The Shifting: Recovery programming evolves from the War on Drugs

For decades, Chuck has been using crack, meth and heroin. The 53-year-old regularly injects drugs to get high. 

He’s been to prison several times for crimes related to his drug use. 

He said he has overdosed 12 times, and two of those times he was clinically dead but brought back by medical professionals. For the remainder of the overdoses, he was revived with Narcan, a potent opioid antagonist — three times in the last month and a half. 

He’s tried to stop using. But, he said, doing so results in “too much pain.” Emotional and physical pain. So, he keeps using it. 

“I should’ve been dead years ago,” he said.

As he spoke, Chuck – a pseudonym — stood next to a heart-shaped memorial in the offices of Punks With Lunch, a Lansing nonprofit that provides harm reduction services in the greater Lansing community for those who use substances, including opioids. 

The memorial pictures some of the drug users that the organization was unable to keep alive.

“But,” Chuck continued, “I want to live to what I feel is comfortable and fun. And try to enjoy as much as I can. Because once you go, there’s nothing left.”

Chuck was receiving support supplies, including needles and food, from Julia Miller, co-founder of Punks With Lunch. The last three doses of Narcan that saved Chuck’s life came from Miller’s organization. 

Miller and Punks With Lunch represent part of a renaissance in how Michigan and America are grappling with the ongoing crisis of substance use disorders in general and opioids in particular. 

Public health officials and activists are working to reduce the risks of using substances, providing services like syringe access and Narcan. Harm reduction is not just a buzz phrase, it’s a powerful reframing of how public officials see and address substance abuse disorder. And this perspective is slowly beginning to reshape public policy, laws and law enforcement practices.

Former Republican State Sen. Rick Jones has been facing the substance abuse crisis for decades. First as a deputy sheriff, then as jail administrator, then as Eaton County sheriff. He took that experience to the Legislature, pushing for a shift in policy.

“I developed a strong belief that rehabilitation and treatment was a better option than locking people away,” Jones said. “Locking people up is very expensive. I supported programs such as the drug and alcohol courts that put people in treatment. If we can turn someone around with treatment and get them back in the workforce, it’s not only better for them but also better for our nation.”

Jones said that during his time in law enforcement, he has witnessed the gruesome results of substance abuse and cars. 

“I’ve picked up body parts,” at accidents, he said. This is a journey many in law enforcement have taken. 

Jones said he supports providing access to Narcan and sterile syringes for those injecting drugs. 

Jones has put behind him a mentality that pervaded American politics for decades beginning with President Richard M. Nixon’s pronouncement of a War on Drugs in 1971.

Chris, 60, a Lansing Black man who has been in recovery for more than 18 years (See Page 5 for a related story) said the drug war triggered a primal response in himself and other crack users. 

“The paradox for me is that it immediately triggered or activated a war-like mentality,” he said. “There were some clear lines drawn between law enforcement and the urban communities.”

For him, the paradox was having family members who were police officers in Los Angeles at the time. To this day, he said, “I don’t know who were the good guys or the bad guys.”

But federal lawmakers had an inkling of an answer. Law enforcement officers were the “good guys,” drug users were the “bad guys,” and they ramped up a tough-on-crime, War-on-Drugs agenda. 

The 1986 federal Anti-Drug Abuse Act led to a dramatic increase in the number of Black people sent to prison under mandatory minimum sentences. Because possession was measured by weight, a person with crack would have a higher weight, resulting in a harsher incarceration time in federal prison. There was a staggering 100-to-1 ratio in sentencing disparities between crack possession and powder cocaine possession. 

In 1988, Congress expanded the Anti-Drug Abuse Act to include conspiracy charges.

“These laws flooded the federal system with people convicted of low-level and nonviolent drug offenses,” wrote Nkechi Taifa for the Brennan Center for Justice in May 2021. 

It wasn’t just conservatives who fostered the War on Drugs mentality

Carol Siemon, the recently retired Ingham County prosecutor and a liberal Democrat, recalled that in her early career, as an assistant prosecutor, she was a cog in a justice system that was punitive and harsh in the ‘80s and ‘90s.  It was a time when the War on Drugs meant heavily armed and armored police officers busting into crackhouses to serve warrants.

