I am an opioid user, or a former one anyhow. 

Contrary to the cliche, I’m not addicted. I never felt trapped or enslaved by my drug use. I never did anything I regretted to get high. I never shared needles – the sole time I shared a cooker due to interpersonal pressure, I promptly got tested for HIV and HCV. When injecting, I was always sure to do so hygienically to avoid developing an infection. I read up on harm reduction practices, doing everything in my power to stay healthy. 

However, occasionally factors beyond my control – such as restricted access to clean needles – caused issues for me. By choosing to use (for it was certainly a choice rather than compulsion), I didn’t harm anyone else. When I couldn’t afford my drugs, I didn’t commit crimes or behave outrageously. Instead, I quit temporarily, binge-watching HBO dramas to distract myself from the physical agony of withdrawal, taking over the counter medications to make the symptoms more bearable. 

My use never interfered with my ability to finish projects or maintain relationships. Nor did it stop me from engaging in a variety of hobbies, ranging from no-budget filmmaking to writing novels. If I’m recovering from anything, it’s not drug addiction but trauma – the very issue that caused me to begin using in the first place. 

The biggest issues with my drug use were always the stigma and illegality, because of my firmly-held belief that honesty is more ethical than secrecy, I never concealed my drug use from the people in my life. I spoke openly instead of hiding. Given that my drug use wasn’t any more of a problem than most people’s cocktail drinking or weed smoking, I figured I might as well let my friends know. 

Luckily, they understood. They could see that I was functional, after all. Eventually, I began tweeting and writing about my use as well, in an attempt to fight the stigma associated with drug use. Being wealthy and white and, thus, able to get away with using banned drugs, I figured I might as well use my privilege for good.  

I used, not because I had an unnatural drive or compulsion, but because the pros of using outweighed the cons during that period of my life. I first used opioids to deal with my then-boyfriend’s abusive cruelty – drugs served a practical purpose. They insulated me from his vile behavior, preventing me from crying or reacting. This in turn made the relationship less painful for me, which allowed me to make concrete, logical plans to escape instead of merely despairing.

After I managed to cut him out of my life, I quit using for the first time. Of course, though the relationship had ended, I continued to suffer from a variety of struggles and symptoms. Everything startled me. I felt unable to trust people. The dark terrified me. I couldn’t sleep during the night or, for that matter, more often than every few days. 

I all but stopped eating, given that I was too distraught to look after myself. Whilst I’d always been depressive, due to both the pain of being a closeted trans person and the years of mockery I’d faced thanks to my autism, I became even more hopeless. Haunted by the memories of my ex, I hardly had a reason to live. 

Months after quitting, I returned to using opioids once again. They gave me purpose. During that miserable, empty period of my life they preserved me, giving me something to cling to. When high, I felt okay rather than wretched. I could sleep at night, allowing me to be more active and functional during the day. I managed to write a fair amount, even taking on a number of editorial internships to build up my resume. 

I could actually work, attend poetry readings, and engage in various hobbies. Every so often I’d detox again for one reason or another, generally because I wanted to lose my increasingly-expensive tolerance, though doing so caused my sleep problems and suicidal ideation to return. Eventually this would be too much for me to bear. 

After I was sexually assaulted by a man I volunteered with and began having nightmares, I became even more reliant on opioids to cope. They kept me alive. They helped me sleep, even during the months in which I dreamt of being assaulted on a nightly basis. They insulated me from my body dysmorphia, decreasing the amount of everyday distress I felt. They calmed me, allowing me to eat and sleep and function relatively normally. I doubt I would’ve survived without them. 

In those days I was close indeed to despairing. A few times, during a fit of sobriety, my roommates had to hide the knives or bandage me up. I never overdosed on opioids and I remained in good physical health, though – disturbingly- I came close to killing myself when sober or detoxing. 

Whilst I obviously didn’t like relying on illegal drugs, I didn’t know how else to get by. Plus, they worked for me. I was in control. I could and did cut back when I wanted to. As the years went by, the nightmares and hypervigilance caused by the assault and abusive relationship (respectively) faded. 

