Due to my mistaken belief that there was a legal restriction on picking up more than a 90-day-supply of Schedule III drugs in my state, as is the case in many areas, I assumed that I wouldn’t be able to get six months’ worth at another pharmacy and didn’t bother to try.

But I wasn’t too concerned about getting more. Considering I’d been officially diagnosed with gender dysmorphia in the States, had undergone gender-affirming surgery and had taken hormones for years already, I thought that finding a new doctor to continue my care would not be difficult. I assumed I could simply ask the school doctor for a referral to an endocrinologist, who would continue prescribing my testosterone.

I was wrong. It turned out, I would first need an official diagnosis of gender dysmorphia from an Italian specialist. The waiting list for an appointment was quite long. Thus, when my medication ran out around finals during my first semester, I found myself forced to acquire a new three-month supply, through means which shall go undescribed for legal reasons.

By the time they finally gave me the papers, I’d run out of my meds again. And this time, I had no immediate way to procure more.

Once my appointment for a diagnosis finally came around, things seemed to go well. They assessed me for various mental health issues and asked me a long list of questions about my gender and sexuality. The well-documented nature of my gender and transition certainly helped. But smoothly as the process went, it wasn’t exactly quick.

My initial appointment was simply for intake; I was then required to make another for the tests; and a third just to be presented with my diagnosis. For some reason, that diagnosis-and-paperwork appointment was also delayed by about two weeks.

By the time they finally gave me the papers I needed in order to book an appointment with an endocrinologist—months away—I’d run out of my meds again. And this time, I had no immediate way to procure more.

Unsurprisingly, the sudden cessation of a medication I’d been taking since April 2021 made me quite sick.

Already, when I took my final injection in March 2023—a quarter of the usual amount—I was extremely out of it, having cut back to preserve my dwindling supply. I felt achy and gloomy.

Usually, I spend hours reading and doing homework in the mornings. But without testosterone—and even with extra tea—I mostly just sat around feeling depressed. A heavy, dense “brain fog” descended. I could barely follow lectures or conversations. Speaking or reading any language aside from my native one became almost impossible—not helpful when you’re studying classics and seeking to communicate with friends who don’t speak English.

I was plagued by wretched headaches. I rapidly lost the strength and weight I’d gained in recent months.

I even temporarily fell out with one friend, who was baffled by my extreme tiredness and sudden inability to form comprehensible sentences in Latin—the only language we share, and one he had helped teach me, making my struggles seem like a personal affront. I hadn’t yet come out as trans to him, and my attempts to explain the situation without outing myself before I was ready only made him overly concerned about my health.

I made ditzy mistakes when trying to work, and was barely able to keep my head up in class due to exhaustion. I was plagued by wretched headaches. Attempting to exercise was hopeless. When I tried to do push-ups, my muscles hurt and seemed to lock up, causing me to sink to the floor. I rapidly lost the strength and weight I’d gained in recent months. My insomnia also worsened significantly. This, on top of everything else, led me to be on edge and snappy.

Despite the perfectly logical medical explanation for all of this, I felt like an absolute failure. 

I also feared that the symptoms would last forever, or at least until my body started naturally producing standard amounts of “female” hormones again—a thought which terrified me, because I desperately hoped to avoid menstruating. Assuming that this situation could last several months, I feared that I would fail my exams if I remained in this state.

During those long, lonely, sleepless nights, I began googling the matter. This led me to various anecdotes and evidence that yes, testosterone withdrawal exists. But I also found out that some of my worst symptoms were likely to last only around a week or two. Having a timeline soothed me significantly; pain is more bearable when you know it’s temporary. Being able to count down the days gave me some sense of control.

Around a week before my May appointment, I got my period for the first time in years.

Still, even after my acute withdrawal symptoms ended in April, I didn’t feel like myself. The exhaustion and insomnia never quite resolved. I begged the school doctor to help me find a specialist who could see me sooner than the one I’d booked for June. Thankfully, he managed to call in a favor on my behalf, bringing forward my appointment to early May—critically, before my exams.

Around a week before my May appointment, I got my period for the first time in years. The pain seemed much worse than previously. I dealt with this as best I could, borrowing hygiene products from my roommate and downing over-the-counter pain relievers. The psychological pain wasn’t as bad as I’d feared, perhaps because I’ve had top surgery and “pass” pretty well. I could bear it, although I would’ve preferred not to.

The appointment itself went surprisingly well. Somehow, the doctor was wholly unaware of my recent struggles to access my medication. When I told her I hadn’t taken hormones in five weeks, she told me I could take my next dose as soon as I got home. She prescribed me a four-month supply, sending the prescription to a sleek, well-lit pharmacy only a few blocks away. While a six-month supply is standard in Italy, she wanted to see how I was feeling on that dose and order blood work before prescribing more.

This prescription was for a monthly injection, as opposed to the weekly one I’d been on before. I’ve found this much more convenient because I don’t need to take my meds and needles with me when I travel. Also, getting needles and syringes turned out to be extraordinarily easy: In Italy they’re over-the-counter, so you just have to walk into a farmacia and ask for the right size.

Unfortunately, it took multiple months of being on medication for my periods to cease again. And even now, although I feel much better, I’m still working on rebuilding the muscle mass I lost.

Why can’t they just let us take our meds in peace?

Things turned out fine for me eventually, largely because I’m privileged enough to be able to access doctors. But a more understanding attitude towards hormone prescribing could have averted months of strife.

I’m allowed to carry bulk bottles of the deeply unpleasant and potentially dangerous amantadine I was briefly prescribed for my tardive dyskinesia. Pharmacists never insisted on only giving me three months at a time. Why not treat testosterone similarly? The same question stands when it comes to limits set by insurers.

Privileged kids who move to Italy to study have little to complain about compared to many other people at risk of losing access to necessary medications and experiencing debilitating withdrawal, as well as the pain of watching your body soften and become feminine again. Many transmasculine people experience far worse, when testosterone is criminalized in many contexts in the United States.

The DEA’s threats to end telehealth prescribing of controlled substances pose a serious danger because so many of us access our care through Planned Parenthood and other telehealth services. At the moment, telehealth prescribing has been temporarily extended through 2024. But thanks to right-wing outcry and attempts to restrict gender-affirming care, many patients—minors especially—are already losing access to the medications they need.

This is all in spite of—or, perhaps, because of—the fact that gender-affirming care significantly lowers the risk of depression and suicidal thoughts amongst transgender people.

Why can’t they just let us take our meds in peace?

Photograph by M.L. Lanzilotta

The post How I Was Forced to Go Through Testosterone Withdrawal appeared first on Filter.

This is not surprising. We live in a culture where many people still believe that using illegal drugs—and sometimes even legal ones, like cigarettes—is utterly shameful. There is this assumption that if you use certain drugs, you cannot by definition be a good person. You must be a thief and a liar, not to mention prone to unprotected sex and riddled with untreated diseases (I’ve been accused of all this by doctors and others). This kind of vicious thinking saturates media depictions of drug users, as well as conversations and discourse in general.

Family members, and friends I admired greatly, told me, for example, that my drug use would inevitably lead me to become homeless. They insisted that I would never be capable of anything—ignoring all the art and writing I produced whilst I used (I didn’t allow my drug use to get in the way of my hobbies and passions, which is one reason I don’t consider it to have been an addiction).

I was unprepared for how much the stigmatization I’d suffered would continue to shape my interactions with the world.

One relative furiously yelled at me that he couldn’t believe a word I said, because my opioid use meant every word that came out of my mouth must be “bullshit.” It didn’t matter that I always did my best to be direct and honest. Indeed, I struggle to lie or keep things to myself, particularly when asked a direct question, perhaps due to my autism.

The vile, dehumanizing stereotype of the junkie is so intensely ingrained that even people who loved me couldn’t see past it. No matter my actions or how carefully I managed my drug use, they reduced me to some hopeless cliche from a lurid Lifetime movie.

This all left me, as you can imagine, with pessimism and mistrust as constant companions. In 2021, as I have described in Filter, I phased illicit drug use out of my life. I expected this decision to have costs as well as benefits. But I was unprepared for how much the stigmatization I’d suffered would continue to shape my interactions with the world.

I had seen all too clearly, for one thing, that my place in my family, as well as elsewhere, was dependent on whether I conformed to other people’s idea of normal and right. That’s no great revelation, for sure—conformity under threat of shunning is a human social mechanism even in supposedly tolerant or enlightened circles.

But the brutality of how I discovered that love was conditional—that even striving to meet other imposed standards, like working hard and achieving things, would not protect me from the withdrawal of affection and support—continues to reverberate as I move forward in my life.

Coming out as trans, for instance, was made even more difficult by my terror that my family would once again decide I didn’t deserve to belong. I knew that they considered being gender diverse, like drug use, more than a little scandalous.

Since family members had so regularly thrown out my naloxone and other harm reduction supplies, I did not tell them I was going on hormones until after I’d begun the medication, because I feared they’d take it from me.

Thankfully, they didn’t do this. To my surprise—even while instructing me to keep my transition from my beloved, now-deceased (Catholic) grandfather—they’ve actually picked up my meds for me at the pharmacy, and helped me find coupons back when insurance refused to cover my testosterone. It has gone about as well as I could realistically have expected.

