Hello and welcome to Talking Shit About. I'm your host, Elizabeth. In each month, I bring on a guest to talk about something they love, something they hate, and hopefully by the end we've all learned something. This is our first rerun episode. I have some more information I wanted to add, so I figured with the election coming up and this being a hot topic, we'd go ahead and replay this for you again with some new information. I recorded this episode with my friend Rachel, who at the time was working for my local health department, doing harm reduction and outreach, and so I think she is a great person to explain this topic. And if you didn't listen to it last time, I hope you stick around because there's a lot of misinformation clearing up that we do in this episode. So without further ado, let's go ahead and talk some shit. And I was like, what the fuck does that mean? I have friends that are firefighters and I know that they use soap. And she was screaming at me over stupid fuck this. I am not ever talking to a psychologist again. These people are all insane. I'm putting my bricks in the dumpster's motherfuckers. Do you see me bitches and throw in my bricks? And he's just like shocking. Hello everyone and welcome to talking shit about today. I am here with my friend Rachel, who works in harm reduction services here with me in Tillamut County. Rachel, welcome to the show. How are you doing? Hello. I am doing good. Thank you so much for having me. Really excited. This is my first podcast. Woo hoo. Yes. I'm so excited to have you on as a guest because I've heard you present on the well, hey, you're just an amazing person. But I've heard you present on this topic that we're going to talk about for. And so I know you're knowledgeable. I know you have a ton of experience. And yeah, I'm very excited. Yeah, no, my last two years, my last two years in my public health career have mainly been focused around fentanyl and substance use and just harm reduction, especially in rural communities. So I am not new to this conversation. And I'm excited to have it at least on a platform where I can send to other people. There's a lot of misinformation around fentanyl and you know, just our drug supply in general, as well as what harm reduction is and isn't. And this conversation can only happen so many times by me. So it's really great to have it on, you know, a recorded platform for other folks to kind of, you know, share the facts. There's a lot of information in the media and just politicians and everyone else who has their own opinions on it. So it's always nice to, you know, have a platform to just speak truth. That is so true. Yeah. And then next time somebody asked you about fentanyl, you can just be like, here's the link. Oh, listen. Yes, yes. We're talking with a friend who's teaching an addictions 101 course in Portland as an adjunct professor. And I had mentioned to her today that I was doing this and she was like, Oh my God, send me the link. I'll have like my students, you know, listen to it and do a synopsis. Like it'll be an assignment. So really excited. Yeah. What we can do with this. Awesome. All right. Well, let's just go ahead and dive right in. We've got some some ground to cover. So what exactly is fentanyl? Yeah. So fentanyl is it's a big one. It's a powerful synthetic opioid. It's similar to morphine. But when we say similar, it's like similar effects. However, it's 52, like a hundred times more potent. It was originally created for to treat the pain and cancer treatment patients. So it had a job and it does it damn well. Fentanyl is short. It's got a short life. It's fast acting with a short life, meaning that it goes to work really quickly and it goes out of your system really quickly, meaning you're going to need more of it. Meaning it's got a higher chance of being addictive. So, you know, why are people using it and why are they choosing to? Well, it gets real real high. It does a good job at what it was originally created for. And anytime that happens, there's always the chance of misusing something like that. So fentanyl originally created again for the treatment of cancer patients. However, what we are seeing now is synthetic opioids that are being the chemicals are being synthesized in China, then they're being sent over and being created in Mexico, which are then being drilled over our borders and then distributed and poisoned into our entire drug supply. So data from federal agencies tell us that most of the drugs specifically fentanyl that are smuggled into the US are from legal parts of entry. Also worth noting, over 80% of people prosecuted and convicted for drug trafficking offenses were US citizens. So this election season, as you hear people say, "Oh, migrants are bringing drugs across the border." It's American citizens doing it at legal ports of entry. So keep that in mind this voting season. Any drug you get off of the street, if it doesn't come from your pharmacist with your name prescribed on that orange bottle or whatever color it comes from from your pharmacist, you can assume and you should assume that it has fentanyl in it. And it's caused all our overdose deaths in America to double since 2018. And now in 2024, we're on track for our 2023 numbers to have doubled 2022. So that's doubling every year, not just like, "Oh, every year since 2018." So these numbers are just getting astronomical. So what forms does fentanyl come in? I've heard powders and pills. We're mostly seeing it in powders and pills. There are patches of fentanyl, so I will give the caveat because it always comes up. Someone