drugs

Heroin Addicts Are Turning to Tumblr to Tell Their Stories — And Save Lives

Originally published in Mic.

“One and done is the rule for using needles,” Nicole*, an 18-year-old from Long Island, New York, writes on her Tumblr, nicolethedopefiendqueen. “After you use it once, dispose of it (capped, in a sharps or other container); you really shouldn’t be reusing needles if you can help it. A fresh, new needle is always better than a used one, even if it’s been sterilized.”

Nicole is an active heroin user. In an email interview, she said she began using at 14 after coming across her terminally ill father’s OxyContin prescription, which eventually evolved into heroin use. On her Tumblr, she posts selfies and re-blogs moody screengrabs from drug movies like Trainspotting, as well as close-up shots of spoons, lighters and syringes.

But to hear Nicole tell it, she doesn’t just use Tumblr as a platform for blogging about her heroin use. She also teaches other users how to do heroin safely. Her blog contains information about what to do if an overdose occurs, as well as how to administer Narcan (naloxone), an emergency antidote to treat opiate overdose.

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“I decided that if I’m going to have a drug addiction blog with lots of followers, I must spread harm reduction information, because addicts deserve to be healthy and to live,” Nicole said in an email interview. “I advocate for safe intravenous drug use, especially to help prevent infection and overdoses.”

Heroin addiction is a rapidly growing epidemic in the United States. The Harm Reduction Coalition reports that overdose is the leading cause of preventable accidental death in the United States, second only to car accidents. Since 2000, opiate overdoses have increased by 200%, in large part as a result of an increase of pain medication prescription, the Centers for Disease Control and Prevention reports. Because pills and heroin are sold on the black market, opiate use can be difficult to track, but a 2014 report estimates there are 1.5 million “chronic” heroin users in the United States.

Nicole’s blog is one of many on Tumblr that track the lives of regular opiate users. Many of such blogs’ posts feature the hashtag #nodsquad, a community that curates images of drug paraphernalia as well as information and resources promoting safe drug use.

Such blogs are based on the principles of harm reduction, which aims to reduce harm associated with drug use, such as overdose and spread of diseases like hepatitis C or HIV, through counseling, opiate substitution programs like methadone and safer injection facilities, or legal, supervised injection facilities where people can use heroin under medical supervision. (There are currently no supervised injection sites in the United States, but some cities and states like New York have toyed with the idea of introducing them.)

As Nicole explains it, “harm reduction is about reducing the damage and harm done from using. It’s not about stopping use, it’s about safety, which is the realistic approach to saving addicts in this epidemic.”

It’s a strategy distinct from abstinence-only programs such as traditional 12-step recovery methods, as harm reduction psychotherapist Eddie Einbinder said in a phone interview. “Harm reduction is not anti-abstinence,” Einbinder stressed. “Harm reduction is pro-choice.”

Susan E. Collins, co-director of the Harm Reduction Research and Treatment Center, thinks Tumblr blogs like Nicole’s can help to reduce harm caused by heroin use.

“[Nicole] is a person who appears to really care about her community, and is trying to help people use safer,” Collins said in a phone interview. “She is trying to reduce harm, and is being honest about where she’s at and her recovery. Personally, I think all of that is really admirable.”

Social media has created a space that didn’t previously exist for active users to connect with others and share information about how to use drugs safely, such as how to sterilize a needleafter use.

“A core concept of harm reduction is meeting people where they are, and I feel like most people don’t spend their spare time reading up on harm reduction techniques. But people spend time on social media like Tumblr,” Caroline, who keeps her own harm reduction blog, fuckyeah-harmreduction, told Mic in an email.

“Having a resource for harm reduction information on a platform that people are already using is a great idea.”

Caroline is not a user, but she became involved in the movement through a harm reduction organization she volunteers at in Washington, D.C., most often doing needle exchange or distributing safer sex supplies.

That said, some of the information being shared on Tumblr, such as user videos on how to shoot up safely, can be shocking to watch for those unfamiliar with intravenous drug use. Such videos, as well as artily lit images of spoons and stashes, has prompted debate as to whether such blogs glamorize drug use. It’s also worth noting that some users visit the blogs as a way to find drugs, if asks from users looking to score in a new town or city are any indication.

“Could it glamorize the use? I think yes,” Einbinder said in a phone interview. “It is hard to create a completely objective vision when you’re creating different forms of reality.”

Other professionals agree that the Tumblr community has potential for both help and harm.

