Ohio Counseling Conversations
Ohio Counseling Conversations
Conversation 31 - From Judgment to Support: How Harm Reduction Saves Lives
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AmandaLynn Reese has dedicated her career to creating positive change in her community, a Cincinnati, Ohio native and a graduate of the Ohio State University. She is the Chief Program Officer at Harm Reduction Ohio (HRO), a national government affairs consultant, and subject matter expert (SME) specializing in harm reduction, naloxone access, and policy development.
Growing up in rural Appalachia with parents who struggled with substance use disorder, AmandaLynn witnessed firsthand how systems fail the people they claim to serve. Ohio is consistently in the top 5 rankings for overdose deaths, yet substance use is seen as a ‘moral failing;’ we need to move away from a ‘criminalization’ mindset and expand our window of tolerance. As both a professional and a person with lived experience, she's working to transform our understanding of harm reduction from a mere public health strategy to what it truly is—a powerful social justice movement built by and for marginalized communities.
For counselors working with substance-using populations, AmandaLynn offers transformative guidance on language, approach, and mindset. She reminds us that people who use substances often carry trauma not just from their personal experiences but from systems that have repeatedly failed them and even possible traumatic brain injury (TBI). It is her hope that harm reduction work, essentially a social justice movement, will lift those who experience societal judgements and cultural misconceptions surrounding substance use to a platform where they can ‘step into their power’ to finally be heard, respected and understood.
AmandaLynn challenges us to have uncomfortable conversations about accountability—both personal and systemic. "Where did we mess up? Where did we fail?" she asks, reminding us that true healing requires honesty about harm. Through her compassionate perspective and practical wisdom, she shows us that when we meet people where they are, we don't leave them there—we walk alongside them toward whatever their vision of a healthier life might be.
Resources:
- https://www.harmreductionohio.org/
- https://www.streetsafe.supply/
- https://neverusealone.com
- https://safe-spot.me/
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Created by the OCA's Media, Public Relations, and Membership (MPRM) Committee & its Podcast Subcommittee: Marisa Cargill, Kendra Thornton, Leah Wood, Victoria Frazier, and Linda Marcel-Rene
·Hosted by Marisa Cargill
·Original music selections by Elijah Satoru Wood
·Closing song: Accretion Discotheque by Who AD
Introduction and Guest Background
Speaker 1Welcome back to Ohio Counseling Conversations, the official podcast of the Ohio Counseling Association, bringing you conversations from around the state. On today's episode, we're joined by Amanda Lynn Reese, chief Program Officer at Harm Reduction Ohio and a national consultant and expert in harm reduction and substance use policy. A passionate advocate and Ohio native, amanda Lynn shares how personal experience led her from activism to leadership and why shifting from criminalization to compassion is essential in addressing substance use concerns. Together, we explore the role counselors can play in reducing stigma, expanding understanding and supporting individuals impacted by substance use. I'm your host today, dr Marissa Cargill, a counselor and counselor educator in Northeast Ohio. Let's dig in, so excited to have our conversation today, amanda Lynn, thank you and welcome to the show, hi thank you.
Speaker 1We're really excited to have you and when we were preparing for this interview, we know you're from Ohio, a Cincinnati native and an OSU grad. Tell us a little bit more about yourself and how you got involved with community work.
Speaker 2Well, I grew up actually in Claremont County and my parents worked in Cincinnati. So I spent a lot of time in both Hamilton and Claremont County coming up and I went to Ohio State, newark actually, first, and then I went to the main campus in Columbus. So I spent a lot of time throughout the state and I'm an only child. The way I came up in the community work was, you know, growing up in rural areas. There's a lot of poverty. I'm Appalachian. Rural areas there's a lot of poverty. I'm Appalachian.
Speaker 2I have a working class family, which means there's a lot of labor, which means there's a lot of pain, which is a lot of self-medicating. There's a lot of things like that going on in my community and there was always just a really high need for social services and compassion. Also, both of my parents had substance use disorder. My father passed away when he was 41 years old. I was eight. I lost my mother. She died when she was 59. And I was in my 20s and so part of this work is because it directly impacted me right. And then also I'm a person who used substances. I mean right now I'm having caffeine and sugar, which are both substances.
Speaker 1So you know.
Speaker 2I know that way. Yeah, so yeah, and I also have just always kind of been a helper. I mean, I watched Mr Rogers as a kiddo and I remember he would always say when times get tough, look for the helpers.
Speaker 1And I want to be one of the people that you could look to.
Speaker 2So, yeah, that's kind of how I got here.
Speaker 1Oh, I love that. That's so awesome. That quote I feel like I see a lot and it's like, yes, that's foundational to being in this field and supporting people, to being in this field and supporting people.
Speaker 1Yeah, thank you for sharing your personal experiences too, because I think it's important. Like we're all human coming to this and we have those human experiences that shape what led us into the field, and we all have our stories that have shaped that desire to help and be involved. So thank you for adding the humanity to it. You know, one of the really main topics that we wanted to talk to you about was harm reduction, because it's a term probably most counselors and other helpers have heard but maybe don't have a full grasp on and understanding, especially in the context of substance use and its importance. Can you explain a little bit more about like harm reduction in this context?
