New York City Moves To Expand Availability Of Naloxone

In the wake of a rising death toll in the opioid overdose epidemic, New York City Mayor Bill de Blasio has announced a plan to make the overdose antidote, naloxone, more readily accessible.

Naloxone, an opioid antagonist also known under the brand name Narcan, will be available for around $50 over the counter at Rite Aid and independent drug stores in the city, according to Newsday.

De Blasio and other city officials announced the change in a press conference on Monday.

According to city data, opioid-related overdose deaths have increased by 56% since 2010. “The deaths are what we all struggle to avoid … but that’s just the tip of the iceberg,” said de Blasio. “For every death, there are literally hundreds who struggle with addiction.”

City Health Commissioner Dr. Mary T. Bassett echoed that sentiment. “In order to recover, you need to stay alive,” she said.

Technically, naloxone is still a prescription medication, but because Bassett announced a citywide standing order to dispense the drug—something Baltimore did earlier this year—it is available over the counter.

Last year, New York City Police Commissioner William Bratton announced that he planned to have the city’s entire force trained and equipped with naloxone. And New York Attorney General Eric Schneiderman announced a statewide program to fund more naloxone for police departments statewide.

In addition to making naloxone more available to the public, the city will spend $750,000 to distribute naloxone kits to New York City drug prevention programs. On a similar note, the city announced plans to train 1,000 more medical professionals to prescribe buprenorphine, a drug that is used for opioid replacement therapy.

At the press conference, 21-year-old James Brenker of Staten Island spoke in support of the initiative. He said that his own life was saved by naloxone when he overdosed on heroin and oxycodone.

“I felt like no one cared. I know a lot of addicts feel that way,” he said.

This story was originally published on The Fix.

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Johann Hari on Billie Holiday, Harry Anslinger, and the War on Drugs

On Wednesday – the same day that New York approved emergency access to medical marijuana – New York City activists gathered in a Chelsea loft to hear Johann Hari, author of Chasing the Scream: The First and Last Days of the War on Drugs, explain why the drug war hasn’t worked.

He began, though, not by talking about the modern drug war, but by telling a story that started more than three decades earlier.  

“In 1939 seven blocks away from where we are now,” Hari said, “Billie Holiday walked on stage in a hotel where she wasn’t even allowed to walk through the front door. And she sang a song. It was called ‘Strange Fruit.’”

That was “the musical starting gun for the civil right movement,” but at the time it attracted unwanted attention from one Harry Anslinger.

For more than three decades, Anslinger was the head of the Federal Bureau of Narcotics. He was the man responsible for waging the war on drugs before it was called the war on drugs.

According to Hari, he had a “really intense hatred” of drug addicts and of African Americans — and Holiday was both.

The same night the rising jazz great sang “Strange Fruit,” Hari said, Holiday got a warning from Anslinger: Stop singing that song.

But Holliday didn’t stop, and Anslinger stayed true to his threat.

He hired someone to follow her and, in 1947, the singer was arrested on drug charges and sentenced to 18 months in prison. After her release, she couldn’t get the license she needed to perform in places that sold alcohol.

“This is what we are doing to addicts all over the world,” Hari said. “We are putting barriers between them and their ability to reconnect.”

Holiday started using again and by the late 1950s, years of drug and alcohol abuse took their toll: She was diagnosed with liver cancer.

Hari
Johann Hari in 2011, via Wikimedia Commons

Hospitalized in 1959, she was arrested and handcuffed to her deathbed when cops raided her hospital room. She died, but Hari doesn’t think Anslinger — who later became an opiate addict himself — came out on top.

“Right now people all over the world are listening to Billie Holiday and they’re feeling stronger and nobody fucking remembers Harry Anslinger,” he said.

That’s not entirely true, though. As Hari recounted, at least one person remembers Anslinger: Maricopa County Sheriff Joe Arpaio.

In the course of his research, Hari visited Maricopa County — and found a picture of Anslinger hanging on the notorious sheriff’s wall.

