A reporter learns to go slow and gain trust for series on harm reduction for drug users

Published on
March 20, 2019

You can’t just waltz into a community of people who are marginalized and under threat, stick a microphone in their faces and start asking them questions.

This is the hard first lesson I learned when I went out to report on harm reduction for drug users in rural California. Harm reduction refers to a set of principles for the treatment and care of people who use drugs, from alcohol to heroin, and will continue to use drugs for the foreseeable future. It is not recovery. It is not “tough love.” It is the practice of keeping people as safe as possible while they inject, snort, or imbibe their mind-altering substances, so they don’t contract communicable diseases, overdose, or otherwise endanger their health (beyond, that is, what the drug does to their bodies).

I’ve been reporting on people who use drugs, and harm reduction, on and off for 20 years. At the LA Weekly in the early 2000s, I produced an entire issue composed of writers’ real-life experiences with drugs. I wrote about needle exchange programs, where people who inject drugs can access clean syringes, back before they were legal in California. Most important, perhaps, I have used, and struggled, with drugs myself in the past, which I used to quell a crippling social anxiety. (I was, as so many illicit drug users are, self-medicating.) So any bias I had going into this project was on the side of the harm reduction professionals and the people they serve — their “consumers,” as they respectfully call them. I set out to expose stigma, to persuade readers that the focus on recovery is sometimes counterproductive. I believed I had the science and studies to back that up: One of the first things you learn when you start reporting on substance use disorder is that 12-step programs not only don’t work for everyone, they work for almost no one.

Did I expect potential sources to know that? Naively, perhaps, I did. Not because they could have Googled me, but because I thought I had laid the groundwork for access. And had I been reporting on a more benign topic, one that doesn’t involve people illegally using Schedule I drugs, my advance preparation might have been enough. For this community — understandably suspicious of outsiders, under political and legal duress, and often living without shelter — it was not.

Before I even proposed my 2018 Impact Fund project and applied for the grant, I’d been in contact with Brandie Wilson, the founder and executive director of the Humboldt Area Center for Harm Reduction (HACHR). We’d first met at a conference on stimulants held by the Drug Policy Alliance in September 2017, and I’d talked to her on the phone extensively while I was writing my proposal. So when I arrived, in June of 2018, at the facility in Eureka, California, pen and notepad and iPhone tricked out with super-pro mic in hand, I expected that people would drop their guards and talk to me — a reporter, a stranger from another city, a person who might very well use their words against them — as so many others had.

But HACHR was, at the time, under siege. A group of city residents were holding its staff and consumers responsible for the needles that littered Eureka’s streets and parks. Volunteers at HACHR who were out collecting discarded needles reported having been harassed by vigilantes bent on sprucing up the city’s corporate image. Certain members of the city council were threatening to rescind HACHR’s ordinance to operate, and Wilson had yet to secure state certification that could override the council’s authority (it was granted in October 2018). When I walked in, I made the mistake of relaying one city councilmember’s complaint about syringe litter, and asking how Wilson would answer it. “That’s your first question?” she asked, incredulous. I tried to reassure her she could trust me. “Sure,” she said. “That’s what everyone tells me when they first come in here.” She almost asked me to leave.

As a compromise, we ended up setting ground rules: No photographs or video of people without their express consent, no faces, no quoting people who aren’t explicitly reminded their words might appear in print. And for most of the first day, I didn’t interview anyone at all. Instead, I just sat. I listened. I hung out. I watched people cook, I listened to the stories they told their friends, I even did other work on my laptop. I participated in random conversations with no intention of using them: In the tea room I counseled a young woman on her love life; in the kitchen I discussed the rules for service dogs; at the reception desk I chatted with a young man about the history of LSD.

By the second day of my visit, I’d come to know a few people well enough to hold my spiffy new mic up to their faces and secure their consent for an on-the-record interview. Some of them asked me to omit their last names. Some of them wanted me to stop recording to make a certain point they didn’t want quoted. But no one told me, “No.”

Over the course of my reporting, I got better at cultivating a non-threatening presence. I also established myself as a familiar face to the harm reduction community by showing up at events where the people I wanted to talk to would be. This helped establish that I wasn’t some fly-by-night interloper looking for a salacious scoop, but a dedicated journalist in sincere pursuit of the truth. When my research took me to Ukiah, to visit the Mendocino County AIDS/Viral Hepatitis Network (MCAVHN), I was well-known enough to MCAVHN’s executive director, Libby Guthrie, that she had lined up a half-dozen people willing to discuss their lives with me, most of them offering both first and last names.

Attending public events also helped me get quotes from people whose agencies had turned me down for interviews. At a conference on the opioid epidemic in rural California, I was able to hear Alessandra Ross, an injection drug-use specialist with the California Public Health Department, address common objections to harm reduction for drug users, including those that come from drug treatment specialists. “I’ll [sometimes] draw a little triangle on a white board and say, ‘10 percent of people who inject drugs at any given point in time are in some sort of substance-use treatment program,’” she said. “Another 20 percent would like to be. Then there are 70 percent of people who are not in any kind of drug treatment program or not waiting for any kind of drug treatment program. Those are the folks that I work with.’”

When you put it that way to drug treatment professionals, they understand better what non-judgmental harm reduction services look like. “Then they’ll say, ‘I think that’s great. We need that! But are we dividing it up fairly?’

I didn’t use that quote in my reporting, nor did I use much else that Ross said. But her perspective was crucial to helping me understand what harm reduction professionals are up against. It also gave me tools to use in my own arguments, reminding me to avoid the word “addiction” in favor of “substance use disorder,” and to use the same “people first” language I’d use for any other group affected but not defined by a chronic illness. A substance use disorder is now fully understood in medical literature to be a chronic illness. But it is still widely regarded as a moral failure — one whose cure requires “tough love” and willpower. The stigma endures, and approaches to curing the disease remain fragmented, contradictory, and hotly controversial.

These were things I needed to keep in mind as I approached people who use drugs and the people who are helping them stay alive while they do. Only by fully appreciating their challenges could I find my way in to tell their stories, stories I knew, in this time of crisis, were badly in need of telling.