always wants to bring it up. There absolutely are transdermal patches for fentanyl, just like there are like a nicotine patch you can think of. So something that is created very specifically and formulated in a way that it will go through your skin's barrier. So those do exist. Those are heavily monitored in medical settings in Tillamut County where we're at. I have not in the three years I've been doing these trainings and been in this work. I've not heard a single first responder. Anybody share out a story where they've been on an overdose call because of a patch? So really what we are seeing and what's happening in our drug supply is powders and pills. And it's powders being pressed into pills. And so this powder, as small as a grain of salt, is the amount of a novelty user it takes to overdose and to cause death. And so when we say a grain of a salt, we say novelty user. We're talking about folks who are not choosing to use opioids. They have no tolerance in their system in their mind. They believe that they're doing something like cocaine or they're taking a friend's Xanax pill, but it's not a friend's Xanax pill. It's a pressed bar that's actually just fentanyl powder. And if you have zero tolerance, it takes maybe a grain of salt amount to cause an overdose. So it's extremely detrimental because nobody's really getting an experimental phase. Nobody gets to experiment with drugs. There is no safe supply at all anymore. What color is it usually? It comes in all different colors. Mostly it's a white powder, white to kind of maybe brown. It can come in kind of a crystal form as well. However, we've also seen purple and blue fentanyl powder has actually been really popular in the state of Oregon and in Tillamet County. So it comes in really back, especially during the pandemic. We heard a lot about rainbow fentanyl. So it's coming in all different colors. I've seen public health reports come out about green fentanyl in certain counties. So I think it really is dependent on where you're at and what the trend is of the time, but mostly it is a white powder. Okay. And I want to go back to how quickly you can overdose because A, that's terrifying, but B, there are some myths surrounding overdosing with fentanyl. I can't remember exactly when it was, but I feel like there were a ton of stories coming out in the news. A cop opens up a trunk of a car and overdoses from being near fentanyl and stuff like that. So what do you have to do in order to get an or what are the words I'm thinking of experiencing overdose? Yeah. Thank you. Yeah. So on record to date, there is not a single person who is overdosed from touching fentanyl or being around it. So all of those OPB actually did a really great article where they went back and examined a lot of those stories, right? Because there were a ton of those coming out because really at first when we did hear about fentanyl, we didn't know a ton about it. So we had assumed that it could go, you know, you could absorb it through your skin and it was a danger to be around, even if it was in the air and someone was smoking around it. We had those thoughts because we didn't know a ton about it. It was new and it was scary. Well, we have studies and we have science. The University of Washington, I think was the first one to put it out there, but others are following suit. I'm actually working with OHA right now to create their fentanyl exposure resources to share out across the state. There is no on record overdose of any law enforcement or person overdosing from touching fentanyl. So they went back, OPB went back and they examined a lot of those stories and they looked at what happened with the officers, right? So they were in a locker room. They were exposed to fentanyl somehow by either touching it or the bag opened in the locker room. So what happened? The heart rate started pounding. They may have painted. They, you know, really when it comes down to it and the toxicology reports coming back with zero opioids in their system, they had a panic attack. And rightfully so because again, we have been telling people that you can and will die if you touch it because we didn't know, you know, the misinformation was so far out of our reach. So a lot of those reactions, a lot of those stories you heard, all of the toxicology reports that have come back from those reports, not a single one has come back with opioids in those officer systems, meaning it was never ingested in their system, meaning they were never overdosing to begin with. How are people ingesting fentanyl? Is it mostly smoking? Yes, smoking is kind of smoking, taking in a pill form. So just ingesting it in a pillar powder, snorting it is another pretty popular way. Unfortunately, there was this really, this really weird shift. And I guess it's been like this for a while and I'm just newer to fentanyl is I came into harm reduction when fentanyl was really big. So fentanyl is truly all I know with harm reduction and some of my older harm reduction pals who were, you know, back when heroin was pure, the drugs were just different and the way that we treat things are different. So typically there's this misconception with people who use drugs that smoking it is safer and that you cannot overdose while smoking it. So when fentanyl hit the scene and fentanyl was being introduced into folks heroin and they were injecting it and they were overdosing, folks started to actually switch to smoking their drugs instead because in their minds they thought it was safer and that they could not overdose. However, you take too much of any drug anyway and