My brother's legacy: all about harm reduction

CW: addiction, overdose, loss, harm reduction, grief

This blog post goes over the legacy of my brother Ashton who passed away in 2017, and contains information about harm reduction efforts and how to get started with harm reduction. It’s broken down into the following sections:

1. My story
2. What is harm reduction?
3. How to engage in harm reduction in your community
4. More about Ashton
5. My brother’s legacy

My story

On March 16th, 2017 I sat down with my fairly-new therapist to talk about an upcoming visit to see my family in Arkansas. I was 25, and had yet to tell them that two years into moving to Portland I had divorced the now-ex husband who once whisked me off to the west coast. I wanted to prepare for a number of hard conversations, some about revealing new tattoos and pink hair, some about my marital changes, some about my new partner–but one in particular felt most important. My older brother had become addicted to opiates, and I wanted to level with him about it, but didn’t know how to start.

I remember sitting down with my therapist and telling her that six months ago he had overdosed by accident and survived. None of us knew before then that he was using. We knew he struggled with alcohol, self worth, and community. He had fallen out with some of his closest friends, and we hadn’t been sure why. I strongly feel the lack of conversation around his struggles, largely to avoid the stigma of drug use, contributed to his premature death.  I know based off of who he was as a person and the work he did while he was alive that he would be comfortable with my sharing his story and using his legacy to promote harm reduction practices.

I told my therapist that day that I felt I could get the call any day that he had passed. The vulnerability of it overwhelmed me. I had avoided talking to him for months out of fear and frustration. I wanted to ask him to be honest with me, and wanted to find some way to express my concern. She talked about treating him with compassion and patience, which I had struggled with in recent years. Sometimes when you feel the helplessness of watching your loved one suffer, a wall of anger rises to protect you. I couldn’t see past it.

That night a good friend came over with a bottle of Sazerac rye and we talked until 2am about all these feelings. I went to bed more reassured, ready to face my flight home in a week. Then I got a call five hours later from my dad. He told me they’d found Ashton in his car that morning, having accidentally overdosed the night before on a supply laced with fentanyl. He was gone.

The events that followed–my family getting food poisoning, my mom and I taking the reins, planning his funeral, cleaning out his apartment, writing his obituary, standing in line at the visitation, his highschool sweetheart pressing his class ring into my palm–are still very crisp in my mind. Seeing his apartment in shambles, I could tell how much he struggled in secret, and felt ashamed. The wind blew the door open and the sunlight poured in, and I felt like he was standing there, saying goodbye.

As I left Arkansas, I made a promise to myself that I would honor his memory as much as I could from then on. The work I did to close this last chapter of his life was like an apology letter from me to him. I wanted to learn more about how I could keep this from happening to anyone else, reading in the news two weeks later that 23 people, all under the age of 30, died from the same tainted supply that took his life. This started my journey in learning more about harm reduction.

What is Harm Reduction?

Harm reduction refers to actions we take to reduce the harm of potentially harmful practices. It can cover everything from drug use to sex work to workplace safety to accessibility. In this blog post I go over harm reduction as it relates to drug use, with a focus on opiates in particular. I’m not a professional educator, so this post goes over my personal beliefs and harm reduction practices, but there are as many ways to do this work as there are people, so cast a wide net as you learn more.

When acting as a harm reductionist, you listen to the communities directly affected as they ask for the resources they need to function. Many organizations adopt the motto of “nothing for us without us.” It means that we center addicts’ voices in conversations around support and recovery–including people who are actively using.

In the case of drug use, most harm reduction practices are geared toward keeping addicts alive, without the requirement of total abstinence and sobriety. This is the most ethical way to help addicts because it keeps them alive for longer, prevents the spread of life-altering infections and disease through their communities, and shows them that they are fully human and deserving of care regardless of their circumstances. To me, harm reduction centers an addict’s humanity and leaves the door open to their future. 

Some of my favorite examples of harm reduction include:

1. Safe use centers, or places where people can use in the presence of a professional who can intervene in the event of an overdose
2. Distribution of free Narcan/naloxone, an overdose-reversing drug that can be administered to unconscious people
3. Fentanyl test strips, which show if a drug is laced with the prescription opiate so potent it can cause overdose in extremely small amounts
4. Direct and free distribution of safe use supplies which can include clean syringes, distilled water, or alcohol wipes
5. Using with a sober companion who can intervene in the event of an overdose
6. Free distribution of PrEP, a medication that prevents the spread of HIV 
7. Non-police emergency phone numbers for assistance with complications of drug use
8. Sanctuary laws that prevent the arrest of users for being in possession of illegal substances in the event that they call 911 for an emergency medical situation
9. Community education on reversing/preventing overdose and other safe use practices

I lose followers every year when I talk about my brother and about harm reduction. Many people find it extremely controversial to offer addicts assistance, saying that it’s enabling their behavior. I’ve heard the same concerns echoed over and over again: that addicts are a waste of public resources, that drug users are criminals, that keeping addicts alive with safe use supplies is as bad as buying them drugs. I counter with this: addicts suffer with a disability that means they especially need community support–not isolation. There is no condition so abhorrent that it merits another person’s loss of life, and this is especially true for addiction, which is not unethical by nature. Addicts deserve autonomy, care, and recovery.

How to engage in harm reduction in your community

The first step in this process is acquainting yourself with harm reduction organizations in your community. Many mainstream addiction recovery centers have a requirement for sobriety or a requirement for the adoption of specific religious beliefs. These methods can be ineffective or inaccessible for some users, so focusing on an organization that centers survival and care regardless of creed or drug use habits is my preference.