Speaker 2Of course, you know I teach a harm reduction 101 course which is an hour long, so we're not going to go there. But what I would like to say is that harm reduction, you know, is kind of a buzzword nowadays, and so I would like to ground harm reduction in people's minds as what it truly is, and it's a social justice movement. It's also a public health approach, but truly it has its roots in social justice. It is a direct response to poverty, to the war on drugs, to racial oppression. It's always been about criminalized populations, marginalized communities and people who use drugs.
Understanding Harm Reduction as Social Justice
Speaker 2It can be about safety and health, but it's about people on the ground know. It can be about safety and health, but it's about people on the ground. It's about activism, protecting people using, you know, people who use drugs, people who engage in sex work, people living with HIV. They built harm reduction out of necessity. You know they needed community and they needed representation, and so, in the context of you know, this conversation, I think that harm reduction is really how we empower ourselves to show up for all people and meet them where they're at. Yeah, does that? Does that help?
Speaker 1Yeah, it does. To understand that it's a part of this larger movement where it's not just happening in the walls of a community agency or anything like that, that it expands out within the communities and in person, like someone's daily life.
Speaker 2Yeah, and everything from a seatbelt to a bike helmet is harm reduction right.
Speaker 1Correct. Yeah, yeah, and so we can expand that into our world as helpers, and specifically maybe helpers working with substance use concerns as well. You are the chief program officer at Harm Reduction Ohio.
Speaker 2I am. What's a big title?
Speaker 1Yes, can you tell us it's a good title and it's an important and meaningful work? What is your role in that entail?
Speaker 2Okay. So you know it's been kind of build the plane in the air. I started as just a you know, a activist and a volunteer in harm reduction work for a very long time and then, as public health efforts started to fund harm reduction whether it was naloxone or different strategies COVID kind of amped that up with PPE and different things. I have been with Harm Reduction Ohio since 2020, august of 2020. As a paid employee before that I was a volunteer and my job is to oversee all programming. So, whether that's our distribution programs, our anti-stigma programming, our education and outreach, pretty much everything that isn't like billing and some of the admin stuff, anything that we like practically do our direct services, you know, and even some of our policy work services, you know, and even some of our policy work. So for me, what that means is reacting to what the community needs, being proactive and creating sustainable programming that will outlive me, that will continue to meet people where they're at and give them the services that fill the gaps of our other programming throughout the state of Ohio.
Speaker 1I love that when I was an itty bitty baby counselor in my internship, I worked primarily like in substance use and IOP. Okay, so that's where I got like my start in this field. And I remember thinking before that, prior to that, like when I'm in my training, like I don't know if I really want to work with substance use. I just really want to work with people who are having mental health concerns. Right, like my naivety as a young person not really in the field, not realizing wait a minute, we're working with whole people and you can't cut that out, and so my practicum experience.
Speaker 1you get a handful of clients and, interestingly, probably two thirds of my little small caseload had comorbid concerns, right. Oh yeah, and then I thought shoot, I better learn more about this. Um and um, I do have a passion, like I really um, like to understand behavioral addictions as well, um, but I was like this is so much more than we, maybe we collective, but also that I hadn't realized. And um, and the need for harm reduction becomes so apparent when you are doing direct client care.
Speaker 2Well, and think about this. You know, you know, I'll. I'll use your sentence you just said to me as a great example. So you said the word addiction. It's not even in the DSM, right, you know? And so I think that there's a lot of unlearning that we all have to do individually, no matter what our world is or where we work, because we're conditioned culturally and as a society to other people and I think people who use substances it's seen as a moral failing and not everybody who uses substances is disordered, right, right, where not everybody who uses substances is disordered, right, right, plenty of people have a dependency on on substances and they're not diagnosed with any kind of substance use disorder but they would go into withdrawal and maybe seek illicit substances to treat that if they lost access to their care, whether they are a cancer patient or you know any of those things.
Speaker 1Yeah.
Speaker 2I think that we are. You know, I'm a dare kid.
Speaker 1Right the names of drugs so you know what I mean.
Speaker 2Some of them not even yeah exactly, and I think that for all of us it feels a little bit outside of our worldview to think that people who use drugs are interwoven into our society. But I think, you know, millions of Americans use illicit substances and millions of those people go to work every day. They pay their taxes, they feed their children and they're wonderful contributing members of society, and the ones that have dual diagnosis and other things that might have some more struggles. Are they hungry? Do they have a roof? Like? Think of you know the hierarchy of needs, and how can people even think about their substance use when they're cold and they're hungry and they're unhoused, you know, and so, of course, it's hard and that like with that word, that there is stereotypes or these like ideas of the face of an addict.
Speaker 1No one's seeing me do air quotes right that that there's an idea about that and I think, when you actually lean into the work and understand it, that we're all faces of that, then every single person there's the potential and like possibility, um, where it can be any person you could imagine. I don't know. I love media. My undergrad is media and that's also where that behavioral piece comes in, because social media addiction to me. That was my dissertation but I started watching the Pit. It's a new max.
Speaker 2They pride themselves on being the most accurate medical drama that it's been ever Right.