you will overdose. It was just a really interesting shift with fentanyl that people and to this day at the exchange that I work at, we have people who come in and tell us that you know, they're going to smoke because they don't think they can overdose or like they were told that they can't overdose if they're smoking, which is always a good education piece and just, you know, a good, you know, hey, well, why don't you take extra Narcan just in case, right? And like, you know, so you can help your buddy out and it's always just a good touch point. But a lot of people are smoking their fentanyl. We on the West Coast are fortunate enough to have like a year to like year and a half lag of the East Coast. So typically they predict our trends. So things happen there before they kind of trickle down over here to us and we unfortunately are starting to see on the East Coast a lot of people are starting to inject their fentanyl. So smoking it and that route is not getting it into their system enough. And so injecting is like the next step up, which is really unfortunate, but it is a way that drugs do kind of trend. So we're kind of expecting to see a lot more folks injecting their fentanyl on the West Coast. Right now, I think it's mostly smoking. And we touched on it a little bit, but how exactly does fentanyl affect the body? Like, what kind of higher people experiencing? I mean, it's pretty euphoric. It's like morphine. I mean, trying to like think, I mean, it's just extreme happiness, drowsiness, confusion. But the big thing is, is that it's, you know, it's an opioid and opioids affect breathing. And when you have too many opioids in your system, they so opioids bind to the receptors in your brain that control the autonomic functions of your body. So you're breathing, blinking, heart rate, blood rate, like those kinds of things that those receptors are in charge of. When you put opioids on those, it makes it a little blurry. And so you can have a hard time breathing. Just like a normal body functions can typically have a hard time. So that's why some people can get nauseous or have diarrhea. It just affects certain parts of your body opioids do. But when you have an overdose of opioids, when you have too much, they bind to those receptors and it starts to weigh them so far down, it drowns out those functions. So you stop breathing. The oxygen stops flowing to the rest of your body. And that's what, that's when you go unconscious. And that's when you, you can, you know, die if nobody intervenes at that point. And do you know of any long-term side effects from fentanyl? All substance use at a core is going to take effect on all of your body systems. I don't have specific effects because I think, unfortunately, we haven't really seen a lot of long-term effects. This fentanyl pandemic is so new. And so we may have some folks who, from just long-term use in controlled settings or other, you know, situations. But truly, we haven't seen fentanyl on this level. It started in 2018 and it's just gotten so much worse. And unfortunately, I don't think that there's a lot of people, and I hate to really say this, but I don't think there's a lot of people that are going to survive this long enough for us to really study the long-term effects if we don't do something now. So it's unfortunate. But I mean, what I can say about fentanyl and its effects is that it's an opioid. So you build up tolerance to it in ways that you wouldn't other drugs. So when you have an opioid added into something like methamphetamine, that isn't something that the body necessarily is going to create a dependence to, but then you put an opioid that your body physically depends on, you start to see these people who are now physically dependent on methamphetamine. And it's now harder for them to get off all drugs, not just fentanyl, but they can't get off of now meth or, you know, whereas other times they could walk away or there were other means of treatment and things that worked. So that has been making it really, really difficult. We've not seen the level of physical dependency on drugs that we have since fentanyl has been introduced. Have you ever heard the term hotshot? Okay, so no, I had not heard it until you texted it to me. So I looked it up. And it looks like, unfortunately, it's, it was like the slang way to say that like it, your, your drugs are laced, right? And like, that's, that's like the way I'm saying it, because it looks like people said hotshot, meaning they knew that, that the heroine had other drugs in it. Today, I would say everything is considered a hotshot, except for people are not being told that or are not expecting that. Yeah, from my understanding, unless it's something like, I've heard at work, I have no idea how like widespread this is or if it like changes depending on the demographic that you're talking to. But from the, for context listeners, I work in homeless services. But a hotshot is like, you're right, something that's laced intentionally. But the intent, again, from like the conversation that I had, the intent is like death is intentional overdose. Okay, so yeah, that's not something that I guess I was hearing, because that that's the thing and people ask me all the time. So I do overdose prevention trainings. And I've probably, I've done over 40 at this point. And I've trained over 800 and something individual. So a lot of different folks and stuff. Okay, okay. And then that's like, oh, sorry, I was like, where are we going with this? And that's like one thing that gets brought up almost every training I go to is people ask, you