Whenever I set foot in a doctor’s office, I might as well be in an interrogation cell for the way it makes me feel.

But my fear has yet to subside. I still do not trust them with much information regarding my health, something that certainly frustrates them, but that is wholly rooted in their reactions to my drug use. 

My relationship with medical practitioners has remained similarly damaged, due to the cruel ways in which I’ve been treated by doctors. I was once thrown out of the office by a family doctor I’d been seeing for years, because someone told him I “had a little problem with opioids,” and he assumed I was high (I wasn’t). And since quitting drugs, I have retained intense anxiety about disclosing anything in medical settings.

I long ago developed the habit of seeking doctors unconnected with hospitals where my file still lists “drug abuse.” I have continued to avoid mentioning my history, for fear that practitioners will deny me the medications and surgeries I need to transition, and thus survive. And whenever I set foot in a doctor’s office, I might as well be in an interrogation cell for the way it makes me feel.

The fact that I’m white, educated and privileged has certainly helped me here, because nobody assumes that I used those kinds of drugs if they haven’t heard otherwise. I don’t know if I could have concealed my history if I were Black or poor. I’ve still found it hard. But the relative leniency I’m afforded makes me boil with rage at the unjust way in which others are treated.

When I first got to my university in Rome, where I study archeology, I lived in fear that someone would google me and find out about my history. Moving across the Atlantic to a faraway country so beloved by my grandfather, who’d spoken often in his last year of visiting once again, felt like a rebirth—a kind of bittersweet return to dreary kingly life after my five or so years as a junkie-poet Prince Hal. I was utterly terrified that this hope, this new chance at a peaceful and unremarkable existence, would be stolen from me the moment someone learned about my drug use.

Although I’d been told again and again that I would never achieve anything so long as I used opioids, I couldn’t shake the idea that quitting wasn’t actually enough. After all, I’m still essentially the same person as I was when I used, albeit more anxious and prone to mutism. If, back then, I wasn’t good enough to deserve or achieve anything, as so many people told me, then what had changed, really? 

On an emotional level, I’m still fearful that I’ll never be good enough. To compensate, I try much too hard.

Years of being insulted, degraded and treated as worthless have left me continuing to suspect that it was justified. Sure, on an intellectual level I know it was purely because I used the wrong sort of drugs. But on an emotional level, I’m still fearful that I’ll never be good enough.

To compensate, I try much too hard. I attempt to read up to 40 lines of Latin prose per day, and hate myself when I don’t. I’m taking six courses for credit and multiple others, including intermediate Latin and Italian (I was also taking beginner’s ancient Greek, but became so mixed up and exhausted that I had to drop the class). I’ve kind of constructed my identity around being as good as humanly possible at a dead language, perhaps because this is precisely the sort of thing that impresses people like my family.

Outside of my studies I hardly socialize, aside from email correspondences with Latinists and other studious types in faraway places. Perhaps foolishly, I am almost structuring my life around being the opposite of the character I was long assumed to be.

This pressure is exhausting. At times, I don’t know how to relax. I worry that if my grades drop, people will assume I’m using again, which I fear will prevent me from achieving the academic career I dream of. When I was in an abusive relationship in high school, my grades began to slip from As and Bs to Cs and worse, because in my despair I didn’t see the point of effort. My teachers accused me then of being “on drugs,” although I didn’t use opioids until I’d graduated and, at that time, hadn’t even tried alcohol, nicotine or cannabis.

I’m still afraid of such accusations. Nobody with knowledge of my past would believe me if I insisted that I wasn’t using. And some weeks ago a relative did accuse me of being high because of how languid I sounded on a phone call, presumably due to exhaustion. The stigma continues to haunt me.

If we hear for years that we’re subhuman or worse, our internalized shame may long outlive our relationships with drugs.

Slowly, though, I’m beginning to learn that my intense, obsessive study habits and lack of personal life are not wholly necessary. Even my teachers tell me to take breaks and go easy on myself, with one sternly warning me not to read or write any Latin over fall break.

And slowly, too, I have begun working up the confidence to disclose my history of drug use to friends who didn’t know, and to new acquaintances. Thankfully, nobody blinks. Some of my classmates even have a history of benzo, opioid or meth use themselves. Most drink or smoke.

Their acceptance is starting to teach me that I’m not some repulsive, unloveable outsider. It’s not enough to soothe my fears entirely. But I’m getting there. I’m slowly growing more confident. And in some ways, perhaps the strife and stress of those years has made me more resilient. If I can survive that, grad school probably won’t be too hard.

I understand why people dehumanize and degrade people who use drugs. They’ve been told that so-called “tough love” will compel us to quit. Many truly believe what they say, as well.

What they don’t see is that people who use drugs can and do achieve great things. But if we’re told that we can’t, we may come to believe it. And if we hear for years that we’re subhuman or worse, our internalized shame may long outlive our relationships with drugs.

Photograph of the Colosseum by Ank Kumar via Flickr/Creative Commons 2.0

The post A Year After I Quit Drugs, the Stigma Still Haunts Me appeared first on Filter.

On a similar note, just because someone is helped by a drug at one point in their life doesn’t mean that they won’t experience problems with it at another point. The opposite is also true, as evidenced by the many people who’ve recovered from addictive patterns and gone on to use positively. I was reminded of all this by a recent experience.

As I’ve previously written about for Filter, back in 2020 I began taking the antipsychotic Seroquel (quetiapine) off-label to treat the sleep issues that were one of the primary reasons I used heroin. By providing an alternative way for me to sleep normal hours on a nightly basis, Seoquel allowed me to eventually phase out my illicit opioid use.

I’ll be forever grateful for the stability this provided. Knowing that I would be able to sleep properly without having to rely on a product from an illicit market with all kinds of risks was such a great relief. Over the past year in particular, I’ve grown much healthier and happier.

Seeking treatment for my gender dysmorphia, in the form of hormones and surgery, has also helped me significantly. If I were still relying on heroin to sleep, I don’t know if I would’ve been able to access these life-changing treatments, because of the stigma people who use drugs face in health care settings.

Yet seroquel, like many prescription drugs, isn’t without its risks.

Instead of simply wobbling or twisting, my knees began folding beneath me, causing me to fall.

This past spring, I began to have some mild weakness in my legs. Occasionally my knees would wobble briefly when I stood for extended periods, causing me to stumble slightly. This was rarely severe enough to cause me to fall, although it alarmed my friends.

At the time I brushed it off as mere exhaustion. I didn’t think anything was wrong until the symptoms got significantly worse in early June. Instead of simply wobbling or twisting, my knees began folding beneath me, causing me to fall. My feet twisted to the side when I walked or stood, further destabilizing my gait. These symptoms were accompanied by a mild aching pain in the areas most affected. Soon, I also began having slow writhing movements in my hips and back, which interfered with my ability to stay upright.

After my psychiatrist examined me, she figured out what was wrong: I’d developed tardive dyskinesia (TD) as a result of the seroquel. It’s relatively common with antipsychotics in general, with prevalence estimated at about 30 percent among people who use the medications. And although I had been on the same dose for quite some time, these side effects typically appear after many months or years of use.

My doctor then had me taper off the medication over the next few weeks. I couldn’t just stop abruptly, of course, because I was physically dependent. This is not a sign that I had an unhealthy relationship with the drug, by the way. Physical dependence isn’t the same as addiction. It’s simply something that happens when certain substances are taken on a regular enough basis that your body, not your mind, comes to rely on them.

The pros had outweighed the cons. But that equation was reversed by the symptoms of TD.

In fact, I had long disliked taking the Seroquel. I hated the way it dulled my emotions, putting me into a kind of vague, distant state which occasionally interfered with my focus. But I was willing to put up with that particular side effect if it meant getting enough sleep each night. After all, my insomnia caused serious issues as well, particularly with thinking clearly and regulating mood. The pros, in other words, outweighed the cons.

But that equation was reversed by the symptoms of TD. No amount of peaceful sleep could justify not being able to walk normally.

The involuntary movements became significantly worse during the taper, which my doctor assured me was normal. I began carrying a cane to prevent myself from falling. Embarrassed by my condition and frustrated by how it inconvenienced me, I spent most of my free time at home, lying on the floor reading.

Luckily, once I was completely off of the seroquel my symptoms began improving. My doctor also prescribed medications which helped lessen their severity.

To my dismay, though, even after a month and a half of being off the seroquel, my movements still haven’t resolved. On my wobblier days I still carry the cane. While I loathe the parental and pitying manner in which people react to this, it’s better than having to regularly grab ahold of nearby shelves or walls or—even more awkward—people to avoid falling.

I remain hopeful that the symptoms will fade with time, although I know all too well that it can be permanent.

Despite the very real issues my movement disorder poses, I certainly don’t believe Seroquel should be banned. Nor do I hate the drug. Certainly, patients who take it should be aware of the potential risks. But this side effect is not inevitable. And if I hadn’t been able to take Seroquel to sleep, I probably wouldn’t be in the better place I find myself today.