In that same visit, Hari passed a chain gang of female Maricopa County inmates digging graves, wearing shirts the read “I Am a Drug Addict” and trying to ignore the jeers from passersby.

According to Hari, that’s the exact opposite of how addiction should be addressed, because it’s based on a misunderstanding about how addiction works in the first place.

There’s an assumption that heroin causes heroin addiction which means that forced sobriety is the solution, Hari said.

He doesn’t think that’s accurate, though.

Early addiction experiments showed that a rat put in a cage with a bottle of drug-laced water and a bottle of regular water would quickly become a drug addict, Hari said. That seemed to reinforce the idea that the drugs were the problem.

In the 1970’s, Bruce Alexander tried a different experiment. He gave the rats the tools for happy, fulfilling rat lives instead of putting them in rat solitary confinement. They had the drug water and the regular water, but they also had toys and — most importantly — rat friends.

“It’s basically heaven for rats. It’s called Rat Park,” Hari said.

“This is the fascinating thing: In Rat Park, they don’t like the drug water. They almost never use it. None of them ever use it compulsively, none of them ever overdose.”

Addiction, Hari said, is not about drugs; it’s about the cage.

“We’ve got to change the cage, we’re living in a shitty cage,” he said.

Hari believes that, like the rats, humans need to bond with the others in their cage.

“But when you can’t do that because you’re traumatized, or isolated or beaten down by life, you will bond or connect with something that gives you some sense of meaning [and] that might be heroin,” Hari said.

“For 100 years we have been singing war songs about addicts … we should have been singing love songs to them all along,” he said.

Safe Injection Facilities: Out of Harm’s Way

Damien Trimingham was a bright kid. He was well-liked and a successful athlete. He came from a good family. He did not seem destined for a life of addiction— and indeed he wasn’t.

At just 22, Damien died of a heroin overdose.

The police did not notify his worried family for three days.

That was in February of 1997, and now almost two decades later, his father Tony, a psychotherapist, has become a leading voice in harm reduction.

On Sept. 30, he recounted his son’s story to a crowd of more than 200 at “Out of Harm’s Way,” a panel discussion in Manhattan.

“It was, of course, a shock even though we knew that death was a possibility with heroin use,” he said. At the time of his death, Damien was trying to stay clean. His father said, “That’s one of the ironies of heroin use, that the people who die are often the ones trying to give it up.”

He continued, “I was to find out later that no one has ever died in an injection center anywhere around the world, even though there are many overdoses.”

That’s when Tony latched onto the idea of safe injection facilities (SIFs). Although they aren’t legal in the United States (yet), there are around 100 SIFs operating around the world, in places like Canada, Spain, Germany, Holland, and Norway.

The idea is that SIFs provide a safer environment for injection drug users. Staff are available to teach safe injection practices and clean syringes are free for the taking. Crucially, there’s also naloxone available to treat overdoses immediately, without any fatalities.

Predictably, SIFs tend to face some initial resistance, but in Australia, Tony was instrumental in turning the tide of public opinion.

The year that Damien died, the Australian government proposed a heroin prescription program, but ultimately the prime minister vetoed it. But the time seemed ripe for harm reduction and so Tony took action. He wrote a letter to the local paper, describing his son’s death and explaining how unnecessary it was. The paper published his piece on the front page, and it sparked debate.

After four years of lobbying and advocating, Tony said, “We got our injection facility, thank goodness.” He added, “It was a hard road because there were opponents.”

Overall, though, he said it’s often apathy and not opposition that is the toughest obstacle. “Most of the general public don’t really care,” he said. “They’re not pro, they’re not against. It doesn’t affect them.”

Like Australia, Germany has safe injection sites, and another of the panelists—former Frankfurt drug czar Werner Schneider—documented the history of his city’s harm reduction efforts. Frankfurt began exploring harm reduction in earnest in the 1990s in response to a significant uptick in heroin use. That exploratory work quickly led to the creation of a safe injection facility.