Speaker 1And recently they had this man who was um, like coping with something and and he's like I'm not an addict, like I'm not that, like I have a job, like I'm a CEO or whatever, and I find that so fascinating because even it was internalized, he couldn't possibly be because he had some big wig job that he felt was he couldn't be victim to that. So, yeah, sorry, I went on a tangent there but I think it's important.
The Changing Landscape of the Drug Supply
Speaker 2But no, you're right, yeah, and I think. I think that's what people think, you know. They think that it could happen to them. They think that you know, because they didn't make that choice, that other people should just not do need to expand our window of tolerance for people who have different worldviews and understand that community takes all kinds and that people, recovery looks different, use looks different and people can use drugs every day and never have a chaotic or problematic experience with their substance use. People really don't want to hear that. They really don't. They want to hear I do you do on drug, you're going to fall into the pit and then you're until you get to rock bottom, and then you it's either, like you know, you pull yourself up and get out or not, and I think there's been a lot of. I hesitate to use the word indoctrination again because you know the 12 step program is something that has benefited a lot of people, correct?
Speaker 2It's also like, caused so much harm, especially in communities of people who practice harm reduction, because it's a very black and white world and I think that for a long time, that was the only answer Right, and I think that for a long time that was the only answer, right, like that was the only place, like even court ordered reactions to substance criminalization, is you have to go to these 12 step meetings, right, you have to bring this in.
Speaker 2You have to do this, not considering that if I am a person of color and I go into the meeting and somebody's wearing a Confederate flag hat, I'm supposed to just sit in that.
Speaker 1Yeah, oh, that's cool, yeah, like that's not going to be a comfortable environment.
Speaker 2Right and, and you know if I live in a small rural community, there might only be one meeting a week and it might be just those people. And so I say all this to say that, like our community is not built, we're. Having conversations around substance use being a real everyday part of the American life is palatable, and it's still something that we I mean you see it in media now. You see it in politics. You see it in people use the platforms of the opioid crisis and substance use to further their agenda a lot, no matter what side of the agenda you're using?
Speaker 1Yeah, I see that. Yeah, I think it's really helpful to understand for our listeners and even just me personally. There are multiple ways of supporting and I think one of the lesser understood by even just the general public is that community is an incredibly important part of that equation because without that kind of support whether that is community within, just social support, but community at large and having access to resources, and without those things like it is really challenging, if not nearly impossible, to really get to a place that is of comfort for the person.
Speaker 2Yeah, and I think you know on that point, community is so critical and sometimes people who find themselves in a really chaotic or problematic space with their substance use the only people who have been there for them are other people who use and their family might look at it as those people are the people who are harming them or keeping them from family.
Speaker 2Society views it one way, but it's hard to walk away, especially like to go into a recovery or treatment program. It's hard to walk away from the people who have been there when you're at your hardest point, who have been the people who have made sure you ate, who have been the person who made sure you didn't overdose, who have been the people who have made sure that you were okay. That is still community and I think that we struggle with the humanization part, really, and just seeing that, as you know, earnest.
Speaker 1Yeah, yeah, and I know you mentioned like it's not chaotic for everyone, like on the surface, like on the outside. Looking in, we might see people and it's like they have daily use behavior that never gets to a chaotic or scary place, but that there are scary places that people encounter and that we, as like professionals, encounter, and so we don't want to scare anyone who's listening, but we want to make sure that we're making our professional community of counselors informed, and so, given your role like and creating these programs, can you tell us a little bit more about some like important trends that would be helpful for us, especially regarding certain drugs?
Speaker 2yeah, of course. Um, so right now, and always because of the criminalization of drugs, um, there is always going to be what's called like an illicit market or a black market for substances, right, and we've really moved away from the agricultural foundation of drugs, which was like opium and heroin, and it comes to opioids and we've synthesized them now, and you know, there's this wonderful journalist who bought all the precursors to make fentanyl legally and had them shipped to her house because it's not challenging to do so All the pieces that make some of these drugs exist and are accessible. And so if you haven't heard of fentanyl, you should hear about that. Especially in the state of Ohio, you can reach out to Harm Reduction Ohio to get fentanyl testing strips. If you're a person who uses drugs, or if you love somebody who uses drugs, we can teach you how to test drugs, because people do use drugs and people don't just use drugs a little, people use drugs a lot. You know, and that's a part of the conversation that people need to understand is that people are going to get high and they don't have to die Right. And so not only is fentanyl really pervasive in our drug supply, there is very little to no heroin at all Like. Even if someone says they're a heroin user, it is 99% likely that they are using fentanyl. Um, if you're going to try to buy a um pressed pill, any type of opioid, any type of benzo like a Xanax, a Valium, um, and even now sometimes stimulants like Adderall, have fentanyl cut into them. And if you're not getting it from a doctor or pharmacist, please don't take it, even if you love that person and know that person, because fentanyl could be there, and not only fentanyl.
Speaker 2There are other synthetic opioids. There's nitazines and carfentanil, which are both stronger than fentanyl, and all of those do react to naloxone. Naloxone will reverse those overdoses. People should carry it and know how to use it. That's a whole nother conversation that I'd love to have with anybody who is interested.
