What does harm reduction mean to you and how does it relate to your lived experience?

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We sought out anonymous input from Midwestern folks with lived experiences regarding addiction, homelessness, sex work, mental illness, and/or trauma, and asked them to answer the above question. This could include first-hand experiences, experiences with friends and family, and stories recalling past struggles with recovery and financial duress, as well as on-going hardships. Here’s what they had to say…

1. Harm reduction, to me, ultimately means education, longevity, and safety. Having education about certain scenarios and how to make it safer for yourself and others around you is so important. When I was a sex worker, due to poor sexual education, I did not know basic safety measures and how to protect myself. Arming myself with the tools and the education would have helped my experience be less traumatic. I still bear residual trauma from this time in my life, even though it has been years now. Seeing how harm reduction could have made my experiences safer made me angry but also sad. Because I was a 19 year old girl, I should have been offered stability, and I should have been arming myself with tools of protection.

I still feel that odd emotion of rage, but also sadness for the little girl I was. I was in a greater state of risk from persecution not just from clients, but also the Police. Treating people as survivors and not criminals is another way to reduce harm. Having Police raids because of a choice you made to survive is not harm reduction. Harm reduction can be your only friend in times of need, which is why it is vitally important. Harm reduction helps all of us.

2. Abortion is harm reduction. So is clinic escorting. Using rainbow umbrellas to block opinions of people who don’t understand is harm reduction. Wearing a rainbow vest no matter whether it’s 99 degrees or minus 20 is harm reduction. Giving directions to food, gas, playgrounds to drivers of patients is harm reduction. Offering hugs is harm reduction. Being there for people making hard choices is harm reduction. Being there for people making easy choices is harm reduction. Watching “Just Wright” every morning in the waiting room is harm reduction. Listening to patients’ stories is harm reduction. Reflecting and validating is harm reduction. Laughing with them is harm reduction. Telling them it’s okay to cry is harm reduction. Answering their questions is harm reduction. Finding funding for them is harm reduction. Referring them is harm reduction. Passing out snacks is harm reduction. Rescheduling is harm reduction. Fitting them in last minute is harm reduction. Staying late is harm reduction. Working together is harm reduction. Making P4P pots is harm reduction. Planting P4P plants is harm reduction. Helping patients choose which pot to take is harm reduction. People making their own choices is harm reduction. Helping people make their own choices is harm reduction. Donating to abortion funds is harm reduction. Sharing your abortion story is harm reduction. Abortion is harm reduction.

3. Harm Reduction means managing my mental illness to the best of my ability so that I can maintain my health and relationships. It’s not about abstinence and perfection. If I mess up I try not to hate myself; shame only leads to despair and the continuation of harm (I still really struggle in this aspect). I have addictive tendencies. I still self-medicate but I’d rather it be with THC than random pills I stole. I drink a lot of coffee now. As a side note, I recently realized that the voice in my head that used to tell me to smoke, now tells me to kill myself. I feel very alone and that there aren’t a lot of options for me in terms of resources. I don’t even have health insurance. I’m high functioning, most days. I get by, and I don’t have time to waste waiting in the breadline. I pray tragedy doesn’t strike while feigning ignorance of its possibility.

I was briefly without a place of residence while in college after I left an abusive boyfriend. I’ve always felt it doesn’t really count as homelessness because I had access to the institution’s facilities. I slept in my car. I don’t have clear memories of that time, but it was enough of an experience to know I don’t want to repeat it. Yet I’m aware of how easily it could happen again in a more severe manner.

I don’t ever want to go back to being the person I used to be (or worse). I can only try to do my best, to try to make progress every day, to do the least amount of harm possible, and be grateful I am where I am in this moment.

4. Harm reduction principles are applicable to all areas of life. I worked on the harm reduction division of the city of Fargo and now I work for another organization that works on a harm reduction model. Harm reduction is having a sober driver when you’ve been drinking. It is eating the food that feels safe whether or not it is the healthiest in eating disorder recovery. It is wearing a seatbelt. Harm reduction meets people where they are at. It doesn’t impose any values, it just wants to be safe.

5. Harm Reduction is a strong community that looks out for one another. I have a friend who is currently without adequate shelter. He’s really not doing well. I can empathize with the pain he must be feeling. My friend belongs to several marginalized communities, including being Native American. He experienced so much trauma as a child and teen. He has overcome so much adversity. He was doing so well but relapsed. He’s sick. He isn’t capable of seeing himself as anything other than a victim. He might be a narcissist. He might even be abusive. I don’t know if he was just using me to fill his narrative. I want to believe that part of him did care about me as a person. I thought he was my friend and it breaks my heart to see him refuse treatment even though he’s so desperate to be saved. I wonder what else we could have done as his friends to have helped prevent this situation, but ultimately he’s the one living the consequences of his actions. Still…I feel like we’ve let him down, the system let him down (and traumatized him), and if he happens to read this…I’m sorry.