having very severe cases

Medications

Prescription and over-the-counter medications can vary in affects based on what is being taken. About 17% of the United States population is prescribed an opioid related medication each year. About 40 people each day die from prescription based overdoses, totaling at about 15,000 deaths per year.

Nicotine

Nicotine is a synthetically produced substance that contains nitrogen, tobacco, and other various plants. Nicotine is often used as replacement drug, meaning that people will begin to smoke to cope or get rid of another habit. It is said that nicotine is as hard to stop using as heroin, and also has very severe withdrawal symptoms. About 1 in 5 people die from nicotine use. It is very rare for someone to overdose from nicotine exposure or use.

Alcohol

Alcohol is a psychoactive substance that usually contains the recreational drug ethanol. Consumable alcohol can be found in many items used throughout our day to day lives. The overconsumption of alcohol can lead to liver, kidney, brain, and heart complications. About 1 in 20 deaths worldwide is caused by alcohol consumption. Around 6 people each day die from alcohol poisoning in the United States alone.

Marijuana

Marijuana, also know as Cannabis, is a psychoactive drug used both for medicinal and recreational purposes. The three main strains of marijuana are indica, sativa, and hybrid. Marijuana is consumed in many ways including through smoking, eating, and dabbing. All have differing effects and duration periods. Some effects can last up to 24 hours. No one has died of marijuana overdoses, it is extremely hard to overdose. This doesnâ&#x20AC;&#x2122;t mean that there isnâ&#x20AC;&#x2122;t a possibility of taking too much.

Psychedelics

Psychedelics, also known as hallucinogens, are considered as psychoactive substance. These drugs affect all the senses and created effects that often change perception, cognitive processes, and mood. The mental affects can be intense and it is suggested that before using that any person does prepping before tripping. Feeling comfortable is key when using psychedelics Deaths from psychedelics are very rare that only about .01% of the United States population die from them.

Methamphetamine Methamphetamines, including cocaine and ecstasy, are considered as controlled psycho-stimulant substance. Most prescribed methamphetamines are used for reducing symptoms of ADHD and Narcolepsy. These types of drugs can cause extreme anxiety, seizures, and even diabetes. About 10,000 - 14,000 people die each year from methamphetamine related overdoses.

Opioid

Opioid, often found in opium poppy plants, are used to relieve pain and relax the body. Although there is many different types of medical opioid, there are also opioid like heroin. Opioid can be highly addictive, and are rarely used correctly. Many people are not taught the safe ways to consume opioid. About 70,000 people each year die from an opioid related overdose. Mainly because recently opioid have been being laced with a potent drug called fentanyl

â&#x20AC;? It was the most liberating kind of experience for me to start to see myself, the world, and the people that I love not in this black and white binary. Rather in a way that honored the autonomy that we all deserve, in terms of our bodies, in terms of our choices. That doesnâ&#x20AC;&#x2122;t necessarily either moralize nor pathologize people who use drugs. That just recognizes that drug use is a beautiful, actual, natural part of life. That people have been using drugs for all of human history, and that we as a people can and should have the right to use drugs in a way that works for us. â&#x20AC;?

Anna McConnell (Episode 2: Maine Access Points) 42

Letâ&#x20AC;&#x2122;s Talk Substance

Lets Talk Substance Icon (March, 2020) Ollie McGowan This photograph was taken for the podcast icon. The microphone not only is used for recording the podcast, but also has a syringe needle attached the bottom of it.

The Podcast Letâ&#x20AC;&#x2122;s Talk Substance, is a traveling podcast about Harm Reduction that creates healing, compassion, and social change through intersectional conversations around the issues facing people who use drugs. Lets Talk Substance was created to share the voices of the people working in the Harm Reduction community and the people who are affected by the War on Drugs. The intention was to have Podcast Layout (Jan, 2020) Ollie McGowan This sketch in my thesis notebook consisted on many pages outlining how I wanted to structure my podcast. I did a lot of research on different techniques and straitgies to creating the best podcast.

Episode 1 Question (Jan, 2020) Ollie McGowan This sketch in my thesis notebook lays out the questions I intended to ask my first interviewer Leo. I did a lot of word-smithing to make sure that I was asking everything I wanted and more.

an accessible platform for those who are interested in learning about Harm Reduction and those who want to support their community. For my thesis, the podcast consisted of only people who are in Maine doing Harm Reduction work because of travel expenses and time. The hope is to expand the network after graduation and gather stories from all over. The Harm Reduction community and the War on Drugs affect many lives and so each podcast was specifically designed to touch a different intersection each episode. Since this was the first time I had ever created a podcast or used sound equipment, it was a big learning process. As I have much experience interviewing and being interviewed coming up with the content was the easy part. Working and processing the equipment was the more challenging bit.

â&#x20AC;&#x153;The biggest thing I want everyone to remember is the best people to distribute Naloxone are people who use drugs. Okay? Period.

Not Cops. Not Doctors.â&#x20AC;?

Anna McConnell (Episode 2: Maine Access Points) 48

Episode 1 Lets Talk Substance: Episode 1 is about the intersections between Harm Reduction work, homelessness and ableism. The conversation address the affects that the War on Drugs has had on homeless and disabled populations. Having experience with both homelessness and disability, Leo accounts their personal story and how it was shaped by the War on Drugs. They also discuss the importance of Harm Reduction and how they witnessed it positively affected their life and others as well. Leo, luckily, is somebody I have the pleasure of knowing. They are an incredibly hard worker, who dedicates their time to mutually aiding their community through Harm Reduction and outreach practices. They are currently doing community organizing work with several non-profits, some of which are Bangor Needlepoint Sanctuary,

Health Equity Alliance, the Shaw House, Ability Maine, Pine Tree Youth Organizing, Maine Youth Action Board, and MaineTransNet. Leo goes by they/them pronouns, and describes themselves as a queer, cripple, punk, comie, intersectional activist, witch, writer, and artist. Their deep wisdom and personal experiences around the conversation of Harm Reduction in relation to homelessness, and ableism is inspiring. Leo does a lot of incredible work, and spreads love and acceptance to all people. The conversation with Leo in Episode 1 can be hard to hear, but also eye opening. Even I learned a lot from them during the process.