“On the one hand, users are often the experts of their experiences and their own needs. If a user is generating content which is informed, safe, promotes hygiene, and teaches people how to reduce risks, then it can be powerful and helpful in a way that resonates with other users,” Sheila Vakharia, a coordinator of a substance abuse counseling concentration for students at Long Island University, Brooklyn, said via email interview.

“However, if user-generated content is full of people doing things in risky, unhygienic ways or if they are sharing false, mixed, or un-researched information, it can be just as harmful as any other problematic content on the web.”

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The blogs also raise the question as to whether Tumblr has any obligation to monitor content that promotes drug use on the platform.  (Mic has reached out to Tumblr for comment, and have not received a response at the time of publication.)

“I don’t necessarily think that platforms have a responsibility to monitor drug use content because it seems like a slippery slope,” Vakharia said. “I also understand that sales or advertisements of illicit drugs are in violation of laws. However, instructional videos from the health professions show doctors/nurses injecting patients all the time. Should a video of a person doing it to themselves be censored because the vial is filled with a substance that we think is illegal?”

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My Shrink Broke Up With Me

Going back to the dark days in my latest for Broadly.

According to therapist-cum-speaker Dr. Julie Gurner, “A responsible psychologist will always make a referral if the client continues to need treatment elsewhere, but it is ultimately the client’s responsibility to follow through with that referral. An exception to the client taking responsibility for follow through might be if they are feeling unsafe (suicidal) or are compromised in some other way.”

Two years ago, on a hot New York Summer’s day, still drunk from the night before, I walked into my shrink’s office and told him I needed to quit drinking and wanted to kill myself. I’m not sure if it was as cohesively articulated as that, but rather a rambling about how high a sixth floor walk-up apartment is, various uses of a cleaver, and that Lenny Kravitz had jumped out of the audience to play drums at the show I attended the prior evening. Regardless of my exact words, my psychiatrist’s response was clear: “I am no longer qualified to treat you, and I must terminate this relationship.” My ex-shrink told me he would be in touch with names of doctors who would be a better fit, and I wandered into Washington Square Park, shielding the sun from my eyes.

The Summer of 2013 was brutal for me: a sexual assault, followed by an alcoholic bottom, a breakup, and my parent’s divorce–I was a suicidal nutcase. As it was August, my ex-shrink was going on vacation, so by the time he got around to calling me with those recommendations he promised, I was already in treatment with someone else, primarily because I was taking antidepressants and benzodiazepines, which were going to run out. Benzodiazepine withdrawal can involve seizures, so it’s something you don’t want to fuck with. “If the patient is taking medication, sometimes they will simply continue the medication under the supervision of the same psychiatrist, but their visits will be less frequent. This would all be an ongoing discussion with the patient,” says Amanda Itzkoff, MD.

I’m too crazy for a boyfriend right now, but am I too crazy for a psychiatrist?

Being broken up with by your shrink can be a brutal blow to the ego–it has you thinking “I’m too crazy for a boyfriend right now, but am I too crazy for a psychiatrist?” Flipping through old diaries from that period feels like stepping into a horrific rape scene that I’ve seen in a movie–there’s a fearful recognition, but I can’t believe I ever actually lived it. Back then; even I didn’t want to be around myself, so I don’t blame the guy for ending the client/patient relationship. But I was curious: why do shrinks break up with patients? Are they even allowed to do that? 

“There are guiding principles you should follow, rather than an official set of protocol,” explains Dr. Gurner. “In graduate school, the act of separating with a client is referred to as “termination.” A fair amount of attention is paid to how you separate from a client…because how we say goodbye and end our relationships is so important.

Often, a psychologist or psychiatrist will terminate a relationship because the patient is exhibiting symptoms they don’t feel qualified to treat, as doctors typically have specialties. A common occurrence of this lies among patients diagnosed with Borderline Personality Disorder, as 10 percent of individuals with BPD successfully complete a suicide attempt. “Some disorders are certainly more difficult to treat, but I have not known of someone ending a patient relationship because of liability. The only reason I would see someone ending a patient relationship based on a diagnosis, is if they did not feel they could provide the specialty treatment required,” says Dr. Gurner. “Almost everyone I know has unfortunately had a client end their life, but none of them have ever faced legal action or fear that element of their practice.”

If the client is not committed to treatment, I would terminate our time together.