Would I still be cycling between sleepless, dysfunctional phases of sobriety and calmer, healthier, yet nonetheless guilt-plagued and somewhat risky periods of opioid use? Would I have been able to transition or resume my education? I really don’t know.

There’s no cause for glorifying or demonizing any substance. We simply need to adjust the tools we use, based on the best information we have.

The other medications my doctor might have prescribed instead either couldn’t be used in the long term or were benzodiazepines, which she wasn’t comfortable prescribing to me. Those, too, come with potential dangers, particularly if mixed with opioids. Plus, since I’d been forced to take benzos as a chemical restraint in a hospital setting as a teen, I generally don’t feel safe taking them.

I don’t blame my doctor for what happened because every option carried risks, and TD is more often caused by older antipsychotics like Haldol. Still, I do think it is something that one must be aware of, if one takes the kinds of medications that can cause it.

So there you have it: Drugs—whether banned, legal or prescribed—all come with potential pros and cons, which must be weighed by both the person taking them and, ideally, their health care team.

There’s no cause for glorifying or demonizing any substance. A drug may have dangerous side effects and harm some people but that doesn’t make it worthless. Different people have different responses to the same substances. The same person can have different responses to a single substance if their circumstances change or, sometimes, for no discernible reason. We simply need to adjust the tools we use, based on the best information we have.

Photograph of the author courtesy of M.L. Lanzilotta

The post Seroquel Gave Me a Reminder That All Drugs Are Merely Tools appeared first on Filter.

This pervasive strain of black-and-white thinking erases the complexity of reality. It ignores the fact that some 90 percent of illicit drug use is not problematic, as well as the fact that most of the minority who do experience substance use disorder grow past it in time, without treatment. It neglects the importance of set and setting in determining our reactions to drugs. And it demonizes drugs and the people who use them—perpetuating stigma and fueling the drug war.

As someone who was “out” about my drug use from almost the beginning, I know this all too well. My actual behavior was never enough to convince people that I was honest. As soon as I told them that I used opioids, they believed that I was a monsterous cliche out of Trainspotting or The Basketball Diaries. They allowed media stereotypes about thieving, dishonest “junkies” to cloud their opinion of me, outweighing my actions.

This issue arose when I began looking into getting gender-affirming surgery.

Yet I had always retained the ability to make logical decisions and to manage my use. I used drugs not because I was compulsively compelled to do so, but because the pros outweighed the cons. For a time, drugs were the best option I could find to deal with various trauma symptoms and my gender dysmorphia. But once I found other, more constructive and legal ways to address these issues, drugs, for me, were no longer necessary.

So last year, I began phasing drugs out of my life without much effort. But quitting drugs wouldn’t entirely free me from the prejudices I’ve described.

This issue arose when I began looking into getting gender-affirming surgery. Even after months of hormones I still had, well, enormous knockers. Although my legs, shoulders, back and arms no longer bothered me, thanks to the way my body had become more muscular on testosterone, I never looked flat enough—no matter how many binders or how much tape I wore. My appearance caused me extreme distress. I had to avoid catching a glimpse of my torso in each reflective surface I passed. Showering or dressing was always a nightmare. Every interaction was made more stressful by my ambiguous appearance.

While all major operations come with risks, I figured that the potential gains outweighed the potential dangers. I therefore sought the surgery as early as I could.

During the process of finding a surgeon, I naturally spent a lot of time reading forums and other sources dedicated to such procedures. I learned how long the healing process was. Scrolling through photos of gnarly red scars, I also read that the pain could be quite significant in the days following the surgery. Being able to access adequate analgesics seemed fairly important.

More concerning to me was the climate around opioid prescribing, which has become another front of the drug war.

The idea didn’t trouble me. Although I don’t use anymore, I don’t identify as sober or “in recovery” either. After all, what would I be recovering from? Discontinuing my use was a practicality, not an ideological or moral choice. Not using drugs isn’t part of my identity, because I know that drugs are simply tools which can help or hurt depending on how they are used. I still drink occasionally, though very little because I dislike the feeling of intoxication. I’m open to the idea of trying other substances, such as psychedelics. And I’m happy to take controlled medications if they are prescribed for me in a way that makes sense. This includes opioids.

More concerning to me was the climate around opioid prescribing, which has become another front of the drug war. The overdose crisis and fears of opioid addiction have been used to justify severe restrictions on prescribing for pain patients who rely on opioids. Never mind that only a tiny fraction of such patients ever struggle with their opioid use. This has caused great suffering.

In these days of prescription drug monitoring programs and paranoia, I knew that my former illicit drug use was highly likely to be turned against me if I sought opioid painkillers. I’d heard talk of another trans guy who’d been denied proper medication after surgery because of his cannabis use.

I therefore chose a surgeon who was unaffiliated with any hospital systems likely to have marked me in their files as a “drug abuser.” I was careful not to mention my history of drug use to any of the nurses or doctors I talked to. In a better world, I could have been totally open with any health care professional I saw. But I had long been used to keeping my drug use to myself in such settings. Honesty, I had learned, is only the best policy if you want to be thrown out of offices and denied help.

About a week before he was supposed to perform the surgery, the doctor called my medications —an antibiotic, anti-nausea pills, and oxycodone—into the pharmacy nearest to my home. I picked them up four days before the procedure. Contrary to the stereotypes, I didn’t obsess over the oxys or struggle to avoid taking them. I simply placed them in a drawer with the rest of the meds. They remained there until the day of the surgery.

During the first day and a half after the operation, I took the pain pills every six hours along with my antibiotics. However, I disliked how dazed they made me. The constipation was also really getting to me; I’d forgotten how bad it could be.

As I write, they’re sitting in the same drawer in my bathroom, along with extra floss and various other items I rarely use.

So during the daytime, the pros of the pain pills didn’t outweigh the cons, and I stopped taking them. Although the pain was significant at times, I could distance myself from it by forcing myself to focus on the television and other distractions. It was the same tactic I’d used to cope with the pain of withdrawal in the past. At night I continued to take the medications, however, because I couldn’t distract myself from the pain and fall asleep at the same time. This enabled me to sleep decently despite my considerable discomfort.

Everything, as it turned out, went well. The surgery was successful and I’m pleased with the results. In fact, I’m far happier than I expected to be. I knew that it would help, but the degree to which I feel better has been a surprise. My daily levels of stress and discomfort are much lower, because I no longer find myself obsessing over avoiding mirrors or windows. I feel much more comfortable interacting with people. I’m misgendered significantly less than I used to be.

Without the pills, I would obviously have suffered more pain. I would’ve had a significantly harder time sleeping, which would have made me even more exhausted than I already was, and might have interfered with my healing. Certainly, it would’ve prevented me from looking after my drains or making food for myself.

Now that I’m feeling better, I no longer need them. A number of pills remain in the bottle, because I didn’t need to use them all. As I write, they’re sitting in the same drawer in my bathroom, along with extra floss and various other items I rarely use. I don’t plan to take them any more than I do the extra nausea meds. Why should I? I’m fine without them, and find the side effects too irritating to be worth the bother.

Despite all of this, some abstinence-minded people (and policies) would still frame my decision to take opioid pain medication as a “relapse.” Of course, such thinking ignores the context. My past use was not addictive because it didn’t interfere with my life and hobbies, and when it no longer worked for me I stopped. But even if my drug use had been addictive, taking pain pills as prescribed after a major surgery isn’t the same as returning to chaotic use. The bottle says “take every 4-6 hours as needed for pain,” and doing just that, regardless of the substance or any drug history, has nothing to do with addiction.

Nobody should be left to suffer because of society’s irrational fears.

I’m extraordinarily glad—and, in the context, fortunate—that my doctor prescribed adequate pain medication. Patients in general are all too often left without proper care due to fears of “overprescribing”—and for people who’ve used drugs, the odds are much worse.

This is inhumane. Nobody should be left to suffer because of society’s irrational fears. Restricting access to opioid prescriptions hasn’t done anything to stop ever-rising overdose deaths, which was the claimed rationale—in fact, it has exacerbated the crisis by reducing the availability of opioids of known purity and dosage, pushing people to riskier unregulated alternatives.

More broadly, viewing drug use in binary and reductive terms is nonsensical and harmful. We all use drugs in a spectrum of ways that vary greatly by individual and by context. Sweeping assumptions—that all drug use is addiction, that addiction is a permanent state, that all returns to use are relapse—dehumanize, infantilize and hurt us all. 

Photograph via RawPixel/Public Domain

The post No, My Prescribed Opioid Use Was Not a “Relapse” appeared first on Filter.

Over the past year, I’ve been moving away from using drugs. One factor is that now that I’ve finally found a sleeping medication I can safely take on a regular basis, I no longer rely on illicitly acquired opioids to sleep through the night. Being able to medically transition has also helped, by making my default level of anxiety and distress far less intense.

I was never addicted to drugs. I always maintained control over my use. From the very start, I took breaks, though these breaks were often quite miserable due to my sleep troubles and various traumas—which were another reason for my using heroin in the first place.