Needlepoint Sanctuary (Feb, 2020) Ollie McGowan This is a still from a time lapse I took while volunteering with Leo at the Bangor Needlepoint Sanctuary. The opportunity to volunteer with them and see a needle exchange operate was incredible.

I’d say I completely agree with that. I think of Harm Reduction as something that is trying to keep people alive by whatever that means for them. It can look like a lot of different avenues for different people. For some people, making sure they have access to clean syringes. For others, it’s helping them get into a treatment program. There are a lot of different avenues for recovery, and like you said abstinence isn’t the only way to recover. All the orgs that I work with all center around the idea that meeting people where they are at is the most important thing. So I completely agree with what you were saying.

It’s really dangerous to have expectations of people especially when it comes to substance use. If you are expecting someone to be recovered when they’re not ready to is just not gonna happen. Not only that, it’s gonna place a lot of stigma on the person and leave them feeling like they can’t come to you for help because you have this expectation of them to be clean and sober. If they are not ready for that then that’s not going to happen. They just aren’t going to come to you at all. Thats where I think a lot of families are completely separated. By substance uses because they expect their family member to be clean, sober and you know doing the recovery thing. That’s not always possible for everybody, especially if they are not having the proper supports.

That’s what we do, is try to provide that support for people. I think that most of the people that we interact with have realized that we are people that aren’t going to judge them no matter what they are doing. If they were clean and sober for 20 years and then they start using drugs again, they aren’t bad people. They aren’t any less, and that is something that is very drilled into their head by society, by their peers, and their family. We also have people who have been abstinent for long periods of time, and come to us saying that what we do is healing for their past selves. That we are the people that they needed when they were younger. It is only a miracle that they survived because they watched their friends and family members die because nobody was there for them. We just try to be there for as many people as we can. So, that’s the basis of it I think.

How do you view Harm Reduction? Why do you feel that it is important to meet people where they are at?

How did you get involved in these organizations? What are some things that you do?

So I want to start off with Health Equity Alliance, because I most recently came onto their Board of Directors. But, I have been working with HEAL for about four years now. I first got involved with their LGBT youth group when I was still in high school, which became a very supportive environment for me.

experiences working with these organizations. That was something that has kinda become a learned thing to understand fully what that stigma can look like to an outsider. Somebody who is not affected by the War on Drugs. From there I kinda slowly became more involved.

They also have a needle exchange there, and I didn’t think much of it when I first started going, but then as I went to youth groups more, there would be more frequent interactions I had with the needle exchange. When I got on testosterone and would have my syringes from after doing my T shot, I’d bring it into the needle exchange and drop them off. It wasn’t like a big thing but I started seeing, and learning what kind of an impact that it has on the community.

We started a needlepoint sanctuary, about a year and a half ago. Me and some of my friends got together. We saw some of the stuff that Jesse Harvey was doing and we wanted to start up something similar. It was kind of inspired by that and started off as something that was alongside, but then we went off and did our own thing.

I have a lot of friends and family members who died by overdoses. Not just overdoses but also illnesses related to substance abuse without harm reductions. Using dirty needles or unclean syringes, then getting substice because of it. Friends dying from Hep C because they didn’t have access to clean syringes and were sharing with their friends. Those types of things were perfectly preventable and it just made sense to me. There was never a time where I questioned it because it was like “oh this is good, it is helping the community” I didn’t really think much of it. But I know there is a lot of stigma around people who use drugs. I see that a lot when I try to talk to people about my

Now we are completely separate entities, but that is where our roots come from. We just all got together and we talked about what Harm Reduction was to us. We saw that brick and mortar needle exchanges weren’t getting the things done that need to be done. They are often not on the front lines, in the streets. They don’t know what it’s like to be interacting with people who are afraid to go into a brick and mortar exchange. They are afraid because that means that they have to interact with this very transactional experience of using drugs. You know, a 1 for 1 needle exchange. It creates intense limitations on how many clean syringes that somebody can get. That means that they are less likely to be going back. It’s just one of those things that are a small piece of bureaucracy that can create stigma. It just shows that “oh, you are only worth

a 1 to 1” That’s just another barrier for people. It stops people from getting that care that they need from Harm Reduction. We saw that, we understood that and we decided to do something about it. We started to give out narcan down in Pickering Square in Bangor every Friday. We have maintained that consistently. I think we have missed a handful of times and very severe circumstances, but otherwise have been routinely going down. We don’t just bring narcan, we bring unused syringes. We also do syringe collections and park clean ups. We host community concerts. We bring out food on Fridays. I usually make soup and we have coffee. We build connections with our community. People see and recognize us as a friendly face. Especially for the homeless populations and people who are using drugs, it means that we are somebody who is reliable, that they can count on who is not going to shame them ever for what they are doing. We don’t have any policies that prevent us from having those very genuine family oriented type things. We recognize these people. We ask them how they are doing. We notice when someone doesn’t show up to the exchange. We worry about these people. We let them sleep on our couches. This is like a network of something that has already existed. We are just providing more resources to it because drug users have always been the first responders in the opioid crisis. They have always been people out there saving lives, first thing.