It may not happen often, but shrinks can be sued, which is maybe why my very handsome doctor felt I was out of his control. “Yes, therapists can get sued,” says Dr. Barbara Greenberg. “If the survivors feel that it was inadequate care. That’s why with all of your patients you have to access carefully for suicidality, or any predictors of violence, and you are responsible, and yes, you can be held liable,” said Dr. Greenberg. One of Dr. Greenberg’s specialties is treating BPD, so fear not Borderlines, there is indeed someone for everyone. “In my practice I get a lot of borderline personality disorders-I like people who are very energized who really need help; I find that stimulating. Substance abuse on the other hand, I might refer that person to see somebody else who had substance abuse as a specialty.” 

How many psychiatrists does it take to change a light bulb? One, but it has to really want to change it. An acquaintance of mine from high school was in treatment for alcohol abuse, and her doctor ended the relationship upon continuously catching her in lies about her drinking habits. “If the client is not committed to treatment, I would terminate our time together. People come to therapy for various reasons, but I would never accept a patient or keep someone as a client who was there at the wish of someone else,” says Dr. Gurner. 

If you’re suffering with substance abuse, please get some help. Find an AA meeting, or if you’re like me and don’t jive with the 12-steps, understand that there are other options. There’s the Buddhist recovery group Refuge Recovery, the science-based SMART Recoveryharm reductionayahuasca healingSatanism, honestly whatever helps you get your life together, I’m in support of.

Because we all really are different beautiful little fluffy fucking snowflakes, aren’t we? As with recovery, when seeing a shrink, it has to be the right fit, or it’s not going to work out. “There has to be chemistry. I call it the “relational bond.” If that bond doesn’t exist, you really can’t do good therapy,” says Dr. Greenberg. A cool thing for me about quitting drinking, is when I was drunk, I checked off all the boxes for probably dozens of diagnoses. When I stopped, it turned out I wasn’t insane; I’m just someone who absolutely does not mix well with alcohol. One spanking new fantastic shrink and two years later and I’m no longer drinking, and no longer suicidal. Maybe, if it continues to go well, the eventual breakup will be amicable. “The goal of any good therapy is separation, and that you’ve taught them how to manage their symptoms well enough that they don’t need you anymore. You hope for them every good thing,” says Dr. Gurner.

SEX, DRUGS, AND ROCK ‘N’ ROLL – I CAN’T FUCK YOU ALL, BARBITURATES, AND JAY ARNER

This is an important one so I’m going to post it all here. VIA VICE BITCHES.

SEX – I CAN’T FUCK YOU ALLL

With that cocky paragraph title, will I be called the next Samantha Brick? I hope not, that shit was annoying.

I’m unsure if it’s due to innate aspects of personality or related to my carefree upbringing, but I am very open about sex, and often wish the rest of the world would be too. I write about sex, I talk about sex, I have sex. However, my sexual candor has gotten me into some precarious situations. People mistake my sexual nature for a desire to have sex with them, or more accurately, somehow mistake my sexual openness with anexpectation that I’ll have sex with them. Not everyone of course, most people are far more awesome than we give them credit, and honest misunderstandings happen. Yet the other day, someone was trying to fuck me whom I did not want to sleep with, and he quoted things to me I had written in this column, as some sort of argument, a harsh rebuttal of my spurning. “Well, you wrote that you’re into…..” Awesome, thanks for the pageviews. Now I’m writing that you can go to hell.

I want a samurai sword to chop away penises. I’ve invented a version in my brain of that  game Fruit Ninja except it’s me, a red-headed Beatrix Kiddo slicing peens flying at me. A reader requested an extra dirty column this week. Sorry, this is not that column. This is a reminder that “no” means “fuck off, bro.” And while I’m at it, I’m tired of hearing this “her words said no, but her body said yes” shit. Sometimes people flirt, sometimes people will even give you a kiss or drunkenly dance with you. I don’t care if a girl has given you permission to fingerblast her or her pussy is in your face, if she says “this is as far as I want to go,” or “stop,” those words MUST be respected. If a girl is telling you “let’s have sex,” or is physically sliding your penis inside her she probably wants to fuck you. If she is pushing you away from her and saying “No, I don’t want this to happen,” she DOES NOT want to have sex with you. I realize it’s hard to think with those things all armed and ready for battle, but please just fucking evolve.

It’s quite simple. NO means NO, for everyone. And if I have to say it more than once, “NO” means “Fuck off, seriously or I am going to chop off your penis with my samurai sword.” You think I’m kidding about this samurai sword thing, but I have a tab open where I’m searching for one on Etsy right now.

