A Space for Grief and Growth: The 12th National Harm Reduction Conference

By Tessie Castillo 10/29/18

When we demand answers without a deep, authentic understanding of the problem, we wind up putting band-aids on gangrene.

Audience members in an auditorium sit with hands over hearts, some with eyes closed.
Conference attendees listen to the opening plenary. Image via Nigel Brunsdon

As I wandered into the opening plenary at the 12th National Harm Reduction Conference in New Orleans last week, something felt off. It wasn’t just the four white-robed women on stage, solemn and elegant in contrast to the mostly grungy, tattooed crowd. It wasn’t the massive indigo chandeliers, which cast a somber blue over the room. It was an energy I couldn’t quite place at first. Then, slowly, it washed over me.


Throughout the morning, as various speakers mounted the stage, the story of grief unfolded. The harm reduction movement is grieving the loss of one of our pillars, Dan Bigg, who died suddenly last August. We are grieving the political landscape, feeling vulnerable and scared as overdose deaths continue to mount and hard-won reforms in drug policy are reversed through a tide of drug-induced homicide laws and other punitive policies against drug users. And we are grieving the conflicts, hypocrisies and dysfunction present within our own movement that at times threatens to tear it apart.

My last report on a harm reduction conference for The Fix was in 2014. At the time, I described harm reduction as a community standing at a crossroads. The 2014 conference in Baltimore embodied the culture clash of a movement that had started as a radical underground community of people who use drugs being overwhelmed by mainstream and professional interests. Tension crackled between old and new, as did fear of co-opting and straying too far from its radical roots. Now, four years later, some of those tensions have boiled over.

One of the plenary speakers in New Orleans, Micah Frazier of The Living Room Project in Mexico, described the harm reduction community as a family full of love and dysfunction. With gentle admonition, Micah urged the crowd to watch how we treat each other and to be careful of how we engage in conflict.

Another speaker, Erica Woodland of the National Queer and Trans Therapists of Color Network, offered a blunt account of how he had left harm reduction six years ago over concerns about the lack of black leadership in the movement and the devaluation of black expertise.

“I got divorced from y’all,” Erica said, to a smattering of laughter. “I came back; we’re dating!” But he warned that the reunion would be brief unless harm reductionists could show capacity for change.

Harm reduction has changed in the past few years. Several of the largest organizations have experienced a shift in leadership as white, male executives who held power for decades have been replaced by women and people of color.

In fact every speaker touched on the need for a “changing of the guard” within harm reduction. They pointed out that the movement, supposedly centered around racial justice and recognizing the dignity of people who use drugs, does not always practice what it preaches. They criticized the prevalence of white, male leadership, while queer staff, people of color and active drug users are often reduced to underpaid “peer outreach” positions or token members of panels, trotted out for the public, then silenced once the cameras are gone. They stressed the pitfalls of sacrificing long-term vision for short-term gain, warned against co-opting by the public health system, and urged the crowd not to forget its roots.

Change is coming. Change must come, the speakers insisted. And transition is not always pretty.

Their words seared right through me.

A few months ago, I left my position with the North Carolina Harm Reduction Coalition (NCHRC) after eight years as their advocacy and communications coordinator. The decision was voluntary, but born from a place of pain. The organization had recently gone through its own changing of the guard and the process had, at times, been ugly.

In fact, the past couple years of my life have been marred by grief as the organization I have loved and helped grow, an organization that has done so much to advance harm reduction in hostile territory, has been tested and torn by the tension between demand for change and resistance to it. These past years have involved a lot of soul searching for me as I have second-guessed past decisions and wondered if I have allowed enough space for the voices of people most impacted by the drug war to lead.

The plenary was an epiphany. All this time I had bathed in private shame thinking that NCHRC was alone in its struggle, uniquely unable to have tough conversations without dissolving into anger and defensiveness. Now, for the first time, I realized that the movement has been changing and hurting across the whole country. We had never been alone.

The heaviness of this opening plenary hung over me for the remainder of the four-day conference. Even the siren call of New Orleans—the bright lights of Bourbon Street and hot gumbo spice—could not penetrate the fog. I don’t think I was the only person struggling. Even as other attendees greeted old friends and met new ones in between workshops, you could feel grief and tension hovering over everyone. There was no relief from it, not even in the blizzard of breakout sessions.

I tried to attend some breakout sessions, of which there were a dizzying number including topics such as fentanyl, friction with police, racial justice, indigenous healing, queer drug use and much more. The breakout sessions seemed designed to ask questions, but not necessarily to answer them. This frustrated a lot of people. I overheard many grumbling conversations in the hallways about how such-and-such a panel had not provided a “solution” to the problem being discussed. Years, perhaps even months ago, I would have felt this way too. Today I feel differently.

A couple of years ago I attended a town hall meeting hosted by activists and founding members of Black Lives Matter. After over an hour listening to them talk about racism and oppression, a white woman in the audience asked the question that had been burning in my brain the whole time: “How can we fix it?”

The speaker responded by politely suggesting that the young woman have conversations with family and friends about racism. The woman sat down, seeming dissatisfied with such vague marching orders. I was disappointed myself and, I’ll admit, a little appalled that the speaker didn’t seem aware of the importance of giving people concrete actions so that they stay engaged in the movement. But today I see the wisdom in that answer. The speaker didn’t give that young woman, or me, an easy answer because we weren’t ready for one.

Lately I have come to appreciate conversations that do not end with solutions. Most societal problems are so complex that any “solution” that can be discussed in a 60-minute panel is probably bullshit. Most of us know surface level things—racism is real, drug policy is killing people, there are too many people in prison—but we don’t truly understand the history or scope of these issues, especially if they don’t directly impact us. We want a quick recap of current affairs and a quick fix, but when we demand answers without a deep, authentic understanding of the problem, we wind up putting band-aids on gangrene.

This, I think, is what the conference was attempting to do—to encourage discussion and exploration and self-reflection, not to provide instant gratification.

I left New Orleans without answers, but with a great sense of responsibility to seek them, even if it takes a lifetime.

Members of Harriet's Apothecary open the conference with calls to be mindful and present.
Image: Nigel Brundson

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Tessie Castillo is a writer and drug policy advocate in Raleigh, North Carolina. Her articles explore topics such as criminal justice reform, drug policy, and harm reduction. Castillo previously served as the Advocacy and Communications Coordinator for the North Carolina Harm Reduction Coalition (NCHRC), a statewide nonprofit that advances drug policy and criminal justice reform. During that time, she played a pivotal role in helping to legalize syringe exchange programs and expand access to naloxone, a medicine that reverses opioid overdose. Find Tessie at her website or on Facebook, TwitterInstagram, and LinkedIn.