I also have been working with Needlepoint Sanctuary to try to do some other things based around lobbying. To try to make legislation more accessible to people who are on the front lines. For example, giving out narcan in the streets. There are so many parts to that process that are really difficult, which is why we just do it anyways. We do it no matter what the barriers are because we are trying to make sure people are alive. That is our number one goal. Some of our members who were arrested no longer work with us because they don’t feel safe to. Some of them work with us in other ways because they are banned from Pickering Square. Some of them have gotten charges because of it. Some of our members have spent time in jail because of it. Right now, nobody is currently facing any charges, but it is still an active threat. We do worry about it every time we are doing our exchange and every time we are giving out narcan. Even though it is legal for us to be distributing narcan, it is something that fears sit in our minds. That’s something I think that after the arrests happened we noticed a significant decrease in the amount of people using our services. It’s something that adds to this stigma of knowing that police could come at anytime. Even though you are not technically doing something wrong. In the eyes of the law we are not doing the right thing. This is because we are not a brick and mortar exchange. We don’t have every single permit that we need to have. What we are doing isn’t

wrong. It’s not immoral. We are trying to save lives. I think part of them knows that. The other part of them wants us to follow their rule book. That is not what saves lives. That’s where we started to begin with the civil disobedience. Trying to save lives, doing this for purpose. It is very intentional. We are going to keep doing it. A lot of people don’t want to be involved with anything that has cops showing up at it and shutting it down. It’s scary for them. It puts lives at risk.

How have you witnessed the impact of the War of Drugs specifically on the homeless communities?

I think there is such a huge overlap between homelessness and drug users. That it is often hard to differentiate. Where one crisis starts and the another begins really.

They know we are safe to talk to. That we are safe people to ask “Hey, I think I need some narcan, and I think I may be at risk. I think I need services.” Those are the things we do very intentionally.

While I was homeless I saw around ten overdoses, but I never saw somebody die because somebody always had narcan. That’s one of those things that I didn’t even know existed until the first time I saw it happen. When I first saw somebody overdosing I thought for sure that I was going to see somebody die that day. But, somebody had narcan on hand. They hit them with the narcan and brought them back. That was something that in my personal experience shaped everything for me going forward with Harm Reduction.

We pick Pickering Square because if you look at the map of Bangor of overdoses, Pickering Square is dead center. It’s where the bus hub is and it’s very close to all the shelters. It’s near the hospitals and it is a hub. It is where people are at constantly. So we figure we can reach the most people in person by just sitting out there for hours on end. You know, sitting out there with food, trying to draw people in. Getting them started on this conversation about something they might not know anything about, or might have a negative opinion about.

The people who are homeless in our community are also often the first responders even if they have never used drugs or are not actively using. They usually are like “I’m going to keep that on hand because I have a buddy who uses,” you know, “I am around town all the time. You never know when you are going to see someone laying on the side of the road from an overdose.” Because there is such a huge overlap in those communities, we are making sure that every homeless person has narcan. There is a higher likelihood of people’s lives being saved by it. Also, just making sure homeless people are being taken care of. Making sure that they know that they have a sense of community to go to. So if they do start using drugs then they have people right there that they already have made a connection to.

I think a time that really stood out to me was when somebody visited us. He was homeless and he was talking to me. He said “I used to not believe in Narcan, and then I saw somebody overdose. It took me 5 minuets to change my mind.” That was because he had seen somebody get narcaned, and brought back to life. It just left such an impact on me that he was very adamant about how he’s never used drugs. That he doesn’t believe in using drugs. That just kind of shifted things for him. It was a friend of his, and he didn’t realize that that person was using drugs. It really changed his world view. I think that is one of things where you have to see to believe to really take that in and internalize it. Really understand the depths of what’s happening. It’s not just like “Oh yeah,

let that junkie die.” These are your community members, these are people who are close to you. Homeless people are often the first people on the scene. They are around, they are everywhere. So it’s really easy for them to be there ready to respond. Most people who are using substances are often homeless because they are either jailed, then released and have nowhere to go. Or they end up in the hospital after an overdose and don’t get set up with recovery services immediately out. Sometimes it takes weeks waiting for a bed to open up at a recovery center. We are just right there for people when they need it. We are close to the jail, we are close to the hospitals. People are often coming to us before they go seek any other services. We very frequently refer people out to other services. We help them get into the treatment services that they might be ready for, or what might work best for them. These things have such huge overlap. If we were to try to address the War on Drugs and not address homelessness at all we wouldn’t be accomplishing anything.

â&#x20AC;&#x153;I used to not believe in Narcan, and then I saw somebody overdose. It took me 5 minuets to change my mind.â&#x20AC;?

Leo (Episode 1: Homelessness and Ableism) 60

Why is narcan important to distribute and provide to people?

I think narcan should be in all first aid kits. I think It should be in standard First Aid CPR training. Narcan use is becoming more and more common which is good. It means it is saving lives. I think for people who don’t have any connections to people who are using drugs, it’s something that should just become a standard. It should become something that’s so regular that people have narcan without thinking about it. I know a lot of people who also have a drug of choice, especially with amphetamine. Which often you don’t have to worry about needing narcan because that’s for opioids, and you’re not using opioid. People are like “oh yeah, I don’t use that substance. I’m not using dope. I don’t need narcan.” More and more there’s been cases of people getting things that are laced or have fentanyl in it, and don’t realize. You know, Xanax bars getting cut with fentanyl.

before, obviously. There is no tolerance to it, so if people even get a small amount of fentanyl they are often dying. They usually don’t have narcan on hand because they don’t think that those drugs don’t affect the. They think that it wont bother them. It can happen to a lot of people. Even if you are somebody who is just walking down the street. You can see an overdose, it’s gonna happen someday. I always carry narcan on me. There have been I think three times now where I have seen people overdose. I had my narcan on me but someone was already there with narcan, thank god. I had that narcan with me and was able to make sure if they needed that second kit that I was right there with it. So, you never know if you are going to become a bystander in a situation you didn’t expect to happen. Or something could happen to you without you realizing it. It’s better to be safe than sorry always.