This isn’t to say that my drug use didn’t come with downsides. The price certainly caused issues for me. This was one of the primary reasons I took breaks, even though I was much less functional when doing so; I needed to prevent myself from spending more than I could afford by keeping my tolerance down. And despite being as careful as possible, buying drugs from the dark web and utilizing harm reduction practices, I was not immune from risks. I experienced some physical ill-effects due to prohibition’s impact on supply and the associated difficulty, at times, of obtaining sterile injecting equipment.

My attempt to fight stigma had a heavy personal cost.

Social stigma certainly harmed me, too. I “came out” about my use to everyone in my life and beyond, through YouTube vlogs and a series of articles. My attempt to fight stigma had a heavy personal cost. I was trying to combat negative stereotypes, but many people made clear that they saw me as eccentric at best and irresponsible at worst. People who didn’t even know me assumed that I must be lying when I called myself functional. Few people, I found, wanted to work with someone who openly used heroin. Strangers insulted me online, which occasionally caused me to despair, sometimes to dangerous degrees.

Phasing opioids out of my life, now that I have reliable sleep meds, was not anything I did purposefully or intentionally. Rather, it just… happened. The breaks between periods of use become longer and longer. At some point in late 2021, I didn’t bother going back to using because the potential issues that went with it didn’t seem worth the trouble.

This wasn’t as big a deal for me as you might imagine. Unlike the lads from Trainspotting, I never considered opioids to be the best feeling in the world. I found exercise significantly more pleasing. Sex, too, made for a more enjoyable diversion than shooting up.

Instead of using drugs to escape the pain of my past, to forget the abusive relationships and the involuntary commitments and the sexual assault, I poured my time into writing fiction. Social distancing in my childhood bedroom, I spent whole days in front of my computer typing.

This new occupation soon took on unhealthy aspects. I neglected hygiene and relationships. I failed to reply to text messages or answer phone calls, leading me to fall out of contact with most of my friends. I wrote from the moment I awoke to the moment I went to sleep, leaving time for nothing more. I managed to pump out a number of manuscripts in this manner, the majority of which I never finished.

Miraculously, one of my few complete projects, a historical fiction novel narrated by an autistic girl, somehow caught the eye of a manager, who now represents me. My near-addictive relationship with story-spinning was thus rewarded.

When high, I could do other things. I could maintain relationships and attend events. Now, my attempts to escape take up the majority of my time.

Still, I couldn’t help but feel that it had become more disruptive than my drug use ever was. I wrote partly out of a desire to create, to build something, but mostly because I wanted to avoid being bothered by the past. If I don’t divert myself, I find myself ruminating endlessly on painful incidents. During my opioid-using days, I managed to suppress these memories, keeping myself in a calm and dreamy state. But now I revisit them constantly, albeit through the lens of fictionalized situations based on my experiences. I mull them over in my mind, dissecting what I can remember, assessing it from different angles, trying to understand the effect it had on me psychologically.

Quitting heroin, in short, has removed some inconveniences but not solved my problems. I still feel as haunted as the protagonist of some dreary old gothic novel, now dealing more directly with my inner turmoil. When high, I could do other things. I could maintain relationships and attend events. Now, my attempts to escape take up the majority of my time. I’m far more antisocial. I am chilly and gruff, particularly with my family. The closest of my remaining friends has expressed concern, though he insists that he’d rather I write compulsively than use drugs that I could overdose on. I both agree and don’t.

I haven’t been able to handle Christmas since I was 16. That year, I spent the winter break in a mental health hospital after reacting poorly to a medication I’d been prescribed, leaving me confused and self-harming. During this time, I had a meltdown (as an autistic person, I experience this when I’m overwhelmed emotionally). The nurses, who had no experience dealing with autistic patients, failed to distract me—something that would’ve calmed me down instantly—and instead locked me in the ward’s Quiet Room. When this failed to soothe me, they gave me a chemical restraint that caused me to lose about 24 hours of memory. Every year since, I have dealt with the dreaded holiday by hiding or getting high.

Since I didn’t want to use, and had temporarily run out of the energy to write, I ended up spending most of the week of this past Christmas studying Latin. I read from Orberg’s Lingua Latina per se Illustrata while listening to the audiobook. I listened to some Latinist YouTuber read Ovid and Virgil for hours upon hours.

I didn’t manage to interact with my family, because doing so would distract me from my “studies” and cause me to remember why I loathed the holidays. On heroin I would’ve been able to politely join in, making small talk and behaving ordinarily. But given that I’d long since lost my tolerance, I opted against buying drugs. I wasn’t going to risk death to make my family happy.

I got through it. But looking back at my Christmas-avoidance strategy helped me to recognize the similar roles that months of writing obsessively and years of using heroin had played in my life.

These issues could yet be addressed, but for now, abstinence has only served to make the wounds raw and painful again.

Perhaps this year I will finally work up the nerve to seek formal treatment for trauma. Although I am already in therapy for the purpose of receiving letters to allow me to transition medically (both surgeons and insurance require documentation from a mental health professional), I don’t yet feel entirely comfortable speaking openly with my therapist. I’ve had too many unpleasant experiences with incompetent or hurtful mental health professionals to really trust her, and these have weighed, too, against my seeking further help.

Either way, I want to be clear that phasing out my opioid use hasn’t solved any of the underlying issues that led me to use in the first place. These issues could yet be addressed, but for now, abstinence has only served to make the wounds raw and painful again.

I plan to remain abstinent from opioids for a number of practical reasons, including, unfortunately, my chances of establishing a career. I am able to abstain and have reason to, so I will. But many of the factors that cause me to abstain are the products of a society that creates barriers to health care and hates drug users. Pressuring people to quit drugs is fundamentally wrong, as well as likely to fail—particularly when nothing is done to alleviate psychological or socio-economic circumstances that may have led a person to use in the first place. Quitting drugs didn’t fix my life, though finding alternative coping mechanisms did allow me to quit drugs.

Photograph by Eliot Phillips via Flickr/Creative Commons 2.0

The post How I Quit Heroin and Why That Hasn’t Fixed My Life appeared first on Filter.

Luckily for me, I was able to find the information I needed on various websites. However, it took me longer to understand that my drug use didn’t make me a sinner or a subhuman. I considered using drugs to be a terrible transgression, and detoxing the necessary penance—an incredibly unhealthy attitude. Though my use was functional and fairly positive, I felt a great amount of shame, only adding to the internalized trans- and homophobia that I am still working to overcome.

Slowly, though, I learned to get over the lies I’d heard in DARE-influenced high school health classes. I began to take pride in the ways I’d preserved my health and dealt with various issues I’d encountered. I stopped viewing abstinence as the only valid path. I began to develop my own views on the matter, rather than parroting stigmatizing and hurtful beliefs. I hope to help others do the same, preferably quicker than I managed.

If you’ve recently (or not so recently) begun using drugs, I want you to know that contrary to drug-war propaganda, this doesn’t make you any less valuable or deserving than anyone else. And addiction, if you end up struggling with it, doesn’t mean that you’re bad or broken, any more than suffering from depression or anxiety does. None of this is a moral failing.

You are not at fault for the conditions created by the War on Drugs.

Neither are health problems the inevitable result of drug use. They are largely the result of the conditions created by prohibition and the drug war. People don’t overdose because they’re foolish or because certain drugs are inherently bad; they do so because it is impossible to carefully and correctly dose drugs if you don’t know how strong they are and what they contain. Unlike substances sold legally, such as alcohol, drugs bought on the street don’t come with regulated ingredients lists. This makes them exceedingly dangerous, despite the many positives drugs may bring.

As for infections or wounds caused by shared or reused needles, if people could legally carry works without fearing arrest or harassment from the police, they’d be able to stock up on enough to never have to share or reuse. Legalizing possession of “paraphernalia” and opening more syringe service programs across the United States, without restricting their operations, would prevent a great many good people from falling ill or developing serious health conditions. Attributing fault to somebody who overdosed (or developed an infection, caught HIV, etc.) is a particularly cruel form of victim-blaming. You are not at fault for the conditions created by the War on Drugs.

Thus, if you run into legal troubles due to your drug use or struggle to manage your use, you mustn’t blame yourself, but the system that inflicts these harms. My own drug use has remained manageable primarily thanks to sheer luck. Being a white person from a privileged background has protected me. I’ve lived in the suburbs for virtually all of my life and that—together with my race and appearance—means I don’t have to worry about the constant searches that target heavily policed neighborhoods.

It is a feature, not a bug, of the racist War on Drugs that I am able to avoid the arrests and prison sentences imposed on members of Black, poor or otherwise marginalized communities for exactly the same actions.  For an eloquent explanation of this horrific phenomenon, I would suggest readingThe New Jim Crow by Michelle Alexander.

Also, while all demographics use drugs at similar rates, addiction is not an equal-opportunity employer. People who are disadvantaged in any way—impoverished or unhoused, disabled or with mental illness, subjected to racism, classim, homophobia or any kind of discrimination or strife on a regular basis—are significantly more likely to develop problematic relationships with drugs.

Addiction is essentially an attempt to cope with pain or suffering of some sort. If you’re experiencing it, chances are that psychological and/or socio-economic stressors in your life have led you there. This does not make you weak.

