Destigmatizing Drug Use

Let me know what you think about this video. What's it take to be a mentor with big brothers, big sisters? It takes 30 minutes in a cup of coffee, a video game, best 2 out of 3. It takes sharing thumbs up emojis, clapping emojis, and loaded nachos at halftime. That's how you make an impact on a young kid's life. So go on, share a few hours a month, because mentorship may sound huge, but the truth is, it takes little to be big. To learn more, volunteer or donate, go to bebignow.org. Almost 3,000 people were killed in the 9/11 terrorist attacks. How did some of their remains end up in the world's largest landfill? They treated my son like garbage. So while the people who killed my son, I have certainly an animosity for them. I have a huge animosity for the people who are running New York. On the latest episode of Revisionist History, the story of a battle over what some see as a pile of dust, and others see as the remains of the dead. Listen to Revisionist History wherever you get your podcasts. This is last day, I'm your host, Stephanie Whittles-Wax. My new book, Last Day How to Stop Losing Our Loved Ones to the Opioid Crisis, is Out Now. Check out the show notes for the link to get your copy. Along with the book, we've been bringing you new episodes of Last Day, and today, I am talking to my dear friend, Stephen Murray. Even as the first to say, he's not a good spokesperson for recovery, which might be surprising. Given that, one, he's built a stable, successful life after overcoming his own severe substance use disorder in his early 20s. Two, he saved countless lives from drug overdoses as an EMT and paramedic. And three, he's the founder and executive director of Safe Spot, the only government funded overdose detection hotline in the United States. But when you hear Stephen's story, it makes sense that he's landed here, tirelessly advocating for harm reduction, rethinking the labels we give people, and destigmatizing drug use itself. I'm so excited for you to hear this episode. When we did the first season of Last Day, I had no idea these hotlines even existed, and I delve into them in great detail in the book. Anyway, Stephen is a good one, and this episode is a good one, and let's get to it. So here's the deal. Last day, we typically revisit, like, singular transformative day of someone's life. But you, as we started digging in, are someone who has had so many last days. So we're going to wind our way through three of your last days, and how each really marked a sort of new era in your journey. So before we get there, though, let's go back to sort of where your story, this story begins when you are 21. You're attending college in Miami. You are a complete overachiever who's literally just been elected to City Council 21. Can you paint a picture of your life at that point on the outside versus what's going on beneath the surface? Like, what's it look and like? Tell us about you. Yeah, I was living a lot of different lives at once. You know, I was sort of like pretending to be a college student, and I had a job. I worked in the business school. I was on the local village council and was doing like political consulting. So I had a lot going on. So it made sense that I was too busy to be doing a full course load because I was working a lot at the same time. But the other piece of this was that I had also done a couple of different phases of the college drug routine. And I say that because I think a lot of it was very normal. Totally. And so, you know, I did the whole like freshman year drinking, smoking weed. I started smoking cigarettes, which I had never done before. Oh, my God. I love smoking cigarettes. I know. I watch you in your slow motion relapse every day. Except it will never happen. Yeah. I just, I just don't pine for cigarettes. Like, it's my lover. It's weird too, is like having had like a random one here and there over the years. It's always worse than I remember it. And I'm like, uh, disgusting. It's such a let down. So awful. Like, when you actually smoke a cigarette, you feel like such shit, but the action of it is just the best. I know. Yeah. Anyway, okay. Glitter's sparkle. Glitter's sparkle. Glitter's sparkle. Okay. So I was doing some level of like self-medication with drugs. A friend of mine died. My freshman year. And then another friend of mine died the following year on my birthday. So I was using opiates to sort of numb myself and they did make me kind of like a little bit like apathetic though, which as someone who is type A, that's not my mode, you know, so Adderall and at times math was sort of like the pick me up, um, which gave me really that anxiety. And so I was also using benzo's to sort of like counteract the anxiety from all the stimulants. So hell out going on. You sure did, buddy. Yeah. At some point your family decides that you need some sort of intervention. You need some sort of treatment. Did you agree with them? How were they intervening? Were they intervening? What did that feel like? So my parents always tended to be trusting of me like I wasn't a kid that was known for being problematic. And my sister knew that I was using drugs and she noticed things were really bad in like the sort of home life side. And she also like kind of found me in like a quasi semi overdose state and like dumped a thing of water on me and like it was like one of those situations. And so that scared her. And then also she was really worried about