Siemon saw the racial disparities. But she didn’t fully understand the role of over a century of criminal laws targeting various communities of color.

Siemon’s self-education chipped away at a “lock them up” mentality. She shifted to viewing substance abuse disorder as a mental and physical health issue, not a moral failing. And she went on to develop training programs for prosecutors statewide.

Medical science was something that Lansing Mayor Andy Schor said helped anchor a state task force on opioids on which he served as a state legislator. The task force was convened by then-Gov. Rick Snyder, a Republican. 

“After the docs talked about the chemical need of addiction, there was definitely a lot of understanding,” Schor said of his colleagues on the task force, including many Republicans. “This is a shift that’s been made over the last 10 to 20 years. I think a lot of them were open to hearing that in the first place but wanted to be convinced.”

Schor said he supports syringe programs in the city but was unaware that Punks With Lunch operated one. 

“That’s great they’re doing that,” he said. “I completely support that.”

Ingham County Sheriff Scott Wrigglesworth said that he supports free Narcan, which is available in the lobby of the Sheriff’s Department, as “insurance” for former users or family members. “Narcan in my view is when somebody’s dying and it brings them back, it certainly doesn’t fix their addiction issues, but it keeps them from not dying,” he said. 

He’s also instituted medically assisted treatment in the county jail for inmates suffering from Substance Use Disorder, a condition officially recognized by the American Psychiatric Association. He has also set up in-jail meetings of Alcoholics and Narcotics Anonymous led by individuals in recovery.

But he’s “not there” when it comes to handing out clean syringes. 

It’s “almost inviting somebody to go break the law,” he said, noting that possession of heroin is a crime. 

Evidence of syringe-access programs actually finds users have fewer problems with HIV and hepatitis infection as well as bacterial diseases that infect the heart. Syringes and other supplies like alcohol prep pads, are often distributed — as with Punks With Lunch — with Narcan and tips to prevent overdosing. 

But science is not always the clincher when it comes to finding solutions to addiction. 

Siemon said when she was first confronted with the idea of “safe injections sites,” where users can test their drugs and inject them with medical supervision, she had a “visceral objection.” Then she joined other county prosecutors to meet with leaders and people who use drugs in Portugal and Germany to see safe injection sites in operation. 

Despite overwhelming data on such programming, which included decriminalizing possession of drugs — but not delivery and sales — she was still wary. The program reported a significant drop in HIV transmission and an 80% reduction in overdose deaths in Portugal.

But it was the people who benefitted from the program that brought it home for her. 

“One thing I really liked is they didn’t just lump everyone who has a drug issue in one housing setting,” she said. “People were dispersed throughout the community because it was like trying to normalize their life.”

The prosecutors met one man who was using methadone, a substitute drug used to wean people off of heroin. She said he had a small apartment and was “really proud of it.” The man had been homeless, and the provision of housing alone restored some dignity to his life.

The group also met an immigrant from Africa who had used cocaine and was a sex worker to survive. She’d become HIV-positive as a result of her use and sex work. They visited her small apartment, where she showed off the pillows and other decorative items she had gathered.

At the end of the day, Siemon said, her visceral objections were overcome by the reality the programs were “saving lives.” And as important, perhaps more so, it was restoring people to “functionality.” They were no longer spending their days chasing their next fix of the drugs they used and hiding to avoid law enforcement. 

From her days working in juvenile court, at the height of the crack pandemic, the removal of children and the inability of parents to regain custody and visitation was problematic to her. Many of those parents were generally functioning as parents, but because of the drugs, their kids were taken. That creates trauma. Trauma is passed down through generations.

Safe injection sites and the German and Portugal models help address that, she said.

“Ultimately, the question is how does someone function in our society?” she said. “How do they live, have a job, maybe have a family? What is in the best interest of everybody, really?”

She said she would support a safe injection site in Ingham County but is uncertain the residents of the county, state or country are ready for that step. 

