In Pursuit of Safer Highs: Harm Reduction with DanceSafe’s Rachel Clark

Since at least prohibition, anxiety has governed America’s disastrous relationship with substance use. As the 20th century increasingly saw anti-drug sentiment used to fuel moral crusades from “saving the children” to quashing perceived threats against whiteness, “Just Say No” became the mantra of a culture that neither understood addiction nor possessed the language to interrogate it with nuance.

The abstinence-only morality Millennials were raised on, in hindsight, did nothing to stall the overdose crisis that now ravages the 21st century. (Neither DARE’s disastrous anti-drug campaign nor virginity pledges signed in exchange for Domino’s pizza, we now know, were marks of a society equipped to respond healthily to social crises.) In the wake of dangerous, widespread drug myths, barriers to safety resources, and billions of dollars spent enforcing ineffective policy, the need for a new approach to the conversation about drugs is self-evident.

In recent years, harm reduction has gained traction as a community-oriented defense against the war on drugs. Its proponents combat misleading drug rhetoric by illuminating biases that, through a century of trauma and targeted political campaigns, the United States has internalized into its cultural psyche.

Through inhabiting an America still waging a war on drugs, loving people who have been hurt by substance use, and the complicated feelings that color our own relationships with substances, our culture’s framework for understanding drugs and the people who use them has become tense, tangled, and fraught. Now, the Drug War Generation is fighting back.

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For more than a decade, Rachel Clark has challenged us to question what we really know about drugs. The scope of her work is too extensive to fit into a few short sentences; there’s no brief pitch to explain the force that compelled a 13-year-old Rachel to obsessively investigate the healing potential of LSD. For all its nuance, though, her guiding ethos is simple: Rachel is a harm reductionist.

Rachel is also the Education Manager for DanceSafe, a national public health nonprofit that has provided harm reduction services since 1998. When I call her, she answers from the road. “I’m about to drive through a swarm of cop cars in Nevada…which I don’t love for myself,” she tells me. “Just gonna go a cool 69.”

How did you come to be involved with DanceSafe?

I started volunteering unofficially when I was 17, and then became more involved in harm reduction and community work as a whole. When I was 18 I attended Lightning in a Bottle with LA DanceSafe; I’d met some of those folks and was doing scrappy volunteering with them. After Lightning in a Bottle, I kept returning and getting more involved. 

When I was 19, I kept trying to get in touch with anyone about starting a DanceSafe chapter around my college in Ohio. I couldn’t get a hold of anyone about volunteering; no one was answering DMs anywhere. Eventually I hit up the Director of Operations Kristin (who I’d met at LiB) on Facebook and I just said, “do you guys need help?” And she was like, “uh, yeah. We would take an unpaid intern right now.” Things have just kind of exponentially ballooned from there.

In your time in this field, what shifts have you seen around drugs and culture? 

I mean, I went from buying $40 grams out of the back of my friend’s sedan in the cul-de-sac to being able to wander into a dispo and have some very nice, alt non-binary person with a bunch of face tattoos offer me the highest quality Gorilla Glue gummies. Seeing just that in the cannabis industry has been pretty weird. 

Seeing the social culture shift around other drugs is pretty striking as well, but for kind of uncomfortable reasons. This whole field is outgrowing its britches really quickly. Millions of people are very abruptly deciding that maybe drugs aren’t quite as bad as they thought they were, but there aren’t enough up-to-date resources available that people can reliably fall back on.

That’s a real problem: as more and more organizations, individuals, academics, and companies in particular gain momentum, people are flocking to them for information at an unprecedented level. The problem is that some of these groups look so reputable that people are not able to pick apart the fact that those well-intentioned publications are frequently just sharing misinformation. It’s kind of frightening, because it’s happening all over the place. 

For instance, there’s a lack of global agreement on how to dilute the fucking fentanyl strips, which is a whole other problem that we deal with every day. There’s no cohesion across drug checking. Every org has its own unique instructions. There are all these new little companies popping up to meet the demand for drug checking materials. Many of them are really trying to do the right thing, but some of them are not. And because of that, people don’t know who to trust. 

It’s creating this whole new question mark. Previously, if people were talking openly about drugs and weren’t DARE, you could probably bet that they were being kind of scrappy about it and they were like fuck it, I’m speaking truthfully about this to the best of my ability. But now there’s such a corporate image to it. There’s so much competition in the materials all of a sudden. The same issue that people have faced of not knowing who to trust about drugs is continuing, but now it’s between publications that have a lot more influence. The gravity of people’s trust is a lot bigger now that there are a lot more people who are reading and interested. 

Why is it important to fight drug myths?

It’s almost impossible for most people to tell what’s trustworthy and what’s propaganda when they’re reading about drugs. News, media articles, even scientific journals are all overflowing with bias, and well-meaning drug consumers are just trying to figure out what’s going on. We end up in this space where basic educational materials are highly politically biased based on generations of stigma with no actual founding in science. 

The whole “injection attack” thing, for example, is well-known by harm reduction experts to be unfounded, but it’s still causing panic. People pass out because they’re terrified of being targeted, which then causes everything to snowball. Then there’s the whole “fentanyl in mushrooms” thing, where we now have people flooding our DMs asking how to test their shrooms when we can barely get them to test the drugs that are actually being contaminated with fentanyl. 

People literally die from drug myths, either due to excessive action or inaction. With fentanyl, for example, people think they can’t do mouth-to-mouth on someone who is overdosing, even though resuscitation breaths are one of the most important parts. We’re in the position that we are because no one can tell what’s real. 