how paranoid I'd become because I was like not sleeping and I was worried that I was being followed by the cops and there's a lot going on there. So anyway, that all like kind of was like bubbling to the surface. And then everybody came down for graduation, you know, we did the bunch of stuff as a family. My uncle was also there for my graduation and he, you know, felt like there was something off about me. He could put his finger on that it was like probably drug-related. And so during one of the dinners that they had that I wasn't involved in, I wasn't you know, at he brought it up to my parents in front of my sister and then my sister broke down and sort of said what was going on. So my actual intervention though didn't happen for another month. But they wanted to be prepared and they had options. I picked the option. You'll love this. I picked the option that I could smoke at. That was my only criteria. Yes. Yes. So I chose my, I chose my rehab based off of it being the only of the three options you could smoke cigarettes at. I'm like, there's no way I'm giving up all these other things and cigarettes at the same time. Okay, so you go through this treatment process and then you start this outpatient treatment at this clinic in New York City and it seems like life starts to get a little more stable day by day. So we're going to jump ahead, right? You end up becoming an EMS. Like you explain that that adrenaline rush of getting the call felt like that like dopamine hit. You know what I mean? That was so striking when I talked to you, you know, when we first met. But it seems like another thing that was really clear about that time is that you were seeing a lot of overdoses. Yeah. So for the first year that I was a first responder, I was a volunteer firefighter in our town. Right. And when I got my EMT, they didn't actually have any full time positions open on the fire department. So I had to go work on an actual ambulance in our neighboring city. Many of you would call it a small town, but it's like what we call a city in the Western mass. So like within a couple of days of working there, I had responded to my first overdose. And I remember the first time I gave Narcan or Naloxone to somebody, my partner was like, here, you do it. And I was like, oh, cool. Right. Because I had actually never done it before and orient us to the year that you're talking about. So this is like 2014. Okay, okay. Got it. Yeah. And that really changed things in a big way, because we would get clusters of overdoses. In fact, I would enter the drug supply for the weekend, 40 people with overdose. And then it would leave. And then we kind of go back to regular programming, which was like maybe a, you know, a hair and overdose once a week. Yeah. Kind of. Yep. It's a, that is the shocking figure, like one weekend, 40 overdoses, and then back to business as usual, it's wild. It's able to track the drug supply in that way. Caregiving. It's the rewarding, challenging work that connects all of us. So I had no idea that this was what caregiving was. I kind of just thought, like, that's what we do for our family. So many of us can relate to this. So why aren't we talking about it more? That's what we do on Squeezed. We share the stories of the ones who care. And to Squeezed, with the Botanical Brown, wherever you get, your podcasts. So while the people who killed my son, I have a certainly an animosity for them. I have a huge animosity for the people We're running New York. On the latest episode of Revisionist History, the story of a battle over what some see as a pile of dust and other see as the remains of the dead. Do you have a family secret? I think most of us do. I'm Danny Shapiro, and I uncovered mine when a DNA test revealed that the dad who raised me wasn't my biological father. That mind-blowing discovery led me to create the podcast, Family Secrets. Each week, I talk with people who've uncovered a family secret of their own. We talk about what a change for them, how they see their family, their relationships, and even themselves. Join me on Family Secrets. Listen wherever you get your podcasts. So, okay, in 2019, you start seeing these ads on Facebook, I think, right? Or you're seeing something for never use alone. And you're working full-time as a paramedic. And what is this thing that you find? And I think you start really at this time connecting with harm reduction more broadly as a concept, as a movement beyond just a recovery and not recovery sort of binary. So walk me through that and that discovery. And then we're gonna go to your next last day. - Okay, so this is a couple of days that are important, actually, that are historical. So September 7th of 2019, my wife and I get married. My shifts together, you know? And so our state rep, Trisha Farley-Buvier, in Pittsfield was the one that officiated our wedding. And so we're talking on the phone one day, preparing for the ceremony, me and Trisha. And she's getting to know me. And she's like, well, is there anything like missing in your life? And I'm like, well, actually, I am in the closet about my own recovery from using drugs. And I wish that didn't have to be because I kind of don't like how everybody I work with in multiple settings, like EMS, police, fire, hospital, nursing homes, everyone I work with treats drug users like shit. And so I would love to be able to put a stop to that. Long story short, she said, what do you wanna fix? And I said, well, I