Schneider said, “The most important result of this program was a tremendous reduction of drug-use related death cases.” Simultaneously, the city witnessed a decrease in criminality and also a decrease in public concern about drug use as a major citywide problem.

Like Frankfurt, Vancouver experienced a ballooning heroin problem in the ’90s. Canadian Senator Larry Campbell—a former law enforcement officer who was also the mayor of Vancouver—told the crowd that as overdose deaths skyrocketed, so did HIV and incarceration rates.

After a decade as a cop and two as a coroner, Campbell got tired of watching the bodies pile up, and so in 2002 he ran for mayor.

“I ran on the platform that I would open a supervised injection site in Vancouver,” he said.

He did that, but keeping open North America’s only safe injection facility, Insite for Community Safety, was a struggle. Although the federal government initially offered the program a three-year legal exemption, once that initial approval expired, Insite had to sue to keep its doors open.

Campbell said that SIFs are a crucial part of the shift from punishing addicts to treating addiction as a medical problem.

“Addiction is a medical disease. Addiction is not a criminal offense. No one starts out life saying, ‘You know what, I think I’ll be an addict,’” he said.

“You can address this as a humanitarian gesture, a humanitarian idea, that we’re all people … but I recognize that there are those who don’t move from a humanitarian end but from an economic end.” That works, too, though, because Campbell explained that safe injection facilities can save on welfare, police and prison costs.

“So whether you believe in humanitarianism or economy,” he concluded, “this is an idea that works. It’s good, and it’s time.”

Liz Evans, a nurse who works with Insite, concurred. She said that Insite is estimated to have saved $14 million in 10 years. “Over 2 million injections have taken place and not one has resulted in death,” she said.

Over time, the community has come to accept the program. Evans said that the last poll taken showed that 76% of Vancouver residents supported the safe injection site.

By bringing users off the streets, it has created a better environment with less public injection around the facility but also, she said, the presence of a safe injection facility seems to encourage people to get help. “If you’ve just come to Insite once, you’re 33% more likely to come to detox or treatment,” she said.

Evans pleaded for “peace” in the War on Drugs and said, “The controversy today should not be around where … a safe injection facility makes sense. The controversy today should be over how we have allowed the status quo to persist for such a long time.”

She added, “In Vancouver, drug users will tell you that Insite is a symbol of care. This is a humane space where we are able to reverse a pattern of exclusion.”

The panelists—and moderator Amy Goodman of Democracy Now!—drew an enthusiastic crowd, and the evening was punctuated regularly by bursts of applause. (One comment that drew particularly raucous support was a question Tony posed to the crowd: “Who in here supports safe injection facilities?”)

Although many audience members came from in and around New York City, some traveled much farther, with four- and five-hour drives from Binghamton and points north.

One of those longer commuters was John Barry, the executive director of an upstate New York syringe exchange called the Southern Tier Aids Program (STAP).

“We need one of these,” he said.

He acknowledged that growing political will and legal support for SIFs could be difficult, but he didn’t see it as impossible: “I think the dominoes have to fall in the right order.”

This story was originally published on The Fix.

Talking Heroin on HuffPost Live

huffpostliveIn some places, heroin is cheaper than cigarettes. That was one of the interesting takeaways from today’s segment on HuffPost Live, featuring me, Major Cities Chiefs Association Director Darrel Stephens, Dixon Police Department Chief Dan Langloss, and Drug Policy Alliance Manager Michael Collins. The discussion covered some of the ways in which police departments have come to realize the value of funneling addicts into treatment instead of jails and prisons. Click here to watch the full half-hour video.

 

Obscenity, Addiction, and Lenny Bruce

“Satire is tragedy plus time,” said Lenny Bruce.“You give it enough time, the public, the reviewers will allow you to satirize it. Which is rather ridiculous, when you think about it.”