State health officials working on substance abuse prevention and recovery said they are “monitoring” the implementation and community response of safe injection sites in other states. But there is no “official policy” one way or another relating to the programming. 

Since 2017, the state has gone from funding five harm-reduction syringe programs in the state to financing 40 of them, officials said. The move has reduced new incidence of HIV and Hepatitis C. And since syringe programs also come with Narcan distribution, overdoses and deaths have dropped as well. 

While law enforcement agencies like the Ingham County Sheriff’s Department are focusing on providing abstinence-based recovery programming for people who use drugs, other agencies are working to help people who use drugs get into treatment programming. That includes the Michigan State Police Angel Program. That was formed in 2017 and is now available at all state police posts. Michigan was the first state in the country to institute a statewide Angel Program. 

But those who work in recovery programs said the abstinence-only programs, often in the form of NA or AA, aren’t necessarily going to work for everyone. 

In 2009, Miller was charged with driving under the influence. She was assigned to a 12-step program as part of her probation. And while it did “help a little,” it ultimately was not a program for her. After she was off probation, she started drinking again. 

“It was getting hard, and I wasn’t enjoying this life as much anymore. And I knew for a long time that I should make some changes, but I didn’t want to go back to 12-step programs. I knew that I wasn’t sure that I wanted to be 100% abstinent. I just knew I needed to slow down, make some changes,” she said. “I was afraid that if I went through a program that was an abstinent-only program, I would be turned away or shamed if I wasn’t abstinent.”

A decade later, she discovered a group of fans of the band Ween who had a Facebook group dedicated to harm reduction-based recovery. She said there was no shame about what her recovery looked like. 

“Some people are choosing not to use certain substances, but they still use others or they’re cutting back on their drug of choice. And there are people who are in that group who are 100% abstinent who do also follow traditional 12-step models,” she said. “It’s all across the board as far as how people choose to find their recovery. And there’s no shame about it.”

The model reflects a definition of recovery that’s been adopted by the federal Substance Abuse and Mental Health Services Administration. The agency’s definition is a far cry from the Nancy Reagan era “Just Say No” messaging and framing.

“A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential,” the definition reads. It’s a definition refined over the last two decades as more medical information became available about the impact on the body of people with substance use disorder, including how the drugs change the brain itself. 

Shawn Patrick, 46, knows, from talking with family, that his mother put whiskey in his baby bottle. He was actively drinking and using drugs by age 12. But six years ago, on June 1 — a date he calls his “soberverisary” — he stopped. 

During his inpatient treatment program, a therapist mentioned that Patrick was “meant for important things in life.” Patrick laughs today at the sentiment, noting, “I think they probably say that to everyone in recovery.” But the message resonated with him. He will graduate in October with a master’s in clinical social work from Spring Arbor University. 

“I want to be there for people when they are starting their journey on recovery,” he said. “I want to be there with those who are using, to help them find ways to reduce their harm, and with those in recovery to navigate life.”

He’s already doing much of that full time. He works with a local agency that intervenes with patients brought to the local hospitals for an overdose. Patrick and his team meet the people and talk with them. Without judgment. “It’s an opportunity to tell them someone cares.”

Patrick knows how important one person caring is in recovery. He needed it in his life, and he’s seen it with others. And when the road to recovery begins, more people step up prepared to give a person in recovery a “step up, not a hand out.” That helps people stay accountable and connected. 

Chris, has found recovery in traditional 12-step programs. He is an advocate for harm reduction. 

“I want people to be around so if they decide they want to get sober, they can,” he said. “And this works. I’ve seen it work.”

The stigma and shame of substance abuse disorder continue to drive people away from recovery and from talking openly and honestly about their recovery process, he said. And when you raise the idea of providing people with syringes and alcohol wipes or Narcan and testing strips, some people, he said, “get all moral about it.”

It’s an attitude that bothers him immensely.

“Go back to your seat,” he said he tells people who oppose harm reduction efforts without an understanding of what that entails. “We’re talking about health care, we’re talking about human beings. And it has to be somebody who can stand up and just say that. Someone has to keep talking about being human and calm down.”