Pubdate: Fri, 09 Feb 2007 Source: North Coast Journal (CA) Section: Cover Story Copyright: 2007, North Coast Journal Contact: http://www.northcoastjournal.com/Welcome.html Details: http://www.mapinc.org/media/2833 Author: Bob Doran FIGHTING DEMONS: THE PLACEBO HARM REDUCTION COLLECTIVE AND HOW IT CAME TO BE The guitar player is dressed head to toe in black. Flanked by a drummer and a key-board player at a Eureka coffee-house on a Saturday night, he rips into a set of music he describes as "zombie surf rock." He starts with a number called "Zombie Songs" and works his way through "Haunt This World" and "Snakes in Your Head," among others. The songs are dark and heavy, but not without humor. You'd have to know something about James Harken, leader and songwriter for The Invasions, to realize how personal some of them are. For years, James has been fighting an army of demons: binge drinking, addiction to drugs (primarily prescription narcotics) and anxiety and other mental problems, including suicidal tendencies. He says: "I see zombies as a metaphor for everything that's going on -- obviously with the drug scene, but also the state of the world with all these people working jobs they hate, living like zombies." While he perceives his zombie-themed songs as a "fun" way to touch on serious issues, it's not hard to see a song like "Haunt This World" and its chorus -- "I don't want to haunt this world alone" -- as a direct expression of what's going on in his head, snakes and all. A few weeks earlier, James shuffled papers as he prepared for the weekly Tuesday night gathering of the Placebo Harm Reduction Collective. The burly 28-year-old, wearing a loose jacket and a military-style cap adorned with a red star, seemed just a tad nervous as he looked at the clock and announced the start of the meeting. The collective's intent is to provide a support group for those facing problems with drugs and alcohol -- it's billed as "an alternative to Alcoholics Anonymous," but the structure is akin to A.A. James kicked things off with the traditional introduction ("Hello, my name is James") and noted that he is the founder of the group. He then read from a mission statement explaining that the collective is not a 12-Step organization; instead, it is "about choice." Without going into detail, he described the group's goal as "harm reduction rather than abstinence." James didn't delve into much personal history or explain why he put the group together. Suffice to say, he was there because he doesn't want to "haunt this world alone," and because he hopes that he can help others like him battling their own demons. What Happened To Dave James was far more talkative when we met in that same room at the Eureka Co-op a few days prior. He explained that he'd been trying to get his life together since he landed a job at the Co-op five months ago. He found a kindred spirit in Dave, who was hired a couple of weeks after James. "We were talking and somehow we got on the topic of suicide and drug addiction," said James, sitting back in his chair as we talked in the new store's demonstration kitchen. He was on lunch break, picking intermittently at a couple of raviolis and swigging from a tall bottle of vitamin water. "Dave invited me over to his house. He'd had problems with drinking and had been part of the A.A. community for a while trying to get past it, but he was still drinking. "He saw the scars on my arms where I'd tried to slit my wrists one time. I told him about that, and about how I'd overdosed on pills last year after I got fired from my last job. I got really depressed and took every pill I had in my house. I was in a coma for two days and didn't know what I did when I woke up." While Dave couldn't really relate to James' suicidal episodes, they became friends. Both were fighting similar demons. In November of last year both were having relationship problems. James had broken up with his girlfriend; Dave's fiancee was working out of town. "He called me up, wanted to hang out. He was freaking out about his fiancee. I didn't know how bad things were for him. I went to his house. I could tell things were bad; he hadn't shaved or eaten and he'd been drinking for a few days straight, but he was out of liquor. He wanted me to buy him a bottle. This was a major relapse for him. Then he said, 'I gotta tell you something: I loaded my nine millimeter today. I want to shoot myself, but I can't pull the trigger.' "I freaked. I didn't know what to say. I told him, 'It's time to call Sempervirens. That's what we should do.' "Dave was very compliant; he said, 'You're right. I need to go there right now. My only other choice is to shoot myself in the head.' "We called them and they were like, 'No, we can't take you.' We said, 'Fuck that,' and drove there. They saw what state he was in, it was obvious he was bad off. They said he needed to go to detox and, 'You can't stay here tonight.' "I've learned since that there's a certain level of drunkenness where you can't be admitted, but I know he was under that level. He was coherent and everything. We were talking with the intake guy in the lobby of county mental health, sitting on the couches. Dave told the guy, 'I need help to get over this thing. I'm a recovering alcoholic and I need help. I need to stay here tonight.' "Again, they said he had to go to detox. But there were no beds available there that night, so he'd have to go in the morning. Dave was like, 'What? You're going to let me walk out of here? I have a loaded gun at home and I'm going to shoot myself.' "They told him, 'Oh, that's just the alcohol talking. Alcoholism can't kill you.' That's a direct quote. Dave was really bummed about the whole thing, but he had no choice. He said he'd go to detox in the morning, then he left with me. "He wanted me to buy him a bottle, but I said, 'No, I'm taking you to detox in the morning.' I also asked if I could see the gun. He said, 'No.' "He's also kind of a chronic liar so I didn't exactly believe he even had a gun. I left him at his place feeling confident that he wasn't going to do himself in. He seemed to realize that detox was the way to go. That's what he said. "Apparently he shot himself five minutes after I left. It really pisses me off. He shot himself