It’s been 49 years, but Bruce’s death—a morphine overdose—is still a tragedy. Though he was many things, first and foremost, Bruce was a comedian. Today, when we think of comedians who died of drug overdoses, it’s names like Mitch Hedberg, Greg Giraldo, John Belushi, and Chris Farley that come to mind. But, before all those, there was Lenny Bruce.

Ozzie and Harriet 

Bruce, who came into the world as Leonard Alfred Schneider, was born on Long Island in 1925. His parents divorced when he was five and then when he was 16, Bruce ran away from home and worked on farms before joining the U.S. Navy at the age of 17. He served aboard the U.S.S. Brooklyn in North Africa, but after three years, he was honorably discharged—after claiming to be gay—and eventually moved back home with his mother.

Then, at the age of 22, he did his first stand-up show at a nightclub in Brooklyn. After a stint in the merchant navy, he met Harriett Jolliff, the singer and striptease dancer better known as Honey Harlow. According to The New York Times, “The couple’s six-year marriage was Ozzie and Harriet as reimagined by William S. Burroughs …  They shopped for wallpaper. They injected heroin. She served jail time for marijuana possession.”

After getting into trouble with the law for a fundraising scam involving a leper colony in New Guinea, the couple moved to Pittsburgh, where they got into a serious car accident. In 1953, they moved to California, and Bruce’s comedy career continued gaining steam.

Bruce’s Style: Talking Dirty and Influencing People

Over the course of his 18-year comedy career, Bruce became known for his stream-of-consciousness style and his wry satire—and also for his obscenity. He stepped away from the family-friendly humor that preceded him and took on serious issues, issues that some people didn’t think it nice to joke about. He said, “All my humor is based upon destruction and despair. If the whole world were tranquil, without disease and violence, I’d be standing on the breadline right in back of J. Edgar Hoover.”

No topic was sacred. He called out censorship and the government: “Take away the right to say ‘fuck’ and you take away the right to say ‘fuck the government.’” He poked fun at religion: “If Jesus had been killed 20 years ago, Catholic school children would be wearing little electric chairs around their necks instead of crosses.” He joked about his own Jewishness: “A lot of people say to me, ‘Why did you kill Christ?’ I dunno… it was one of those parties, got out of hand, you know. We killed him because he didn’t want to become a doctor, that’s why we killed him.” He talked about everything from sex to mothers-in-law to law enforcement.

As Paul Krassner, the journalist who edited Bruce’s 1965 biography, How to Talk Dirty and Influence People, told Rolling Stone in 2012, “What Lenny did as a performer was break through the traditional targets of humor and talk about things that really mattered. Everything from teachers’ salaries, racism and sexism to abortion rights and atomic testing – all different forms of injustice.”

The willingness to address those topics in and of itself created a new form of comedy. In 2013, The Guardian wrote, “Lenny Bruce was not the first standup comedian, but he did create what we now mean by ‘standup comedy.’ The idea of some guy on a stage, often some guy with problems, who finds himself at odds with the establishment and has only his wits to resist with: that all begins with Bruce.”

“Life is a four-letter word.”

In pop culture, the ’60s are remembered as a time of flowers, acid, and anti-war protests.

For Bruce, the ’60s were a time of obscenity trials and drug arrests. In September 1961, he was arrested after cops entered his Philadelphia hotel room and found methadone, speed, and needles. Although it made national headlines, that particular arrest did not lead to a conviction as the grand jury failed to indict; the comedian had prescriptions for everything he’d been arrested with. At the time, Bruce was convinced the arrest was retribution for his handling of religion in his on-stage performances. That would not be Bruce’s last drug arrest. In 1962, was arrested again for drug possession and in 1963 he was caught with heroin, methedrine, and syringes. 

Just about a month after the 1961 Philly arrest, Bruce was arrested for using the word cocksucker at a show in San Francisco. Although he was acquitted, that arrest was only the first in a string of obscenity-related arrests finally culminating in his arrest for a performance at Café au Go Go in Greenwich Village. That arrest resulted in a conviction and a four-month jail sentence, although the sentence was stayed pending appeal.