People also just don’t know what drugs do in your body. 

If I put out an Instagram poll asking, What’s the most dangerous drug?, the answer is almost always heroin or fentanyl. So I’ll say, “okay, how does it work? What is heroin? What is fentanyl? How is it dangerous?”

Oftentimes, there’s a lot of really emotional response to that—especially from people who have been personally impacted by other people’s use of certain drugs or their own use of certain drugs. There’s a very, very deep emotional response that is not my place to challenge in that moment. It’s not my story, you know? 

But a lot of the time people are just like, “actually, I don’t have a clue what meth does in your brain.” So how can we deem this drug to be bad for you if you don’t understand what it does? How are you ever supposed to make an evaluation if you’re basing this off of anecdotal experiences of watching people use the substance in certain ways?

Let’s say you put two different people in the same room, and you give each of them 100 milligrams of caffeine. Let’s say that they’re both caffeine-naive: neither of them has a tolerance to it. One of those people is like, “holy shit, that was way too much caffeine, I’m jumping out of my skin, I’m having an anxiety attack.” But the other person is cool as a cucumber. On that basis alone, it is not just about the drug. That, right there, is definitive evidence that there is something more going on than just the black-and-white statement of, Put this drug in your body, this happens.

That’s important to dig into, because there is validity to the fact that many people have a really hard time with certain substances. And there’s validity to the fact that other people don’t. 

Your work encompasses users of all substances. It’s not just about the “fun” drugs or psychedelics. 

I used to be a psychedelic exceptionalist, very much so. That’s why I tell people you really have to have humility about how much your mind can change and how much you know—because everything that I know is different than I thought it was. Everything that I knew about good drugs and bad drugs is different than I thought. 

This is a big thing that I talk about: If you’ve ever been in a toxic relationship with someone that you have known or had inklings was not good for you, and everyone was telling you, like, “dump his ass,” and you didn’t, or you came back, you owe your allegiance to people who are having a hard time with their drug use.  That’s something that people just don’t understand. “Oh, well, you chose to use it in the first place.” Yeah, well, you chose to go and hang out with this dude that gave you bad vibes and then start dating him. That was your choice. Am I gonna tell you to eat broken glass because of it? Or are we gonna talk about what comes next?

Drugs as relationships is a big one that I talk a lot about. It’s about giving people more concrete methods to see that your relationship with a drug is not about this specific situation, but about a broad set of things you should be looking at that will interact differently with the situation. When you’re looking at interactions, a lot of it is an interaction with context as well as an interaction with pharmacology. 

We can take cocaine as a good example. A lot of people will be like, “I love psychedelics, they expand my mind, they fulfill my life, they’re great for me…Fuck cocaine. You’re an idiot if you do cocaine.” When I ask why, they say things like, “it makes you fiendy,” “you just get aggressive.” But there are many people who consider a really fulfilling experience to be one where they are at their social maximum in terms of interacting with other people. On cocaine, they feel like more of themselves instead of less of themselves. We start getting more and more into this concept of, okay, well wait a minute. How are we defining something negatively impacting someone’s life?

I use anecdotes about, say, people who suffer from social anxiety and don’t want to drink caffeine at night because it will disrupt their sleep, so they do a bump of cocaine and it gives them the confidence to continue socializing throughout the night. That might just be that one person’s experience, but is it your place to say that it’s not improving the quality of their life?

If someone is very depressed and isolated and lonely and is using cocaine as a way to build their community and that does not develop into a problem or a crutch for them, then who is to say that that is any more or less problematic than someone who has depression utilizing an SSRI to enhance the quality of their life?

It’s interesting that you bring up SSRIs. I recently realized that I advocate so much for destigmatizing drugs, but I still couldn’t accept that I should be taking an antidepressant.

Same.

For me, destigmatizing drugs in my own life meant admitting that I should be taking SSRIs. Even with prescription drugs; even with mental health medication, stigma plays a huge role.

Yes! There’s this pervasive notion; this American raw-dog mentality that you need to prove that you are not weak enough to be reliant on anything. Being dependent on anything is considered to be a sign of moral failing. It is considered a sign of weakness to accept help when you are struggling.  We really are just in a constant place of identifying other people’s moral and behavioral failings, and chastising them for it.

I think a lot of that [aversion to medication] is very pro-capitalist. It neglects to recognize external factors and systemic issues as a significant disruption to physical and mental health in the first place.

[Taking medication] is the recognition of: what is the purpose of denying yourself a more fulfilling existence, other than maintaining a sense of moral superiority over some baseline standard of what it means to be a successful person?

I also did so many different drugs before trying SSRIs, and I fucking love SSRIs. It’s so worth not being able to roll anymore. 

I also know tons of people who have had terrible experiences with SSRIs—people have perfectly valid reasons to not trust pharmaceutical marketing, especially folks belonging to marginalized communities. It’s truly a grab bag, but I find it pretty infuriating that people are made to feel inferior for wanting to try something that might improve their quality of life.

This whole thing, I think, can be distilled into: respect people’s mistrust of systems that have harmed them, and destigmatize people experimenting with different ways of living fulfilling lives. Because that’s what it is: every time you’re doing a drug, you’re experimenting. And that pursuit of fulfillment looks totally different to everyone else. 

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Rachel’s latest article: Context Clues: Fentanyl in Mushrooms? 

DanceSafe’s Drug Checking FAQ

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