I had somebody talk to me about how she only uses crack and has only ever used crack. Then she had to get narcaned because she overdosed without even realizing it. That’s why not just having narcan,but fentanyl testing strips is super important. It’s something that we try to give out. Giving out fentanyl strips to people who, especially if they are not using heroin or any other opioid because that means that things could be laced and not realize it. You are way more likely to have an overdose if you have never used opioids

How have you seen ableism play a role in the War on Drugs?

Specifically to my disabilities, I have chronic pain. It’s something that affects a lot of people with my type of conditions, it’s really common. I know a lot of people who started off using opioids because of chronic pain. They are given a prescription for an opioid and then they take it at night to help them sleep. All of a sudden they become dependent on it. It’s within the law for that to happen. So that’s been happening, the doctors have addressed that and they are starting to not prescribe opioids as often. There are some downsides to that. A pro is that less people are becoming dependent on drugs, but it also means less people are getting access to drugs that can drastically improve their quality of life. I know several people with chronic pain, with very similar conditions to mine that take opioids regularly. I have a friend who takes it once at night That’s what they need to get by to help with their pain and it helps them a lot. I have another friend who just has an as needed script for a small amount of an opioid and it helps them. I think it is great for chronic pain, it’s good for use in the ER. It does have its medicinal value. It is wrong of us to think that people should never use an opioid because that is not, even in an ideal world, what we are striving for. I think for being a person with disabilities, if I show up to the ER and I am talking to them about my pain. There is very frequently times where before I even go into depths about my pain, doctors are like “I am not giving you drugs by the way.”

I can’t take opioids, they actually make me really sick. That’s in my chart, but doctors don’t always understand that. You can get labeled as pain seeking or pain medication seeking. This can limit your access to care for everything else. So a lot of people with disabilities are heavily targeted by the stigma of people who use drugs. You know, if what we are doing is trying to dismantle that stigma around people who use drugs, it also dismantles the stigma around using drugs. One of the reasons why getting weed from a dispensary is so safe is because its controlled. Its a controlled environment. You know what you are getting. You have somebody to hold accountable. If it’s legal for you to process that then it’s something that you feel safe to be able to go to your doctor. Maybe say to them “Hey, I think somethings not right with my weed.” Things like that, there is an accountability, there’s safety measures. That doesn’t happen with street drugs because there is no government entity that’s saying “ Yes, it is okay for you to be using’’ say meth for example. We don’t want you using it at all, so if you mention it to your doctor you can get arrested. That’s something where people aren’t going to mention that to their doctors. It impacts how they are cared for. Also, people who use drugs I think have disabilities in various forms. A lot of people have PTSD, or depression and are self medicating for that. Until we have access to healthcare for everybody it’s going to be something where people are going to be self medicating

because they don’t have access to a doctor to begin with. To say “Hey I need help.” Even if they want to do that or they try something because of a doctor’s recommendation, say you get a script after surgery, they are taking it as directed, but then the prescription gets cut off very suddenly. There’s no protocol for you to be tapering off of it. That’s there’s no way that doctors manage that. That’s something where they’ve given you that, it is legal and you’re fine to have, but then they cut it off very suddenly. All of a sudden you are going through withdrawal affects even though you thought you were just taking a simple thing to help with your pain after the surgery. That’s stressful, and so then people start going to street drugs. I hear stories like that over and over again. That starts off as something harmless and legal. If there were better regulations around when we were prescribing opioids. What we do when people are prescribed opioids, and give them the support they need to understand what dependency can look like. Then help them taper off of drugs and provide them with the support they need to navigate that process. Instead of stigmatizing them because you cut off their prescription and are expecting them to not go out and seek other drugs. You just want them to go through withdrawals on top of still being in pain that was initially started from that surgery they just had.

So, there are a lot of people who are disabled, who are using drugs and do so in a very healthy way. They should continue to do so. There are also a lot of people who are disabled and using drugs in unsafe ways because they don’t have access to the care that they need to be getting that help. It’s rampant with ableism and stigma against people who use drugs. Again it is one of those things that are heavily interconnected. One impacts the other. If you are someone with chronic pain and you want something to help with your pain, one doctor may say “ Oh, you’re pain seeking, you can’t have this.” Another doctor might say “Here, have a script for thirty days.” Then they leave you with nothing. I’ve had some experiences with pain management doctors who’ve really offered no support in that regard. Other doctors are even afraid to give me medication for anxiety because they are afraid that I’ll abuse it. Despite wanting me to control my anxiety. There’s the two sides where they are so terrified of addiction that they don’t want to give you any tools to avoid you becoming addicted but not managed. That’s something that harm reduction tries to focus on is that we become healthcare providers essentially for people. Where we are referring them to a specialist, like an organization that we know will readily provide them with the care tools they need. Possibly the medications that they need to help them taper off of the drugs that they

are using. Or to get that drug to them in a legal manner. To make sure that they are safe while doing so and provide them with care. We often become experts about these drugs. We are like “How much Suboxone are you on?... Well, you will need to taper off of that before it’s really safe for you to quit cold-turkey.” We have a lot of people who worked in the recovery coach field, and recovery services. So, they know about these things and are very aware. It’s providing people with the support that they need. Ideally if we had better access to healthcare, then it wouldn’t be an issue for people to not have really good readily available treatment. But again, we still need to dismantle the stigma around people who use drugs before we can start to dismantle some of the ableism that comes from being a person who uses drugs in a way to support your disability or to help with your disability.