know, will our people overdosing intentionally? Like, are they doing it on purpose? I've never met someone at my exchange that, that truly wants to overdose, right? They do not like, it's not something that they, you know, feel they can control. Even when we give them Narcan, and we give them everything, it doesn't always work. And they've seen that firsthand. So none of these folks that I'm working with want to go into these and like, not wake up. That's never been a conversation I've had. And that's always a question that comes up because I working with like our prime plus peers, one of the things that they share that I think is a really hard concept to grasp. But once you do it kind of opens your lens of harm reduction is that being really high on an opiate or like heroin is so close to death. Like that really high good feeling is just so close to death, but you're not there, right? You're not wanting to die, you just want to get close, you want to feel that warmth, and then you want to come back to the world. So that's a really, you know, delicate place. But again, people don't want to die, and they don't want to slip over into that place. But people have a hard time understanding how they can let themselves get there and not want death. Like, it's a, it's truly an interesting concept. But yeah, that was, that was something that really opened my eyes is that, you know, being really high on heroin is really close to death. And when you reverse someone in an overdose, you know, a lot of the times they're really confused. They might lash out, they may, you know, be really pissed off at you because what Naloxone does in an overdose is it puts you into opioid withdrawal, which is a really shitty feeling. Like your body hurts, like everything sucks, you're back to, and this is the thing, you probably have zero idea in that moment coming to that you were actually not breathing and you were unresponsive, right? You're just upset because someone fucked up your high. And, you know, in 20 minutes, once you realize and you de-escalate, and you explain to this person and they realize that you just saved their life, they're going to be a lot more thankful. But it may take that 20 minutes of de-escalating, because again, they are going to have no idea what just happened or the fact that you probably just brought them back to life. Hey, Elizabeth here. The word I was looking for earlier was murder, as in people are murdering people with hot shots. So it's an intentional overdose of somebody else. I didn't articulate that very well. Either way, if someone offers you drugs, probably don't take them. If you're going to take them, get them from someone that's your reputable, and if you're going to buy weed, buy it from a dispensary because you never know what's in it. Okay, back to the interview. Well, this is a good segue into talking about overdoses. I think you already kind of covered how an overdose occurs. But let's say you are out, could be anywhere, and you see someone and they're unresponsive and you suspect it might be an overdose. What do you do? So the first thing is if someone's unresponsive, I'm hopefully with someone else. And if not, I'm calling 911 or having them calling 911. And I'm immediately going up to the person. If they're unresponsive on the ground or somewhere, I'm going to try and put them on the ground in a safe place too. I'm going to assess my scene first off as well. I'm not going to do this. If there's weird, I'm going to make sure my safety is important as well, because I don't want to cause harm to myself or others if I'm responding. So I'll assess my scene, call 911, get down on my hands and knees, get this person on their back. And then I'm going to really make sure that they are truly unconscious. So if they are not breathing, or if they are breathing, so that's the thing is if they're in like a deep nod, so they're still kind of responding, every couple words, there's still a couple breaths coming out, but they're shallow. I'm going to stay with that person. I'm going to monitor them, and I'm going to make sure 911's on their way, because that person could slip into an overdose. And I just want to make sure that they get medical attention. If they truly are unresponsive and they're unconscious on the ground, I'm going to get down on my hands and knees, and I'm going to do a nice sternum rub on, I'm going to take my knuckles, and I'm going to really aggressively rub their sternum right in between their chest. Pretty hard, because that's going to, sometimes you may come across someone who is snapping, or who has, maybe does live out on the streets and has been harassed by people telling them to move or whatever. So they don't want to respond. So if you do a sternum rub on someone and they truly are unresponsive, then no, you need to get into action. If they wake up and go, hey, buddy, move on, move on, right? Like move on, apologize and get going. But if they truly are unresponsive, again, we hope 911's already being called and on the way. At that point, I'm going to go ahead and start CPR. So I'm CPR certified, so I'm going to do 30 compressions to rescue breasts. If you are not CPR certified in these situations, but you come across someone who is unconscious and not breathing, rescue breasts are some of the most important things that you can do to keep someone alive. It just keeps the oxygen flowing to them. Even if you don't feel comfortable in like the chest compressions, that's okay. Two, two breasts every about 30 seconds and really making sure you're lifting that, you know, tilting that chin