Once you’ve learned more about these organizations, find one that’s geared specifically toward your talents. I am not an addict, not a registered medical professional, not a counselor, not even college educated–but I am an artist and a compassionate listener. For that reason, I spend time with the Artist Mentorship Program (AMP) in Portland, a space providing resources to youth experiencing homelessness that allows youth to come and go, gives out free fentanyl test strips, keeps Narcan in stock for overdose prevention, and gives them a safe place to spend time with their community. 

Through the judgment-free connections I make there, I talk to youth about their struggles and problems, but also about their joys and potential. The most important thing I feel we can do for our most vulnerable populations is remind them that we see their value. Our personal value determines what future we live for. Showing people they have a future worth living for keeps them alive.

Here are some other ways to practice harm reduction:

1. Learn how to prevent an overdose and notice the signs. Then carry Narcan (you can get cute keychain holsters for it, even) so you can use it in the event of an emergency
2. Make sure your closest people know that you care about them without judgment,  and the door is always open for them to let you know if they’re struggling
3. Share fact-checked, reliable resources for addicts with your community. Please bear in mind that almost none of Ashton’s friends knew he was using. Even if you think you don’t have any followers who use substances, you very well may!
4. Donate funds or supplies to organizations who distribute safe use kits (or distribute them yourself, if you’re able and the law allows it)
   

I donate to an organization in Arkansas called Central Arkansas Harm Reduction Project, or CAHRP. They distribute harm reduction supplies on the ground in the place where my brother died. The work they do for the community is absolutely essential, and does its best to cover the gaps where our government fails us. You can learn more about them here:

https://www.arkansasharmreduction.org/

Here are some additional resources I crowdsourced from the amazing followers of the Bus 20 Instagram account:

-The People’s Store PDX (@thepeoplesstorepdx on Instagram), a mobile free store distributing supplies to Portland’s unhoused community

-Northwest Family Services https://nwfs.org/ an organization focused on family stability, child well-being, and victims of crime by addressing social determinants of health

-Community Free Store PDX (@communityfreestorepdx on Insta) - a free store providing essential supplies in Portland

-Yellow Brick Road ( https://janusyouth.org/homeless-youth/ ) an organization that moves on the ground to distribute supplies for free directly to vulnerable populations

-Needle exchange at Outside In ( https://outsidein.org/ ) - the youth I work with love Outside In and have benefited a lot from their programs

- Jamie Daniels Foundation ( https://jamiedanielsfoundation.org/ ) 

Feel free to include your own recs in the comments!

I provide free bereavement work, memorial consultations, and urns to victims of the opioid crisis, victims of anti-LGBTQ violence, and to bereaved parents. Reach out to bus20ceramics@gmail.com for more information.

More about Ashton

Ashton graduated with two degrees and a high GPA from his bachelors program at Arkansas State University, where he majored in political science and philosophy on a full academic scholarship, and served as president of his fraternity. He lived in Washington DC for a time, dreaming of becoming a politician or lawyer, where he could make real change for others. He proudly advocated for leftist policies and wanted to use his gifts to support his community. He lit up every room he walked into, loving the spotlight and any opportunity to make someone laugh.

I have memories of playing Zelda together, when I held the guide book and he fought the enemies. We used to play spaceship in our living room. He was always the captain and I was the first mate, and he made up so many clever adventures for us to go on. He loved Godzilla movies so we had to watch them a million times. As a teenager he would blast AC/DC from his boombox, and I would blast Sarah McLachlan. We fought when he read my diary out loud to all his friends at a sleepover, when I told our parents he was hooking up with his girlfriend in his bedroom, and hundreds of other times over hundreds of other things. When he died, I discovered I was in his phone under “granola munching tree hugging bitch,” and I still laugh about it.

At 27, he privately became focused on an end-of-life plan–an age where no one should have to confront their own death. Because of the plans he made, when he died, I was taken care of financially. These finances enabled me to fund scholarships and charitable programs, pay off his debts to others, cover his death expenses, and create a foundation for my life. He was not a selfish or unkind person–just someone slowly losing control over who he was and the life he was living, while feeling powerless to stop it.

When I think of Ashton’s legacy, I think of all the messages I received in the wake of his passing detailing small acts of kindness he carried out over the years. His visitation had a line out the door of the funeral home, wrapping around the building, and people of all ages came to pay their respects to the family. I saw a room full of people with a shared love for a good man gone too soon.

I understand that his struggles with addiction largely came from a combination of trauma, genetics, and bipolar disorder with a later-in-life diagnosis. He experimented with substances recreationally as almost every person I know did, but they took hold of him in a way that doesn’t happen to everyone. His drug use started with a prescription and escalated over the course of two or three years to becoming heroin addiction. Addiction can begin in a number of ways, and regardless of any outsider’s perception of their ethics, all addicts deserve care.

It’s very strange now being older than my brother. When I spend time with 27-year-olds I think of how young they seem to me and can’t believe he was only that old when he died. My son inherited his name, born the day before his birthday. I tell stories about him and keep his memory alive within my home and little family.

Ashton I love you and I wish you were still here! Even as grief becomes more familiar, the loss of you still stings every time something happens I wish you were here for. Wish you could have met my son, wish you could have seen a certain someone we know get too high at Dave Matthews Band, wish you could help me feel less frightened by our insane president. I hope wherever you are you’re laughing at it all and I look forward to seeing you there someday.

If you’ve read this far, as always, I thank you. Please consider volunteering or donating to a harm reduction organization in your area today. If you’ve lost someone to the opioid crisis, my heart goes out to you. 

-xoxo Frankie