How has Harm Reduction impacted your life in regards to ableism and homelessness?

Harm reduction, we do it in our day to day lives all the time. It’s not safe to get into a car but we put on a seatbelt anyways. We have fancy exteriors and these nice airbags. We take that risk, but we do so in a safer way. We see it everywhere in our day to day lives, from some pretty common things that we mention when we think of harm reduction. In these conversations is usually about you know, fentanyl testing strips or narcan, and new syringes. But also things like condoms, and those are something that we frequently have on our table. We also have Plan-B and we give it out for free, provided by one of our partner organizations. Harm reduction is something that is so ingrained into our society that it has become a common place, but there is a socially acceptable form of harm reduction. Even things like condoms still have these huge amounts of stigma attached to them. Mostly because there’s still stigma around sexually transmitted diseases. So, because of the fear of sexually transmitted diseases condoms aren’t used as often. Which is a paradoxical way of how things work. It’s because people are afraid of them that they don’t want to talk about something that could prevent it, and those conversations never get started. Then that safety isn’t met, that need isn’t met. Things like that also happen with harm reduction in terms of drugs. We are afraid of an overdose. We are afraid of dependency on a substance. So in turn we don’t want to talk about those methods like safe consumption

sites that might save lives and help keep people safe. Because we are afraid of those big scary red flags. I think that there is a culture around our society that doesn’t like to be too uncomfortable. Some of those harm reduction things aren’t always super comfortable to initiate, but once they become a common place are very comfortable and very easy to do. You understand that it is a safety measure. There are so many safety measures that are everywhere in our day to day lives. I am trying to think of more examples... Like it’s dangerous to cross the street, but you got traffic lights that tell the cars when to stop, then for you to walk. You still take a risk when stepping onto the road, but you are still doing something that is ultimately safer. It has become a common place of understanding that we are all going to follow these rules. We understand that it saves lives so we are going to do it. A lot of legislation is based around those things. It’s why j-walking is illegal because they understand it is an unsafe practice in most legislative areas, like judicals. There’s an understanding that there’s things that are inherently dangerous about our world. There’s lots of things that are big and scary and dangerous. Nobody wants to get hit by a car. Nobody wants to be in a car accident. Nobody wants to die of an overdose. Those things that we do to make our lives a little bit safer can be an uncomfortable transition, but it’s better for the greater good of society. There are so many ways that harm reduction impacts our day to day lives.

Some of them are kind of silly because they seem like things that should go without saying, but not everybody knows those things. Don’t drink shampoo, for example. Don’t pour the chemicals under your sink in your eye. Those things are harm reduction labels. They advise you not to do something that might create more danger in your life. Creates more risk, but reduces the harm by saying “Hey, don’t do that.” We as a society could be so much more accepting of the harm reduction that we are afraid of right now. I think most people when asked “Do you hate people who use drugs?” They might say “Oh yeah, I hate people who use drugs. I hate junkies, we don’t want them in our lives.” But, If you ask them “Well, do you hate the person or do you hate the drugs themselves?” They are like “Well, yeah of course I hate the drugs. The drugs make them into a bad person.” You wanna know why. When you press further to the root causes of some of that stigma around people who use drugs it often comes back to an inherent fear of losing somebody. It’s often about losing somebody to an overdose, or them becoming dependent on a drug. Not being who they normally are. It’s heavily related to loss. Humans are social beings, we create ties to people. That’s how we survive. So of course we don’t want to lose somebody. When you start thinking about it in the sense, like “Well I’m more afraid of the loss of people who are close to me. I don’t want my kids

to become addicted to drugs because I don’t want to lose them.” It’s an understanding that there’s ways to prevent you from losing them. There’s things that you can take. Those proactive steps you’re taking are harm reduction, that’s what they look like. You look at some of the studies around safe consumption sites in other places, like Canada. Where their are safe consumption sites have zero deaths. That’s something that is unheard of. In Bangor, when we look at hundreds of people dying each year to drug overdoses. Thousands in decades, most people know somebody who has been impacted and affected by that. Most people will know somebody who’s overdosed. A lot of people know somebody who’s overdosed and died. These things are perfectly preventable. It’s really hard to see that happen and know that. There’s this change that could be made, but it makes people a little bit uncomfortable to bring that up. It makes them uncomfortable to have to address that they are afraid of that loss. They are afraid of losing people. When we start talking about those feelings, it creates an open dialogue where we say “Hey, there is something you can do about this.” You set them up with a plan of harm reduction. Which hopefully they can carry it everywhere in their life. To help people make healthcare choices however healthy looks to them and for them. Hopefully people are safer because of it.

That we don’t lose as many people. It’s this very cyclical thing. We just need to break the cycle of immediately saying “I hate people who use drugs because they are using drugs, and drugs are bad.” Understanding that we don’t like the drugs that they are using because of the outcomes. We don’t just hate the drugs by themselves. The drugs by themselves aren’t doing anything wrong. They are not inherently hurting people just by existing. It’s the people using them safely that’s causing the issue. We are just filling In those gaps, and it’s something that really needs to be discussed in openness to understand your feelings about it. It might be hard. It might be hard for you to talk about. It might be a sensitive topic. It might be something that has affected your life very personally. You might have lost somebody to drug use. It can create this very inherent hatred of that loss. Understandably so, but then you start to hate other people who are using drugs. Even if they are doing so safely. This is not what is keeping people safe. It’s not what’s keeping people alive. So we have to take time to address those uncomfy feelings and get it out on the table. We figure out, like “Its okay. Harm Reduction is there for us. We can make this safer. It doesn’t have to be dangerous. We don’t have to lose people.”

