How My Drug Use Has Become More Sustainable Over Time

    When I first began using opioids, in 2017 when I was 18, I knew nothing of harm reduction. My high school drug education consisted primarily of hysteria, misinformation and scare tactics. My Catholic family wasn’t much help either. Nobody told me how to use drugs safely—they merely insisted that avoiding drug use at all costs was the only valid, socially acceptable choice.

    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.

    • M.L. is a writer from the Washington, DC metro area. He’s the author of a number of novels. In his spare time he paints, dances, directs, acts, cooks and embroiders.

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