Recovery, by the way, is not the same as abstinence from drugs. Instead, it means managing your life in a way that works for you.

Sadly, the unfairness of addiction doesn’t end there. Recovery is significantly harder if you’re excluded from employment, education or society at large. Willpower is a useful trait, but expecting people in such circumstances to rely on willpower alone is a form of blindness to the injustices of the world—a lie spread by high-profile recovery evangelists whose circumstances tended to be very different.

Have empathy for yourself if you’re struggling. Do not blame yourself for larger issues that are out of your control. Be careful not to fall into the trap of believing that you could recover completely if only you really wanted to.

Recovery, by the way, is not the same as abstinence from drugs. Instead, it means managing your life in a way that works for you—which, for many people, involves continuing to use drugs. Don’t be discouraged if you don’t reach every goal you set for yourself. Most of us try different things before we find a path that works, and very few of us manage it alone. There’s no shame in asking friends or family (biological or chosen) for support or practical help—that’s just a normal part of being human, especially when dealing with something as complex and serious as addiction.

On a related note, comparing yourself to people who are unlike you—or even people who are similar to you, or appear to be—isn’t productive. You’re you, not somebody else. The only person you should be comparing yourself to is other versions of yourself.

If you plan to seek formal treatment, I would suggest choosing something evidence-based (such as medications or contingency management) and/or finding a way to treat the underlying issues that led to your use to become problematic. However, these options are frustratingly inaccessible for many people. Avoid religious or 12-step rehabs. Not only are they very ineffective for most people (like 12-step programs themselves) and in need of radical overhaul, but they can be traumatizing—or worse. If you return to using opioids after a stint of enforced abstinence, you’ll be particularly vulnerable to overdose due to your decreased tolerance.

Be aware that most people naturally move past addiction in time without treatment—and that your safety is paramount.

Obtain, learn about and carry naloxone.

So when you use drugs, whatever your relationship with them, take care. Check what’s in them before you use: Fentanyl test strips are an inexpensive, imperfect but potentially lifesaving option—and you should use them for drugs sold to you as cocaine, methamphetamine or benzodiazepines, as well as heroin. If you inject drugs, don’t share or reuse needles: Accessing sterile works and supplies (whether through a local syringe program or online) is a marvelous step that allows you to avoid blood-borne diseases and infections. Switching to a less risky method of ingestion (snorting, smoking, boofing) is another great idea.

Read up on harm reduction techniques around the drugs you use and your preferred ways of using them—including advice and risks around using combinations of different drugs. Start low and go slow, as the saying goes. Use with other people present, if you have that option. And obtain, learn about and carry naloxone, the opioid-overdose reversal drug; drugs not sold as opioids can still contain them, and naloxone has so often made the difference between life and death.

Do all you can to stay safe and healthy. At the same time, don’t beat yourself up if you don’talways opt for the healthiest option. Societal barriers and personal circumstances mean it isn’t always possible. Many of us have had to use alone during COVID. Even adopting safer behavior or cutting back some of the time is something to be proud of.

And we need that pride in taking care of ourselves. Because when we seek medical help, doctors typically treat us like shit—not because we are, but because their profession shares society’s prejudices. Even if you have health care access, which many do not, it can be incredibly challenging to make use of it when the doctor-patient power imbalance is so great. Be careful about what you say to doctors, at least unless you are certain that they understand harm reduction.

We can be heroes, too, and many of us are.

Since the world is so cruelly biased and hateful towards people who use drugs, we are often left to look after each other. If we don’t, nobody else will. Contrary to the cliche, people who use drugs are not monsters. We’re just as good and deserving as anyone else. We can be heroes, too, and many of us are. We’re generally the ones who reverse overdoses. On more than one occasion I’ve seen someone prevented from reusing or sharing works by a friend or drug seller carrying extras (yes, people who sell drugs are often good people too).

So many of the great activists who’ve fought for harm reduction and against the drug war have been drug users themselves. The same applies to many of our most beloved cultural icons.

This goes back a long way. Opium was widely taken amongst 19th century poets and writers, some of whom became addicted to the substance. Thomas de Quincey published the classic Confessions of an English Opium Eater in 1821. More recent examples of drug-using artists have included many who passed prematurely. They range from the German New Wave director Rainer Werner Fassbinder, who died of polysubstance overdose in 1982, to members of the so-called 27 Club like Jean-Michel Basquait and Janis Joplin, to Prince and Juice WRLD. I’m sure you can think of countless others. How many more great works could have been created if they’d been able to access a safe supply of legally regulated drugs?

So whenever someone makes you feel worthless for using drugs or struggling with addiction, remember the company you keep. Recall that using drugs is a normal human thing to do, and always has been. Know that the idea that certain drugs ought to be outlawed and their users punished is relatively new, based primarily in racism rather than science or logic—and that banning such substances has made them significantly more dangerous.

You are valuable and lovable. You are just as deserving of safety, health, freedom, love, housing, food, care and life as anyone else. Though you may be struggling or miserable, you are worthy of respect and decency. The general public may look down upon you and treat you terribly indeed, but they are wrong.

Don’t be angry at yourself or other people like you. Be angry at the politicians, policymakers and others who have failed us by perpetuating prohibition and ignoring both evidence and humanity. Know that you are far from alone.

Photograph by Brodie Vissers on StockSnap

The post What I Wish Someone Had Said to Me When I Started Using Drugs appeared first on Filter.

Due to the sheer unhelpfulness of the various adults and authority figures in my life, I quickly concluded that it would be up to me and me alone to ensure that I didn’t get sick or hurt. This could’ve been depressing, though I preferred to see it as empowering.

I began googling safe injection practices and other harm reduction techniques. Thanks to websites like Black Poppy and Erowid, I managed to learn correct injection techniques and various other important information, including how to check your drugs. I also learnt that my nearest syringe program in the DC area was no more than a brief metro ride away. I began going there regularly. Given all I’d read on the dangers of sharing and reusing works, I was always careful to carry extra supplies so that I wouldn’t be tempted to do so.

While I enjoyed using drugs and indeed relied on them in various ways, I considered my writing and various other hobbies (drawing, painting, filmmaking, ballet) to be more important. Developing serious health complications or having to be hospitalized would likely prevent me from being able to take dance classes or wander around the city sketching, so I wanted to avoid this if at all possible. I didn’t always manage it, but I usually did. I decided that if I was forced to choose between my writing and my drug use, I’d opt for the former.

Over the next few years this determination to stay healthy and functioning served me well. From the very start of my use, I was in the habit of taking occasional breaks to keep my tolerance low and to give my veins a break. I actually made a point of not making as many drug-related connections as I would’ve liked, so that I’d be forced to detox more regularly. I was friends primarily with people who didn’t use illicit drugs, and their perspective and support was invaluable.

Being able to cope with withdrawals gave me a degree of confidence. I felt in control of my use, and I was.

Though the idea of quitting forever upset me terribly and indeed proved impossible for years—because I both enjoyed opioids and relied on them to cope with especially bleak depressions—I always continued to manage to take breaks.

Detoxing was naturally a deeply unpleasant experience. But within the first couple of years I developed tactics and strategies to deal with various symptoms—for example, taking fever reducers or sleeping medication, as well as watching films to give myself something to focus on other than the physical pain I was in—and I eventually became quite an expert at treating my dope-sickness. At times I was even able to attend therapy appointments or work on writing assignments whilst ill. Being able to cope with withdrawals—as horrible as they were—gave me a degree of confidence. I felt in control of my use, and I was.

In my heaviest periods of use, from the fall of 2018 to December 2019, I generally began using again only a few weeks after detoxing. This was primarily because I was still dealing with trauma symptoms related to the abusive relationship I survived in my senior year of high school, as well as nightmares and hypervigilance related to being sexually assaulted. Being able to use made these symptoms significantly more bearable. I likely would’ve killed myself if I hadn’t been able to take something to distance me, however mildly, from my psychological distress.

During those years I also had serious sleeping problems. Opioids were the only drugs I knew that could help me consistently sleep through the night at that point (when I didn’t take them, my sleep patterns became very erratic, which made functioning normally a challenge). Indeed, I’d likely still be relying on them to sleep normally if my doctor hadn’t found a medication in early 2020—a low dose of an antipsychotic, prescribed off-label—that I could safely take for my sleep problems on a daily basis. 

My pattern of use was changing, with the breaks growing longer and longer.

This, combined with the fact that I’d stopped having nightly trauma-related nightmares in late 2019, made it easier for me to take longer breaks from using. I managed to stop for months rather than weeks. While I still struggled to deal with hypervigilance and other symptoms, they’ve mercifully begun to fade as time passes.

So my pattern of use was changing, with the breaks growing longer and longer. Once the pandemic hit, I was also forced to stop buying from local sellers. I therefore began sourcing my drugs online, often with the help of more tech-savvy friends. This also meant I was able to buy actual heroin instead of the fentanyl I’d gotten used to using. I find the former vastly superior, both in terms of feeling and legs, so I decided that I would no longer use the latter.

