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.
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Flourishing After Addiction with Carl Erik Fisher 
