00:00:00.560 --> 00:00:04.879
You know, um, best I can do is try to find some resources.
00:00:05.040 --> 00:00:06.400
Like, are you safe right now?
00:00:06.559 --> 00:00:07.440
Try to plan, right?
00:00:07.519 --> 00:00:24.079
I think I had the wherewithal, the safety plan with him, but just didn't wasn't prepared and didn't know until I looked into it that oh my gosh, this is an entire field, this is an entire phenomena that is really yeah, so it's very interesting.
00:00:24.239 --> 00:00:25.839
Um chemsext.
00:00:26.079 --> 00:00:33.439
Sexualized drug use among men who have sex with men, typically involving methamphetamine, methadrone, and GHB, among others.
00:00:33.679 --> 00:00:42.719
Chemsex misuse is a worldwide epidemic that needs attention, dialogue, and hope for those lost in it, which is the purpose of the Aftermath Podcast.
00:00:42.960 --> 00:00:52.320
Please note the views expressed by the host and guests on this podcast are not to be taken as medical advice, and the content around sex and drug use can be triggering.
00:00:52.640 --> 00:00:54.799
Hey, welcome back to the Aftermath Podcast.
00:00:54.960 --> 00:00:57.280
Welcome here, and I'm glad you're here.
00:00:57.520 --> 00:01:03.280
I'm glad you're going to take this uh tour with us today, this little journey into harm reduction.
00:01:03.439 --> 00:01:19.680
As you know, if you've listened to me for a while, that I like to present all sides of recovery, and I want to present a side of chemsex recovery that's been proven to be probably the most successful, and that is harm reduction of some tour, some type, some kind.
00:01:19.920 --> 00:01:27.359
Um, and we've discussed that harm reduction is just one big spectrum between abstinence and active use and everything in between.
00:01:27.519 --> 00:01:49.840
So we don't want to separate it either from abstinence or harm reduction, but I will say if you look, if you want to do your own research, go out and research and see what's happening, see what's coming up in terms of long-term uh success, full chem sex recovery, and long-term successful measures that save lives, you're going to find harm reduction in the center of that in some form.
00:01:50.000 --> 00:02:03.359
So I want you to stay informed and I want you, if you're listening and you just can't seem to stop, and you just can't seem to fit in any other recovery abstinent program, look into some harm reduction techniques.
00:02:03.519 --> 00:02:04.879
We use it in my program.
00:02:05.120 --> 00:02:07.120
Some some people are tapering off.
00:02:07.280 --> 00:02:08.639
We have planned uses.
00:02:08.800 --> 00:02:11.039
I mean, we there's a lot of different managed use.
00:02:11.280 --> 00:02:17.680
There's a lot of different ways to do this with an end goal, if it's negatively affecting your life, of stopping.
00:02:17.919 --> 00:02:24.800
So today I have an expert, the expert, um, and in the U.S., actually, too.
00:02:24.960 --> 00:02:29.680
Uh, Taylor Edelman is a harm reduction consultant and healthcare compliance officer.
00:02:29.840 --> 00:02:34.400
Um, and you have your own your own company that we're going to talk about too.
00:02:34.560 --> 00:02:44.400
Um, but I I want to get some credentialed, informed, research-based professionals here so that you're not just hearing me talk about harm reduction.
00:02:44.560 --> 00:02:48.159
I want you to hear from the from the actual people in the field doing this.
00:02:48.319 --> 00:02:51.439
So, Taylor, welcome to the Aftermath Podcast.
00:02:51.759 --> 00:02:53.680
Yeah, thanks so much for having me here.
00:02:53.759 --> 00:02:54.800
It's a pleasure.
00:02:55.039 --> 00:02:58.960
Um, so I'm Taylor Edelman, use he, him, his pronouns.
00:02:59.039 --> 00:03:02.879
Um, I have my own consulting practice called Needle in the Hay Consulting.
00:03:03.039 --> 00:03:07.439
Um, I've been doing harm reduction and practicing it for, I would say, well over a decade now.
00:03:07.680 --> 00:03:14.080
Do a lot of work around gender-affirming care, harm reduction, health equity, organizational development.
00:03:14.319 --> 00:03:26.000
Um yeah, and I have previously worked at the National Harm Reduction Coalition, where I was overseeing a group that was focusing on queer and trans people who use drugs and engage in sex work.
00:03:26.319 --> 00:03:35.360
Um, and currently I work with a number of different harm reduction organizations, recovery organizations, anyone who really has the desire to kind of level up their practice.
00:03:35.439 --> 00:03:58.719
Um, I focus primarily on really incorporating and getting people to understand that harm reduction and gender-affirming care are braided movements that are really introverted by the concept and framework of bodily autonomy, which largely pulls from like the reproductive health space, but trying to get people to realize that um we share a lot more uh than we have that separates us, right?
00:03:58.879 --> 00:04:01.199
So just wanted to throw that out there.
00:04:02.159 --> 00:04:05.360
So bodily autonomy, can you talk a little bit about that?
00:04:05.680 --> 00:04:06.000
Yeah.
00:04:06.080 --> 00:04:10.960
So the way that I kind of talk about and express it is really, really simple.
00:04:11.199 --> 00:04:17.439
Just the ability to do with your body what you feel is right and what you feel is appropriate and necessary and what you're entitled to.
00:04:17.600 --> 00:04:17.920
Right.
00:04:18.000 --> 00:04:24.720
So that's really ensuring that people have the information, the education, whatever they need to make informed decisions, right?
00:04:24.800 --> 00:04:30.000
Um, like for example, in gender-affirming care, easiest thing I can think of is informed consent, right?
00:04:30.160 --> 00:04:36.480
Because uh not too, too long ago, and even myself, um, yes, hi, trans person here.
00:04:36.800 --> 00:04:46.560
Um, I had to go through the rigmarole of you know seeing a therapist before I was given, you know, a formal diagnosis to then go to an endocrinologist to start hormones, right?
00:04:46.720 --> 00:05:00.720
Where now it's very much there's an exchange with a medical provider around, you know, these are the risks, these are the benefits, just kind of letting you know, informing you so that you can then initiate um, you know, that part of your transition, the medical transition.
00:05:00.959 --> 00:05:09.199
So really it's just overall having the ability to do what you want and what you feel is necessary with your body, right?
00:05:09.360 --> 00:05:20.319
Nobody kind of imposing on you, which unfortunately we see happening um, you know, at an accelerated rate here in the US, but really I would argue around the whole world.
00:05:20.720 --> 00:05:21.120
Sure.
00:05:21.279 --> 00:05:21.759
Yeah.
00:05:22.319 --> 00:05:25.759
And as that as that relates to drug use.
00:05:26.000 --> 00:05:35.759
So uh if I'm giving all the education, if I'm given all the information and I'm making an informed decision, I want to use drugs.
00:05:36.800 --> 00:05:39.519
So the goal is okay, that's your decision.
00:05:39.600 --> 00:05:42.560
That's your body, you have body autonomy, you want to use drugs.
00:05:42.639 --> 00:05:46.639
If you're going to, here are the ways to do it safely.
00:05:47.040 --> 00:05:58.079
And here are here are some consequences that you may face that if you're going to do it, please do it in a safe way that is healthy and that is, you know, that you know it will save your life.
00:05:58.160 --> 00:05:59.199
Is that correct?
00:05:59.600 --> 00:06:00.160
Absolutely.
00:06:00.319 --> 00:06:20.399
And it's it's I love that you say that because a lot of people will assume, maybe not a lot, but there are definitely people who assume that, oh my gosh, you know, and I've had people say this, you harm reductionists, you know, you're you're not pragmatic, which is very funny to me because if you actually look at the principles of harm reduction, pragmatism and realism is literally in there.
00:06:20.480 --> 00:06:23.839
Like we accept the fact that there are risks and benefits, right?
00:06:24.000 --> 00:06:33.680
So just because you you purport and you talk about bodily autonomy doesn't mean that you're kind of obtuse, you're oblivious that there are downfalls, right?
00:06:33.839 --> 00:06:37.759
It's I argue the opposite that we are pragmatists, that we live in reality.
00:06:37.920 --> 00:06:39.519
Drugs have always been here.
00:06:39.680 --> 00:06:42.720
Uh right, they're here right now, they'll continue to be here.
00:06:42.879 --> 00:06:44.720
People will continue to use, they have used.
00:06:44.800 --> 00:06:49.439
There's no sense in kind of uh shutting people down and stigmatizing them further.
00:06:49.519 --> 00:06:51.920
That's that's never going to work.
00:06:52.079 --> 00:06:52.639
It hasn't.