So far I have managed to stick to this rule. Though I am occasionally tempted to pick up a few bags from the street where I used to buy now that the world is starting to open up once again, I always talk myself out of doing so. I personally find fentanyl rather dreadful compared to other opioids, so resisting the temptation isn’t so hard. All I have to do is recall how brief and cold the high of fentanyl is, as well as the dangers that come with using it after a lengthy break.

My desire to use drugs isn’t some intense, unnatural drive that I’m unable to resist. Rather, it is a logical interest that comes from how positive and pleasant my experiences with opioids have been in the past.

I enjoy these drugs. I find them comforting and calming, particularly when I’m under stress or dealing with something like nightmares. I’m also able to weigh the pros and cons of using to decide what’s best for me. This is why I consider my drug use to be helpful and recreational, rather than an addiction or problem.

Buying online has made me more mindful of my use. It’s easier to keep track of how much I’m spending and ingesting when I’m purchasing larger quantities (enough to last a week or more) at once. This has encouraged me to make a point of cutting back, primarily because doing so seems financially prudent.

By late 2020, my pattern had morphed from using for a few months and then quitting for a few weeks to using for about two weeks and quitting for several months. Earlier in 2021, I actually went without using for more than six months. This wasn’t an intentional choice or anything I tried to do. I merely had a number of complicated writing projects that I was focused on, which kept me busy enough that I didn’t have time to use.

Contrary to the cliché, my drug use has grown more sustainable, rather than less, as the years have gone by.

Of course, that doesn’t mean I’m finished with opioids. I’m still fond of them. Though I no longer enjoy using them as often as I used to, I don’t plan to swear off them forever, unless they actually start to interfere with my functioning or hobbies. This is unlikely considering my history.

Contrary to the cliché, my drug use has grown more sustainable, rather than less, as the years have gone by. I’m not someone struggling with addiction. Rather, I’m a member of the silent majority—about 90 percent—of illicit drug users whose use is not problematic.

Considering that for many people, drug use is a choice rather than a compulsion, it is perhaps unsurprising that we’re able to adapt our behavior as we grow. People who use drugs are just as capable of changing or learning as anyone else. And those people who do experience addiction, or who use in high-risk ways, typically grow past it in time, often without discontinuing their drug use altogether. Rather than being hopeless lost causes, we’re all human beings trying our best to survive in a stressful and messy world.

An example of this would be my friend Douglas.* When he first began using a variety of substances, including opioids and cocaine, he didn’t care or think about the potential effects on his life. He used significantly more than he ought to and regularly developed miserable-to-break physical dependencies on various drugs, as well as neglecting to sleep properly for lengthy periods due to his stimulant use.

Throughout all this he did manage to attend college classes and maintain good grades. Still, it couldn’t go on forever. After facing social, academic and health-related consequences for his recklessness in early 2020, he realized, he told me, that he needed to “incorporate drugs into my life as opposed to allowing them to consume it.”

Over time, particularly with the right information and support, we are all capable of adapting our behavior.

Now, he plans carefully, taking into consideration how the drugs and the expected aftermath will affect him. He is much more focused on sustaining his health and ability to meet his life responsibilities. This attitude has served him well. Acutely aware of the eventual crash that comes with many of his favored highs, he is now much more cautious and plans further in advance. Like me, he doesn’t plan to quit drugs entirely anytime soon, but he is managing his use in a way that fits his life.

Though some might turn up their nose at such a thing, I believe it to be a big achievement and am relieved by how much healthier Douglas has become.

Despite hurtful stereotypes, people who use drugs aren’t illogical zombies who prize our drug of choice over all else. Nor is all drug use doomed to lead to addiction and disaster. Reaching a point of sustainable drug use is perfectly possible, and indeed likely. Over time, particularly with the right information and support, we are all capable of adapting our behavior to reduce harm and improve our health.

Photograph by Kastalia Medrano

*Name has been changed to protect privacy.

The post How My Drug Use Has Become More Sustainable Over Time appeared first on Filter.

I don’t think I’ve ever seen a movie or read a book with a sympathetic, well-meaning character who sold heroin or so-called “hard” drugs. Even if sellers of marajuana or “club” drugs have, on occasion, been portrayed more sympathetically in recent times, like Jay and Silent Bob from the films of Kevin Smith.

I once had a person insist on seeing my ID, because I looked like I might be underage.

Fictional dope “pushers” often try to get white middle-class suburban kids “hooked”—something that always seemed hilariously unrealistic to me. In my experience, some won’t even sell heroin to people unless they can prove that they already use, usually by showing their track marks. I even once had a person insist on seeing my ID, because I looked like I might be underage.

I have certainly encountered unpleasant sellers. These include some who sexually harassed or belittled me, or who pressured women to exchange sex for drugs. One I briefly knew kept giving me free drugs, then tried to coerce me into doing sex work at parties he hosted, which led me to stop speaking to him. But then, I have encountered equally unpleasant and sexist people in many occupations.

My long-time regular heroin seller was quite different. I haven’t seen him since the pandemic began, and have been unable to contact him—his phone number no longer works—but I doubt I’ll ever forget him.

A quiet, thoughtful middle-aged Black man and fellow heroin user, he operated his business from an SUV he kept parked in a certain parking lot downtown. I have a lot of warm memories of him. He always treated me, and all of his customers, with respect and consideration.

When a number of people were robbed near where he usually parked, he agreed to meet me in a safer neighborhood. And if I didn’t have cash on me, he’d front me (this was mostly because I always paid him the next time; I was careful to only use when I could afford to).

He kept naloxone in his car in case someone overdosed. After all, he liked his customers.

When I showed up at his car window already in withdrawal, he’d let me inject a small dose in the backseat. If I’d run out of clean needles or sterile water, he’d let me have some from the large bag he kept hidden under the passenger seat. He also warned me whenever the drugs were stronger than usual. And he kept naloxone in his car in case someone overdosed. After all, he liked his customers.

In short, like many people who sell drugs, he practiced harm reduction.

As well as kind, I found him interesting. When I stopped by to pick up my drugs, I’d often stay for a little while, just to chat. He’d often ask about my latest article or artistic project. Sometimes I brought him printed-out stories to read, or books I was finished with. Like me, he enjoyed mysteries solved by Great Detectives. We often talked about our mutual fondness for Agatha Christie, especially her stories starring Hercule Poirot. He liked Poirot’s rather flamboyant sense of style—the shiny shoes, the suits, the famous moustaches.

I think he liked talking to me because he was lonely. Most of his buyers just stopped by the car for a second to pick their drugs up.

Unfortunately, after he was stopped by the police one too many times, he no longer allowed me to sit and talk with him. Instead, he tried to get me to leave as quickly as possible, so that neither of us would look suspicious. He also stopped letting me take drugs in the back of his car. Though I didn’t mind. After all, I liked him and didn’t want him to get arrested again. He was a friendly, well-meaning person who deserved a better life.

Over the years I bought from him, I picked up pieces of his story. He’d grown up in a rough neighborhood and gone to jail numerous times on drug-related charges. At one point he’d been in college and studied psychology, but his drug use had gotten him kicked out, so he started selling drugs to support himself.

He had a son whom he loved very much and visited whenever possible. Apparently the son was a rather good student, which he was especially proud of. He displayed a photo of the kid in the front of his car.

Despite all he’d been through, he was surprisingly religious and truly believed in God. Yet he didn’t consider his work sinful or immoral. Instead, he thought that by doing his best to provide real drugs that people wanted, charge his customers fairly and warn everyone about strong batches, he was doing the right thing. He was doing his best with the hand he’d been dealt.

Once I started asking around, I heard a lot of stories about drug sellers who became, quite simply, friends.

Of course, there will always be some people who use violence and intimidation, or who try to take sexual or financial advantage of drug users. But most, like the rest of us, are just trying to get by in a difficult world, sometimes on the margins of society. Quite obviously, they have as many friends, loved ones, personality types and non-drug interests as anyone else. They are certainly not to blame for the overdose crisis, and none want their customers to die.

More than that, once I started asking around, I heard a lot of stories about drug sellers who became, quite simply, friends. Garth Mullins of the podcast Crackdown told me about a seller who used to bring his cat treats and toys. The same person apparently warned him not to buy any heroin after a major bust because of the decrease in quality.

Another person—we’ll call him Alex—told me that while past sellers he’d gone to to buy his preferred OxyContin had preferred not to chat, his current source is “really nice” and cares about his well-being. They often hang out together playing video games. Alex’s seller is a former heroin user himself, and apparently shares Alex’s concerns about the extent of his opioid use. With this man’s support, Alex has been trying to cut down on Oxy with the help of kratom and marijuana.

Another story stood out to me because for how it defies stereotypes about both drug users and drug sellers—and illustrates how that distinction, regularly applied in persecutions like drug-induced homicide charges, is often blurred and arbitrary.

A man we’ll call Joseph once knew a woman, “Sarah,” who’d sell her prescription hydromorphone to pay for cocaine. She was enstranged from her family due to her drug use and lesbian identity.

Sadly, in the 1990s, Sarah contracted HIV from a used needle, which eventually progressed to AIDS. In the last months of her life, as she was dying of an inoperable spine abscess in 2017, Joseph would pick up extra hydromorphone from the pharmacy for Sarah when her morphine drip wasn’t enough. He’d keep watch while his partner, who was also Sarah’s friend, snuck the drugs into her IV.

