For the last 14 years I have bounced around nearly every part of the drug-use spectrum, though I’ve rarely stayed at the extreme of total abstinence for long.

    My experiences have ranged from smoking pot out of a bong made from a hummingbird feeder, found in the top of a closet of a friend’s house at a sleepover when we were 14 years old, right through to injecting heroin and crack cocaine. While common nomenclature might apply the term “addiction” to my life, characterizing different relationships with specific substances in more nuanced terms paints a far more accurate and useful picture.

    I had an incredibly intense, chaotic relationship with heroin during my late teens and early 20s, however.

    Personally, I have a terrific relationship with marijuana. It helps me to manage my polycystic ovarian syndrome and lifelong gastrointestinal issues. It has helped me sleep through recurring night terrors, and to manage the symptoms of PTSD. It generally makes me a more pleasant person to be around.

    I also have a healthy relationship with benzodiazepines, one in which I use them only after panic attacks or in the rare case that I have significant difficulties sleeping. While I’ve tried crack cocaine, powder cocaine and methamphetamine, I’ve never really developed a proclivity for stimulants.

    My relationship with alcohol is wary. I have a drink only every few months, and very rarely to the point of discernible intoxication. The drunk high is too difficult to predict, I find, and lowers my inhibitions beyond my comfort level. I can feel out-of-control when I drink, so throughout my life I have only rarely chosen to do so.

    I had an incredibly intense, chaotic relationship with heroin during my late teens and early 20s, however. This relationship was born from my psychological circumstances. I used heroin to numb the pain of being sexually assaulted early in my life. I used it to drown out my fearsof growing up, of not knowing who I was, or of not knowing if I wanted to be anyone at all.

    After several years abstinent from heroin, I still choose to use other drugsboth medicinally or therapeutically, and at times recreationally. I outline the specifics of my own drug use to show that not all drug use is created equal, even within one person. Even within a person who struggled for years with one form of drug use, healthy drug relationships—with other substances or, later in life, with the same substance—can and do exist.

    To understand how I developed my currently healthy relationships with drugs, I have to examine what the chaotic relationship looked like.

    My relationship with heroin wasn’t problematic because heroin is a “bad” or “hard” drug.

    It was a time of great hardship in my life. It was also, in retrospect, a valuable learning opportunity—both for understanding the trauma of communities far more marginalized than I am, and for understanding my own personal trauma, which had never really been acknowledged.

    It didn’t get bad right away. I initially used heroin recreationally for a year, every so often, on weekends, with trusted friends. I felt in control of my use, despite having been exposed to the scare tactics of DARE. I enjoyed the feeling of euphoria, especially when it came with a sense of having beaten the system.

    I had experimented with marijuana and MDMA prior, I figured, with life-altering positive experiences, so why would heroin be any different?

    It became very different—rapidly, after that first year, progressing into something problematic—but not because heroin is a “bad” or “hard” drug. It became different because the person I was began to find that particular sensation irresistibleand also because I was uneducated on the use of opioids and how quickly dependence can form.

    If I’d had access to honest information about the frequency of heroin use which can bring about physical dependence, perhaps my story would be different. If someone had helped me understand that I could use drugs, but needed, in my life circumstances, to set myself limits around the frequency of heroin use (for example, only on weekends, or only twice a month), perhaps my story would be different. If someone had explained that you could rotate different drugs to utilize the coping mechanism while reducing your chances of becoming dependent on a specific substance, my story could have certainly been different.

    People who use drugs are capable of logical decision-making when presented with appropriate information and opportunities to use them safely.

    I was subjected to sexual assault by low-level “runners”who deliver heroin and hold great power over those who use it, especially women.

    My chaotic relationship lasted for four years of injecting three-to-five times daily, following that first year of recreational use. My need to obtain heroin exposed me to many dangers.

    I engaged in petty theft. I was subjected to sexual assault by low-level “runners”who deliver heroin and hold great power over those who use it, especially women. I was threatened with a gun to the back of my head. I watched someone get pistol-whipped for selling fake product. I was asked by cartel representatives to be the name on a lease in a trap house. The list goes on.

    For most of my relationship with heroin, I used exclusively alone, placing myself at increased risk. I did everything I could to keep my use secret.