After firing his attorneys, Bruce began preparing the appeal on his own. One of the fired lawyers later observed that, as the comedian immersed himself in the legal process, ”He was a guy quickly sliding down, into drugs.”

The repeated obscenity charges made him almost unemployable; no one wanted to risk hiring him. Given his lack of work and the cost of repeatedly defending himself against charges in multiple states, Bruce had to file for bankruptcy.

On Aug. 3, 1966, Bruce found out he was going to lose his Hollywood Hills home. Later that day, he was found naked on the bathroom floor, a needle still hanging out of his arm. At the age of 40, Bruce had died of a morphine overdose. Regarding his drug use, Bruce is often credited as saying,“I’ll die young, but it’s like kissing God.”

Although he’d already been a drug user, some blamed his death on the continual legal battles he fought; he later came to be known as a First Amendment martyr. One of the district attorneys who prosecuted him in New York later admitted, “We drove him into poverty and bankruptcy and then murdered him. We all knew what we were doing. We used the law to kill him.”

As Bruce once said, “Life is a four-letter word.”

His Memory

While comedians today can anticipate that almost every performance will be filmed, put on YouTube, and shared on Facebook, that wasn’t true in Bruce’s day. Today, there’s only a handful of videos of Bruce performances, and most recordings are audio-only. Some are available in transcripts—such as those paraded out at his obscenity trials—but the net result is that his era’s technological limitations have diminished our collective memory of him. For many young people today, he’s never been a household name like Chris Farley or John Belushi.

Nonetheless, he’s had a lasting impact on the world of comedy. As Nat Hentoff wrote in Gadfly: “A long and growing list of comedians—actually, social satirists—owe a great thanks to Lenny Bruce. These include Richard Pryor (who came closest to meeting Lenny’s standards), George Carlin, Eddie Murphy, Chris Rock and an emerging number of young black and Hispanic fearless, funny commentators. Bruce opened the doors not only on the way we live, but also on the way we often cover it up.”

Posthumously, Bruce’s memory has not been covered up so much as it has been revised—for the better. In 2003—almost four decades after his death—New York pardoned his final obscenity conviction.

This story was originally published at thefix.com.

Interview with David Dastmalchian, Former Heroin Addict and Current Film Star

Now, he’s a big-time actor, but in 2002, David Dastmalchian was living out of his car, shooting heroin. Though his best-known role is as the Joker’s henchman in The Dark Knight, recently he starred in and wrote something more of interest to readers of The Fix. Animals, a tale of two heroin addicts in love, is partially based on Dastmalchian’s own experience. The struggling characters, Jude and Bobbie, spend their days pulling off scams for drug money and their nights sleeping in their car parked near the Lincoln Park Zoo. The film debuted on May 15, and The Fix ran a review of it the same day. This week, Dastmalchian made the time to talk about his film, his recovery, and his life. (Note: This interview has been condensed in places.)

So first, let’s start with the easy stuff—how do you say your name? 

The trick is to imagine that you have a small chin and you’re saying “this small chin.”

You may have seen it, but we just reviewed Animals. 

Yeah, today we posted Richard Roeper’s big review and that was exciting. I think we’re going to put up The Fix one this afternoon. It meant a lot to me, in particular, just because I know I read The Fix and I think it’s just, it’s been tough, to be quite honest, and terrifying to figure out where I feel comfortable talking about my history and at what points I feel comfortable breaking my anonymity or my family’s anonymity while at the same time wanting to be as open as I can about the film because I’m 13 years into my recovery. I think people can spend their whole lives fiercely guarding their anonymity. Because it’s such a personal nature connected to the film itself, it has been 90% of the time, really rewarding for me to be as open as I’ve been able to be about the fact that I was an addict.

