August 31st, 2016
Today is International Overdose Awareness Day. Days like this used to feel weird to me. I spend most days working with and loving people who use drugs—providing trainings, working at syringe access programs, doing street outreach, and fighting against harmful and racist drug war policies. Being around overdose deaths and communities affected by them is my norm. So official awareness days can feel disconnected from my daily struggle.
This isn’t to say I don’t want people to know about overdose—though perhaps we should more often talk about “drug-related deaths,” since most deaths involve combinations of different drugs, rather than too much of one.
I do want people to know.
I want people to know how horrible it is to have lost so many people that you stop dressing nicely for funerals, and eventually stop going altogether. By the time I was 21, I had more dead friends than fingers. I stopped being able to tell the difference between suicides and accidental overdoses—I stopped thinking that differentiation mattered. I leaned into the temporary nature of friendships and relationships, celebrating connection hard because it could very well dissolve at any moment.
I often want to scream and cry about overdose, to make people know about how crushing it is—but usually this sentiment is strongest when people I know or am connected to die, or when something in particular makes me remember them.
August 31 isn’t always that day.
But there’s something to be said about holding space. Time for reflection and collective consciousness can be both beautiful and useful. As I’ve grown and lost more people, I’ve learned to value sharing the weight of the world with others, the weight that impacts them and me.
Recently, a friend reached out. Someone her son knew had OD’d. She was having trouble connecting with him about this loss, this very palpable tragedy that rips through the chests of everyone close enough to feel.
Her son didn’t want to acknowledge his friend’s death as a tragedy, she told me. Instead, he wanted to celebrate him for “dying the way he lived, dying living the life he chose and wanted.”
Her heart seemed doubly weighted with the grief her son refused. But while every drug-related death is tragic, there’s something to her bereaved son’s sentiment that resonates in my torn-open chest.
It’s reminiscent of the colossal walls of sound that reverberated through the warehouse shows of my teens and early twenties. So many of my midnights were spent in stolen or borrowed spaces, my eyes too glazed to see that I was on stolen and borrowed time. I often laughed with my friends when we would lock our bikes four-high on fences without remembering the ride. My sweat was as wonderfully toxic as the music we loved. We bathed in sounds born of hopelessness and hurt—of alienation from society outside of those narrow confines.
I have had more privilege than many, but something about a junkie rejection of the state hits close enough for me to understand it, at least in glimmers and fragments. Our capitalist society doesn’t create accessible opportunities for pleasure, expression, growth and connection. It leaves those of us on the bottom, socially or economically, without the agency to create or find the meaning that makes life worth really leaning into and loving sincerely.
Refusing to engage this hatefully violent system on its own terms feels noble, if not alluring. With drugs, those seeking agency or pleasure need only look so far. It’s relatively easy to hit a vein, even easier to snort a line—to find bliss, connection, empowerment, life in a world that offers too little of these things.
Not everyone who uses ends up using frequently or “problematically,” but use does become a driving force for some. Bruce Alexander’s oft-cited “rat park” study is demonstrative.
Early research on addiction offered lab rats the opportunity to self-administer morphine (or sometimes other substances) in the water they drank. These rats’ drug use almost always increased to the point of death, solidifying to some the biological inevitability of addiction once substance use begins.
Alexander, noting the rats’ glaring isolation as a variable worth exploring, designed a different study. The lab rats were placed in a large cage with toys and tunnels, where they were allowed to be social and have sex. In this experiment the rats consumed significantly less morphine and never died (Alexander, Beyerstein, Hadaway and Coambs, 1981—a cute comic depicting this study can be found here).
The obvious but vital implication is that drug use does not exist in a vacuum, but is heavily influenced by opportunity and environment. Rather than brazenly assuming that addiction is inevitable, we should recognize that our society creates, for many people, an isolated cage.
This, to me, is the site of the deepest pain I feel today.
While each overdose death is its own devastation to those affected, our collective incapacity to create a human equivalent of rat park—denying people agency, pleasure, community and freedom to the point that they feel the need to reject society in such a harm-associated way—is beyond tragic. There’s no amount of candles to hold an appropriate vigil.
On this Overdose Awareness Day I mourn not only the lives lost, but the life lost. So many of those who don’t die have wanted other paths that have been denied them. Their isolation is so strong that people may not even realize when they want other opportunities and connections.
Yes, we can and must demand every kind of real help and human kindness and harm reduction intervention. But without deeper structural change, this is a superficial kind of comfort. As deeply committed as I am to harm reduction practice, it is not in and of itself a cure.
Read more from The Influence:
A junkie rejection of the state may be deeply resonant, but it is only beautiful if we accept that this heinous capitalist society is the only possible society. This is not a conclusion I assent to. I believe we can do better. We need to do better.
People are dying and have been for a long time—long before white kids in the suburbs started dying and people recognized the “opioid epidemic.” Relegating people to the margins will have that effect.
I hope that today you are aware, that you mourn, that you do whatever you need to do to take care of yourself in the face of intractable loss.
But more than show awareness, let’s do the work to dismantle a broken system and build a better one. Let’s take action. Let’s recognize harm reduction as resistance to the social and economic structures that produce the harm in the first place. Let’s expand our conception of harm reduction to include struggling to change the system so that it allows for human growth, opportunity, meaning and agency.
Let’s take today to grieve, but tomorrow, let’s come back and fight.
Soma Navidson studies and works in health care; she’s rooted in harm reduction and primarily focuses on housing justice, prison abolition, queer and trans liberation, and fighting the drug war. Some of her thoughts on nursing and the medical-industrial complex can be found at her blog: nursingroar.tumblr.com.