00:06:52.800 --> 00:06:55.040
We've seen it and we're seeing it in real time.
00:06:56.000 --> 00:06:56.560
That's right.
00:06:56.639 --> 00:07:04.000
I mean, I think somebody's going to use drugs, you stigmatize them, you shame them, you tell them, you know, you shut them out.
00:07:04.160 --> 00:07:06.959
That's going to drive them to want to use more.
00:07:07.040 --> 00:07:10.240
I mean, because shame got them to where they are for the most part.
00:07:10.560 --> 00:07:11.040
Absolutely.
00:07:11.199 --> 00:07:24.319
People suffer in silence, and and the layer of not only substance use, but why it's so important to talk about this in the context of our, you know, queer and trans folks, is that there are so many other layers there, right?
00:07:24.480 --> 00:07:37.759
Like I'm sure people have talked about this on the podcast before, and you yourself know, and a lot of the listeners probably know, is you know, you have something like the minority stress model that was created, right, to specifically address the needs of gay and bi men.
00:07:37.839 --> 00:07:43.839
And really, you know, now that's been through several iterations and adaptations, but it's very real, right?
00:07:43.920 --> 00:07:52.480
There are very real external factors, right, happening at the structural part, the interpersonal part, right, the individual part.
00:07:52.720 --> 00:07:55.120
Those pieces add up and they accumulate.
00:07:55.199 --> 00:07:58.000
And those things are very specific to queer and trans people, right?
00:07:58.079 --> 00:08:03.759
Like what's going on legislatively, you know, having the most amount of anti-trans legislation ever.
00:08:04.000 --> 00:08:23.759
I mean, just the incessant attacks on the community and queer people in general, um, you know, hospitals closing programs and things, um, you know, organizations now being threatened with not being able to get funding if they even mention gender-affirming care or that they're providing care to trans people and trans youth specifically.
00:08:23.920 --> 00:08:26.240
So when you shrink that, where are people gonna go?
00:08:26.399 --> 00:08:29.279
They're still going to identify and be themselves.
00:08:29.519 --> 00:08:30.879
They have no outlet.
00:08:30.959 --> 00:08:32.960
And where does that pain go?
00:08:33.360 --> 00:08:33.600
Right?
00:08:33.759 --> 00:08:35.200
It turns inward.
00:08:35.600 --> 00:08:46.000
Um, you know, people turn to substances more, which again, if you use drugs, absolutely no shame in that, but right, it can get you to a place where it's very difficult to get out of.
00:08:46.559 --> 00:08:47.840
You're limited with your options.
00:08:48.559 --> 00:08:49.039
That's right.
00:08:49.759 --> 00:08:50.159
That's right.
00:08:50.240 --> 00:08:50.879
Yeah.
00:08:51.279 --> 00:08:51.519
Yeah.
00:08:52.320 --> 00:08:55.600
What do you see as far as chemsex goes?
00:08:55.759 --> 00:09:00.960
Um Do you what do you see the role of harm reduction in that?
00:09:01.120 --> 00:09:06.480
And yeah, I mentioned I mentioned the research that's out there, but how do you see it helping?
00:09:06.879 --> 00:09:07.519
Yes.
00:09:07.919 --> 00:09:21.120
So in my experience, uh, because in my previous, my previous kind of work and work that I still do largely, um, I work with many harm reduction programs in New York, specifically in New York City.
00:09:21.200 --> 00:09:27.919
And what was very interesting to me is I kind of went in with this naivete of thinking like, oh, okay, everybody knows about chemsex, right?
00:09:28.159 --> 00:09:40.000
Drugs are drugs across the board, not realizing that the majority of programs, which weren't queer and trans-led, they were focusing on, you know, cocaine, crack, and opioids.
00:09:40.080 --> 00:09:50.720
So when I was talking about things like meth, like G, right, like ketamine, MDMA, it was kind of like, you know, it's almost like that meme with that lady looking around and it's all like the meth being done.
00:09:50.799 --> 00:09:55.759
Yeah, you can see kind of like, oh, um, there are other substances, right?
00:09:55.919 --> 00:09:57.679
And there was a lot of work to be done.
00:09:57.759 --> 00:10:04.240
So I think, first of all, is being very real and assessing like what is kind of your drug IQ?
00:10:04.399 --> 00:10:06.960
Like, do you even know about chemsex and what it is?
00:10:07.279 --> 00:10:24.399
Because I think we were talking about this in our initial conversation, is that you know, I don't fault people for saying this, but I do think it's problematic framing when you say, oh yeah, yeah, um, you know, um straight couples, right, cishet people, we we do chemsex.
00:10:24.480 --> 00:10:28.080
We you know, we go out and have a couple drinks and we go home and we have sex and whatever.
00:10:28.320 --> 00:10:33.360
That's a very, very different context than what is going on, right?
00:10:33.519 --> 00:10:35.360
Than circuit parties, right?
00:10:35.440 --> 00:10:38.080
Like things that are happening in communities, right?
00:10:41.039 --> 00:11:07.840
So I think harm reduction plays a really integral role also in advocating for um, you know, contingency management for groups, for really these models that have been emulated within harm reduction and making sure to incorporate it as part of kind of just the practicum, kind of the continuum of harm reduction, because um it really startled me, I think, just how many providers weren't comfortable, didn't know.
00:11:08.080 --> 00:11:18.240
And you can't just assume that because someone's a harm reductionist that they're automatically on board with chemsex and even further with queer and trans people in general.
00:11:18.480 --> 00:11:29.759
I mean, a lot of my job was going into these organizations, and um, I mean, I had several, you know, LGBTQIA staff come up and say, like, I'm so glad you're here talking about this.
00:11:29.919 --> 00:11:34.159
Like, we're stuck on pronouns, like we can't even get past pronouns.
00:11:34.559 --> 00:11:47.279
You know, the extent of a lot of people's knowledge is talking about, you know, the AIDS epidemic, right, and HIV, and being stuck in like Ryan Whiteland when yes, that's part of it, but there's so much more.
00:11:48.000 --> 00:11:52.720
Um, and I think it's just it's really bringing it back to that training.
00:11:52.960 --> 00:12:08.000
Um, so I know in a lot of the work I do, I've incorporated that as kind of like a base 101 chemsex training, because um, yeah, I think without it we're doing providers a disservice and they're uncomfortable.
00:12:08.080 --> 00:12:10.240
A lot of people are uncomfortable admitting that they don't know, right?
00:12:10.320 --> 00:12:13.120
Because they're expected to be the expert or the practitioner.
00:12:13.279 --> 00:12:15.360
Um, and they could stand to learn so much.
00:12:15.519 --> 00:12:27.279
Because one final thing they'll say about this is that when I was part of that program, I actually uh commissioned a community member, someone who was engaged in chemsex, and I said, You have these great ideas.
00:12:27.759 --> 00:12:35.679
I agree with you that I think that you know, the reason that there aren't queer and trans people going to these programs is because they don't feel comfortable.
00:12:35.759 --> 00:12:37.279
There's not that like drug IQ.
00:12:37.440 --> 00:12:45.039
So we did like a very, very small, I think it was like a dozen or so people, dozen or so queer and trans people who use drugs and do sex work.
00:12:45.600 --> 00:12:50.799
We found that probably only one of them went to an actual uh harm reduction program.
00:12:50.960 --> 00:13:07.200
The rest of them were self-medicating, um, trying to just handle things on their own, taking substances on their own to um, you know, feel liberated and kind of validated with their gender identity or the fact that they were doing um sex work.
00:13:07.360 --> 00:13:08.960
So I found that really interesting.
00:13:09.039 --> 00:13:20.000
And I kind of use that as a way, like a wedge almost to get into a lot of programs to say, you may think you're serving a lot of people, like even though we have a small N here, this is what people are really saying.
00:13:20.159 --> 00:13:29.039
Um and that report, if people are interested in reading it, I believe is still on uh National Harm Reduction Coalition's website and their Lighthouse Learning Collective program.
00:13:29.600 --> 00:13:36.879
But I had a hunch that um something was going on and we were we were pretty spot on.
00:13:37.440 --> 00:13:37.679
Yeah.
00:13:38.240 --> 00:13:39.200
Yeah, yeah.
00:13:39.440 --> 00:13:40.639
Yeah, it's interesting.
00:13:40.879 --> 00:13:47.600
This like the the whole even the term chemsex is so it seems confusing in the US.
00:13:48.399 --> 00:13:58.480
I had a I had a harm reduction um organization reach out to me and try to they were they didn't like my my Instagram and they had some problems with it.
00:13:58.799 --> 00:14:04.960
And they told me like, even if someone takes a caffeine pill, that's chemsex, you know.