    I kept up my performance in college. One morning, a police officer presented to my college class about the signs of people who use heroin. “These types of people wouldn’t be able to maintain a job, or a high GPA,” he said. I remember laughing internally, reflecting on my 3.5 GPA at the time. This man knew nothing.

    When it was finally time to quit, it wasn’t because I had “hit rock bottom” or because of anyone’s “tough love.”

    But the more chaotic my use became, the harder it was to hide. I maintained a job, but everyone knew something was off. Drug use is often so taboo that even if people close to you notice something, they often won’t bring it up. They prefer to blame exhaustion or stress in their “high-functioning” friends, and lack the words to ask whether you need help. While many people are able to live with daily heroin use and function just fine, I wasn’t one of them.

    When it was finally time to quit, it wasn’t because I had “hit rock bottom” or because of anyone’s “tough love.” I had just become too tired to continue, and too depressed. I reached a point where I knew I would intentionally overdose if I didn’t get off the drug I was so deeply dependent on. I couldn’t continue to live in the cycle I had created, and I longed to work through my pain rather than numb it.

    Access to Suboxone or methadone might have kept me much safer as I quit. But as a young person on my parents’ health insurance, I felt stuck: I couldn’t admit to my family what I had been through. So I kicked my habit cold turkey.

    Three things kept me going through those days of withdrawal and general misery: the uplifting spirits of the few friends I clued into what was happening, vegetable broth and music that moved my soul. Without those things, I might have made a different decision.

    I went without eating solid food for days, was too ill to smoke or eat marijuana, and just lay and waited in agony for it to end. In the early days after quitting I still had cravings, but the pain I had endured prevented me from ever wanting to go back.

    Once I was no longer dependent on heroin, I started to rebuild my life in ways that hadn’t been possible when I had needed to focus all my efforts on acquiring money and tracking down dealers to avoid withdrawal.

    The fact that I now use different drugs is not my identity; it’s incidental.

    I now work a full-time job, have a loving partner and serve on boards of nonprofits. Through my work in harm reduction, I have reversed seven opioid overdoses using naloxone. I mentor young people, and advocate to make the world a better place for those targeted by racist drug laws. The fact that I also use different drugs is not my identity; it’s incidental.

    After quitting heroin, I began to get back into different forms of drug use, which has always been and will always be a part of my life. I use marijuana regularly. I use MDMA and LSD infrequently, and I’ve replaced those at times with dissociative drugs such as ketamine and other PCP analogues, with great success.

    I also go to therapy to work through my trauma, reduce the symptoms of my PTSD and help heal the wounds of my early adolescence. Many people find medication helpful. While I haven’t yet found any prescribed meds that work well for me, my journey in recreational drug use has provided huge relief to my mental health.

    Drug use exists on not one spectrum, but many.

    People who use drugs are teachers, lawyers, social workers, churchgoers, uncles, daughters, loved ones and all the rest of us. Next time you find yourself instinctively meeting someone’s drug use with judgment, reach deep to find compassion. Problematic and chaotic use needs to be met with support and resources, as well as work against the systemic causes of suffering. Unless we see the full picture of people’s lives, we cannot help them to make informed decisions to prioritize their safety and their future.

    Drug use exists on not one spectrum, but many. It ranges from interested experimentation to effective medicine (prescribed or not), tools for exploration, coping mechanisms for past and existing trauma, and many other forms—forms that can simultaneously exist in different individuals in different ways.

    Unless we acknowledge that people use drugs for myriad reasons with a full range of outcomes, we perpetuate suffering and abuses. Until adequate access to honest information is available, we will keep setting people up to suffer. Until we eliminate and repair the damages of systemic racism, housing and food insecurity, and generational and situational trauma, we will not solve the overdose crisis.

    When we meet drug use with judgment, we create a tidal wave of stigma and shame that smothers all who encounter it.

    Photo by Joshua Earle on Unsplash

    • Quinn Bell is a pseudonym for a worker at a harm reduction agency in Colorado. When she isn’t giving out sterile supplies for injecting drugs, she creates educational graphics around safer drug use and works to reduce the stigma around people who use drugs.

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