Vapes and Methadone: An All-Round Harm Reduction Story

    Danielle Russell is a third-year PhD student at Arizona State University, and a co-investigator on a current study examining access to methadone during COVID-19.

    She herself began taking methadone around 2006. As a former drug user, she’s a member of Urban Survivors Union (USU), advocating for the rights of people who use drugs and for methadone clinic reform. And she’s the board chair of Sonoran Prevention Works—an organization that works to improve the lives of Arizonans who use drugs through street-based outreach, organizational capacity-building and statewide advocacy.

    When I learned that Russell is also a former smoker who switched to vaping, I wanted to ask her more. Her experiences equip her to place this form of harm reduction in a wider context—vaping is clearly analogous to methadone—and to recognize crackdowns on vapes for what they are.

    “Alright, fuck it, I’m going try one of these stupid vape things they keep giving me.”

    People with substance use disorders (SUD) have high rates of smoking. One study found that 56 percent reported cigarette use in the past month, compared to 18 percent of people without SUD. An older paper found an even higher rate77 percent—among methadone patients. Researchers have found that vaping is more effective for smoking cessation than nicotine replacement therapy, so it’s imperative to help smokers in these populations switch to vaping—something USU is working on.    


    Helen Redmond: How did you start smoking and what did it mean to you?

    Danielle Russell: I have smoked since the age of 14 or 15. I smoked Marlboro Reds. In high school I went through a Camels no-filter phase. As an adult I smoked two packs a day. I loved smoking after a shower, after eating, with a cup of coffee. But it got too expensive and I started feeling unhealthy. I’ve had TB and smoking wasn’t great for that health problem. My partner didn’t like that I smoked and it’s always been a bone of contention between us. There is a stigma attached to smoking cigarettes. It’s seen as a very working class habit to have.


    How did your switch to vaping come about?

    It was so much easier than I thought it was going to be to switch to vaping, but it took some time. I had a friend who quit smoking with Ecstacy herbal cigarettes. She talked about how using fake cigarettes helped her stop. That is where I first got the idea to try and quit.

    I tried Chantix but it gave me horrible nightmares, so I stopped taking the medication. Then I got a hold of a super, hipster big vape mod that you fill up. They blow a lot more clouds, unlike the cartridges that are more subtle. I tried e-liquids and they seemed a lot stronger than the pods, and I didn’t like the ones you need to fill yourself. People kept giving me vape stuff because they knew I was interested in stopping smoking. I remember having a little pile of vapes and never really using them. 


    What changed?

    Finally, one morning I woke up and I was out of cigarettes and I was like, Alright, fuck it, I’m going try one of these stupid vape things they keep giving me.

    It’s kind of like the same thing with the damn methadone which I’ve taken since 2006. It didn’t work and it didn’t work and then with Blu vanilla pods, it just worked. I like that flavor and it helped me switch.

    “I’ve been vaping for six years now. I feel a lot healthier.”

    I can use them in the house, they’re not stinky and I can moderate the amount I vape much easier. I use zero-nicotine or 2 percent; I alternate between the two. I prefer the pods because I don’t have to go to a special store. When I go to the gas station, I can buy them there. It’s so much cheaper to vape, too.


    How would you assess the harm reduction impact for you?

    I’ve been vaping for six years now. I feel a lot healthier and I noticed my lung capacity is better. I haven’t had a medical evaluation since I quit, but I just feel better. I got my teeth whitened so they’re no longer stained.

    The only time I went back to smoking was when I was on a cruise in Cuba and I couldn’t get any vapes. So I got cigarettes from someone on the ship and smoked. I felt gross afterwards and smelled bad. But I’ve never gone back to full-time smoking.


    What does nicotine do for you?

    Nicotine is really nice because I have a lot of stress. It helps me unwind. Vapes are part of my ritual for relaxing. Right now, I’m walking around my backyard vaping. I have a lot of pain, too, and I swear to God it helps with that to some extent.

    I’m tapering down on my methadone—not that I want to, but because I hate my fucking methadone clinic so much. I have to weigh out, do I want to be a prisoner and abused for my entire life in that clinic, or how much pain is acceptable to me? So I think vaping in some weird way has become helpful for that.

    With the little vape cartridges you can hold them like a cigarette and that helps with the fidget impulse. I sit down and read for school and have a coffee and a vape. It’s not obtrusive like other drugs that I’ve used and it doesn’t impose on people around me or scare them.


    Do you worry about whether you’ll be able to keep getting vapes?

    They keep eroding access. I was concerned that I needed to stockpile or limit the amount I vape in case of a ban. I believed there was no way they were going to ban flavors [for pods]—we are not full police-state fascism yet. But holy shit, they did! I was quite shocked. In retrospect, I was naive. When they banned the vanilla pods it was very destabilizing and I almost went back to smoking, but I said no. I had to force myself to stick with the tobacco flavored pods. I was like, fuck!

    The government is so intrusive to be banning flavors of things. Damn, they just can’t stop telling us what to do with our bodies!

    Recently I was in Cape Town, South Africa. But before I left, I went to the gas station to stock up because I didn’t know what products they would have there. The clerk informed me I was only allowed to buy three packages of pods per purchase, claiming that this was the law. But the amount of cigarettes I could buy was absurd, I think it was up to five cartons. I could buy ass-loads of dip. If I wanted vodka, no limit on that.

    What am I going to do, eat it? It’s so patronizing and paternalistic. And cigarettes are so much more harmful.

    In Cape Town I bought vanilla pods and I was able to get them in zero-nicotine and 2 percent. I brought back a stockpile. I’m hoarding them now.

    The government is so intrusive to be banning flavors of things. Damn, they just can’t stop telling us what to do with our bodies! I feel like I’ve given up so many other pleasures. I’ve got this one thing left, and they’re still trying to make this shit illegal too. Leave me something, please?  



    Photograph of Danielle Russell courtesy of Sonoran Prevention Works

    • Helen is Filter‘s senior editor and a multimedia journalist. She is on the methadone, vaping and nicotine train. Helen is also a filmmaker. Her two documentaries about methadone are Liquid Handcuffs and Swallow THIS. As an LCSW, she has worked with people who use drugs for over two decades. Helen is an adjunct assistant professor and teaches a course about the War on Drugs at NYU. She lives in Harlem.

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