Speaker 2There's also something in the drug supply now that's a large animal tranquilizer called xylazine and even a small animal tranquilizer that's now coming out, and the thing about these drugs is that they were added to the drug supply, to what's called give it legs, so heroin used to last a long time. You could use heroin and it would keep you feeling the way you intended to feel, or just at least not feeling sick. If you're a person who's dependent and might go into withdrawal for a longer period of time. When we saw heroin overdoses in the nineties and the early aughts, um, those took longer to happen because of how it's metabolized in the body Fentanyl, nitazine, carfentanil it happens immediately. It is so quick, um, there's very little time to react.
Speaker 2And the xylosine was added to kind of prolong the feeling, to give it legs, they say, to make it more like heroin, which is what people desired. Right, they didn't desire fentanyl. But it's cheap, it's light, it's tasteless, it's odorless, it's easy and it has a higher profit because of that. And so the xylosine it causes respiratory depression and it's not meant for human use. So it also causes necrotic sores in people that are really problematic. They're very treatable. But when they first came on the scene, we were seeing necrotic tissue, people were losing limbs. The surgeons were like, oh, you have gangrene, let's remove it. You know, and people who use drugs already have such intense barriers when it comes to services and medical services.
Combating Stigma in Substance Use Work
Speaker 2So, um, you know it's very challenging, but people should know that it causes respiratory depression. Um, and people can be passed out for long periods of time. You might administer naloxone and they still don't wake up and that's because that sedative is still so strong in their system. You have reversed the opioid overdose, but they still need respiratory support because of that. Unfortunately, we're also finding that especially our unsheltered folks who are using drugs are finding that they've been, you know, sexually assaulted or robbed because they're out for hours at a time and they don't know, and that was not the intention.
Speaker 2It's not the usual effect that the drugs they're used to buying have on them, and I think something that folks need to know is if you use crack cocaine regular cocaine, it's in there too. We are disproportionately losing people of color, especially men over the age of 65, to overdoses, especially in the state of Ohio, and it's a national trend as well. But here, as we see, overdose trends go down, which like huge win because of all the things we're doing. It is disproportionately rising in some communities. Also, like native women of color, it's also rising in those communities, and I think that we really need to remind ourselves that, even if this is not what we think is about us, it is.
Speaker 2It is pervasive in the drug supply and so carfentanil, xylosine, nitosines I don't want to fear monger either, but when you know better, you can do better.
Speaker 2And people who use drugs you know they should just go low and slow. They should test their supply and don't use alone. If you can help it, I like to take this moment, if that's okay, to plug Never Use Alone and Safe Spotter. These are both programs for people who might use drugs where they're totally anonymous, programs for people who might use drugs where they're totally anonymous. They are volunteer hotlines that are managed by people who are medical professionals or who use drugs themselves, who stay on the line with you. They talk to you, you can tell them what you're using, how you're administering, and if something happens, if you stop responding, they tell you to leave your door unlocked, they contact EMS and they make sure that you're okay and so you don't have to be alone. If you're a person who uses drugs and is not able to be honest with somebody in your family or somebody who cares about you, there is support, there is community for you and it'd be okay.
Speaker 1And those services are harm reduction right, exactly, exactly. Services are harm reduction right, exactly exactly right. Um, and, like I, I can't help but think the pit actually had, um an episode where there was some of that happening to. Um, some college students bought danx and it was laced, I think, with carfentanil, I'm not sure, or fentanyl in general. Yeah, um, and you know, they were able to catch it with one of the, a roommate caught it with her friend and another kid, no and like, and so it was. He was brain dead on the episode. I maybe this is like not to like, you know.
Speaker 1That's great, because he was gone Traumatized, but I think it's realistic like right, that this is the what could happen, and I know, like you said, they I've. I'm a pop culture person too, and so some of the podcasts I listened to have talked about how, the, how much that show has actually tried to make sure they're being accurate, who they've hired, and so I'm like, goodness, I love it. I binge watched it this past weekend Cause I have clients who are like I work in healthcare and that's a great like. This is.
Speaker 1This is relevant, this is accurate to some of the experiences I've had and I'm like, okay, well, I guess I better get on board and yeah.
Speaker 2Well, and I'll say too, because you mentioned, that I think what's really beautiful about media being earnest and showing things, it's not all Pulp Fiction where you're putting like an epinephrine in somebody's chest. Like that's not the real case, or even, you know, train spotting or some of these other places in media where drug use in its most earnest form or rawest form is being portrayed. I love to hear that. And I actually did a training at University of Cincinnati a couple of nights ago and somebody was like, have you seen the Pit?
Speaker 2And I was like, okay, I got to watch the Pit because they're saying exactly what you're saying, and so to validate, that, but I would also love to say, since the people who are going to really be hearing our conversations are folks who might be working with people who engage in substance use you mentioned the young man or the student was brain dead, so something that happens with overdose. The real risk of overdose is that hypoxia, which is lack of oxygen in the brain, and so sometimes, even when we respond to an overdose, that person may have had no oxygen in the brain for so long that they have, if they do survive a traumatic brain injury. Right, and imagine a person who's overdosed more than once in their life.
Speaker 1Yeah.