Episode 2 Lets Talk Substance: Episode 2 is about the organization Maine Access Points and their work around naloxone distribution. Anna McConnell, co-founder of Maine Access Points addresses the impacts that the War on Drugs has on rural populations. Having experienced multiple Harm Reduction movements , Anna accounts personal stories of her journey creating MAPS. She discusses the beauty and the hardships the her communities are facing, and how MAPS is trying to aid that.

Being a co-founder of the organization, Anna has had close contact with many budding Harm Reductionist including myself. I have learned many things from her and the MAPS team. Working and distributing with them this past year has been very eye opening.

Anna, luckily, is somebody I have the pleasure of knowing. She is an incredibly positive and caring person who dedicates their time to mutually aiding their community through Harm Reduction and outreach practices. MAPS Form (Dec, 2019) Ollie McGowan Maine Access Points has many volunteers including myself. This form is for Naloxone trainers to give to their trainees after they have completed their training and received a naloxone kit. This form helps MAPS to keep track of how much Naloxone is being distributed.

One thing I’ve learned more recently is in thinking about the intersectionality of the Harm Reduction movement with our other movements. Whether it is reproductive justice. Whether it’s racial justice. That like the emphasis on autonomy and self determination is really this throughline that connects our movements. You know for me personally, I think having a critique of the ways in which people experience oppression and the ways in which exploitation links our shared experience. I am trying to say that the Harm Reduction movement is so linked to our other struggles. The fight for autonomy, for self-determination, for justice of our bodies, of ourselves and of our communities is a fight that is so shared throughout the reproductive justice movement, throughout the racial justice movement. We have this shared vision. It is actually about fighting for a society in which we get to be free. That that freedom is like living in a world where we are not actually exploited. Where we are not experiencing oppression. That is a very big idea. So Harm Reduction I think, in the most important sense, is connected and rooted in our other movements. In some ways I think when the Harm Reduction movement gets isolated to only drug user health issues we lose the vision. Of fighting for the world and the society in which we want to live. But, Harm Reduction is really important. I think Harm Reduction is a place we actually have to begin.

We have to begin with meeting people’s basic needs. That looks like syringe access services. That looks like naloxone distribution. That looks like safe consumption sites. We are literally in a mode of survival. We are surviving. We are doing everything we can to stay alive. That is the state of the world that we are in right now. We are fighting for these basic needs, for our basic survival. At the same time we are fighting for so much more than that. It is through that struggle. It’s through creating these basic services that we are actually like building communities that have the power to fight for so much more. I think that’s where Harm Reduction has so much potential, and so much power. Is in our rooted organizing and community organizing that we start to envision things that we have never envisioned before. We’ve never figured out how to have a safe consumption space in Portland, but we are going to. It’s going to happen. It’s happening through that process of organizing and community. I think it’s so beautiful the ways in which we are fighting for the day to day, but through that experience are fighting for our future.

How do you view Harm Reduction?

What is a safe consumption site? How would that along with naloxone distributing help our communities?

A safe consumption site is a place where people can use drugs safely. With the support of trained, usually medical professional or peer trained staff. Who would be available to respond to a medical emergency, like an overdose or seizure. Be able to support that person in staying alive. Getting the care that they need in that moment. It is also more than that. It’s also a place where people can come and connect to other people who love them. Who are wanting to spend time with them. To have a community and hang out. Safe consumption sites are like, in the best, most beautiful way, a place for people to be and to be safe. Using drugs is a part of that, but is also so much more than that. When we look at our mentors and our leaders, like in Canada who are running these beautiful peer run safe consumption spaces. This is like what we are fighting for. These places where people can just be and be safe. Not be harassed by the police. Not be alone. Not be afraid that they are going to die in a bathroom in Starbucks. We are fighting for those spaces to exist. I think in Maine, one of the challenges certainly is the rural nature of our state. How geographically distant people are from each other. So Maine Access Points was really an organization that we started very intentionally to provide services in those rural places. We knew that there were people like Portland OPS and the Portland Needle Exchange who are doing beautiful organizing work in Portland. There’s similar organizations in Bangor. Through the Health Equity

Alliance, Needlepoint Sanctuary and other kinds of drug user-led organizing work. Our intention as MAPS or Maine Access Points was “Hey in all of the places outside of Bangor and all the places outside of Portland, we need to start to make some naloxone accessible to people.” To start to build a network of support and care that can exist and sustain in our places that are smaller. That are more geographically distant Where people are more isolated. Not to say that drug users aren’t isolated in Portland because I think that is still true. Certainly it’s much more accessible to access safe injection supplies and naloxone in Portland rather than in Princeton Township. But through building this kind of rural based network we’ve been able to form some of these relationships to make those supplies at least more accessible. The Harm Reduction movement in Maine is going to be simultaneously developing these kind of city based interventions, like safe consumption spaces. That’s going to be transformative. Knowing that safe consumption spaces aren’t necessarily the tool that are going to be useful in our smaller towns. What do we create alternatively to be able to meet the needs of people who are more geographically isolated. Both of these things need to be happening at the same time. I think we are slowly kind of starting to do that, but the interventions are going to look very different in different places. Right? Depending on people’s access to transportation, people’s access to physical space. Right? It’s going to look very different in different places.