Eventually, I managed to find a prescribed medication that I could safely and legally take on a nightly basis to treat my sleep problems. This allowed me to use even less often, taking breaks of months rather than weeks. About a year later I began taking testosterone to transition medically. I came out to my friends, dressing and acting as the man I actually am for the first time.

Though I am still misgendered regularly by strangers and naturally still feel some gender dysmorphia, I am not longer perpetually suicidal as a result. I’ve begun to heal from the abusive relationship and later assault. As a result I no longer need opioids to get by. Still, I remain grateful that I was able to use them. Without the drugs I wouldn’t have survived the most difficult period of my life. They kept me alive so that I could be the confident, healthy person I am today.

Thanks to my overwhelmingly positive experiences with opioids, I believe that we must stop viewing substances as either wholly bad or wholly good, and instead acknowledge that most can be either helpful or hurtful depending on the precise context. Just like psychedelics or cannabis, heroin can be as live-saving or life-preserving as well.

On the flip side, some people do develop hurtful or problematic relationships with drugs perceived as harmless. Like so many things, drug use is a wide spectrum including both healthy and risky behaviors. Whilst there are certainly people who struggle with their use or find that the cons outweigh the pros, these experiences are not the majority. They are merely the ones we hear the most about. Indeed, an estimated 90% of people who use drugs do not develop a problem.

If this sounds implausible to you, I suggest you think of all the people in your life who drink alcohol or consume cannabis. No doubt the vast majority do so as part of a rounded, healthy lifestyle. Some – like the exceedingly brave Dr. Carl Hart, neuroscientist and author of Drug Use For Grownups – use opioids solely for recreational purposes. Others, like me, use or used to function. 

Framing drug use as an inherently or inevitably illogical activity erases the very real reasons that people use drugs. It also serves to make us look crazy or irrational, when in fact drug use is often a highly purposeful activity that tends to make sense if understood in context. Not only that, it obscures the way treating various underlying issues can help PWUD decrease their reliance on drugs or cut back if they desire. People regularly use drugs to meet needs that otherwise go unmet. For example, Joseph [name changed] used opioids to keep his pain and PTSD under control so that he can “care not only for myself and my cat, but provide support to my partner who is also disabled”.

Despite having suffered a number of still not fully healed back injuries due to physically grueling jobs he has worked over the years, he’s still able to do two people’s worth of domestic work, as well as perform maintenance around his apartment building for his landlord (to help him keep his place affordable). Opioids allow him to be far more functional, both psychologically and in terms of mobility, than he otherwise would be. He accesses his pills via a safe supply program in his local Canada, which eliminates many of the potential risks that come with sourcing from the illicit market. This in turn enables him to live a more stable and functional life.

 Unfortunately, due to the stigma surrounding illicit drug use – particularly the use of opioids, benzos, and stimulants – few functional drug takers speak openly and publicly. The few who do generally do so under pseudonyms or after becoming abstinent. This is perfectly logical, considering the potential financial, social, and legal risks of openly admitting to breaking both laws and cultural taboos. Of course, when the only drug use anyone hears about is the severely problematic sort described in lurid memoirs or by celebrities in recovering from addiction, people get the impression that all drug use is a grave issue. 

This is why I speak and write about my own functional history with opioids. I hope to balance the scales, to help encourage a more nuanced attitude towards drugs and the people who use them.

We are not zombies with hijacked brains, nor monsters to fear. We are simply human beings attempting to survive and stay sane in a hostile, frightening world. Some of us use solely in a pragmatic, positive manner whilst others develop unhealthy relationships with their drug or drugs of choice. However, I firmly believe that we all deserve empathy and respect. Our drug use, however taboo, doesn’t negate our humanity. 

M. L. Lanzillotta is a freelance writer and harm reduction advocate from the greater Washington, DC metro area. His hobbies include painting, filmmaking, and complaining via twitter. Tweets @MLLanzillotta1

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