00:14:05.600 --> 00:14:16.000
And I'm just like, uh I don't you know I don't know, you know, and I I don't want to like act like I know everything.
00:14:16.240 --> 00:14:18.559
However, you know, you're missing it.
00:14:18.639 --> 00:14:21.840
You're you're missing, you know, and how are you helping people?
00:14:22.000 --> 00:14:22.240
Right.
00:14:22.320 --> 00:14:23.759
How are you helping people?
00:14:23.919 --> 00:14:32.000
Um because also someone using meth for with sex, they're not going to know the term chemsex either.
00:14:32.080 --> 00:14:38.559
And so then when they hear it and learn it from a uh a facility that doesn't understand it either, it's so confusing.
00:14:39.039 --> 00:14:39.840
Very confusing.
00:14:40.080 --> 00:14:42.080
Yeah, oh my gosh, it's making me think.
00:14:42.240 --> 00:14:45.519
So years ago, I was an HIV medical case manager.
00:14:45.759 --> 00:14:50.559
That's kind of why I brought up HIV and Ryan White, because I used to work in that program many years ago.
00:14:50.799 --> 00:15:02.720
And what was so fascinating was um much of my caseload was a lot of like monolingual Spanish speakers, a lot of like young, gay and bilatine and black men and um trans women.
00:15:03.120 --> 00:15:13.919
And that was really so eye-opening in the sense that they didn't have the vernacular, like chemsex, I didn't have that in my kind of repository, my vocabulary.
00:15:14.080 --> 00:15:14.799
They didn't either.
00:15:15.039 --> 00:15:20.639
And they had opened up, you know, because we had established a relationship and trust over many years.
00:15:20.879 --> 00:15:28.000
And they started talking about, you know, I had one guy call me, he was maybe like 25, 26, and he said, Taylor, I need help.
00:15:28.159 --> 00:15:29.519
And I was like, what happened?
00:15:29.600 --> 00:15:32.240
Like you get hurt, you like lose your medication, what do you need?
00:15:32.320 --> 00:15:35.279
And he goes, I don't know what to do anymore.
00:15:35.519 --> 00:15:39.039
I, you know, was having fun, I was partying, but I'm scared.
00:15:39.200 --> 00:15:44.320
Like I'm smoking meth like every every other day now.
00:15:44.480 --> 00:15:49.039
Like I met this guy and I, you know, had fun at this party and like we hooked up.
00:15:49.200 --> 00:15:52.720
And I was like, oh wow, because I I honestly didn't have any clients.
00:15:52.879 --> 00:15:58.879
A lot of my clients who were using, they were using crack um or heroin.
00:15:58.960 --> 00:16:02.720
Um, because fentanyl was kind of like coming up at this at this time.
00:16:02.799 --> 00:16:06.480
It was maybe only like 2016, 207, 2017, about.
00:16:06.879 --> 00:16:13.360
But anyway, so they were discussing it and kind of and and saying, like, you know, I don't I don't really know what to do.
00:16:13.519 --> 00:16:15.840
Like, is there a place that I can go?
00:16:16.399 --> 00:16:19.600
And um, you know, again, naive.
00:16:19.840 --> 00:16:21.840
I was like, well, let me see what I can find here.
00:16:22.000 --> 00:16:23.919
I was like, there's probably gotta be something out there, right?
00:16:24.000 --> 00:16:28.159
There's probably gotta be if you want to go to a treatment program, you know, I have my referral book.
00:16:28.399 --> 00:16:29.200
Nothing.
00:16:29.440 --> 00:16:30.559
There was nothing, right?
00:16:30.720 --> 00:16:33.919
Because a lot of these centers, they're oh yeah, just opioids.
00:16:34.000 --> 00:16:37.919
There's nothing for stimulants, there's no medications, there's no treatment.
00:16:38.159 --> 00:16:40.240
I didn't know about contingency management.
00:16:40.399 --> 00:16:41.519
I mean, there was nothing.
00:16:41.759 --> 00:16:54.720
I was working in a large city in Connecticut where I'm from, and um so basically, uh and I had left maybe a few months after he had told me, um, you know, and I felt really bad about it.
00:16:54.799 --> 00:17:08.000
He wasn't the only one, but I think, if nothing else, I was there to support him through it and not provide any judgment and just say, hey, you know, um, best I can do is try to find some resources.
00:17:08.160 --> 00:17:09.440
Like, are you safe right now?
00:17:09.599 --> 00:17:10.559
Try to plan, right?
00:17:10.640 --> 00:17:27.359
I think I had the wherewithal, the safety plan with him, but just didn't wasn't prepared and didn't know until I looked into it that, oh my gosh, this is an entire field, this is an entire phenomena that is really yeah, so it was very interesting.
00:17:27.599 --> 00:17:43.440
Um, but yeah, we didn't have the language, the shared language to really discuss what it was, other than, you know, I'm using this drug and I'm having sex and I don't feel good about my body, you know, I want to lose weight, and this guy, you know, made me feel free.
00:17:43.599 --> 00:17:46.400
And yeah, yeah, yeah.
00:17:46.640 --> 00:17:47.279
Wow.
00:17:47.599 --> 00:17:47.920
Yeah.
00:17:48.559 --> 00:17:54.799
So there there really is a lack of resources um and for treatment.
00:17:55.599 --> 00:18:08.319
So, you know, I was just I was in LA uh recently for a chemsex conference, and it was three of the uh they're they're saying the top chemsex treatment centers in the country.
00:18:08.640 --> 00:18:14.000
Um they're all in LA, but they're all abstinent-based due to insurance funding.
00:18:15.519 --> 00:18:19.920
So what do you think about abstinent-based treatment for chemsex?
00:18:20.480 --> 00:18:31.680
Uh so the thing is people largely think that us harm reductionists are completely against abstinence, but what most people don't realize is that abstinence is folded into harm reduction.
00:18:31.839 --> 00:18:39.200
However, the biggest difference is we do not pretend that that is the where, like be all, end all, that's the only option, right?
00:18:39.359 --> 00:18:47.599
I know many people they go to NAA meetings and that's worked for them and that's great, but they also know full well that that just works for them.
00:18:47.759 --> 00:18:51.039
They're not gonna throw that out and put that on everybody else, right?
00:18:51.279 --> 00:18:53.359
Do I think that there's a a place for it?
00:18:53.519 --> 00:18:55.440
Sure, if that's what someone's asking for.
00:18:55.519 --> 00:19:00.319
But what I don't appreciate is one, pretending like that's the only option, that's the best option.
00:19:00.559 --> 00:19:12.400
Um, and two, you know, um trying to get people to fall in line when that's not something that they're asking for and making them feel bad about it, right?
00:19:12.559 --> 00:19:17.839
Like I'm sure you know many, many people who right, they've gone into treatment.
00:19:17.920 --> 00:19:21.680
And I I don't even think I know anybody that has gone into treatment once, right?
00:19:21.920 --> 00:19:29.039
It's this perpetual ping-pong, but you're made to feel largely bad, that it's a failure.
00:19:29.200 --> 00:19:31.759
Every time you go back, it's a failure, right?
00:19:31.839 --> 00:19:44.720
Um, it's very, very expensive, it's not accessible, there are long wait lists, um, and that there's like this cookie cutter framework, and that if you aren't suddenly better in 15 days, 30 days, 90 days, right?
00:19:44.960 --> 00:19:51.519
And you're also in this environment, I know you and I talked about this, where that's not your everyday reality.
00:19:51.759 --> 00:19:52.000
Right.
00:19:52.160 --> 00:19:57.680
You're in this nice treatment treatment center with the ferns and the this and the that, and you've got whatever, right?
00:19:58.400 --> 00:20:03.519
But that's not when you go back home, you have those same triggers, you have those same relationships.
00:20:03.680 --> 00:20:03.839
Yeah.
00:20:03.920 --> 00:20:05.920
Um, so I think it's very, very difficult.
00:20:06.160 --> 00:20:11.200
And I think we need to be honest with people about how freaking hard it is, right?
00:20:11.359 --> 00:20:20.240
And also, there's a way to go to treatment, but still use, right, if you want to, right, and not feel bad about it.
00:20:20.400 --> 00:20:20.559
Right.
00:20:20.640 --> 00:20:30.160
I know many people who they go to treatment, they were made to feel like you can't smoke weed, you can't like you can't even drink coffee, you can't do anything for the rest of your life.
00:20:30.400 --> 00:20:33.839
And they were like, you know, I have a drink every now and then, right?
00:20:34.000 --> 00:20:38.160
They're like, I'll maybe do a line every now and then, but I have control over it.