up, you're plugging that nose and you're really blowing firmly in, trying to get the oxygen into their lungs, can really help and give, you know, give some time for the first responders to get there. So I'm going to start two compressions, or 30 compressions to two rescue breasts. I'm going to do about two rounds of that. And then I'm going to go ahead and administer my first dose of Narcan, Naloxone, whatever you have. We give out injectable as well as nasal. I give out nasal to all of my community partners and to mostly general public, trying to ask anybody to inject anything into anybody under any circumstance is quite a lot, especially when it's a traumatic situation like an overdose. So unless people ask for injectable Naloxone, I give out nasal Narcan. So I go ahead and pull out my, I carry my little kit with me and it's got my little CPR mask and all of my little kits of Narcan and all my other goodies that I need. So I'd go ahead and pull out a dose while this person's still laying on their back. I would go ahead and give a full dose, one dose of Narcan. And then at that point, if they do start to come back to and breathe, I would go ahead and put them into recovery position. So you lay them on your side, you bring their top arm up and over, and then I think it's the underarm goes up and around, and then you bring the knee up. Recovery position, look it up. I am terrible at explaining it. I usually just sprawl myself across the floor, but that doesn't help on a podcast. But you want to put someone, if they do start to come to in that position, when you do reverse an overdose, folks can have all kinds of symptoms. So they're going to have, you know, probably body aches, they're going to have chills, they might throw up, you know, all kinds of symptoms. So you really want to get them into recovery position, especially if you're not going to continue on with CPR, because if they do come to and throw up, you don't want them choking if they're on their back, because then you have two crisises now and first responders, at least in my county, no shade to them, but it can take up to like 30 to 45 minutes to get there. So one crisis is enough in that timeframe. But at that point, you would just stay with that person. It could take more than one dose of naloxone to bring somebody back. Unfortunately, our hearing that that's normally the case in Tillamut County, it takes typically anywhere from four to five doses to reverse an overdose. However, there are still overdoses we hear that are reversed with one. So you always start with one dose of naloxone and you wait two to three minutes at a minimum between each dose, really giving it time to work. You did already kind of mention what Narcan is. Can you also use it on pets or children? Yes, and right. So Narcan is safe for youth, for babies, infants, for pregnant people. It is safe for use on almost any human. There are very, very rare side effects. I've never heard of any enduring my trainings or heard of anyone sharing anything like that. So there are those very, very rare instances of that. It's not approved for use on animals. However, I was in a training at the end of last year and one of our first responders, a fireman, shared out that they used Narcan on a dog during one of their calls recently and it revived the animal. And then I shared this at another meeting recently and another law officer shared the same thing and said, "Oh yeah, there was another call like that and we used Narcan on the dog and the dog came too." So I've heard of two anecdotal local stories of it being used and I believe them just because of the science behind the way Naloxone works in the brain and like how it goes to find the opioids and the receptors. But I am not going to be quoted on that because they're not last stories. So if you give Narcan to somebody who's not overdosing, is it going to affect them in any way? Nope, it will cause absolutely no harm to someone who's not experiencing an overdose in the entire county of Tillamook. And honestly, I got you throughout the entire state of Oregon, but especially here in Tillamook, I can speak for them on all calls where there is an unconscious person. First thing first responders do when they get on site is administer Naloxone or Narcan. It is safe. It will not harm anyone if you do not have opioids in your system. And if you do have opioids in your system, it's going to give the paramedics or the EMS a better idea where they should start their care. So especially if you are with somebody and you call 911 and the EMS does show up and you're still with that person, the first thing you should explain to them is I have been here for two, 20 minutes. I have given three doses of Narcan two, three minutes in between. We've done this much CPR. You're communicating all of that with them because it's going to give them an idea. Okay, well, maybe it isn't an opioid overdose. Maybe it's an overdose from this, and they can start on their processes a little bit better. Like they just have a leg up in saving that life. And where can people find Narcan? Like where do you get it? The state of Oregon, anybody can walk into any pharmacy and you can walk into any health agency. And essentially, the law says that any provider should be able to write you a prescription for naloxone. And then you can go pick it up at your pharmacy. So when I say write you a prescription, that's usually what's required your insurance to kick in to pay for it. So if you have, if you have a prescription, typically almost all internships will cover it. So then that's free. In Tillamut