Speaker 2That's compounding TBIs. And so, as counselors, when somebody is running late, when somebody doesn't remember what happened, when there's billable services and they can't sit for the whole 56 minutes or they're erratic in their behavior and there's things like that, start understanding the baseline of TBI. Start understanding that might not be drug use or the substance use that this person is experiencing, the symptoms. It literally could be a brain injury. And how would we treat somebody with a brain injury? Not the same way we treat somebody who uses drugs, because there is a medical hierarchy Right, and so I just mentioned that because it doesn't go without saying. There's also the compound risk. If somebody is a victim of intimate partner violence they also use as drugs. They may be strangled, they may have, you know, blood force trauma, they might also have overdose. These things take a lasting effect on our brain health and our ability to manage and regulate our emotions, and I really hope that folks can consider that in their work as they treat this population and counsel them.
Speaker 1Yeah, it's important to destigmatize and also like, if we're talking about meeting people where they are understanding that traumatic brain injury, like aspect, as well as any other medical, and they might not be diagnosed, is what I'm saying, right, yeah, oh, of course, but like that, that there might be other medical issues at play that, like we're I I'm not a medical provider I can't diagnose, but I can understand, like that this is, you know, maybe an added layer to the situation. Yeah, for sure. So you know, on or in that vein, the destigmatizing one of the projects that Harm Reduction Ohio has is the anti stigma project.
Speaker 1And they really try to amplify and lift voices for people who are impacted by, like this judgment, these stereotypes that we've talked about. No, we've probably addressed some of the misconceptions, but what are some others that you feel like are encountered regarding substance use?
Speaker 2So I think one of the most harmful misconceptions is that people who use drugs don't care about their lives. That's not the truth. Most people are trying to survive in really hard conditions. Most people are trying to survive in really hard conditions. Most people have a trauma background.
Speaker 2Another is that drug use is purely a personal failure or a choice, and if it is, why do you get to determine harms that come along with that?
Speaker 2And so this project aims to identify stigma, teach people how they practice stigma every day in their lives and how that actually might be like a belief of theirs that's based on a core value, and I've always believed in my life that our core values make us who we are and our beliefs inform them and informed by them.
Speaker 2But our beliefs can be challenged, and I like to challenge that belief that people should be isolated, that people should moralize drug use that we need to respond to like the complex human issue it is, and you know, a great way to do that, and one of the things that the Anti-Stigma Project aims to do is just educate people on person-first language.
Speaker 2If I say I'm a person who uses drugs, I led with the fact that I'm a person. Efforts in that project have been, you know, finding different communities in the state of Ohio, whether it is communities of refugees, whether it's communities that are Spanish speaking, whether it's elderly communities, whether it is communities of young people, and finding out what the individual stigmas around drug use, substance use, are, and then having those conversations with them about which of those things to like, some stigmas, came from a valid place of hurt, right, you know, if somebody who uses drugs in your life has been really harmful to you, like they've stolen from you, they've lied to you, they've done these things, when people do that it's because they're either trying to form a perception or, you know they have a deep shame or fear.
Speaker 2And those things can be worked through right, with accountability and support and just knowing that stigma kills, stigma is what costs us lives, those stereotypes and those judgments, and that we practice them all the time Like girls, like pink, you know and pink used to be a boy color generations ago, and I think that as time changes and as we evolve as communities, we learn that stigma is what keeps us isolated and separated, and so that's really what the program aims to do is just identify those and find the barriers, dismantle them and form new connections to help build trust and relation and community with clients who've maybe had some past negative experiences engaging with other systems in the community.
Building Trust and Supporting Dignity
Speaker 2I say, you know, obviously, start by listening, validate their experiences, even if it's not your experience, especially when people have been injured by systems. We have to engage with them, right, like we have to engage with systems Like. I was an unmedicated college student who had ADHD. I found that a lot of my drug use was me supplementing the fact that my executive function was lacking and I had no language for that. I was just a talkative young woman and so often those symptoms went unnoticed because I was able to score high on tests but not get homework done. But you know those types of things, and so there's no hierarchy of need, right.
Speaker 2When it comes to the people we're serving, each person, even the people who represent harms caused by structural systems, deserve the same level of care. And you know respect, and I think that don't say things like clean versus dirty. If they're talking to you about how they have to routinely get drug screens, ask them if their test came back positive screens. Ask them if their test came back positive. Ask them you know how the systems that they engage with are impacting them and help them navigate. That, like, trust is earned, right, respect should be given, but trust is earned, and for a lot of people.
Speaker 2You could be the first provider who didn't treat them like a problem to fix, and that really really matters. Didn't treat them like a problem to fix, and that really really matters. And I think that, as counselors, too, we have to really unlearn like I talked about earlier, those things that we've been taught, because if that works, this person wouldn't be sitting across from us, yeah, and so ask them what the version of their healthiest life looks like and start understanding that sometimes quality of life over quantity of life is what's important to people. Also, start understanding how. This is hard for me to say, because some people don't seek counseling because they want to right. They're within these systems where they're, like obligated to and don't take it personally, it's not you.
Speaker 2If you're the one having that conversation, it's not you and you know it's okay that that person hates it. It really is and it's not you.