DRUGS – BARBITURATES

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Photo of my new tattoo of the quote below, “A prayer for the wild of heart that are kept in cages.” Tattoo and photo by the very talented Joseph Aloi 

“A prayer for the wild of heart that are kept in cages,” the subtitle of Tennessee William’s Stairs to the Roof, are words that have always been dear to my heart, along with a special fondness for Tennessee himself. Beyond appreciation of his work, I feel some deep affection for the man I can’t fully explain. Although it is believed that Tennessee choked to death, barbiturates were also found in the room, a drug he abused throughout his life along with alcohol and amphetamines.

Today barbiturates are rarely prescribed, replaced by their B brother benzodiazepines, which have a lower risk for overdose. Like benzos, they were prescribed largely as anti-anxiety and sleep medication. Common early brand names included Veronal and Luminal, or perhaps you have heard of Seconal. Particularly fascinating to me is the super short-acting Pentothal, known as “truth serum.” I’m often an open book, those close to me might prefer I was prescribed whatever the opposite of Pentothal is, but I am quite curious if it does, in fact, work. Bill, is that what you shot Beatrix Kiddo full of before she stopped your heart? Spoiler alert! But fuck you if you haven’t seen Kill Bill yet, and for fuck’s sake it’s in the title.

By the 1960s scientists figured out barbiturates were pretty fucking dangerous. In 1965 the Drug Abuse Control Amendments were stamped into law, and then came the Comprehensive Drug Abuse Prevention and Control Act of 1970. All those fun drugs got a stamp of their own, the one that read, “warning,” but many of us see and read “fun.” Doctors tapered off prescribing them, although the drugs were still available on the streets through the 1980s.

Many, like my dear friend Tennessee have experienced the haunted merry-go-round of prescription drugs. The user, like Tennessee, truly does experience anxiety, depression, or other demons that lead to their prescription as an illness. However, the longer you’re on the ride the faster you go until around and around and around and eventually the drug itself creates the same symptoms you started taking it for, and you need more, more, more, and the withdrawal process is more painful and difficult than what forced you on the ride on the first place.

ROCK ‘N’ ROLL – JAY ARNER

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Jay Arner’s album cover. Thanks to Jay and Riot Act Media. 

The segmentation of this column is so random, I’m always curious of the artist’s reaction. I’m sorry Jay that you got chopped off penises and dead writers, I oh-so-much dig your songs!

Vancouver’s Jay Arner has played the field musically. He fronted an indie rock band, bopped around in a pop duo, even made up one tentacle of an eight-member collective. If I had a turd of musical talent, I’ve always said I’d be a solo artist, since humans can be annoying and attention is fun, so maybe after dabbling in such numerous groups Jay was finally like, fuck it, I’m flying solo.

Jay bird shows off his wing span on his self-titled debut, from 70s punk to 80s synthy shit to my favorite pop track of the album, “Don’t Remind Me,” which starts out with words we’re all familiar with, “About last night…”sung with a wink and a hint of embarrassment.It feels like waking up on a Sunday morning with flashbacks of stupid yet awesome shit you did the night before and simultaneously laughing yet cringing at yourself. I don’t think I would be in need of breaking out my samurai sword around Jay. We’d make out publicly and act like total fools but he would be respectful and put me in a cab home when I was like “Dude, you’re awesome, but I’ve got to call it a night.”

The self-titled debut is out June 25th on Mint Records. Stream “Don’t Remind Me” below.

SEX, DRUGS, AND ROCK ‘N’ ROLL – NOT SLEEPING WITH ONE-NIGHT STANDS, RUM, AND GAY REGGAE

Below are tidbits from my latest VICE column. Read it in its entirety here.

SEX

 I know it’s harsh, but from being both the victim and perpetrator of hitting and splitting, the truth is if someone peaces out minutes after orgasm, they’re just not that into you. You like someone, you stay. You stay for the morning sex and go to work in the same clothes as the day before or a borrowed T-shirt.

DRUGS

Vodka is for anorexic WASPs. Gin tastes like Christmas trees and not in a good way. Tequila makes you fuck your best friend’s brother in the back of a car. Whiskey… OK, whiskey, you’re cool. All I am saying is give rum a chance.

ROCK ‘N’ ROLL

One of my favorite modern-day reggae songs is “I Wanna Be Loved” by Buju Banton. I put it on and do my hippie dance. Now, I have adamantly defended the reggae genre from haters the same way I did above with rum. However, as I also touch upon in the drugs section of this column, I do have one major problem with the genre: it can be extremely homophobic.