What has come down as criticism … was one radio host who felt like certain details were “embellished.” I didn’t want to get into it but I wanted to pick up the phone and call up the station and be like, “That literally happened to me!” I’d say 98% of the response from the recovery community has been so positive. There’s been a couple of painful things to read. That’s the danger of things like social media … it’s a subject matter that is so fundamental to who I am as a human being, my recovery as an addict. As an actor, I’ve been doing this for a long time and I don’t even read what people say about me. They can attack my acting but it’s not so deep to the bone as the other stuff. It’s been an incredible ride, not without its bumps, but it’s been an incredible ride.

If anybody in recovery watches this film and feels that I’ve exploited something for some reason, they’re entitled to their opinion. There’s nothing that I can do other than feel really sad about it. I didn’t make the film to make it a “recovery film.” I didn’t want to make a message film because I still don’t even know what the message is. I feel like addiction is such a complicated and complex issue that the only message I’ve got is that we’ve got to stop giving up on people.

How much is the male lead actually based on you? 

Both of the main characters are based on, inspired by—god, every character that I ever write is somehow based on me. What I was trying to convey with Jude was somebody who probably could really be an amazing lawyer or doctor … I think I wrote him a lot smarter than I am. And Bobbie is a lot like me in that her journey in addiction ultimately led [to] the same trajectory that mine did.

I was homeless because of the heroin. I didn’t pull off as intricate of scams as Jude and Bobbie—like the date scam was actually some friends of mine that I shot up with sometimes. That was absolutely something that I used to watch this couple do. I lived in a car on and off for almost two years. And then a lot of my journey as an addict, for me, Chicago was the backdrop for my journey.

As we tell the story, people who watch it see how much pain people go through even at their worst. I never knew an addict that was giggling when they were preparing to pull off a robbery or a scam. I never knew an addict that was enjoying a single moment of that. I hope you see that with Jude and Bobbie and I hope people feel their humanity and don’t look at them as criminals, they look at them as their kids, their siblings, their neighbors.

You ended up in a hospital like Jude, right?

In real life, it happened to me twice. That’s another thing about the movie, an addict’s journey can be difficult to portray in cinema because it took me so many tries to get clean. I was never taken directly to a detox or rehab, I was taken directly to a psych ward. I’m also a dual diagnosis—I deal with depression too, and other psych issues. I had made an attempt on my life which had landed me in a hospital but because I didn’t have insurance I was transferred to a psych facility where I spent a month, month and a half. That was a necessary experience for me. It was hell at the time. I was quite literally strapped to a bed and given Motrin.

It was a state-run facility so their resources were pretty scant but they were wonderful. From there, I was able to reconnect with my family. I went to treatment, got out, tried sober living, started to think I could drink again … and it was weeks before I was making eight-hour drives to score dope again. Then it took me another six to eight months of being back out again, maybe over a year of just going really hardcore. Then I got really sick from both infection and dirty using practices and I knew I was going to die. I had that desire to live and I wound up back in the mental hospital again, but this time things changed for me. I can only describe it as a miracle that my family was still there to love and support me when I was ready to ask for help.

I personally utilized, with the doctor’s care, a very specific and well-planned maintenance program with methadone to come down off of dope. I know that’s such a hot-button issue and it’s tricky for me when addicts ask me if I used methadone. I feel like it’s such an abused medication. I mean, I’m not ashamed of the fact that I used methadone, because, you know, there’s a lot of shaming of methadone. It was part of my replacement therapy—meetings, medication, exercise.

via animalsthefilm.com

 

So that’s sort of how it ended, but how did you get into drugs in the first place? 

Addiction runs in my family for sure. I totally believe in the fact that there are genetic factors involved. I was in like the sixth grade [the] first time I got intoxicated and I just felt completely at ease for the first time. I felt completely confident. I felt completely in control. So it started with the alcohol which in high school turned into pot, inhalants. I really abused cough syrup in an intense way in high school.

