A Compassionate Alternative to the War on Drugs, with Maia Szalavitz
Aug 26, 2021
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Maia Szalavitz, an award-winning author and journalist, shares her transformative journey through addiction and the harm reduction movement. She reflects on how harm reduction practices saved her life during the AIDS crisis and advocates for a shift in addiction treatment from moralistic views to compassionate care. Maia discusses the historical evolution of harm reduction, its vital role in recovery, and the importance of human connection in healing, emphasizing the need for empathetic, organized advocacy to address addiction's complexities.
Harm reduction approaches prioritize health and safety by minimizing the negative effects of drug use rather than insisting on abstinence.
Maia Szalavitz highlights the necessity of integrating personal narratives into addiction treatment to better support unique recovery journeys.
The existing addiction treatment system often perpetuates harm through punitive methods, necessitating a shift towards empathetic, health-centered care strategies.
Deep dives
Understanding Harm Reduction
Harm reduction prioritizes minimizing the adverse effects of drug use rather than eliminating drug consumption itself. This approach focuses on health and safety, acknowledging that many individuals will use substances regardless of legal restrictions. By emphasizing individual well-being, harm reduction creates more effective public health policies, ensuring people have access to safer options, like needle exchanges and supervised consumption sites. This movement challenges the moralistic views of addiction that label users as criminals or failures, promoting empathy and support instead.
The Role of Personal Experience in Recovery
Maya Svalovitz emphasizes the significance of personal narratives in understanding addiction and recovery. Having experienced addiction herself, she acknowledges that her journey informs her advocacy for harm reduction. Her recovery story illustrates that traditional treatment approaches are sometimes inadequate and that individuals must be supported in ways that resonate with their unique experiences. This highlights the importance of incorporating personal perspectives alongside established treatment practices to foster a more supportive recovery environment.
Critique of the Current Treatment System
The existing addiction treatment system often operates under punitive and moralistic frameworks that can exacerbate issues rather than resolve them. Many treatment programs are steeped in ideologies that shame individuals, using methods that can lead to further trauma rather than healing. This problematic approach is compounded by the criminalization of addiction, which prevents users from accessing the care they need. Instead, a more empathetic and scientific understanding of addiction should guide treatment practices, recognizing it as a health issue rather than a moral failing.
Coercion in Addiction Treatment
Coercive treatment strategies for addiction, such as interventions or mandated programs, are largely ineffective and can lead to further harm. Personal choice and agency are crucial for successful recovery; when individuals feel forced into treatment, their engagement and success rates diminish. Instead, harm reduction principles advocate for meeting individuals where they are, providing support without compulsion. This approach fosters a sense of ownership over one's recovery journey, which can lead to more sustainable outcomes.
Activism and Community in Addressing Addiction
The podcast discusses the potential for activism in the addiction community, drawing parallels to the successful mobilization seen in HIV/AIDS activism through the organization ACT UP. There is a call for grassroots movements that unite both active drug users and those in recovery to advocate for more compassionate drug policies. By creating inclusive environments that prioritize human connections and shared goals, a powerful collective voice can emerge. This unity can drive systemic changes in policy and treatment, ensuring that those affected by addiction receive the support they deserve.
Roughly 35 years ago, harm reduction saved Maia Szalavitz’s life. It was 1986 in the East Village, and though Maia was an Ivy League kid who read two newspapers a day, she had no idea that her regular intravenous heroin use put her at risk for HIV. Thanks to a chance encounter, though, Maia learned about some simple harm reduction practices that helped her stay alive through that deadly epidemic.
In the years since, Maia has become an award-winning author and journalist well-known for covering addiction, neuroscience, and harm reduction. Her most recent book, Undoing Drugs, is a sweeping, ambitious, yet tightly plotted and fast-paced history of harm reduction, ranging across the globe to tell a vivid history of harm reduction as a revolutionary movement. I was lucky to have her on the podcast to talk about the story of harm reduction, the elements that she argues makes it a truly revolutionary paradigm, and how her own lived experience with addiction and a drive for justice has motivated her work.
Maia Szalavitz is the author of the New York Times bestseller, Unbroken Brain: A Revolutionary New Way of Understanding Addiction, which received the 2018 media award from the National Institute on Drug Abuse. Her earlier book, Help at Any Cost: How the Troubled Teen Industry Cons Parents and Hurts Kids, was the first to expose the damage caused by the “tough love” business that dominates youth treatment and helped spur Congressional hearings on the matter. She has also authored or co-authored six other books, including the classic on child trauma, The Boy Who Was Raised as a Dog (with Bruce. D. Perry). Her numerous essays and features have appeared from High Times to the New York Times. Her latest book, Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction, is available now. Her website is https://maiasz.com/ and you can find her on Twitter
In this episode: - A simple yet powerful indictment of our current situation: “You can’t criminalize and destigmatize something at the same time" - Her definition of harm reduction, and how harm reduction goes beyond concrete practices to notions of justice. - How to think about coercion in addiction treatment, and how her own experience showcases the excesses and harms of the criminal legal system today. (See also her piece on the history of “tough-love” and its roots in a bizarre cult from decades ago) - How harm reduction is not in conflict with traditional 12-step recovery, and her stories of early harm reduction pioneers who were also active in 12-step recovery. (see also this oral history with Richard Elovich, as well as “25 years of AIDS”, a great panel discussion from 2006 featuring Allan Clear and several others—including Larry Kramer sparring with Tony Fauci) - The need for an ACT UP for people with addiction - The ways activism is part of flourishing in recovery: “"you have less space in your head to be obsessing about the drugs all the time when you're working on the activism" (about VANDU, the Vancouver Area Network of Drug Users) - What the Biden administration is getting right about harm reduction, and what it’s missing.