“We have to begin with meeting people’s basic needs. That looks like syringe access services. That looks like naloxone distribution. That looks like safe consumption sites. We are literally in a mode of survival. We are surviving. We are doing everything we can to stay alive. That is the state of the world that we are in right now.”

Anna McConnell (Episode 2: Maine Access Points)

How do you view Harm Reduction?

The biggest thing I want everyone to remember is that the best people to distribute naloxone are people who use drugs. Okay? Period. Not Cops. Not Doctors. Not your Counselor. People who use drugs are the best people to distribute naloxone. This concept is something we are very much fighting for, right now, in the state of Maine. As there has been more acceptance of Harm Reduction or willingness to support Harm Reduction from the level of the State, from hospital institutions, from the kind of powers of funding and organization. People have kind of bought into naloxone as an effective intervention for the overdose crisis that we are in. What we’re fighting for now is that we actually retain some power in resources as an organization. So that drug users are the ones doing this work. One, because drug users started this work, okay? This whole intervention of naloxone distribution, of access to sterile injection supplies, of safe consumption spaces. Harm Reduction started by drug users. Has been maintained and runned and fought for by drug users from the beginning. One, this is our intervention. We started this. Two, we are the ones that are connected to people who are in need. Not doctors. Not cops. Not our institutions. What we are seeing know is on the one hand we are really excited that people have recognized the value of the work we do. But on the other hand we are having to defend the work that we

created. To say that we are really the ones that should be funded to do this. I think the challenge and the beauty of what we are doing is we’re deinstitutionalizing this stuff. We are saying that this is actually just a basic thing that we as non-medical people can do to care for one another. We can train each other. We can carry this medicine. We can respond to overdoses and save each other’s lives. We don’t need doctors and cops and paramedics to do it for us. We have the capacity to do this and not only do we have the capacity, but we build this network of trust so that we can actually connect with the people who are the most at risk. I know that people who are isolated and who are using drugs are not going to be talking to their doctors. They certainly don’t want to interact with the cops. We have to respect that because drug use is criminalized. People are uniquely harmed by the War on Drugs. Therefore we live in a world in which drug users aren’t able to connect to the systems, the institutionalized systems that exist. People aren’t safe connected to their doctors always about their drug use. People aren’t safe connecting to the police or connecting to EMTs. What we know is that people are safe when they can connect to peers who they trust. That we have these networks that already exist. We already have these networks of care and support and love that exist. By utilizing those for an avenue of distribution. We can utilize it as an avenue for connection. We really get to meet the people who

are most in need. Itâ&#x20AC;&#x2122;s beautiful that there is this willingness to have more training. That in general is I think a really positive thing. That the narrative has changed around naloxone. That it is considered more universally accepted. I think that narrative is good and thatâ&#x20AC;&#x2122;s a move in the right direction. The reality is however that we need to make sure that drug users are really the ones that are benefiting from the kind of shift in the narrative. That we are getting into the hands of people who are most in need, not just concerned citizens. I think that it is important that concerned citizens should be able to access this medication if they need, but this isnâ&#x20AC;&#x2122;t created for concerned citizens. This is created for drug users.

What is Naloxone? What does it do?

Naloxone is the generic name for brand name narcan. Basically, naloxone is this really amazing medicine that works as an opioid antagonist. It works only to reverse an opioid overdose. It goes in the body, it goes in the brain. It replaces the opioid on the receptor on the brain. It takes place for about 45 minutes to an hour and a half. During that time, it allows the person to start to breathe again and become conscious. Return from the overdose experience. One of the amazing things about naloxone is that it doesn’t have any other harmful effects of the body. If someone is not having an opioid overdose it wont hurt them at all. That’s a big question we get a lot is “Well, What if I find someone who is unconscious, but maybe they had a heart attack or maybe it’s a diabetic coma?” You can still give them naloxone and it probably just won’t do anything. It wont reverse the heart attack, it wont reverse the diabetic coma, but it’s certainly not going to have any harm. It is always safe if you find someone who is unresponsive. It’s always an appropriate intervention to give them naloxone, just in case it is an opioid overdose. It won’t harm anyone. It won’t harm that person if you give it to them. Because of the unique way naloxone only affects the opioid receptors, it’s an incredibly safe medication.

works so uniquely in the body that we are able to really confidently carry this medicine, use it, and save people’s lives with it. In some ways, you know, what’s interesting about the history of naloxone is for many many decades, it was held exclusively in the realm of medicine. Only doctors and paramedics had access to naloxone. When someone had an overdose. When you went to the hospital they would give you naloxone. For many decades, since the 60’s when naloxone was first manufactured, you could only access it in a medical setting. It wasn’t until the late 90’s that a really radical Harm Reductionist said “Hey! Why don’t we have this medicine? Why do doctors and paramedics get this medicine? But meanwhile I just watched my friend die or my partner die when I could have given them this medicine.” It was through that radical organizing work through serious civil disobedience that people acquired naloxone and started distributing it.

Which is why we are able to carry it, use it, distribute it, train others in the way that we do. If we had a medicine that had side effects or other potential negative effects then we wouldn’t be able to run the kind of program that we do. But it’s because of the way in which it

For the future, What do you hope for in regards to Maine Access Points and drug policies?