Speaker 2And the compassion fatigue is something I hear about a lot too, and um give yourself grace because secondary trauma is real and hearing about that hardship, when you know the systems are failing and that you can meet with that person and you can listen and you can validate and you can believe in them. But if they still don't have shelter, if they still don't have food, if they still don't have things that people deserve, if they don't have basic human rights, you're a part of the system too and it's failing you as the counselor.
Speaker 1Yeah, we can't underestimate the importance of just our presence and being like a calm and safe, understanding presence, um, and yet, like we are still part of this other side, like yeah, and empower dynamics, right?
Speaker 2I guess I would also mention that, like for a lot of people, um, think about how your chair is oriented. Is the door behind you and shut? Do they have to get past you to get through a shut door? They might've been put in a lot of positions where they weren't safe. Um, can they see the exit? Can they like I know that there's probably training and all these things like I'm not a counselor, right?
Speaker 2So I can't say what everybody's professional experience is here, but I can tell you, when I had to be in the seat of a person, I was a person who uses drugs how the system hurt me and I think that, just being mindful that this can be a refuge, this can be the only 40 minutes a week where that person got to talk about themselves.
Speaker 2Minutes a week where that person got to talk about themselves, got to sit in silence, got to breathe, and I think that it is truly an opportunity to be restorative and to give that person a little bit of their dignity.
Speaker 1Yeah, I can see it as like, almost like its own type of shelter, right, um, because you know common conceptions of like homes, right, are like this is my reprieve from the world. Well, what, if you don't have that right, can we give you know 56, 56 minutes? Yes, that vibe. Yeah, for sure, in this work there are challenges. You mentioned the compassion, fatigue and the secondary trauma. What do you feel like are some of the biggest challenges in like harm reduction work, specifically as it kind of relates to changing public perception?
Speaker 2People want simple answers to complex issues, and so the biggest challenge is that, like those, there's a lot of these easy narratives that we have to combat.
Speaker 2You know, we're finding decades, like decades, of radical fear and myths and lies, sensationalized stories, media policies that treat people like they're disposable, and it's really frustrating when lived experience is dismissed in favor of some outdated or punitive approach, because that's just the way we do it here. Self-imposed barriers that, like you know, it will be a liability to have naloxone here. We don't want to have phenol test strips in our office because people will think that, like you know, we are OK with drug use and those are just like real mild ones, right. Like we have to keep showing up, we have to keep telling the truth, we have to keep building power in communities that have been left out of conversations for way too long. Like I was so grateful that I was asked to be here today because this could be the first time somebody hears any of this, and I really feel like I stand on the shoulders of legends who aren't here to use their voice Because the challenges in this work a lot of people don't live very long.
Speaker 1Yeah.
Speaker 2And, excuse me, it's seen as what they get. It's seen as their, what they deserve for the life they chose, and that's really hard. You know, my parents lived a hundred years between the two of them and, as I turned 37, um next week, and I think about the fact that in five years, I'll outlive my father and I have a six year old son, and I think about, as a child at eight, um, the hushed conversations I heard about his life, and I think about the children of a hundred in 2021,. 106,000 Americans lost their lives to substance use and overdose that we know of. I think those are underreported, right, um? And I think about the fact that Ohio is in the top five for overdose death every single year, even with the deaths declining, and that means 4,000 to 5,000 souls in the state of Ohio lost their lives. And who's telling their story? And so some of the biggest challenges we face is accountability the folks who use this platform to create more harmful punitive policies that do not serve the people they claim to serve and protect.
Speaker 2And just those really deep rooted fears that it'll happen to you because no one's coming to save us.
Speaker 1Thank you for sharing, Of course. Yeah, I think policy has been a pretty big part of conversation that we've been having like as an organization on our episodes and interviews, but that a lot of what you mentioned earlier like there's othering, some of that is trying to be like written into policy, which is certainly kind of a challenge. I can see like we need to wrap our community supports around them and this is saying like kind of like shoe, like why bother in some of those like policies that are are being established.
Speaker 2So and and. There's compounding policies too, like you know, if I am, you know, a trans person who uses drugs. If I am HIV positive and I use drugs, like there's a lot of things that like, um, the intersectionality of those policies. That's really problematic as well.
Speaker 1And I appreciate you sharing like that. You know this has deeply affected you in your personal life. Yeah, I guess, like for counselors who are listening who maybe have had similar experiences or just deep personal experiences of their own, that might be tough to balance with this line of work. Can you shed a little light on, like, how you balance those things for yourself?
Speaker 2So yeah, like you said, this work is personal for me. I've lost a lot of people I love and I carry that with me, and I also think I find strength in the community that we've built. I know I'm not alone in this fight, as you've said, and I think taking time for rest, remembering that this work never turns off like it never, ever turns off it's always going to be that serious, but, like you, matter Turning off your phone and not reading the news today is a privilege, but also it is resistance. Joy is a form of resistance and I really think that sharing spaces with people who get it please see somebody yourself. I go to therapy every other week and I'm never going to stop?
Speaker 2I'm never going to stop And'm never going to stop, and sometimes I tell my therapist like I just paid you so that I could hang out with somebody who I didn't have to explain this to from the ground up for just a little bit just a little bit and I think it helps.