wanna come out and she's like, well, it seems like you're in a position where you probably can do that. But you should probably talk to your boss first. So go to my boss and I'm like, hey, so I wanna tell you about myself and see what you think. And he responded very positively. And was like, that's cool. Like that's awesome. You've like been in recovery for eight years. Like that's really cool, you know? So I, next last day, I come out publicly about my history. And that video kind of goes like, you know, locally semi-viral and like mass life picked it up in our state and whatever. So that was how I actually then like, stepped into this role of like, hey, I'm like this paramedic that is in recovery. And like, let's talk about drugs and like, what's going on? And so when the recovery community was like, you know, trying to grab me in to be like one of those feel good, positive, stand up on the stage and get clapped for stories. I was like, whoa, whoa, whoa, like that is not my, that's not my jam. - Hmm, even then you felt this like, I don't, I don't wanna be your spokesperson. - Yeah, I didn't want to be this like beacon of recovery and hope. And I heard about harm reduction was like, oh, that's way more my jam. Like we should support people and make them safe. I'm a paramedic. My job is to like, do harm reduction basically. - Right. - People safer and like, I hear about never use a loan and I'm like, oh, like this is exactly solving the problem that I keep seeing in the field, which is that everybody. So to give you a little more context by 2019, bystander in Aloxone is very common. We choked overdoses, people will be awake. They'll be out there, right? - Wow. - You know, people call on panic, we'd show up. They'd order to be awake. They'd be throwing up or whatever was going on. We'd offer to care them, sometimes they would refuse whatever. But the other thing that didn't change is that fatal overdoses were not going down. Fatal overdoses were going up. And that was very evident to me that what all of those people had in common is that they were using a loan and nobody recognized they were having an overdose. And so someone going like, oh, yeah, here's a phone line that you could call. I was like, that's actually a really good idea because this is exactly the problem that I'm seeing and I can articulate this is the problem that I'm seeing. - And for people who don't have any idea what you're talking about, and this is the first time they're ever hearing about this kind of a hotline that you can call, what is this hotline? - Yeah, very basically. So an overdose spotting hotline is a place that you can call 24 hours, seven days a week, 365 days a year. And we hang out with people while they're using drugs alone. And I say hang out because we really are hanging out. It's pretty mundane and chill. And if something goes wrong, we've done some safety planning with the person to prepare their space for 911 to show up. And we know the only really identifying piece of information we have about the person is we know exactly where they are. And so we call the 911 system on their behalf. We hang out and wait on the phone and keep trying to wake them up while they're on their way. And then the person is revived. Now we've supervised like 54,000 times people have used something like that. I think we're not even at 50 overdoses yet. We're like 48 overdoses. So yeah, so that's what we do. - So okay, you start volunteering for this hotline that is called Never Use Alone. And you are also working as a paramedic. You get dispatched to an overdose. Tell us about that. It's a young woman who's overdose, you responded. Why was this like such a monumentous call for you? - Yeah, so this wasn't even my only overdose that week. I was the shift supervisor at the time on Saturdays and it's a Saturday sort of like mid-morning and call for an overdose that is literally 0.3 miles from our station. We're abnormal, but as we move through the house and no one is answering us, find a young woman who is blue on the floor for bathroom. And then I feel for a pulse and she has a strong enough carotid pulse that I was like, oh, she's alive. Shit, I have work to do. I was already in my head getting ready to like pronounce her and not disturb the scene, especially because nobody was there. Like you're doing as a medic, you're doing a lot at once. I'm calculating. I'm like, where am I stepping and my destroying evidence? So I drag her out, the bathroom's tiny, I'm big. I'm not gonna fit in there. I drag her down the hallway and my team is now entering the house. 'Cause I was in a fly car, I got up there faster than I'm in ran-in. And so they're down coming through the door with all of our equipment. And so I drag her into the living room, wake her up, you know, and be given her a can, wake her up. And a bunch of stuff happened. She agreed to go to the hospital. She gets loaded in the ambulance, which I'm not gonna go with her because the crew is gonna take her up, having the supervisor. So I just like kinda did my thing and I was gonna leave. And as they're about to leave, I'm like, oh, I should, I should scold her. So that she scolds her friend who left her for dead. So, my nose he asks, Karen, self, I walk over there and I'm like, hey, listen, whoever was with you called and ran and left you for dead and we almost didn't find you here. Like, you need to tell them never to do that again. And she's like, I wasn't with anybody, I