When I was 18, I went to Chicago to study acting and at this point I [was] a daily practicing addict of some form of substance abuse or another. I wasn’t on opiates yet. I was definitely a partier, too—I liked the social aspect of using. When I almost 20, 19 turning 20, I was friends with some guys who were shooting and I was with one in particular … he was trying to kick dope and had just bought eight bags and we were going to go on a roadtrip together and he was like, “Can you please keep these out of my hands?” and I was like, “Oh sure.” And I just started doing it. I started as a weekly—a Saturday—user for a very long time and then there was one week in particular when I was 21 and I said, “Oh I can try on a Wednesday, just once.” It was just a matter of weeks before I turned into a daily user.

I went from being a sniffer to using needles pretty soon. At this point, I was not a partier anymore, I was just a very successful student. I was working on really intense material as an actor in school. I was high-functioning. I wasn’t shooting to get high anymore, I was just keeping well. That went on for a long time and I really truly believed that was going to be the rest of my life. Eventually, one day, the bottom just dropped out.

How do you even get from Point A—homeless heroin addict to Point B—movie star? 

[Laughs.] Well, you take five years—I took five years when I got clean. The point at which I reached the bottom that I reached was so low when I finally had my miracle—that I all wanted in life was the ability to have a little apartment with a futon and a TV where I could just watch movies and make pizza in the oven. I just wanted to be alive. I thought acting was off the table for good. I didn’t know if that was a trigger for me. How much was acting or my career a part of my disease? It took me a long time to realize that it wasn’t. It was about getting psychologically healthy, about going to meetings all the time, submitting to the greater will. I just reached that point of willingness that I was going to do it no matter what.

I worked in a movie theatre as an usher, then I got a job as a telemarketer and the clean years just started to build up and I started to find each year I was getting more happy, psychologically. I started to realize that I was building the tools for how to navigate those waters without getting high. I ultimately went through some very trying times, I went through a horrible breakup with someone whom I’d spent a lot of time in recovery who relapsed. My sobriety has been tested many times, I’ve lost people that I cared deeply for. Then I had a friend, when I was five years clean, who’s a theatre director—actually, two friends, two theatre directors in Chicago. They both said when you’re ready to, we’d like you to get back up on the boards. That was a big test for me and it was a-fucking-mazing man. It was the greatest feeling in the world.

I need to cut this short now—I’m with my wife and son and this is kind of an amazing thing that I’m talking to you right now. We are literally standing across the street from the Lincoln Park Zoo in Chicago and right now I’m walking into the zoo with them. I’m literally in the same place where, 13 and a half years ago I was using the bathrooms here to get high in and now I can eat an apple and carry my son around and introduce him to the gorillas. It’s pretty amazing.

This interview, by Keri Blakinger, first appeared on The Fix.

Me and My Mugshot

If there were awards for Worst Mug Shot Ever, mine would certainly be in the running. In 2010, while enrolled as a student at Cornell University, in Ithaca, New York, I was arrested with a large amount of heroin and sentenced to two and a half years in state prison. At the time of my arrest, I was using—as is pretty apparent from the picture—and also selling to support my habit. In my mug shot, my face is blotchy, my hair is all over the place, and I have scabs where I picked at my face while high. It’s pretty horrible.

When news outlets ran my mug shot in their coverage of my arrest, some of the comments that it inspired were pretty horrible, too. Certainly I did not expect sympathy, but even so, some of the comments surprised me. People called me a “whore” and “slut” and riffed on the “Ithaca is Gorgeous” slogan, writing, “Ithaca is Whoregeous.” These comments obviously did not stem from the fact that I actually looked like a prostitute; it should have been abundantly clear from the picture that absolutely no one would have paid to sleep with me at that point. The comments were intended as sexist, stigmatizing insults.

Part of that is due to a sexist nature of commonly used insults, and part of it is due to the nature of bad mug shots. But the most pernicious part of it is a reflection of the way our society generally views addicts.

When a man is arrested for drugs and has a horrible mug shot, people may insult his appearance but they usually won’t insult him sexually. That is, they’ll say he’s ugly, but they won’t say that he’s got a small penis. With a bad female mug shot, though, it seems OK to make the insults sexual in nature.