I am really glad you brought that up. I think it is hugely important that we center the multiple needs people have for syringes. Syringes are used for a lot of things. We really just are fighting for universal access for everyone, for any need. Testosterone injections being one of them, but there being many reasons that people need access to sterile injection supplies. This is not just a drug user health issue, this is a trans health issue, this is a queer health issue. We have to think about it in that way. When we are looking at the policies I think... A, we definitely need to abolish the criminalization of syringe possession. Currently under Maine law, eleven or more servings is considered criminalized without a prescription. If you could get a prescription. If you can get how many at the pharmacy, then it would be fine. But without a prescription, if you have more than ten it’s considered a criminal charge. That is a huge issue for people who need access to injection supplies. Also, you mentioned the one for one needle exchange clause. We know that one for one needle exchange is a completely ineffective public health policy. That it only increases rates of disease transmission. That in fact, it doesn’t even reduce the rates of improperly discarded syringes. When we have one for one needle exchanges in our communities, we are not helping anyone. We are making it difficult for people to access sterile supplies. We are actually making it more likely that people are going to improperly discard of syringes because they are unable. Because of the law we

have, which criminalizes syringes possession, even if people are incentivized to bring them back. People don’t want to hold onto them because they would be considered evidence of a criminal charge. People can’t hold onto twenty, thirty, forty used syringes to bring them back to the needle exchange because they fear that having more than ten is gonna be considered a legal case for them. Under our current laws in which we have both the criminalization of syringe possession and one for one mandated needle exchanges. We’re really like shooting ourselves in the foot because people aren’t able to carry the used supplies that they would need to be able to access new ones. If that makes sense. What’s happening is for the people who can access the preexisting needle exchanges, they are rarely able to get enough to meet their needs. What we know is most people who are injected are reusing syringes on a regular basis. It’s kind of ubiquitous at this point that people would reuse their own syringes. How many times is another question, you know. Some people are only reusing them five times, other people are reusing them for a whole month. It’s a variable in terms of what what access people have to get new stuff. We really really really really need to prioritize this. I think this is one of the biggest issues in the drug policy and Harm Reduction movement right now. We are living in an epidemic of Hepatitis C. People are kind of increasingly hospitalized for skin and soft tissue infections and endocarditis. It is like

as much of a public health emergency as the overdose crisis is. I think kind of decriminalizing syringe possession, making it and abolishing the one for one rule. So that people can access as many supplies as they need. It has to be kind of top on our list of to-dos because until that happens, people are going to keep struggling. We are just going to keep seeing the rate of Hepatitis C and other infections rising. There is definitely so much more that we need than that too. Continuing to fight alongside Portland OPS and fighting for safe consumption spaces is going to be really important in the city of Portland. We need these like newer systems of support and care to be able to save peopleâ&#x20AC;&#x2122;s lives. I feel like until we make it universally accessible to people, for people to have safe injection supplies, I donâ&#x20AC;&#x2122;t know where we are going to go from here.

Outro I wanna end on a positive note… which is that… We are doing this! Our community is making the most beautiful and incredible progress. We are demanding our livelihood. We are demanding our safety. We are demanding space. We are completely changing the ways in which our communities are thinking and talking about drug use and about drug user health. We should feel so empowered to like to keep fighting for our movement. It is incredible in the last three years that I’ve been in Maine, how much our things have changed. Unfortunately that is in the context of so much loss and so much grief. One of the things that I know. That I’ve learned is to be able to hold that grief. To be able to sit in that grief. To recognize like who are our comrades, who are our people who we are going to change this with. In doing that

and in building these relationships and seeing each other fully. The full humans that we are and hearing our stories. That we are starting to actually change the conditions of the world in which we live. We are going to abolish these laws. We are going to change them. I am really inspired and grateful for you, for the work that people are doing throughout the state to be in solidarity with me. And be in solidarity with each other because I know that we are doing it. We have to stay grounded in our collective vision to really have a collective liberation. I am really very grateful to be a part of it.

Podcast in Progress

Episode 3 Lets Talk Substance: Episode 3 is about the stigma placed upon mothers use drugs. The discussion with Cait Vaughn, a harm reductionist and healthcare provider, explores the concept of accepting mothers who use drugs. Women, in general, are judged more harshly than male identifying individuals. Based on this stigma, mothers are given a harder standard to uphold than father in regards to taking care on the children. because both using drugs and reproductive rights are considered controversial topics, marginalized groups are equally affected by this stigma.

are better off with their parents. Speaking from experience, Cait Vaughn accounts her experiences with Harm Reduction and hoe she became an advocate for mothers who use drugs. Luckily I have had the pleasure of working alongside her in Portland Overdose Prevention Society. She brings a lot of passion, knowledge, character, and love.

Cait Vaughn addresses with me the idea that in many cases the child wants to stay with the mother. That separation is traumatic and most times children

MAPS Form (Dec, 2019) Ollie McGowan

Maine Access Points has many volunteers including myself. This form is for Naloxone trainers to give to their trainees after they have completed their training and received a naloxone kit. This form helps MAPS to keep track of how much Naloxone is being distributed.

What is Next? During this time of COVID-19, the question â&#x20AC;&#x153;What is Next?â&#x20AC;? can seem daunting. Many are unsure of the next steps they will be taking since the pandemic is so unpredictable. Even though the pandemic is in full swing, I do plan on staying in Portland to continue my Harm Reduction and activist work. Lets Talk Substance is only the beginning of what can be achieved within the Harm Reduction community. I am very grateful for the people that took the time to talk with me, to critique me, and to support me. This project is far from over and I feel that it can expand in many ways.

Need Naloxone?

Text 207-319-8823 Maine Access Points

This book was written and designed by Ollie McGowan (circa 2020) Submitted in partial fulfillment of the requirements for the degree of Bachelor of Fine Arts, Maine College of Art, Portland Maine, May 11, 2020 Major in Graphic Design. Colophon set in 20, 40, & 60 Avenir