was alone. And I was like, well, and she's like, I was on the phone with the hotline. And it was like one of those moments where like, there was like, ooh, ooh, ooh, like around my head. I'm like, where I was having like one of those moments, like, who? What? (laughing) Ha, ha, ha, ha, what? And that's how I found out that she had called, never used a loan. And the reason she called is that she had found one of the shitty ugly business cards that I had made with my lack of graphic design skills and printed to put into Narcan kids. Like, that was the only reason she knew we existed. - God, it's incredible. - But that was like a moment where I thought to myself, like, oh, oh, shit. We like came up with a public health that are mentioned that saved this woman's life and I got to be there to see it. Like, I actually got to see it work. - Great, huge monumental moment. When we talk the first time, you tell me, you know, you're tired of pulling bodies out of the river and you wanna move upstream. And for people who don't know that metaphor, they should have deals into this show. But what does that mean? What is that river analogy? - Yeah, so like when you work in frontline medicine, especially emergency medicine in particular, I feel like you are in this constant state of reaction. Like you're not preventing anything. You're just responding. - And that's pretty exhausting after a while. I feel like a lot of people do whole careers that way. I admire them for doing that. But for me, I was like, with overdose in particular, I was thinking to myself, like, these deaths are preventable. And so I thought to myself, well, if I'm in this river just like trying to scoop up bodies and a lot of those bodies were dead bodies and seeing the wreckage and seeing the families that were like losing their loved ones and just like being part of that all the time. I was like, what if we could like fix the bridge upstream and find ways to just prevent this all from happening in the first place. And so the idea of overdose prevention, I guess, sparked an interest in me that something I could do and something I could specialize in. - Yeah, and you, I mean, I'm gonna speed up as part of the story. You really like click with this. You feel like, okay, this is it. I feel like I wanna head in this direction. And you get your master's degree in public health and you get your master's degree in public health. you eventually end up launching your own more professionalized hotline called Safespot. And it is the first government funded overdose detection hotline in the United States. And one of the best parts of this story is that you keep in touch with Kimber. And she's your first full-time hire. Before we move forward though, how is she doing today? What's she up to? Tell our listeners. Well, we're gearing up for her annual pilgrimage down here to Plymouth for us to spend a week on the beach together, which I'm looking forward to, with her fiance and their daughter and my family. So looking forward to that, Kimber is, you know, she's the operations coordinator for Safespot. And she also has her shit together in so many different ways. So yeah, Kimber is doing good. I'm super proud of her. And she's actually not the only person on our team and not even the only person on our, like we have other people on our full-time team who also started off as collars to the hotline and are now employees and full-time employees of our team. That's incredible. Hey, it's Julia Louis-Dreyfus from The Wiser Than Me podcast, among other things. And I've got a little holiday wisdom for you. Hosting during the holidays means lots of cooking and that means your trash is going to be full of smelly, rotting food, yuck. So here's the wisdom. Get a mill food recycler. I did. We've had hours for years and it has totally transformed our kitchen. It's unbelievable how much less waste and less odor there is now. Plus, it's so easy to use. You toss in basically any food you don't eat, peels, pits, meat, dairy bones. Last year we put in a whole turkey carcass, really. While you sleep, mill automatically dries and grinds all your food waste down to about a fifth of its size. That means at night you can fill it after a big elaborate dinner and by morning they'll be room for breakfast. Nothing rots, nothing stinks, no fruit flies. Am I favorite part? Using mill means none of our food ends up in landfills, which means we're doing a little good for the planet while keeping our kitchen tidy. If you want to manage your food waste in a cleaner, calmer way this holiday season, go to mill.com/wiser for an exclusive offer. That's mill.com/wiser. Happy hosting. Caregiving. I had no idea that this was what caregiving was. Listen to Squeez with the Bethnickel Brown, wherever you get your podcasts. I have a huge animosity for the people who were running New York. In terms of safe spot, when exactly just orient us to, when was safe spot formally launched and you're the executive director of safe spot and you know, just sort of give us and you guys are like going into all these other states now and like give us the safe spot. Sure, yeah. So as you pointed out, like I started the Massachusetts branch of Never Use Alone back in 2020. And we started it kind of right as COVID was kicking off. And the phone number for safe spot is the same phone number that was the Never Use Alone Massachusetts line. We've kept it across a couple of different rebrands. So I ended up getting a