Mug shots like mine are dehumanizing. And when we see people as less than human, it becomes easy to lob insults with impunity.

Terrible mug shots are a dramatic appeal to our basest instincts. They’re fascinating in a sort of train-wreck-you-can’t-stop-watching way. The thing is, those mug shots are not of trains, they’re of real people. People who need help. You certainly don’t see that image of me and think, “Wow, we’re so much alike. That could have been me. That could have been my sister/mother/daughter. I hope that person gets help.” You think, “Eww, that’s gross! That would never be me or anyone I know.”

Some people commented that my picture was “the face of addiction.” Although my face clearly was the face of someone entrenched in an addiction, this should not be what we think of when we think of the face of addiction. Most addicts don’t look like this. The true face of addiction runs the gamut—there are beautiful models addicted to cocaine, mothers addicted to painkillers and mayors who smoke crack. And although none of them may have the dramatic “face of addiction” that I did, we are all struggling with the same demons.

Nonetheless, the “face of addiction” has become its own genre of image. Google the phrase and you will find thousands of faces like mine. The widespread “faces of meth” pictures are the most popular of the bunch. They’ve been used as the basis for fear-based prevention campaigns, and over time they’ve also come to do much harm as stigmatizing clickbait. Sometimes, these images come with a “before” and “after” picture so that viewers can marvel at how disfigured and inhuman a drug addict can become, almost as if addiction were a demonic possession. The truth is that the face of addiction can also be much more subtle, but no matter what it looks like we are all struggling with the same demons.

At the time of my arrest, it made sense that news outlets would run that picture. The thing is, five years later, it still appears in articles about me.

Since my release from prison in 2012, the Cornell Daily Sun, Mic News and, as recently as last week, the Washington Post have all published articles that included that mug shot. I’ve accepted that this picture is something that will continue to hold a somewhat morbid fascination for some people. I don’t hold it against the editors and writers who ask to use this picture. In fact, I get it. Most of the time, they have good intentions; they want to offer a visceral representation of how bad addiction can be. The problem is that they are unwittingly contributing to the stigmatization of addiction.

Usually, the picture is contrasted with a picture of me now. Although that comparison offers a moving comparison between how badly I was doing then and how much better I’m doing now, it also plays on a dramatic visual contrast between “normal person” and “ugly, addicted criminal.”

It’s true that addiction is ugly—but when we contribute to the stigmatization of people with addiction, we make it harder for them to seek help. For most people in an active addiction, it is difficult to admit to the seriousness of the problem. By stigmatizing addiction, we only make it more unlikely that addicts and their families will recognize the need for, and seek out, help. After all, nobody wants to admit that they or their loved ones are part of this seemingly reviled demographic.

Every time I see that mug shot, a part of me wilts. It brings back all the shame, remorse and regret I associate with who I was then. I have to constantly remind myself that that’s who I was then. To avoid obsessing over that image, I have to dissociate myself from the person it depicts.

Living with the shame of a past addiction is something that every recovering addict has to deal with—some more publicly than others. Although the continued use of that mug shot will probably always bother me on some level, one thing it has taught me is that I have a truly wonderful group of friends.

When people I know shared the column I wrote for the Washington Post on Facebook, they all—every single one—chose the “remove preview” option so that the picture doesn’t show in the post. I didn’t ask them to do this. They just did it. To them, I am a real person, not an abstract representation of the face of addiction. Consciously or not, they chose not to contribute to the stigmatization of one face of addiction—the face that they know personally. To them, it wasn’t that I could be their sister, daughter or friend; it’s that I am. Nothing helps defeat the stigma of addiction like actually knowing someone who’s overcome it.

Note: This article was originally published by substance.com on Jan. 28, 2015.  Also, the original refers to “arrest and trial.” I deleted that here, but the word “trial” was added in by an editor; since I took a plea my case did not go to trial. The vast majority of cases do not go to trial.