00:20:38.400 --> 00:20:46.720
I have different relationships, I have different relationships to substances, and that's the part that a lot of these centers don't talk about, right?
00:20:46.960 --> 00:20:47.599
That's right.
00:20:47.759 --> 00:20:48.480
That's right.
00:20:48.640 --> 00:20:50.000
Yeah, that's right.
00:20:50.240 --> 00:20:50.880
Exactly right.
00:20:51.039 --> 00:21:07.920
And that's what we're seeing is this uh cycle of coming out of treatment, going back in, you know, this pattern of um that that that um transition out of treatment between coming out of treatment and then getting some momentum going.
00:21:08.240 --> 00:21:31.759
There's a gap there that I think that hopefully like a coaching program, not to plug my coaching program, but like a coaching program or something that could fill in very easily and offer them if so coming out of it, let's maybe start off with a managed use, like a a tapered uh, you know, like that there's a there's a lot of there's a lot of guys that come into my program, if they're using regularly, I'll say, Let's do this.
00:21:31.839 --> 00:21:34.400
We're going to plan a use three weeks from now.
00:21:35.519 --> 00:21:39.839
So when you know a a use is coming, it's easier to say no now.
00:21:40.400 --> 00:21:40.960
It just is.
00:21:42.720 --> 00:21:53.440
And then you get momentum under your belt, you get time under your belt, you start to feel better, you start to feel stronger, clearer, your relationships start to get better, and then it comes three weeks, and you're like, most of them are like, can we push this out a week?
00:21:53.519 --> 00:21:54.640
I'm not, I don't want to use.
00:21:55.759 --> 00:21:57.119
You know, and maybe they do.
00:21:57.200 --> 00:21:59.759
And then when they do use, they it's structured.
00:22:00.240 --> 00:22:04.559
Like I'm gonna start on this day, I'm gonna use this much, I'm gonna, you know, I'm gonna stop here.
00:22:04.720 --> 00:22:11.200
Now it's not always really gone to plan, but let's let's set up a metrics of 10 things.
00:22:11.359 --> 00:22:14.559
And if you can meet seven of those, six of those, you've done great.
00:22:14.720 --> 00:22:16.799
Let's celebrate, let's celebrate that.
00:22:16.960 --> 00:22:18.720
And then they're in charge of their use.
00:22:18.799 --> 00:22:29.279
And then they feel they their the trust in themselves grows, their self-confidence grows, and they get an idea in their head that they can say no and they can decide when to use or not.
00:22:29.359 --> 00:22:31.440
And that helps them stop.
00:22:32.079 --> 00:22:32.880
Absolutely.
00:22:32.960 --> 00:22:33.680
Yeah, absolutely.
00:22:33.759 --> 00:22:36.559
Because you know at the end of the day, hey, I have control over this, right?
00:22:36.640 --> 00:22:40.400
And it's something, it's almost like a muscle you have to exercise like anything else, right?
00:22:40.480 --> 00:22:54.559
You know, and the big parallel I see and when we're talking about this is that, you know, when I was when I was working case management too, we had a case manager that was dedicated to working with people who were coming uh who were previously incarcerated.
00:22:54.720 --> 00:23:05.200
So I think of it as no different where why aren't there specific programs set up for chemsex for people who are coming out of treatment, just a transitional program to work with them?
00:23:05.440 --> 00:23:09.039
Because it's you're going from one extreme to the next, right?
00:23:09.119 --> 00:23:19.440
And and we know recidivism is a thing where people are coming out of prison, they're going back in because they don't have the resources, they're literally left with a little bag of clothes and and left to their own devices.
00:23:19.599 --> 00:23:20.640
It's the same kind of thing.
00:23:20.720 --> 00:23:26.960
I see it the same way where there should be that proper support there because that's a really tough transition.
00:23:27.279 --> 00:23:30.720
And a lot of people, maybe it's family, friends, right?
00:23:30.880 --> 00:23:31.839
They don't understand.
00:23:31.920 --> 00:23:35.440
They can't possibly understand what that experience has been like for that person.
00:23:35.680 --> 00:23:43.599
And also it's including them in the conversation too, because the onus is usually put on the person using drugs, right?
00:23:43.680 --> 00:23:50.720
It's always seen as their problem that they have to sort out, um, which it shouldn't be that way.
00:23:50.960 --> 00:23:52.319
Yeah, exactly right.
00:23:52.480 --> 00:24:01.119
Yeah, like we know you and I talked about too, it's like sometimes you have to go through the experience of using to learn how not to.
00:24:01.519 --> 00:24:01.920
Right.
00:24:02.160 --> 00:24:05.680
But inside the treatment center, you don't have that option.
00:24:05.920 --> 00:24:06.240
Right.
00:24:06.880 --> 00:24:14.079
It's like you have to live in the real world and you have to have this phone, and you have to live with this and not use chemsex.
00:24:14.319 --> 00:24:23.359
You know, because that is paraphernalia, as Milma Kraken says um from no matter what, you know, it's it might as well be a pipe in your hand, the phone.
00:24:23.599 --> 00:24:24.000
Mm-hmm.
00:24:24.160 --> 00:24:26.960
So yeah, it's the great connector to everything, right?
00:24:27.119 --> 00:24:27.279
Yeah.
00:24:27.440 --> 00:24:31.599
You can get sex, like you can get pizza, you can let Uber eats it, get it right.
00:24:32.000 --> 00:24:33.200
Yeah, it's very real.
00:24:33.359 --> 00:24:33.680
It is.
00:24:33.920 --> 00:24:34.880
Yeah, that is right.
00:24:35.039 --> 00:24:35.440
Yeah.
00:24:35.680 --> 00:24:42.880
So can you tell us a little bit about how the chem sex looks um in the trans across the trans population?
00:24:43.119 --> 00:24:44.559
Like how does it differ?
00:24:44.720 --> 00:24:45.200
Yeah.
00:24:45.680 --> 00:24:48.720
Yeah, I think there's a lot of, I think there's a lot of overlap.
00:24:49.039 --> 00:24:54.079
I mean, particularly, you know, when we talk about like body image, right?
00:24:54.240 --> 00:24:58.960
I don't I don't think that's anything that's just specific to to trans folks, right?
00:24:59.119 --> 00:25:07.279
I think um, you know, when you're part of a very marginalized community and you're made to feel bad and there's certain body standards, right?
00:25:07.440 --> 00:25:08.400
Like we know that very well.
00:25:08.559 --> 00:25:18.319
We were just talking about phones like social media, you go on, you see a certain body type, you know, white, you know, full head of hair, ripped, masculine, the whole thing.
00:25:18.480 --> 00:25:21.599
However, I think that's leveled up in the trans community, right?
00:25:21.839 --> 00:25:43.680
Um, you know, there's definitely this camp of folks who, you know, who are maybe more binary, they're more trans femme or trans mask, and they're very much into kind of the medicalization aspect of right, of getting all gender-affirming surgeries, not just hormones, but looking very binary and looking and holding up to a certain societal standard, right?
00:25:43.839 --> 00:25:47.680
But there's also, what about non-binary folks, right?
00:25:47.759 --> 00:25:49.920
What about gender non-conforming folks?
00:25:50.079 --> 00:26:04.160
Um, so I think there's different levels to it where it can be a lot more intense within trans communities because there's usually a bit more involved in terms of like, you know, how you want to modify or change your body.
00:26:04.240 --> 00:26:07.119
And I think chemsex can be a really liberating way to do it.
00:26:07.279 --> 00:26:17.200
However, there's definitely a certain point, um, and I know this just from people who've gone through this, is that it can get to a point where it's not so liberating anymore, right?
00:26:17.279 --> 00:26:25.359
Where it's kind of having like the opposite of the intended effect where you're like, you know, um I'm just partying playing with someone.
00:26:25.519 --> 00:26:26.880
They're making me feel good about my body.
00:26:27.039 --> 00:26:29.200
Maybe I'm not thinking about my chest, right?
00:26:29.359 --> 00:26:33.279
But maybe I get top surgery and I realize I really like the high that I was getting.
00:26:33.359 --> 00:26:36.319
I really kind of like the fun time I was having, right?
00:26:36.559 --> 00:26:49.039
The other part of it too is there are many, many um studies that have talked about and come out over the years about just the rate of um eating disorders in trans communities.
00:26:49.119 --> 00:26:50.960
Uh trans women, trans men.
00:26:51.519 --> 00:26:53.119
Um they're very, very high.
00:26:53.200 --> 00:26:57.279
And that feeds into the last point I was talking about, obviously, with body image, right?