job at Boston Medical Center working on a research project with Dr. Alex Wally. And he's addiction medicine doctor. He's the state medical director for BSAS, which is our Bureau of Substance Addictions Services. And then he was like, hey, why don't we try to bring the Never Use Alone thing under our work here and like make it a real thing? And I was like, that's a great idea. So we apply for some pilot funding. And with that money, our mission was to find a sustained source of funding for the hotline so that it could grow. And so that funding was awarded in October of 2022. By August of 2023, less than a year later, the state of Massachusetts had issued us an emergency contract to like make the line professionalized. And we went down as the first ever government funded overdose checks on the US. And since then we've spread our funding into three more states. So Connecticut, Maine, and Wisconsin. And we're a workforce project to the end of the day because you can call us from anywhere in the US and Puerto Rico and Virgin Islands, etc. You can call us anywhere in the US. But what the phone is most likely going to be answered by someone who lives in one of those states that we are contracted in because we hired people who lived and let me experience to staff our hotline. And you also are potentially calling to someone who is a former or current caller of the hotline. We're not a recovery or treatment hotline. We don't believe that drug use is an issue. We're really addressing here. We're addressing solitary drug use, not drug use. Those are two different things, right? We're not trying to change or fix anybody. We are just trying to let people know that they have value wherever they are and they're drug using journey. And we don't really care where they are whether they're in chaotic use or this is the first time they've ever used or they just get out of rehab or jail and they're scared and they're calling us or you know they just lost their roommate to an overdose and now they're alone. There's a lot of reasons people call us and all those reasons are valid and I truly deep in my heart and soul believe that all people deserve safety without conditions. And that to me is really the key here is that we are not keeping you safe so that you can go into recovery. We are not keeping you safe so that you know you can live to fight another day into your recovery journey or you can get sober like that is not our goal here. We actually don't give a shit. So we're just here to keep you safe in this moment and a lot of people call us only one time. They're in some sort of situation and we never hear from them again and that's cool. Some people call us hundreds of times. We have people who've called us thousands of times. All of those are great. We accept all of that. You know this is actually exactly where I wanted to go next which is the sort of last day number three I want to talk about which is more this sort of internal quiteershift that's been happening in you in terms of your own identity which I think is a really important and interesting part of your story and your journey. So you know I know with your own viral you know Facebook video it was like I don't want to be a recovery spokesperson. I don't really identify as a person in recovery and in fact someone triumphantly overcoming their addiction is that story that people love to hear but you sort of started to feel like I think that actually does more harm. It stigmatizes drug use. You know when you stand up in front of a crowd like you said and you say I'm a person in recovery you get a standing ovation but saying your person who uses drugs doesn't get the same reaction and so I'd love for you to talk about that a little bit and and why have you shifted to identifying as a drug user and why do you think that's more impactful in the long term than identifying as a person in recovery. What I've learned over time is that people identifying in recovery and clapping for one another makes other people who are in recovery feel good and it makes normies feel good. It doesn't have the same effect on families who have lost people families who have someone who's still kind of in it or they're worried about and it doesn't make drug users feel good. And so thinking about audience and my audience and who I sort of hope to reach is like I want to reach people who are using drugs. I don't want to put up that wall in any way that like because it's not true you know like we're all drug users and that's part of the hard part is like you go into any recovery community and you see excessive caffeine and nicotine use and so like those are drugs and so I don't really like like the drugs that we've labeled as being dangerous or hard drugs or illicit pharmacologically are not any worse for you than any of the other things that we just regularly consume. Even our food supply is so bad for us generally from a health standpoint that when I actually like compare cocaine pharmacologically and opiates sort of at their base level pharmacologically to alcohol or food, really from a health standpoint, there's not a huge amount of difference here, but there's a massive safety difference, and the safety difference is driven by prohibition, and by the fact that these things are illegal, and that we choose not to regulate something that is very clearly in my mind, and it wouldn't be the case if we wouldn't have this podcast, or both of us wouldn't have books coming out, like about