SEX, DRUGS, AND ROCK ‘N’ ROLL – IN-HOME HIV TESTS, OXYCODONE, AND THE LAST BISON

My latest Sex, Drugs, and Rock ‘N’ Roll column is now up on VICE, in which I take an in-home HIV test while at home for the holidays, rant about oxycodone, and love on the Last Bison.  Click the link and read the whole damn thing! Here are some highlights:

SEX

At home HIV tests already existed, but you had to take a blood sample and mail it off then wait a few days and call some hotline to get your results. With OraQuick, it’s the same oral swab test they use at Planned Parenthood. You know, they take you into a room and swab your mouth, then you spend the next 20 minutes in the waiting room making a mental flow chart of all the people your partner’s fucked trying not to have a panic attack.

DRUGS

The last time I was given oxycodone was when I went to an emergency clinic for horrible cramps, I was convinced I had a ruptured ovarian cyst or something and they gave me 5/325 Percocet. I didn’t end up taking them, but rather saved them in my bedroom drawer – you know the one, where the dildos and nipple clamps live. They’re for “emergencies” but sometimes I’ll nibble off a little crumb of one before a tattoo or Brazilian bikini wax appointment. Judge away, but Brazilian waxes are paid-for torture.

ROCK ‘N’ ROLL

For the day after Christmas, when the cats wrestle in the wrapping-paper jungle left under the tree, and the Brits and anyone else smart enough to take advantage of Boxing Day are drunk once again, and for all the cold wintry days to follow — it’s nice to take a break from your usual hip-hop or punk and play something a little merrier. I’m convinced the Last Bison are lovely any season, in fact their upcoming full-length album doesn’t even come out until March, but I found them so delightfully perfect for the holidays I had to write about them now.

VAGINA EATING, AMBIEN, AND RENNY WILSON – SEX, DRUGS, AND ROCK ‘N’ ROLL

The latest. Read the entire thing at VICE.com.

SEX – FIVE SINGS YOU SHOULD TRY VAGINA

You understand what Lady Gaga meant in “Poker Face” – Unless you’re a Mennonite, you’ve heard by now that “Poker Face” is about Gaga trying to keep a straight face while fantasizing about a woman to get off during sex with a man. Ever find yourself being pounded by a penis and imagining he’s a hot tattooed domme wearing a strap-on instead? Perhaps you should stop imagining and change your OkCupid sexual preference.

DRUGS – AMBIEN

A few weeks ago I flew back from Australia and the jet-lag brought my insomnia back in a major Tyler Durden way. After about a week of no sleep I found myself spending most of my time either crying or laughing hysterically for no reason, unable to write, and wandering the city with random pieces of bacon in my purse. After trying every other method I could think of with no success, I finally talked to my doctor about Ambien.

ROCK ‘N’ ROLL – RENNY WILSON

My Renny sexual fantasy involves a thrift store disco ball turning very slowly, bouncing light off of two frosty mugs of beer. He’ll then strut across the room, locking eye contact, and hand me my glass. He’ll put the vinyl copy of Sugarglider on, and whisper in my ear that I’m the first girl to hear it. Despite his somewhat dorky looks, I have a feeling Renny could get a girl wetter than Prince can.

HANDJOBS, NATURAL STRESS SOLUTIONS, AND DUMBO GETS MAD – SEX, DRUGS, AND ROCK ‘N’ ROLL

SEX

The handjob is a lost art. Sure, plenty of us gave them in high school, and threw some pity handjobs in college. You know the kind where you drunkenly go home with someone and realize half-way into the make out session that they look like a Dr. Seuss character. Perhaps you realize too late that that’s a NASCAR poster on his wall, but his cock is already out. There’s no way that thing’s going inside an orifice. Only option is a HJ.

DRUGS

Anyway, I squeezed a couple drops of lemon balm in my water and nothing happened, so I poured a shot or two more into my water and gulped it down. About a half an hour later, I felt goooood. Then I take a look at the bottle and discover this “liquid lemon balm” contains 30 percent grain alcohol.

ROCK ‘N’ ROLL

I’m a jet-lagged insomniac who hasn’t slept in days. I’ve tried all the tricks I know; meditation, medication, marijuana, masturbation. Nothing is working. Dumbo Gets Mad’s upcoming LP Quantum Leap sounds like how I feel. Like I’m half awake and half asleep, in between the worlds of dreams and reality.

Above are selection, read the entire thing at VICE.com.