Speaker 2I think you know remembering the work itself as a form of grief and healing. There's so much to hold and it's so impactful and meaningful, but it's critical, right. The helpers are so critical, like without the helpers, where would we be? And don't forget to wrap yourself up. And we always say you know, self-care like I hate. I hate it because it's like it puts the onus on us to be responsible for it. And so what does it look like to take care and what does it look like to be honest and have coffee with that honesty?
Speaker 2of how freaking heavy it is and how personal it is and you know that it just is real, it's real.
Finding Balance and Joy in Challenging Work
Speaker 1Two things are immediately coming to mind as you say that, and I think it's one of these important messages that, to be transparent, I've learned from black women that we can't self-care our way out of crappy systems, like. And so self-care, yeah, it's great, it's wonderful, but, like, if the system is bad, then there's work to be done there before we can, like, really do those things. But joy and rest are are acts of resistance and it's still important for us to do the work, but making sure we're incorporating these other like space for the other things too, so that we aren't consumed by it, so that we aren't burnt out. And then getting your own as an active self-care, getting your own counselor having space for that.
Speaker 1Don't forget to eat. Please have some food.
Speaker 2Water.
Speaker 1Because I think as a counselor sometimes it's really easy for me to intellectualize, just like plenty of clients do right, Like I can understand it, I can conceptualize it right, and so we try to do that to ourselves and that's all well and good. But then I, when did I give my space, myself space to feel it?
Speaker 2I. That's my biggest challenge intellectualizing everything Right and it's like where is that in my body? And it's hard because it keeps the spores, they say yeah.
Speaker 1Well, and that like I think again, baby counselor Marissa being like, oh, what a woo woo question. Now, if you ask me about, I'm like pro, woo, woo, like, but that I it's because I didn't understand it, Like, where do I feel it in my body, what are you talking about? And then it's like, oh right, Because we physically feel things too. It's also part of the emotional process and that we are whole beings where it's good that I've got that thinking cap on, but that thinking cap can't take me all the way and um, into being well. And so I think, uh, you make excellent points in terms of self-care is important, but maybe can't be the only thing. But we still have to make space for it, and I think you mentioned social media.
Speaker 2you mentioned you like media and I was thinking about how do I balance this weight of?
Speaker 2my work and the emotional labor, because it's labor. It is labor. And just hearing somebody talk, listening to this it is labor. And you know, just hearing somebody talk, listening to this conversation is labor. You whoever's going to say this you're going to be, it's going to stir feelings in you, you're going to have thoughts about it and it's you're burning calories. I think they did a study once where these chess players were like hooked up to all of this stuff and they were like they burnt like 600 calories on a move and I was like, whoa, I'm going to play more chess, but I'm saying like it's literal labor.
Speaker 2And it's important for us to really value that labor the same way we would a whole day working in the garden and mulch and that kind of stuff. It's still labor.
Speaker 1It's still labor and I guess, like bringing it back to social media and sort of the topic that we've been having is like, if we're looking at harm reduction, I mean it happens in all spaces, like right, like if you would go out and garden, you might put your gloves on, you might have the little knee pads, doing things to protect yourself, while still being able to enjoy the hobby. The same way it might be with a substance, the same way it can be with social media, that, like we can be intentional users.
Speaker 2Correct.
Speaker 1On these platforms and listen. I'm not going to sit here and tell you those algorithms aren't dang smart, but they know me, they know me smart, but they know me, they know me.
Speaker 1But there are ways to curate and reduce harm, even when the algorithm is feeding you things. Because I, I, you know, um, thankfully, I think, um, the algorithm, knowing me well enough, knows like I'm not going to buy into certain things, but I, you know, I know I have clients, I know my best friend, so I'm not going to buy into certain things, but I, you know, I know I have clients, I know my best friend, so I'm not sharing her name and I don't know she's not a counselor, so I'm not sure she listens to this podcast, gets fed stuff that's like very anxiety provoking, right, and I'm like tell it you're not interested, right, like you know, and intentionally maybe search some joyful things because it's going to also like mimic your searches and so, like I see so many cat videos that make me laugh, a couple of them might be, share the cat videos right, and so those news every day like you can seek out good news.
Speaker 1And so it's not to say that we can't use social media to also pay attention to things that are happening that maybe aren't so pleasant, but also, if we need to get some joy, like we can use it that way, like we can intentionally use, and that's just another means of harm reduction.
Speaker 2It is and uh, you know I was going to say the harm reduction part like there are settings now that I have to utilize that, tell me, like you've spent 90 minutes on this app today, girl, 90 minutes and so like. And then it just it says that's enough and it closes it. And doing that, taking a time to look at your week's worth of what you've used and don't shame yourself, don't stigmatize yourself. I'm telling you right now, but that way, you just know, you're just aware and knowing is how you can make positive change.
Speaker 2And that's what I like to say about harm reduction, if you don't know how to define it, like there's principles of harm reduction. I encourage you to look that up. I encourage you to, you know, visit the national harm reduction coalition's website, our website, things like that. But I think what you really need to know is that any positive change is harm reduction, and practicing radical, unconditional empathy is what is harm reduction, and that starts with you yourself.