County, anybody can walk into any Adventist Health location and ask for it at their front desk. They have a community supply. And so it's at all of their front desk, so Manzanita, Pacific City, and in Tillamut proper, you can walk in any of those locations and ask for it at the front desk. I walked in and asked for a case and they're like, yes, ma'am, and let me walk out with a ton. So anyone can go there. And then there's also, I think, five or six locations in Tillamut County, where we have nalox boxes. And so those are just those are boxes that are kept on the outside of buildings. So they're available 24/7 to anyone in Tillamut County or anyone anywhere who needs naloxone, who can get to those locations. And so there's one outside of the Health Department's new public health building. And that's in Tillamut. There's one outside of Care Inc in Tillamut, Serenity Club in Tillamut. Rising Heart Studio has one up here in Nahalum. And oh, gosh. Oh, Tillamut Veterinary Hospital. That's another one. That's a newer one I just got put in. And I'm really excited to have them have their box up there. They invited me in to do a training. They're pretty close to where some of our camps are. And they just want to kind of help however they can. So they've been a really cool partner in getting that nalox box put up. And people have been using, have been using it and taking Narcan from them, which is really great. For listeners who are not in Tillamut County, would you recommend maybe going to like the local hospital or health department? Yeah, I would say reach out to your health department. If you have, I mean, I would also just look up if you have a local harm reduction agency. Depending on where you're at, especially if you're in a bigger city, there's going to be a lot of nonprofits that can do this work that have put money into it. And those are going to be a better place for you to probably get free items. If you're closer, like the Portland area inside out is amazing. Multnomah counties exchange and all of their resources are great. But inside out is really doing some amazing work. They have a drug checking machine that is open to the public. So you can take your drugs there and get them tested. No, you know, anonymously, no judgment. And it's really cool. They've got some really great advanced stuff going on with peers and their Portland. So they have treatment and they have, you know, real referral loops that like lead places, which is amazing. So they're a really great advocate there. But I just say reach out and look, do your research about who's doing local harm reduction in your area. We're very fortunate in Oregon to have the good Samaritan law that protects anybody who responds to an overdose and good faith, as well as folks who have, you know, certain, and protects folks from certain drug crimes as well, or, you know, penalties and things like that. It's really unfortunate because I have to make it very clear when I talk to people that that's Oregon's good Samaritan law. Idaho just created laws that make it harder for general public to actually have and carry naloxone. I think only paramedics and licensed medical providers can now carry it around. So it's really scary what people are doing and what like why they're trying to police Narcan for whatever reason. But we're very fortunate to be able to have solutions in our own hands and take care of our neighbors. And so I think everyone, you know, if you are able to and you feel so inclined to, I think everyone should carry Narcan and know how to use it. I carry it always all the time. One of the highlights of my bachelorette party is my bridesmaids took me on a scavenger hunt throughout Missoula. And we were on campus at the university and they had a Narcan booth and I was so excited and I stopped at Narcan and test strips and like everything. Yeah, all about it. You never know you're going to find it. Super cool. You never know who you're running to, who may need it. I've run into people out here. Like people want to act like it doesn't happen out here. I've been in restrooms where girlies are snorting stuff off of keys. Like it's happening here. It is here in these bars, right? Like it is happening in our community. And you know, to turn a blind eye, it means that we would possibly lose a community member. And I'm just not, I'm not ready to do that because you know, who am I to judge? Rachel, you're so good at entering into our segues. You've said the term harm reduction a few times. What is that? I hate harm reduction is loving people and meeting them where they're at. It's a range of intentional practices that we do to lessen the negative social and physical consequences that are associated with substance use. So we hold the exchange mainly in the way that we explain it to, you know, constituents and you know, to our commissioners and stuff is that we're reducing harm by reducing the prevalence of disease. So we help people not share supplies by exchanging it for them and getting them clean supplies. We acknowledge that drug use is a part of our our community and that we don't have enough treatment or referral loops or those kinds of resources to take care of that. So we need to reduce the amount that it drags on the rest of our systems like our hospital system. We need to make sure that, you know, folks aren't going to the hospital all the time for, you know, abscesses and wounds that are festering because they are, you know, sharing supplies with people, you know, they have the right ability to clean their own wounds without having to go to the ER every time they need