00:26:57.599 --> 00:26:59.359
Because what do we know about stimulants?
00:26:59.599 --> 00:27:01.039
They suppress your appetite.
00:27:01.279 --> 00:27:02.000
Right, right.
00:27:02.640 --> 00:27:07.200
Um, so that's a that's kind of like a big emerging field of research.
00:27:07.359 --> 00:27:19.119
I have some colleagues who do a lot of amazing work in terms of like art therapy and you know, mental health work around eating disorders with trans folks because it is um a large issue.
00:27:19.279 --> 00:27:35.279
And I do think that there is more attention that needs to be paid specifically to trans men and trans masculine folks and the crossover um into chemsex and you know, having sex with men, with cisgender men, a game by men.
00:27:35.440 --> 00:27:41.200
Um, and we also see kind of the same paradigm happening with HIV, right?
00:27:41.359 --> 00:27:49.839
Is that there's usually this big focus um, you know, more on maybe trans women and sex work, right?
00:27:50.000 --> 00:27:57.359
But there's also this growing kind of pocket of trans men who are crossing over and having sex, right?
00:27:57.599 --> 00:28:03.839
Uh condomless sex with men and not knowing, still thinking that their testosterone is birth control.
00:28:04.079 --> 00:28:05.920
That's a very real thing, right?
00:28:06.160 --> 00:28:08.960
And yeah, it's a it's a bigger phenomenon than people think.
00:28:09.200 --> 00:28:10.960
But many people are ashamed to talk about it.
00:28:11.039 --> 00:28:17.920
So when you build that shame, the shame of substances, it's a very nuanced, very complicated thing.
00:28:18.480 --> 00:28:21.359
So those those are the big pieces I see.
00:28:21.680 --> 00:28:25.039
Um, you know, I had mentioned sex work, yeah.
00:28:25.119 --> 00:28:33.839
Um that can have its its own complete topic as it should, obviously, with the important caveat that not all trans people are engaged in sex work, right?
00:28:33.920 --> 00:28:43.039
But I think that that is a very real connector and way for trans folks engaged in sex work to be able to do the job, right?
00:28:43.200 --> 00:28:43.920
To be able to do it.
00:28:44.000 --> 00:28:56.160
And that's actually something when I mentioned that study before with that very small group of people in New York City, most of those folks were sex workers and they were trans and they were using a myriad of substances, right?
00:28:56.720 --> 00:29:00.480
Poppers was number one, which poppers was always number one, right?
00:29:00.720 --> 00:29:04.160
And methan G, ketamine is huge, cocaine.
00:29:04.319 --> 00:29:10.160
Um, but largely it was a way for them to really stay up, get more clients, right?
00:29:10.240 --> 00:29:16.799
To be able to push through and also kind of fight against any kind of body dysphoria that might have been going on.
00:29:16.880 --> 00:29:20.319
Maybe they didn't have access to care, maybe they didn't want to seek care for whatever reason.
00:29:20.400 --> 00:29:23.440
It was a way to just kind of get out of that headspace.
00:29:23.759 --> 00:29:35.599
So there are a lot of overlaps, I think, uh, with the larger queer community, but there are definitely things that I have seen um that I think are a little bit more complex and specific to trans folks.
00:29:36.640 --> 00:29:47.920
And some I I I've heard from some trans folks that straight men will hire them, especially trans women, right, and expect them to bring drugs.
00:29:48.559 --> 00:29:48.880
Yes.
00:29:50.480 --> 00:29:50.720
Yes.
00:29:50.799 --> 00:30:26.319
I remember being it was actually one of the first, I think, chemsex trainings that I was sitting in on when I was on my previous job, and it was a group of all black and brown trans women, and we were having a phenomenal conversation about chemsex and drugs and things, and they said that exact thing where a lot of times they'll get hired, you know, these guys coming in from you know, financial district, right, Wall Street, also Long Island, hiring them with the expectation, right, that they're gonna party and play and offering more, sometimes not, but offering more to engage in that.
00:30:26.559 --> 00:30:34.640
But also there was this shame I was picking up on where some of the girls were like, I actually kind of enjoy it, but I feel bad saying that.
00:30:34.799 --> 00:30:41.359
Like I enjoy engaging in it sometimes, but I don't want to admit that because everybody talks about how that's a bad thing.
00:30:41.599 --> 00:30:48.640
I thought that was really interesting, is that rarely is anything just good or bad, right?
00:30:48.720 --> 00:30:55.599
There's more in the gray, and a lot of us have a hard time sitting with that, but I'll never forget that conversation.
00:30:55.759 --> 00:30:57.119
That was really interesting.
00:30:57.359 --> 00:30:59.440
Yeah, yeah, it is interesting.
00:30:59.759 --> 00:31:00.559
It's interesting.
00:31:01.279 --> 00:31:05.839
So you worked with the harm, you you worked with the harm reduction coalition.
00:31:06.799 --> 00:31:21.359
If I'm thinking about it if harm reduction is right for me, is is there a set, is there a criteria, is there a set of questions that are asked, you know, that so because because you know, the harm reduction, like you said, isn't for everyone.
00:31:21.519 --> 00:31:29.119
Maybe going into an abstinence-based treatment center is what you need based on the maybe the severity of your use or something like that.
00:31:29.279 --> 00:31:35.519
But I are there a set of questions that someone could ask themselves or read or or be asked?
00:31:36.160 --> 00:31:37.680
Yeah, it's an interesting question.
00:31:37.839 --> 00:31:40.640
I mean, to my knowledge, it's not anything that's specific.
00:31:40.799 --> 00:31:44.160
I mean, I think I think number one, I always invite people to go.
00:31:44.400 --> 00:31:52.079
I mean, NHRC has them on their website, but they're the ones that 30 some odd years ago they created the the principles of harm reduction.
00:31:52.240 --> 00:31:56.319
So I think like if those resonate with you, I think then it's for you, right?
00:31:56.400 --> 00:31:58.079
I think that's kind of the base level.
00:31:58.319 --> 00:32:03.680
Uh but again, going back to what I said much earlier is that abstinence is folded into harm reduction.
00:32:03.920 --> 00:32:09.839
But I think the way that harm reduction gets branded, yeah, right, is that it's at odds, right?
00:32:10.000 --> 00:32:17.200
Like a lot of the recovery community, they'll have you think that like, oh, harm reduction is against us, we're gonna absolutely be folded in.
00:32:17.279 --> 00:32:20.000
It's just not it's like a PR problem, right?
00:32:20.079 --> 00:32:23.279
It's the way that people talk about it in media and frame it.
00:32:23.519 --> 00:32:33.680
Um, but I also think that if you're someone who's deeply uncomfortable with the idea of ever using it any capacity again, you might be more abstinence focused and base, and that's okay.
00:32:33.839 --> 00:32:42.079
And if you're comfortable and you just want to call that abstinence and you don't want to even name that harm reduction, who am I to tell you that you need to call it harm reduction?
00:32:42.240 --> 00:32:45.920
But to me, it's folded into it, it just is.
00:32:46.160 --> 00:32:46.559
Yeah.
00:32:46.880 --> 00:32:53.519
Yeah, I I catch myself kind of when I'm articulating it, it sounds like I'm separating them out.
00:32:53.680 --> 00:32:58.079
Oftentimes it's to to help people maybe understand what I'm trying to say.
00:32:58.160 --> 00:33:01.279
But I I also agree, like it's all harm reduction, right?
00:33:01.359 --> 00:33:02.240
It's all together.
00:33:02.480 --> 00:33:10.799
It's just drug, right, drug use of either either, you know, actively or abstinence, all in in all in its uh a spectrum.
00:33:10.960 --> 00:33:22.480
But you're right, like it mostly because because the accepted culture of recovery is an abstinence-based program, then that we think that's separate, but it really isn't.
00:33:22.640 --> 00:33:22.880
Yeah.
00:33:23.119 --> 00:33:23.440
Mm-hmm.
00:33:23.599 --> 00:33:24.799
And there's also this.
00:33:24.880 --> 00:33:33.359
Um, I'm sure many of the listeners and you yourself know this, there's this superiority too of I have this badge of like, I don't use it all, right?
00:33:33.440 --> 00:33:37.279
I went through recovery, you know, I have my chips, I did this, I have my years.
00:33:37.440 --> 00:33:37.519
Yeah.
00:33:38.000 --> 00:33:59.440
Um, there's and and there's a lot of people, and I've seen this in real time, I've seen it with within like the peer workforce too, um, is just people feeling as though they they can kind of instruct others to live as as they're currently living and not realizing that you need to give somebody the space, right, to make their own decisions and give them options.