Speaker 1Yeah, yeah, I love that. Thank you for sharing that. Are there any other, I guess, like strategies or advice you would give for counselors to really integrate more of these principles into their practice? You know?
Speaker 2what's your goal, I would ask yourself. Start by understanding your goal and be willing to shift or pivot. It's not about stopping drug use. If you're, if you're serving someone who is someone who uses substances, um, it's about keeping people safe, connected and supported. You know um. You can take trainings like I was just talking about. You can visit harm reduction programming Um if your health department has a um, syringe exchange or they're called um in a syringe service programs. And sometimes we're even shifting the language now because it's we don't want to just serve people who inject drugs. We might want to serve people who use administer drugs different ways. Go see what those are like. Go see, you know, if you have a client that needs medical attention or things like that, maybe go to an appointment with them. See how they're treated. Yeah, you know, continue to learn. There are some great books that I would love to share a list with you.
Speaker 1Yeah, yeah, we can link them in the show notes for sure.
Speaker 2They're wonderful books and you don't just remember. You don't have to have all the answers, you just have to show up with respect and willingness to be open and willingness to be open and I think that those strategies, that ability to, like I said before, increase your window of tolerance and open your worldview. Substance use disorder isn't a casserole disease. I always say when someone gets sick, like with cancer, or they have a surgery, there's a meal train and people bring a casserole and they open the curtains and they sit with that person and they love on them and they have community. When someone uses drugs and has any type of coexisting issue with that, they close the curtains, they keep it to themselves, they don't get support, treat that person like they need a meal train.
Speaker 1Yeah.
The Rewards of Harm Reduction Work
Speaker 2Yeah, that's how, that's what I would say yeah.
Speaker 1Um, we talked about some of the scarier parts and some of the negative parts of of this work and heaviness. What are some of like the joyful, rewarding aspects of this work?
Speaker 2Oh, thank you for asking me that question. People never ask me that question and I really like it. Seeing people step into their power, seeing people have that shift where they're like, hey, these experiences are really valid. Hey, I survived this system, I survived these opinions, I survived this illicit, dangerous drug supply. There comes survivor's guilt with that.
Speaker 2But then earning the trust in yourself that you are, like I said, said earlier, using your voice to amplify the voices of people who cannot speak, watching someone go from being dismissed and other to leading a training, to, um, changing a policy, hearing their story, save somebody else from the impact that it had on them.
Speaker 2Um, every time I hear somebody say, um, you saw me or you heard me, that is so restorative because that means that I was heard and, um, I think you know those are rewards A lot of people like get into this work to be like, oh, I save lives and I don't love that like saviorism piece of it. I love the idea that we're saving ourselves by making it safer for others and I think that harm reduction, you know, isn't just about preventing death or negative consequences. It's about supporting life on people's own terms. When we meet people where they're at, we don't leave them there, yeah, and I think that we sit there with them until what's next for them happens, and when somebody shows you what that next step is, buddy, is that the best part.
Speaker 1Yeah, I love it, um and it it aligns with the values of the counseling profession, where we want to empower, uh, the people that we work with, but we respect their autonomy.
Speaker 2Autonomy is hard. I think at that same training the other night somebody said well, what do you do if somebody doesn't want follow-up care? They don't want help? And I said, autonomy is so tricky, isn't it? Autonomy of choice is challenging because people get to be who they want to be and when somebody appears to be under the influence of things that change cognitive ability, it's hard for us to recognize in that moment that they still have autonomy Right.
Speaker 1And.
Speaker 2I think our systems um really make that challenging, and I think we just need to learn how to work within them. There are other helpers, and you might be that one you know, and your community and your system that makes things possible.
Speaker 1Yeah, so we ask this question on every episode because the name of our podcast is Ohio Counseling Conversations, so we always want to know from our guests what important conversations do you think counseling professionals should be having with each other and or their clients in our lovely state?
Speaker 2You know, harm reduction gives us a framework for positive change, for doing better, right and our best looks different every day and it starts with honesty and uncomfortable conversations. But on the other side of uncomfort is change every time, every time, and uncomfortable conversations about power, about equity, about what real care looks like and being mindful that we have to honor autonomy and hold ourselves accountable, because not just to each other, but to who we're serving Right. And I think what important conversations we could be having is where did we mess up, where did we fail? And like owning that failure.
Speaker 1Where can we take accountability?
Speaker 2Where can we take that accountability? Because sometimes I know for me that's the biggest harm is that nobody else is accountable for what happened, but I'm responsible and that sucks yeah. It sucks and and so, like, what does accountability really look like? Because we can't have restoration, we can't have healing, we can't have safety, we can't have met needs without accountability. And so just what does it look like?
Speaker 1Yeah, oh, I'm going to sit with that one for a while, well, after today's interview. Amanda Lynn, thank you so much. This was such a wonderful conversation and much needed, and I hope that those listening and beyond will maybe ask themselves these questions.
Speaker 2Thank you so much for having me and thank you for asking me questions that get me to be joyful.
Speaker 1Yay, I'm glad that we did, and I am so grateful you're here and listener. We're grateful for you too. We will see you next time on Ohio.
Speaker 2Council.
Speaker 1Conversations. Thanks, Amanda Lynn.