something. You know, we want to make sure that, you know, we have plenty of Narcan given to folks so they can reverse overdoses in their own community when they don't feel safe to call 911. You know, it's it's about acknowledging that people are self, what are we trying to say? So self autonomy, right, that you get to be in charge of what's right for you. And we're just here to help educate and give you the tools you need to make your best choices. So our exchange is anonymous, it's free. And it's a we like to consider it a safe place. So people come in and the only real, you know, lecturing, if you will, that we do at folks is we we give education on fentanyl and fentanyl test strips when we give those out and just making sure people understand that fentanyl is in everything. And then we talk about, you know, why we don't want people to share supplies. So we, you know, talk about how it can reduce the amount of abscesses and wounds and, you know, disease that is spread. And so those are the only two real touch points that we, if you will push on to people, the rest of it is just, okay, now what do you, what do you need? What are you working on? What, what can we help you with today? And a lot of the times for the first two or three, it's just they come grab supplies, they barely look at us. In our intake forms, we'll ask questions, you know, about what substances do you use in those things? And they'll say nothing, nothing, nothing. And then by the third, fourth, when we've held that space and we've created, you know, such a safe space, they come in and they finally like, okay, so I have a tooth and they'll open up their mouth and you get to, you know, see what, what actually needs taking care of and you're just like sitting there like quietly in the back of your head, you're like, yes, I'm in like, because you built that rapport finally, because it's, you know, and you know that every time they've come in, they've wanted to say something, they just don't know if they can trust you yet. So it's just building up that space, creating that safe space for people to come back to. We don't hold people accountable to really anything but themselves. Everyone else is holding on accountable for everything and putting consequences and saying, if you don't do this than this, that's not us. You can come see us or you don't have to, you can, you know, we won't see you for three months and you'll come in and we'll be like, hey, it's great to see you. What do you need today? You know, it's not like this big, well, where have you been in this whole story? It's just, it's good to see you come on in and it, you know, people feel safe in that space. So we just try to continue to create that because, you know, that's not not really being created anywhere else. And it seemed to work. We just had a success story really, unfortunately, when some of our exchangers don't come in for a few months, typically that means they've overdosed and passed. And there was one that we hadn't seen for a while. We were getting really nervous and we reconnected with them pretty recently at a separate community event. And they were so excited to come up and share with me and Jennifer that they are no longer injecting drugs anymore. They've now switched to smoking, which is a safer choice for them. They had all kinds of wounds and just some really, really unfortunate stuff going on because of the injecting. And they almost all but healed at this point because they have been, you know, abstaining from, you know, injecting and have switched to a safer method because they felt, you know, they were safe to do so and, you know, excited to share that with us. And that is a huge win for us in terms of harm reduction is that, you know, this person is happy with their choice and they're doing better because of it. And at some point, I'm sure it will lead to them abstaining from use altogether if that's what makes sense to them. And if it's not, we're still beyond excited for them. That's awesome. Rachel, I appreciate the work that you do so much and your attitude while you do it too. Thank you. Well, it's my community, you know, I want to give back, I live here. And the more I give back to it, the better my neighbors are for me and the better my community is. So it just, you know, it all adds into it. And I mean, it's just, it's people like us because I mean, you do it too. Like, it's people like us that are going to change this community for the better and like, they need us. They do. Well, Rachel, do you have any closing thoughts before we wrap up? Just, you know, support harm reduction. Love people who use drugs, you know, and take care of each other. Look out for your neighbors. Perfect. Rachel, thank you so much for coming on the show. I really appreciate it. And again, appreciate all the work that you do. No, of course. Thank you so much for having me. That's a wrap for this month's episode of Talking Shit About. We'll be back in November with some new content for you. And speaking of November, it's voting season. The only candidate that this podcast supports is Vermin Supreme. If you haven't gotten a chance yet, go check out our last episode on Project 2025. And when I say R, I mean mine with my husband, Gil. You can learn more about Project 2025, who's behind it, and what potential policies and such would look like under a conservative administration. Our two-party system is broken and everything is fucked up. But if you want to vote to make yourself feel better, go for it. I support you and I support Vermin Supreme. So with that, we'll see you next month. [BLANK_AUDIO]