Joseph got along with Sarah so well because they were both, to use his words, “throwaway people”—their families and society at large had cast them aside, and they bonded over that. As an outsider myself, as a queer heroin user who has experienced family rejection, this is something I understand.

I haven’t seen or spoken to my favorite seller in nearly a year. But whether or not I find him again after the pandemic, I will keep many fond memories. He treated me far more kindly than most of the doctors, psychiatrists and other professionals I’ve encountered in the past few years. To him, I was a real human being, not just some dumb junkie.

I just hope so much that he has survived the pandemic and the associated increase in overdoses. He is a good person, with more empathy than most. And there are many more like him.

Photo by Giorgio Trovato on Unsplash

The post The Kind Man Who Used to Sell Me Heroin appeared first on Filter.

Decades of propaganda have spread the notion that we can’t be caring or honest. Employees who fail drug tests are fired. Parents who use drugs have their children taken away. People of color who use drugs are killed. And our drug policies willfully ignore evidence-based harm reduction practices that would stem the longstanding, growing crisis of drug-related deaths.

As Dr. Carl Hart, a researcher and advocate who has been open about his own drug use, noted in a speech related in Vincent’s article, we can’t expect the most marginalized drug users, who already suffer the worst harms relating to health and criminalization, to debunk dangerous stereotypes at their own risk. If more privileged, white drug users were open about their use in the context of their functional, successful lives, things would change. But even among this group, few dare—apart from former drug users, safely in abstinence-based recovery—for fear of consequences that are still very real.

One result of this is that most drug use, most of which is not problematic, remains hidden. But through contact with emergency rooms, treatment facilities, law enforcement or mortuaries—all amplified and sensationalized by media—the most chaotic or harmful forms of drug use are highly visible. This distorts the public perception of the wide spectrum of drug use, reinforcing societal stigma and the drug-policy status quo.

I figured that being totally honest about my drug use might help others who were struggling.

But when I began talking, writing, tweeting and vlogging about my heroin use a couple of years ago, I’d never heard of any of these arguments. I just hated lying. Also, I figured that being totally honest about my drug use might help others who were struggling—including functional drug users who might feel agonizingly alone, as I had.

I figured, as well, that defying stereotypes by working for my drug money and always telling the truth would make it harder for people to shun or mock me, and others like me. I wanted to be living proof that drug users can be good, caring, moral, responsible people. Thankfully, my close friends believed me. Others weren’t so kind.

On YouTube, my vlogs about my heroin use slowly gained hundreds of views. While that’s nothing by internet standards, it was enough that I soon had a handful of regular commenters and a great many haters. Some accused me of glorifying drug use. Others merely called me names.

One person accused me of inventing my drug use to get attention, and posted comments all over my videos claiming I needed psychiatric help. They only left me alone when I made a video in which I pointed out that the track marks on my arms and hands would be pretty hard to fake.

That wasn’t the worst part. I had the hardest time with comments that said things like, “Are you whoring yet?” Those hurt the most, because they made me feel guilty about the sex work I had done, including selling photos, stripping and going on paid dates. I didn’t want to lie about it, but I felt like I was hurting other women who use drugs by playing into the stereotype that we all engage in sex work. (In fact, I began selling photos long before I began using—and partly because I found it liberating and empowering, contrary to the sex-work stereotype of financial desperation.)

It’s an isolating experience. So many strangers who don’t know me at all have absurdly strong opinions about me.

Publicly representing a severely marginalized, criminalized group put a lot of pressure on me. I had wanted to be honest about myself, not to claim that I represented anyone else’s experience. But I still felt like I had to seem a certain way. I thought I couldn’t publicly admit it when I contracted an infection through injecting, for example, because I was afraid it would both discredit me and contribute to mistreatment of others.

In another challenge, strangers would write me, asking for help in navigating their own relationships with drugs—help I didn’t always feel equipped to provide.

I felt almost totally alone, because I didn’t know anyone else who was as young as me (I was 19 when I began vlogging), a woman and in a similar situation. The other “out” drug users I knew were all much older, and most were men. It’s a very isolating experience. I mean, I barely even know who I am, yet so many strangers who don’t know me at all already have absurdly strong opinions about me.

The worst thing that happened in connection with my being open about my drug use in my general life was in a work situation, when an older man in a position of power harassed me, exploited me and ultimately sexually assaulted me. He used the offer of giving me drugs (fake drugs, it turned out) to manipulate me, and demeaned me as a “junkie,” among other things. I am certain that knowing I was a drug user made him feel empowered to do those things to me. When I tried to tell HR about what had happened, they refused to believe me—because, I’m sure, I was a known, “out” drug user.

Despite everything, I still felt that I was doing the right thing by being open. And that contributed to my writing an article for Filter—published the same month as Louise Vicent’s piece—about my choice to continue using heroin.

After that was published, I received many comments that were similarly hostile or dismissive to those I’d grown used to on YouTube. But I received many positive messages and comments too, and those have helped me to feel supported.

Wonderfully, some people said my honesty helped them to go from hating drug users to empathizing with them.

Many of these messages have been DMs from people I’ve never met. Some just tell me that they now feel less alone as fellow drug users. Occasionally, people whose loved ones are experiencing addiction have told me that my writing helped to increase their understanding of drug-related issues. Most wonderfully of all, some people have even said that my honesty helped them to go from hating drug users to empathizing with them.

I’ve also made a few friends thanks to my writing, including other writers who are open about their own drug use. I’m glad we met, and potential collaborations have arisen. Two film students separately asked me to work with them—both are drug users, and both are interested in creating more honest portrayals of functional drug use than the usual fare.

These people’s support and interest has given me hope. Perhaps our generation will end the drug war… or at least, work to reduce stigma by portraying functional use accurately and compassionately. And maybe I haven’t totally ruined my chances of having a career.

Throughout my time of being “out,” my dearest friends have all been okay with my use—even though the vast majority of them don’t use drugs themselves. They have offered kindness and support on both emotional and practical levels. Renting me a room. Calmly talking with me, without the judgment and anger I have received from my own family, when I was going through a crisis. Buying band-aids when I self-harmed. Not complaining when I detoxed at their house, even though I groaned and sobbed in pain late at night. In all these ways, they saved me from despair.

Being an “out” functional heroin user is not fun or pleasant. But I don’t regret writing that article or making my YouTube channel. Every random stranger who DM’ed me, saying they felt so much less alone, has made it worth it. As has the kindness of all the people who refused to abandon me.

I am not one of the most marginalized drug users, but neither am I one of the most privileged. If I can do it, many others can, too. And the more of us there are, the easier it will get.

Photo by Dominik kielbasa on Unsplash

The post What It’s Like to Be “Out” as a Person Who Uses Heroin appeared first on Filter.

I, for one, have basically given up on Washington, DC’s street “heroin.” Distressingly, it’s mostly oddly colored fentanyl. The vast majority of “down,” as they call the dreary, unpleasant stuff, doesn’t even contain heroin. Plus, the far-too-common grey sort (known confusingly as “grey death,” despite often being on the weaker side) is rather hard to inject. A pale, ashy shade in powder form, it turns pitch-black when mixed with water. This opaqueness makes the flash of blood impossible to see, so you never quite know whether you’ve hit a vein.

After one too many experiences with this joke of a drug, I decided to look for a new source. I’ve heard from friends and drug-user forums alike that dark-web drugs tend to be of better quality, and that buying in this way reduces some risks. In short, dark-web markets could be a form of harm reduction.

Various friends and acquaintances of mine have a lot of experience of buying in this way, so I decided to ask them about why they choose to do this, and how they assess the pros and cons.

They differ in how they came to this resource. My friend Cory*, for example, is an experienced customer of darknet marketplaces, as they’re also known. He no longer likes buying from the streets of New York, as he did when he began using heroin in the 1990s, because of the risks he experienced in certain neighborhoods. Now in his 40s, he claims to have purchased dope from every dark web seller in North America. Knowing him, I wouldn’t be surprised.

Marie had never purchased drugs in the conventional way—and still hasn’t.

Canadian software engineer Marie, on the other hand, never even bothered with offline purchasing. Her decision to begin buying drugs online came at an extraordinarily trying time in her life, in 2016. She’d just escaped an abusive relationship and lost most of her support network in the process. And despite being in psychiatric treatment, Marie didn’t feel as if she were improving.

“At some point, I was bargaining with myself, trying to find a reason to live, and I thought: Of all the drugs they’ve given me, they’ve only targeted a few areas of my brain. What if the problem is somewhere else?” she told me. Having heard that ketamine can relieve symptoms of depression, she decided to try it herself. She had never purchased drugs in the conventional way—and, at the age of 28, still hasn’t. Her background in computers and information security gave her an advantage when it came to navigating the dark web.

Terence decided to begin buying online because—as a mid-career professional and father from Minnesota, now in his late 30s—he no longer has the connections that he did when he was formerly addicted to heroin. He wanted to be able to buy high-quality psychedelics from a trusted, reliable source and the dark web seemed like the best place to do so. 