this subject, if it wasn't a very widely consumed consumer good. And so we have advocated that responsibility to regulate and protect the consumers of the drugs that we've decided that people can't have, and so that is really where I, my sort of like mission sits is around like, well, if we can't provide people with a safe product, I have to provide them with a safety service, and in order for me to provide them with a safe service, I have to be a safe person, and to be a safe person in particular for my own team, where the worst thing that can happen is for one of my operators to die from an overdose. And so I want to make it very clear to the people, the people that we serve, but also to the people who are doing the serving, that their drug use does not matter to me, and it doesn't say anything about them to me, at least, as to whether they can perform for the job. There's a lot of other ways we track performance. So I really think it's important that we put the message out there to our people that you can pick up the phone and call your job and use drugs safely with us, and that will not impact your job. And that is where recovery fails, recovery organizations, people die constantly, a lot of harm reduction organizations fail this test as well, which is really sad that their service is not safe enough for their own people to access or to feel safe disclosing what's going on. And that is a major, major, major driver of overdose death in our communities, and I refuse to be the safety person and not have that be at the front of my philosophy, and my philosophy is like my own values and sort of how I define myself. I should feel safe to pick up the phone and use our service if I had to, and that it wouldn't impact my job. And I know that I've built a place where that's the case. Yeah, I mean, you told me something in a one of our early conversations that has really stuck with me, which is that I'm quoting you, so that I actually don't think there's a pathway currently to fix the overdose crisis, because to get anything done in America on the policy level, you need state courage and federal apathy or you need federal courage, which is not going to happen. So this is where your views I think are important to your own organization, but in a broader landscape and with a broader lens, for all of us to be destigmatizing drug use in our own families and communities, and to be telling stories that are not recovery first and to make drug use safer in a country that is just not going to fucking do what they need to do. Period. It's really fucking important. And I agree with you. And you know, I know a lot of your listeners or families, and this is a very hard thread. I get it. Totally. I have kids. I get it. It's a leap. It is a real leap. And you know what? If you would have told me when I started making last day, because I lost my brother doing overdose, and I wanted to know what we could have done differently. If you would have told me I would be talking to you right now about legalizing, regulating drug supply, like the seemingly radical shift that is actually quite practical, I would have told you you were fucking crazy, but I genuinely, with my years of research in here in this area, agree. It is maddening, I think, for you, obviously, for those who have been in the space doing this research for so long, to have solutions and to just not fucking employ them. So it is very much up to individuals. And that is why I admire you from afar, because I'm like, you're doing shit. You are getting shit done. You are taking a different approach. And I just am grateful for you as a human and a friend and someone who's fighting this fight day in and day out. Thanks for that. I mean, I was lucky enough to get an advanced copy of your book. And so I did read it already. And I think like what people should know about the book is that you are very much documenting your own process of discovery. You know, by the end of it, you actually are challenging in a lot of I'm like, yeah, because I think growth is so important on this. We are so stuck. We're so stuck. And so we're both trying to figure out that baseline understanding. We can tell that the foundation sucks and there's all these problems with it. And we're trying to figure out like, what is it about that foundation that we built this very non-functioning house on top of? And so I think it's beautiful to see you walk through that. And yeah, I think just one thing to close maybe on is around families. And I think that both the hardest and the easiest thing you can do is just to change how you talk about drugs to the people around you. Also like so much diagnosis of substance used to sort of happens because families believe that that person's having a problem with drugs rather than being like, oh, there's actually something else going on here that we should be like working on. Totally, totally. You're my favorite. I don't know what to tell you. You're my favorite. Thanks so much for listening. Last day is a production of Lemonade Media. I'm your host, Stephanie Whittles-Wax. Executive producers are me, Kristen LePore, and Jessica Cordova Kramer. Our producer is Hannah Boomer-Shine. Bobby Woody mixed this episode. Music is by Hannah's Brown. Maggie Krausshore is our senior director of partnerships. You can help others find our show by leaving us a rating and writing a review. Check us out online at Lemonade Media and you can find me @WhittlesDephani.com. [Music]