00:33:59.599 --> 00:34:01.119
I always used to call it a buffet.
00:34:01.200 --> 00:34:06.160
I'm right, and like I want to bring someone to a buffet, they get to choose what to put on their plate.
00:34:06.319 --> 00:34:10.000
You know, I might not like that food, that might not work for me, but it works for them.
00:34:10.079 --> 00:34:13.440
Who am I to tell someone I have a different lived experience, right?
00:34:13.599 --> 00:34:17.199
I don't know what they've been through, that they need to walk the same line as me.
00:34:17.440 --> 00:34:20.159
That's just that's not reality.
00:34:20.320 --> 00:34:20.719
That's not.
00:34:20.960 --> 00:34:21.440
That's right.
00:34:21.599 --> 00:34:22.000
That's right.
00:34:22.159 --> 00:34:23.039
Yeah, I like that.
00:34:23.280 --> 00:34:23.599
Yeah.
00:34:23.760 --> 00:34:34.239
So if if you're listening and you're thinking about what am I maybe I'm better suited for harm reduction, I would go to the National Harm Reduction Coalition website and look at the principles.
00:34:34.480 --> 00:34:39.039
And like like Taylor's saying, read them and see if they resonate with you as a start.
00:34:39.679 --> 00:34:46.239
Um there are also plenty of harm reduction organizations, nonprofits, there's harm reduction therapists out there.
00:34:46.400 --> 00:35:00.159
Um, you know, I've taught I've had a couple of people, well, one on the podcast, one not, who saw a harm reduction therapist who helped them, you know, eventually, um, eventually become abstinent from where they were.
00:35:00.719 --> 00:35:03.920
Uh, and so they they did a managed use plan or something like that.
00:35:04.320 --> 00:35:07.679
So um okay.
00:35:07.920 --> 00:35:13.920
I wanted to, if it's okay with you, I'm going to um well, we'll talk about needle in the hay.
00:35:14.400 --> 00:35:26.000
Um I'm gonna look look at your Instagram page, but I want to pla I want to share the screen and play the clip that you made for harm reduction or chemsex awareness week.
00:35:26.239 --> 00:35:26.960
Yeah, sorry about that.
00:35:28.079 --> 00:35:30.559
Um share this here.
00:35:31.599 --> 00:35:33.760
And we'll listen to what you have to say.
00:35:33.920 --> 00:35:57.840
And it for those listening, as you're listening to this, uh I want you to think about if you uh go see a healthcare provider or a therapist or even a addiction counselor treatment center, there's some really important guidance that Taylor is giving the healthcare professional here that you could give the healthcare professional uh talk about autonomy, you know, right?
00:35:58.239 --> 00:36:03.199
Is is you could uh actually volunteer these questions and tell them to ask them too.
00:36:03.280 --> 00:36:11.679
So I want you to listen to this and we'll put the link in the chemsex isn't a fringe issue, it's showing up in the exam rooms you walk into every day.
00:36:11.920 --> 00:36:14.400
And most of the time, no one's asking about it.
00:36:14.559 --> 00:36:17.760
Or if they are, it's reduced to a yes or no question.
00:36:18.079 --> 00:36:25.599
Let's talk about why engaging your patients about chemsex is so important and what you can do differently starting with your very next visit.
00:36:26.320 --> 00:36:28.800
Chemsex carries real health implications.
00:36:29.360 --> 00:36:34.719
Overdose risk, HIV and STI exposure, and significant mental health impacts.
00:36:35.440 --> 00:36:39.440
There are also medication safety concerns most providers don't even think about.
00:36:40.159 --> 00:36:48.159
Certain HIV medications, benzodiazepines, and sleep aids can interact with chemsex drugs in ways that raise overdose risk.
00:36:48.559 --> 00:36:53.679
And chemsex can make it harder for patients to stay consistent with prep or ongoing treatment.
00:36:54.239 --> 00:36:59.199
But here's the thing patients usually won't volunteer this unless we've shown them it's safe to.
00:36:59.760 --> 00:37:08.559
Many of them have been judged, lectured, or felt a provider shut down, pivot to abstinence, or document things in ways that felt punitive.
00:37:09.039 --> 00:37:13.920
In turn, patients learn to keep discussing things like drugs or sexual health to themselves.
00:37:14.480 --> 00:37:23.760
And when that happens, we lose the opportunity to offer harm reduction, talk through safe reuse, or even just create a space where they can be honest about what's going on.
00:37:24.480 --> 00:37:25.360
Normalize it.
00:37:25.920 --> 00:37:31.199
Make it part of your social history for all patients, not a separate or exceptional question.
00:37:31.840 --> 00:37:33.519
And remember to start open-ended.
00:37:33.679 --> 00:37:35.519
You can always get more specific.
00:37:35.679 --> 00:37:37.519
But don't start with a yes or no.
00:37:37.920 --> 00:37:43.760
You might say, tell me a little bit about whether drugs play any role in your sex life, if at all.
00:37:44.079 --> 00:37:48.719
Then once they've opened the door, you can get more specific about drugs and medications.
00:37:49.119 --> 00:37:58.639
When you're reviewing their medications, you can add, walk me through anything else you might be taking, prescribed, recreational, or otherwise, so we can think about safety together.
00:37:59.280 --> 00:38:10.639
Lead with curiosity, follow with specifics, and respond the same way you would to any clinical information with clarity, options, and respect.
00:38:11.599 --> 00:38:13.440
Screening is not surveillance.
00:38:13.920 --> 00:38:23.840
Done well, it's an invitation and a signal that your exam room is a place where patients can bring their whole selves, and that is the care our patients deserve.
00:38:24.239 --> 00:38:29.679
This Chemsex Awareness Week, it's not just about whether you ask, it's about how.
00:38:32.480 --> 00:38:33.440
Very good.
00:38:34.639 --> 00:38:35.280
Thank you.
00:38:35.360 --> 00:38:39.840
Yeah, that's a great campaign, and it's it's second year, which is amazing.
00:38:40.000 --> 00:38:40.719
But yeah.
00:38:41.119 --> 00:38:41.519
Yeah.
00:38:41.679 --> 00:38:42.000
Yeah.
00:38:42.159 --> 00:38:44.000
I didn't even know about it last year.
00:38:44.159 --> 00:38:44.719
I don't think.
00:38:45.119 --> 00:38:46.400
Well, we were just starting it out.
00:38:46.559 --> 00:38:46.880
Yeah.
00:38:46.960 --> 00:38:56.000
It was a project between National Harm Reduction Coalition, the program I manage, Lighthouse Learning Collective, and Bhawk Partners, uh, building healthy online communities.
00:38:56.159 --> 00:38:57.280
You're wonderful.
00:38:57.519 --> 00:38:59.199
Um yeah.
00:38:59.599 --> 00:39:00.079
Yeah.
00:39:00.239 --> 00:39:05.840
They they connected me to with you, or that that's how I found you with uh B A Bhawk.
00:39:06.320 --> 00:39:19.119
Um so the for the listeners listening to that, you just saying I do meth to a healthcare provider isn't enough when we're thinking when when we're talking about chemsex.
00:39:19.679 --> 00:39:23.519
It's the meth and the sex together, it's the fusion of it.
00:39:24.159 --> 00:39:27.119
And the more specific you can get, the better.
00:39:27.360 --> 00:39:27.599
Right.
00:39:27.840 --> 00:39:28.400
Yes.
00:39:28.880 --> 00:39:34.480
And you're like you're saying just saying the term chemsex, your healthcare provider may never have heard of that.
00:39:35.039 --> 00:39:35.920
Absolutely.
00:39:36.159 --> 00:39:36.559
Yeah.
00:39:37.280 --> 00:39:38.559
Yeah, no, absolutely.
00:39:38.719 --> 00:39:47.519
So one of the things we did with the campaign is um, you know, in that in that clip, you know, I'm speaking directly, the audience is to medical providers, right?
00:39:47.679 --> 00:39:53.440
For the reasons you just said, but one of the things we knew when we created the campaign was that it wasn't going to just be enough.
00:39:53.519 --> 00:39:56.320
And also, is that real even going to get to a provider?
00:39:56.559 --> 00:40:00.719
So one of the things we did was work with partner organizations to actually make a toolkit.
00:40:00.880 --> 00:40:03.440
So within it, there's a number of videos.
00:40:03.519 --> 00:40:05.679
There's also educational posts.
00:40:05.840 --> 00:40:10.719
Um, it is really just a way to start the discussion with providers, right?
00:40:10.880 --> 00:40:17.360
I often argue that a lot of times, like the people who are interested in it are the people who already have base knowledge.