“Turns out the process is fascinating and [it] was interesting to learn all the aspects of it, from PGP encryption to TOR basics, TAILS, etc,” he explained, making me wish I knew more about computers. Interestingly, buying in this manner also led him to develop a lasting passion for computer science and privacy.

Brian, a writer, harm reduction supporter and avid drug consumer in his 60s, hasn’t ever bought directly from the dark web. He has been buying online since the 1990s. Before the United Kingdom, where he lives, banned “legal highs” in 2016, he would purchase spice, mephedrone, kratom, salvia and psychedelics from specialty websites. He began doing this after the law cracked down on brick-and-mortar headshops. To this day, he still orders nitrous oxide from cream charger companies. 

“The maximum most cream charger companies will let an individual buy is 200 whippets, which I pay £60 to £70 [GBP] for. For legal reasons you have to say what legitimate reason you want them for (getting high is excluded) so I always write ‘for use in erotic parties where we squirt cream all over our bodies and lick it off,’” he explained to me over email. “Must try that one day, haha.”

Brian usually buys his illegal drugs from “traditional dealers,” as he put it. But occasionally, he’ll ask a friend who already uses a darknet marketplace to get him something from there. His reluctance to make the purchases himself stems from fear. He’s heard too many stories about buyers getting busted when law enforcement organizations take over sites to feel comfortable. After weathering seven in-person busts over the years, he’d prefer not to get caught again. 

The Pros of Buying From the Dark Web…

Dark web marketplaces aren’t the lawless Wild West many newcomers might assume them to be. Comprehensive review systems hold vendors accountable. If their dope contains fentanyl or benzos, everyone will know. Buyers can typically give overall ratings (on a scale of one to five), as well as seperate ones for qualities like price, stealth and delivery speed. They’re also able to write out reviews the way one might on a mainstream shopping site. However, unlike Amazon, buyers can only leave feedback on items they’ve purchased. This keeps people from posting fake reviews.

“You’re able to do the research before you buy—just as you might with a new blender or lawnmower. This adds a layer of safety.”

Terence bought psychedelics online for this very reason: the accountability of online marketplaces. “I have hopes that DNMs [darknet markets] could do a lot for user health and safety in general,” he said. “When you buy from [an in-person] dealer, you don’t know that much about what they’re selling. Virtually all your information comes from the seller. Because of how quickly transactions happen, especially on the street, you don’t even have a way to verify anything. For all you know, the dope could be a bag of crushed aspirin! But when you buy online, you can read reviews and look at the forums. You’re able to do the research before you buy—just as you might with a new blender or lawnmower. This adds a layer of safety.”

People who sell through the marketplaces have a much harder time ripping buyers off. They can’t, for example, sell fake or weak dope without getting called out by reviewers. They’re also unable to take someone’s money and never deliver the product, thanks to the payment scheme. “You deposit bitcoin into the escrow system—no different than paying for something on eBay or Amazon,” Cory explained. “When the package arrives, you ‘finalize’ the transaction, which releases funds to the dealer.”

Vendors with higher feedback ratings can get away with asking for “early finalization.” This system (along with the reviews and forums) incentivizes them to sell what they say they’re selling; ripping people off has consequences.

Purchasing online also eliminates risks associated with visiting open-air drug markets, where both robberies and law enforcement busts might be common. Marie, who no longer uses, found that buying from dark-web marketplaces did cost more than buying from the street in Vancouver’s Downtown Eastside. But in her view, the relative safety of online purchases, as well as the increased purity and sheer variety of drugs available, more than made up for it.

While the purity of coke and heroin that she bought varied somewhat, it was much easier to avoid fentanyl. She also found that the psychedelics were virtually always of high quality. Like Cory, Marie felt that the rating system kept sellers honest.

Purchasing drugs online also eliminates the danger posed by traveling in possession of illegal substances. If you happen to live far from your dealer—for me, stocking up on dope used to mean taking a Metro trip and walking through a sketchy neighborhood—this is a significant plus. Being able to have your drugs delivered right to your door is so much simpler.

My sources agree that unwanted fentanyl is found in lower levels in drugs bought online compared with street drugs.

The anecdotally reported lower presence of unwanted fentanyl in dark-web drugs is an attraction for many in an era when opioid markets have been flooded with it. And if unwanted fentanyl does crop up online, buyers can easily warn each other by way of the review system or the forums.

That’s not to say that fentanyl is absent. According to Cory, only one online dealer in North America sells truly fentanyl-less heroin anymore. While a number claim to sell “fentanyl-free” dope, reviews indicate that they’re lying. (Some people also seek fentanyl and there are vendors who openly sell it.) Still, my sources agree, unwanted fentanyl is found in lower levels in drugs bought online compared with street drugs. Marie credits this with saving her life.

Being able to order drugs for self-medication so easily and discreetly, Marie continued, also kept misguided friends from trying to force her to quit. Contrary to popular belief, making a loved one become abstinent (even if you can) won’t cure the underlying issues that may have led them to use in the first place. For people who use opioids, it also increases their risk of overdose when they resume use with lower tolerance.

Some people really are better off using drugs (especially if their use helps them cope with serious trauma—and it often does). I know this from experience. Without dope, I’m too hopelessly depressed to work, study or even eat regularly. “I hate to imagine where I’d be without it,” said Marie of her use during a traumatic period of her life.

….And the Cons

Despite the advantages, buying online does have its downsides—what doesn’t?

One obvious point is the challenge, for people without technical know-how, of accessing dark-web marketplaces through the necessary software. I would be able to do it with the help of my friends’ advice; without it, I’d be stuck relying on online guides that I might not feel comfortable trusting.

Similarly, you have to become a semi-expert on Bitcoin. After all, you can’t exactly use Paypal or your credit card to pay for illegal drugs. Cory explained that Bitcoin’s anonymous nature is both its greatest virtue and worst flaw. If you accidentally send it to the wrong address, you’ll never get it back. The same goes for Bitcoin stolen by hackers. There’s also the problem of the currency’s constantly fluctuating value.

“Bitcoin is expensive and highly volatile, so $100 today might be $60 tomorrow (or $160),” Terence told me. He and Cory explained that you therefore have to be strategic about when you buy something with Bitcoin, unless you want to pay more than you might have just days before. Keeping money in Bitcoin isn’t the greatest idea, either, for obvious reasons. Instead, they recommend trying to exchange ordinary money for Bitcoin right before you make your transaction.

“Because the URL changes every few minutes, you could unwittingly log into a phishing site, deposit money, and never see it again.”

Phishing—fraudulently seeking personal and/or payment details—poses another risk. In a dark-web environment, according to Cory, “because the URL changes every few minutes, you could unwittingly log into a phishing site, deposit money, and never see it again. That happens many times every day.”

Other scams occasionally happen as well. Before escrow systems became commonplace, Marie once fell prey to a so-called “exit scam.” That’s when a dealer who plans to stop selling on a marketplace continues to take orders that they never plan to fulfill. Luckily, Marie’s order wasn’t very large; she only lost about $30 CAD. She also received less-than-stellar drugs on two occasions. Still, such instances were rare. “Except for those three times, I never got shorted, and the product ranged from good to excellent quality,” she noted.

Mercifully, the escrow system now largely keeps dealers from pulling these sorts of tricks (they don’t get paid until the product arrives, after all). Yet similar problems can still happen if you aren’t careful. Buying directly from an online dealer—as opposed to through one of the marketplaces—is generally inadvisable. There’s no escrow system when you do that and, therefore, no guarantee they’ll actually send you something.

On a mundane note, ordering online isn’t as immediate as purchasing in-person. If you’re physically dependent, you’ve got to remember to stock up pretty regularly to avoid withdrawal. Despite claiming to ship overnight, Cory explained, most dealers prefer to ship as many packages as possible at the same time. Vendors with fewer customers tend to wait longer. “I waited nine days for one dealer’s wares to arrive; another arrived two days after I placed the order,” he said. Still, that’s not too bad; nine days may be a very long time if you’re in withdrawal, but it’s manageable if you plan in advance.

No method of acquiring illegal substances is perfect. Still, some happen to be safer than others.

Cory—an American—tends to buy from sellers based in the United States. This helps keep orders from taking too long. International shipments, on the other hand, can spend two-to-four weeks in the mail. Terence, who is also in the US, wishes he’d known this before he ordered drugs online for the first time: some psychedelics from a Canadian dealer. Both he and his wife were very afraid they’d get caught. She even began having panic attacks when nothing arrived. After 14 excruciating days, they finally received their order of psychedelics.

No method of acquiring illegal substances is perfect. Still, some happen to be safer than others. Dark-web markets do have their risks. But reviews and forums give buyers more power, as does the escrow system. By offering so many options, these sites also just make it easier for psychonauts to explore what’s out there.

Some of us who use drugs are lucky enough to have physical access to a safe supply. For everyone else, dark-web marketplaces are a pretty reasonable idea. 

*All names have been changed to protect sources’ identities.

Photo by Kaitlyn Baker on Unsplash

The post Why Dark-Web Drug Marketplaces Can Be a Refuge appeared first on Filter.