Ted (not his real name) arrived at my apartment two hours after Jason (also not his real name) texted him. I was expecting somebody young, but Ted was an older man, in his 60s or 70s. The van he pulled up in was white and unmarked. He was wearing a red turtleneck sweater, jeans, old sneakers. He had a ponytail. He looked like someone’s off-beat, slightly disheveled great uncle. Everything about him—the van, especially—embarrassed me. He hauled a bag of supplies: rapid blood tests, forms secured on a clipboard, and condoms.
I was panicking because Jason, who was my on-and-off-again boyfriend at the time, had recently relapsed on heroin. Jason had assured me he always used clean needles, but by that point, I didn’t believe much of what he said. I wanted both of us to get tested for HIV and Hep C. Jason told me he had a “friend from an organization” who could provide us with free and rapid blood tests that day.
I didn’t know then what harm reduction was, or that Ted was a harm reduction practitioner. Ted was there to help us, but I was too caught up in my own fear to see this. In my mind, Ted was just some guy Jason had saved in his phone, someone who showed up when Jason texted—and because of that, I mistrusted him instantly.
Jason had a lot of support, but when he was relapsing, it wasn’t his doctor, his sponsor, or his drug court counselor he called. He avoided these people; I didn’t learn their names, and I never met any of them. The way I perceived these people and their roles in Jason’s life were filtered through Jason, but when he was using, his supports quickly turned into the enemy. Everyone, it seemed, was coaching Jason to move from the drug world to the real one—the nine-to-five, three meals a day, regular showers, and sleep at night way of life. Ted was someone Jason could call no matter where he was.
It wasn’t really that Ted existed in both worlds. For Ted and Jason, it was all the same world—or at least, the line between the two was not so stark. Ted’s services were not going to fluctuate depending on where Jason was or how bad things got.
When talking about addiction, people tend to use black and white language, and Jason even used this language to describe himself. But from where I stood, things were never so absolute with him. Harm reduction acknowledges that recovery isn’t black and white; that it rarely happens all at once. It exists on a spectrum and it happens differently for different people.
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Jason and Ted greeted each other warmly in my living room. The visit went smoothly. Ted was chatty, but not overly personal—although the questions on the forms were. He asked about our drug use and our sex life and ticked off boxes as we answered. I was not a drug user, but Jason had been for years. We hadn’t been using condoms. When Jason proudly announced to Ted that he had decided to get clean—Ted smiled and said, “Hey, that’s great.” Jason had just gotten out of rehab that morning and had been sober for a matter of days.
Then Ted spoke a little about his own recovery. He told us that he had been sober for decades, but it was still one day at time. Working as a harm reduction practitioner was part of his way of staying sober. Serving people who were actively using reminded him, every day, that he did not want to return to the life he once had.
I tried to imagine Ted lying compulsively to a girlfriend or nodding out in his car, but I couldn’t picture it. Ted was twice as old as Jason, and there was a calming, steadying presence about the older man. He was extraordinarily kind. He pricked our fingers—mine first, then Jason’s. All of our tests came back negative.
Every day, an estimated 196 Americans die from a fentanyl overdose. Overdoses reached an all-time high during the pandemic in 2021, and an estimated 108, 000 people died of a drug overdose, a 15% increase from the year before, due to the fentanyl crisis. We know that “just say no” doesn’t work. Conversely, treating addiction as a medical disease is not the answer either. These simplified approaches contradict one another. It doesn’t make sense to call addiction a disease and at the same time, criminalize people for it.
Harm reduction offers an alternative approach, grounded in the belief that everyone is worthy of quality care, whether or not they’re using drugs. People are given voice and agency in their own treatment and are free to be honest about their drug use and sexual behavior, without judgement or legal ramifications. Aside from HIV and Hep C testing, harm reduction includes referrals to health care and mental health services, overdose and Narcan training, clean needle distribution, tools to check drugs for the presence of fentanyl, and access to supervised drug use sites.
According to the CDC, Syringe Service Programs are estimated to bring down the transmission of HIV and Hep C by 50%. People who use these programs are five times more likely to eventually go into drug treatment and three times more likely to stop using altogether, as opposed to those who don’t. Research has proven that harm reduction works, but stigma surrounding harm reduction has made some communities wary of it. Needle exchange programs and safe injection sites are seen as encouraging drug use. Harm reduction does not stop people from using drugs, but it does not enable people either. If someone is determined to use, they will find a way to do so, no matter what.
I don’t know how often Jason called Ted, or what their relationship looked like when Jason was using, but I know that they had one. Jason made it a point to keep his phone calls private from me when he was relapsing. I listened in though, and I eavesdropped as much as I could. I believe that Jason’s relationship with Ted was life-saving, at least for a while.
It’s easy to pick up the phone and reach out when your life is turning out the way your family and friends hoped for you—when you know you will be applauded, or at the very least, you won’t be pitied, for how you’re doing. When you’re sober, when you’re in a relationship that other people approve of, when you’re employed. But how many of those same people do you call when things are falling apart?
Witnessing Jason struggle with heroin addiction was devastating. I was barely holding it together. I only met Ted once, but the care he showed both of us stuck with me for years. Ted didn’t offer me advice about my relationship, or look at me with alarm and pity for being with Jason. His lack of judgement made me feel like I could answer his questions totally honestly.
Jason always told me that if he was going to hurt anyone with his addiction, it would be himself—not me—or anyone he loved. This turned out not to be true. However, I believe Jason was protecting himself by keeping in touch with Ted. By doing that, he was also protecting the people he loved the most.