00:40:17.519 --> 00:40:20.320
It's always the people who aren't in the room that need the message, right?
00:40:20.400 --> 00:40:29.360
But it's better than nothing just trying to have a jumping off point to get these providers engaged to say, you know what, chemsex wasn't part of my clinical training.
00:40:29.519 --> 00:40:29.599
Yeah.
00:40:29.840 --> 00:40:32.960
Maybe drug use of any kind, that wasn't part of my clinical training.
00:40:33.280 --> 00:40:39.199
Um, and I'm gonna look into this and really treat the patient as they're the expert, right?
00:40:39.280 --> 00:40:43.119
And it's my job to look in, see if there are things I can do, right?
00:40:43.199 --> 00:40:54.079
Maybe it it starts the conversation about about PEP and PrEP, um whatever it may be, different sexual health practices, how to taper their use, right?
00:40:54.239 --> 00:41:00.159
It's just really important to start that conversation because, like you're saying, so many people providers don't even know that it exists.
00:41:00.480 --> 00:41:00.960
Yeah.
00:41:01.280 --> 00:41:05.679
So it might be up to you as the patient to bring it up.
00:41:05.840 --> 00:41:09.599
Uh to and because you your life is at stake as well.
00:41:09.679 --> 00:41:19.760
Like as as this clip, as this reel says, some of the medications they may put you on could interfere with the med with the drugs you've been on, especially G G H B, right?
00:41:20.159 --> 00:41:33.760
Um and so really just I mean, I know that some of the atmosphere, like you're saying, some of the uh the environment might feel that container might feel constrictive and it might feel judgmental and it might feel you know stigmatized.
00:41:34.000 --> 00:41:49.679
So it might be hard harder to do that, but this is a chance for you to use it to you to use your agency to say my life could be at stake here, so I'm going to make sure he understands he, she's they understands exactly what's been in my body and what I have been doing.
00:41:49.760 --> 00:41:51.280
When's the last time I slept?
00:41:51.440 --> 00:41:52.880
All of that, that information.
00:41:53.599 --> 00:42:00.079
Yeah, especially since you know, I'm sure many people know that our drug supply is absolutely awful, right?
00:42:00.239 --> 00:42:16.079
Although I will say, particularly with meth, there um hasn't been a lot of instances, at least in New York City and the drug checking programs I was familiar with, there's been a lot of um, you know, kind of uh poisoning or contamination of fentanyl with with meth.
00:42:16.239 --> 00:42:21.760
Largely what they had found is that people were, you know, using both substances but putting them in the same container.
00:42:21.840 --> 00:42:26.159
So they would inevitably get cross-contaminated.
00:42:26.480 --> 00:42:31.199
But, you know, uh with ketamine, with pressed pills, right?
00:42:31.280 --> 00:42:35.119
Some of the pressed pills look really damn good and you can't tell them apart.
00:42:35.360 --> 00:42:39.840
Um you have no idea what you're taking, right?
00:42:40.079 --> 00:42:45.599
Um, so encouraging people to test their drugs, get a drug spotter.
00:42:45.920 --> 00:42:59.280
Um, if you don't know what drug spotting is, that you should look up an organization called Safe Spot, where literally you call the line and there's someone who will sit with you on the phone while you're using to make sure you're safe.
00:42:59.440 --> 00:43:04.400
And they won't call the cops or anything unless you want them to, and they create a safety plan.
00:43:04.559 --> 00:43:08.639
Just a quick plug for them because that could really save somebody's life, right?
00:43:08.800 --> 00:43:14.239
And also that provider making sure that somebody has naloxone, something as simple as that, right?
00:43:14.320 --> 00:43:17.440
And knowing how to use it and that the people around them have it.
00:43:17.599 --> 00:43:22.639
Um, I think those pieces are just really, really critical.
00:43:23.119 --> 00:43:24.480
Yeah, yeah.
00:43:24.800 --> 00:43:30.880
Yeah, I'm still I mean, I I did this when I used, but things were different.
00:43:30.960 --> 00:43:44.159
But you know, just the the the times that we pick drugs up from somebody we met on sniffies and just put it right in our bodies to in this day and age is just amazing to me.
00:43:44.480 --> 00:43:49.360
It is, and you know, one of the things too, and I sometimes this pisses people off when I say it.
00:43:49.440 --> 00:43:52.719
I think that's because of the their prevalence, but I talked about poppers earlier.
00:43:52.800 --> 00:43:54.480
I mean, poppers where you're like, what?
00:43:54.639 --> 00:43:55.840
I wouldn't even consider that part.
00:43:55.920 --> 00:43:58.800
I'm like, you know, everybody, everybody's using it, whatever.
00:43:59.039 --> 00:44:10.239
But if you look At like the the label or the indications for like Cialis and Viagra, they literally say on there to not use with certain medications, right?
00:44:10.400 --> 00:44:19.039
To not use, you know, like particularly with poppers and like ED medications, they can bottom out your blood pressure, right?
00:44:19.199 --> 00:44:20.960
And you can pass out.
00:44:21.199 --> 00:44:34.320
I mean, I won't say it's a super prevalent thing that people are going to the emergency room and you know and and dying from it, but it has happened, particularly as we age and our bodies go through a lot of wear and tear.
00:44:34.639 --> 00:44:37.599
Um it happens, right?
00:44:37.840 --> 00:44:40.320
Especially if you have a previous condition.
00:44:40.400 --> 00:44:44.800
I think not to scare people, but like talk to your provider about it.
00:44:44.960 --> 00:44:51.440
Because I see those medications as someone who works in healthcare, they're prescribed left, right, up, down.
00:44:51.519 --> 00:45:03.599
I mean, you can go on, you know, all these different services now, you can get them, and people just don't know because it's kind of like you pop it, you know, you're good and whatever, but not knowing kind of the reality of it.
00:45:03.679 --> 00:45:06.000
And I feel like it's something that a lot of people don't talk about.
00:45:06.079 --> 00:45:10.800
And again, it's not to scare people, but just kind of a a heads up, right?
00:45:10.960 --> 00:45:15.599
Like if you feel weird, it could be validating too to be like maybe there was an interaction I didn't know about.
00:45:15.760 --> 00:45:16.000
Yeah.
00:45:16.159 --> 00:45:17.039
You know, that's right.
00:45:17.199 --> 00:45:17.599
That's right.
00:45:17.760 --> 00:45:18.800
Yeah, yeah, yeah.
00:45:19.039 --> 00:45:23.119
Okay, can you talk to us about Needle in the Hay a little bit?
00:45:23.440 --> 00:45:24.079
Absolutely.
00:45:24.239 --> 00:45:24.559
Yeah.
00:45:24.719 --> 00:45:38.880
So I officially started Needle in the Hay, my consulting practice um earlier this year, although I've been, you know, consulting, doing trainings, kind of doing technical assistance with different healthcare organizations.
00:45:39.199 --> 00:45:41.599
Yes, there's finally got the website up.
00:45:41.840 --> 00:45:43.440
Um I appreciate it.
00:45:43.599 --> 00:45:44.000
Yeah.
00:45:44.079 --> 00:45:50.000
Um, so I've been doing you know, training, consulting in different capacities, probably for like the last 10 years.
00:45:50.159 --> 00:45:59.360
Um, but you know, I really wanted to um have a place to put all of my work and connections and really put out there the things that I've been working on.
00:45:59.519 --> 00:46:06.639
Um, you know, largely a lot of my work is centered around what I talked about in the beginning, kind of this overlap of different movements.
00:46:06.800 --> 00:46:17.119
So whether it's harm reduction and gender-affirming care, you know, um also adding in sex work, reproductive health care, again, with that basis of bodily autonomy.
00:46:17.280 --> 00:46:23.760
So a lot of what that looks like is um, you know, like I said, trainings, doing different facilitations.
00:46:24.239 --> 00:46:33.039
Um I recently facilitated a spring retreat for a very large coalition in New York State, recently spoke at the New Jersey harm reduction conference.
00:46:33.199 --> 00:46:44.719
Um, you know, did a, and that was that was on really gender-affirming harm reduction, which is kind of my like um base uh, you know, flagship training.
00:46:44.960 --> 00:46:52.239
Um, you know, done motivational interviewing sessions with folks, um, done some keynote speaking.
00:46:52.400 --> 00:47:02.159
Um, I was able to speak last year at the Harm Reduction International Conference in Bogotan, Colombia, where I presented um, it was phenomenal.
00:47:02.239 --> 00:47:04.400
If if you ever have the chance to go, I recommend it.
00:47:04.480 --> 00:47:06.639
I believe it's gonna be in Belfast next year.
00:47:07.280 --> 00:47:08.719
Um wonderful.
00:47:08.880 --> 00:47:14.400
And they do actually have sessions on on chemsex, they tend to get those abstracts in.
00:47:14.800 --> 00:47:37.840
Um, yeah, and that was largely it was there to talk about a toolkit, a gender-affirming harm reduction toolkit that I created over several years, which chemsex is is absolutely a part of, and it's it's talked about, and they're actually animations, and that's also available on uh you can look at that through the website because that was work that I did with NHRC and Lighthouse.
00:47:38.079 --> 00:47:45.360
Um, but yeah, also a lot of it is organizational development, and what that looks like is talking to organizations about what their goals are.
00:47:45.519 --> 00:47:55.280
You know, they'll come and say, Well, we want to be more gender affirming, and I'll have them do an assessment, and sometimes they're like, We're nowhere near where we need to be.
00:47:55.440 --> 00:47:57.679
We'll come back to you maybe in a year, right?
00:47:57.920 --> 00:48:01.360
Um Right, because I'm like, I don't want to waste your resources and time.
00:48:01.440 --> 00:48:04.480
And to be honest with you, I'm not just gonna take your money and do whatever.
00:48:04.639 --> 00:48:11.119
You know, I really want to engage with people who are values aligned and really want to do the work, right?
00:48:11.280 --> 00:48:14.320
So um, yeah, it's been a smattering of different things.
00:48:14.480 --> 00:48:18.639
I love creating resources, um, and you can check all that out on the website.
00:48:18.719 --> 00:48:27.679
And there's even a version of the assessment that I put on there that you can take and then you'll have the ability to to get it scored, and I believe you can download your own PDF of it.
00:48:27.760 --> 00:48:30.559
So if people are interested, that's a free tool.
00:48:30.719 --> 00:48:32.559
But um, yeah.
00:48:33.039 --> 00:48:33.519
Right.
00:48:33.760 --> 00:48:34.079
Nice.
00:48:34.239 --> 00:48:35.519
You you're busy.
00:48:36.159 --> 00:48:36.480
Busy.
00:48:36.880 --> 00:48:37.119
Yes.
00:48:37.280 --> 00:48:42.079
Yeah, it's probably the the neurodivergence where many of us, right?
00:48:42.719 --> 00:48:44.800
There's a huge overlap there too.
00:48:45.360 --> 00:48:47.199
Yeah, you have a lot going on here.
00:48:47.519 --> 00:48:48.400
A lot going on.
00:48:48.639 --> 00:48:49.119
I love it.
00:48:49.280 --> 00:48:49.599
Yeah.
00:48:50.079 --> 00:49:01.280
Well, I love I I really love meeting people like you here in this country and who are really doing the great work um and understanding the value of harm reduction.
00:49:01.840 --> 00:49:05.440
All of it's harm reduction, I know, but educating us too.
00:49:05.840 --> 00:49:07.280
Um, thank you.
00:49:07.519 --> 00:49:09.519
Yeah, and what you're doing is really helping.
00:49:09.679 --> 00:49:13.760
Um and I think that this this podcast today is going to help.
00:49:14.480 --> 00:49:35.360
If if we could just if it just helps one person who finds themselves in in front of a healthcare provider and knows what kind of questions to ask, you know, then and if we're we find one person who just desperately trying to to maybe they want to stop and they're desperately trying a way to do it, this harm reduction could be the answer for you.
00:49:35.599 --> 00:49:38.079
And it's it's okay to consider that.
00:49:38.400 --> 00:49:42.719
You know, there's just such a such a misunderstanding, isn't there?
00:49:42.960 --> 00:49:44.480
Um my gosh.
00:49:45.199 --> 00:49:46.159
See it everywhere.
00:49:46.320 --> 00:49:56.000
I mean, I know, I mean, I know social media and the internet is not the greatest litmus test, but you know as well as I do in the comments, if anybody's talking about it, they'll say, why are you promoting?
00:49:56.079 --> 00:49:57.360
Why are you encouraging this?
00:49:57.760 --> 00:50:00.400
The point is completely going over their heads, right?
00:50:00.639 --> 00:50:03.199
Where we need more people vocalizing and talking about it.
00:50:03.360 --> 00:50:08.639
But I get that it's hard to do it when you get continually shut down and shamed for expressing yourselves.
00:50:09.039 --> 00:50:12.239
But let me tell you right now, more people are doing it than you think.
00:50:12.400 --> 00:50:14.000
It's just not being spoken about.
00:50:14.239 --> 00:50:14.880
That's right.
00:50:15.119 --> 00:50:15.760
That's right.
00:50:15.920 --> 00:50:17.199
That's exactly right.
00:50:17.360 --> 00:50:18.639
Um, that's exactly right.
00:50:18.800 --> 00:50:31.199
And I will say too, if you uh if you uh keep relapsing, if you keep using you don't want to, uh, and you're trying to stick to some abstinent plan, you're planning your use anyway.
00:50:32.320 --> 00:50:34.320
But it it's just subconscious.
00:50:34.559 --> 00:50:36.159
It's you're it's controlling you.
00:50:36.719 --> 00:50:43.840
You know, so why not get ahead of it and you control it and you decide when and where uh and how long you want to do it?
00:50:44.000 --> 00:50:49.519
I mean, it really does give you a sense of agency in your life when you're feeling powerless and unmanageable, right?
00:50:49.679 --> 00:50:51.519
As they say in the the 12th steps.
00:50:51.679 --> 00:50:55.199
So um oh Taylor, thank you so much.
00:50:55.360 --> 00:51:03.119
Um is there something that I left out today that you wish that I had brought up or a topic we could have discussed?
00:51:04.079 --> 00:51:06.079
No, I think I think we covered it all.
00:51:06.159 --> 00:51:09.119
We covered it all in a real short amount of time, which I appreciate.
00:51:09.519 --> 00:51:09.840
We did.
00:51:10.320 --> 00:51:20.719
No, but no, I would just I would just say to people that you know if you've been skeptical of harm reduction for a long time, maybe take this as a sign and a signal to look into it a little bit more.
00:51:20.960 --> 00:51:24.880
Um and there are a lot of good resources and look for yourself, right?
00:51:24.960 --> 00:51:26.719
Not just what other people are telling you.
00:51:27.039 --> 00:51:29.280
Um there's always more to it, isn't there?
00:51:29.519 --> 00:51:30.480
Yeah, that's right.
00:51:30.719 --> 00:51:38.239
Listen, go to Google Scholar and just look at peer-reviewed research articles if you want, if you want to see what is it going on out there.
00:51:38.480 --> 00:51:45.360
Most of the harm reduction studies that I see are, you know, in Europe, Europe and um other countries like that.
00:51:45.519 --> 00:51:51.519
But there's there's a lot of research happening right now and looking at the effectiveness of of this approach.
00:51:51.599 --> 00:51:54.559
So um, there you go.
00:51:54.719 --> 00:51:56.320
Hopefully just do your own research.
00:51:56.400 --> 00:51:58.320
Just be the executive of your own recovery.
00:51:58.400 --> 00:51:59.039
I always say that.
00:51:59.119 --> 00:52:05.119
Just uh just stand up, stop listening to everything else and see what resonates and fits with you and your body.
00:52:06.079 --> 00:52:07.599
Absolutely, be your own advocate.
00:52:08.159 --> 00:52:08.400
Yes.
00:52:08.800 --> 00:52:11.440
Yeah, Taylor, thank you so much for your time today.
00:52:11.679 --> 00:52:12.639
Really appreciate it.
00:52:12.880 --> 00:52:14.079
Really appreciate you and your work.
00:52:14.400 --> 00:52:14.800
Thank you.
00:52:14.960 --> 00:52:15.199
Thank you.
00:52:15.360 --> 00:52:15.840
I appreciate it.
00:52:16.000 --> 00:52:16.639
Love being here.
00:52:17.280 --> 00:52:17.599
Good.
00:52:17.840 --> 00:52:18.480
All right, guys.
00:52:18.559 --> 00:52:22.159
If you have any questions, comments, you want to join this the discussion.
00:52:22.239 --> 00:52:31.760
Uh you can comment on Spotify, you can comment on YouTube, or you can DM me, and I'm sure you could DM Taylor if we're going to put it his um Instagram information into the show notes.
00:52:31.840 --> 00:52:35.519
Um, DM one of us, have a discussion, we'd be glad to talk to you.
00:52:36.239 --> 00:52:37.199
And that's it.
00:52:37.280 --> 00:52:38.400
We'll see you next week.
00:52:38.639 --> 00:52:39.599
Take care.