in the right temple and blew his brains all over the room. That's what happened to Dave." James' Story James seems to be on the path to better choices now, but that was not always the case. "I started using when I was 12, the summer between 6th and 7th grade," he recalled in our first encounter at the Co-op. "Every weekend I'd get drunk and take pills. Me and my friend would get drunk and my mom had had back surgery so I'd take her pills. "I tried pot but never really got into it -- I was more into pills and drinking. When I was 15 I got into Primatene, an over-the-counter medication with a lot of ephedrine in it for a speed high. Then I started doing speed like crazy. I dropped out of high school; I wasn't doing very good. I lied about my age and got a job at Hewlett-Packard, so I was making a bunch of money. I was still living at home so I always had money for drugs." Moving from speed to opiates, he found himself addicted to Vicodin and Percocet. "It escalated pretty bad until around the time I turned 19 when I decided to quit, did a complete 180, started going to A.A. and N.A. and went vegan straight-edge. "N.A. is where I met all my heroin junkie friends. I was just a pill junkie. Then those friends started dropping like flies -- pretty much all of my junkie friends are dead now, either from drug overdoses or other problems. I decided to quit that whole scene and go to school. I got my GED and came up here to Humboldt for college." Moving to Humboldt was a good move, at least at first. He joined a rock band called Mutiny (playing punk-style sea shanties of all things) and joined the Placebo, a youth organization setup to give kids a place to play music and to offer an alternative to drugs and alcohol. "It was OK at first, but then I started drinking again, then I fell in with a part of the music scene that was into pills. A lot of them had kicked heroin, but they were still into pills." He joined a new band and found a new creative outlet, but the drugs and liquor got the better of him. "Once again I was taking a lot of Vicodin. I had some minor medical problems and I'd use that for doctor-shopping. I'd have like four doctors prescribing things for me and I'd go to different pharmacies." On top of his physical problems he was dealing with recurring mental problems -- depression, anxiety and suicidal tendencies, for which a doctor prescribed Lexapro and Klonopin. Between the pills for his psyche problems and the opiates for his pain, he was a walking medicine cabinet. "I'd been drinking through all that. I decided to quit. The last show for my old band was the last time I drank. I didn't think I'd been drinking that much, but I got really sick. It really messed with my anxiety." Then when he landed a job at the Eureka Co-op five months ago, he set about trying to get his life in order and stop taking pills. Most of them, anyway. Around the time Dave shot himself, another band James had been playing in was sailing on troubled waters. One of his bandmates who'd been battling heroin addiction, "went off the deep end," as James put it. "He relapsed big time. And I started to relapse myself, mostly drinking on top of the prescription drugs I was taking. I knew I needed to do something." James and his friend started going to A.A. meetings, "but he just couldn't deal with it; I couldn't either. There's the whole God thing, giving yourself over to a 'higher power.' We didn't want to hold hands and do that whole number where you try to convince yourself it'll work if we just keep coming back to meetings." James was raised Catholic, but now considers himself an atheist. So for him, sitting at an A.A. meeting pretending to ask God for help seemed hypocritical. Beyond that, he sees A.A.'s first step -- admitting that you are powerless -- as an abdication of personal responsibility. God is not going to defeat his demons, he has to do it himself. "Plus, A.A. doesn't really focus on the fact that drugs and alcohol can be self-medication for anxiety and suicide. It all goes hand in hand. I choose to be sober and abstain from drugs, but I do have to take my meds. I need Klonopin to stop my anxiety attacks; it keeps me steady. A.A. doesn't allow that because it's a narcotic. A.A. says drug addiction and alcoholism are a disease, but it doesn't focus on the fact that mental issues and self-medication are part of drug addiction." All of that was running through his mind when Julie Ryan, a Placebo coordinator, asked him if he'd be interested in leading some A.A.-style meetings in the youth group's Eureka space. He'd been reading a book titled, Over the Influence, about something called "harm reduction," and suggested something more along those lines. "Harm reduction meets the user where they're at, tries to help them move toward sobriety. It sees progress as cutting down, not just the time you've been sober, whereas A.A. only measures success by how long you've been sober; you get a chip for 30 days or whatever. The truth is, every step you take toward sobriety and improving your mental health is a huge thing and should be celebrated." Through Julie, James got in touch with Nancy Courtemanche. Nancy's son, the musician/artist Rob Rierdan, lost a battle with his personal demons and died of a drug overdose in November 2005. (See sidebar) Since then, Nancy has been reaching out to the local youth music scene, mostly through Placebo. Last summer she became a sponsor of Bummerfest, Placebo's annual music festival, which was founded in part by her son. She gave a couple of impassioned speeches telling Rob's story and urging the crowd to recognize the impact of choices they make in their lives. Nancy became a major champion for James' plan for a Placebo Harm Reduction Collective. Since the group formed she's attended every meeting offering support and testimony. She suggested to James that the group adopt Rob's signature character, Happy, as a mascot of sorts. "Happy was like Rob's alter-ego, it is what Rob would have liked to have been," Nancy said. "I see it as a symbol of making a positive choice, a good choice."' Social Workers, Cops And Harm Reduction Ronnie Swartz is a trained social worker who teaches courses at HSU with titles like "advanced practice in problematic substance use" and "drugs, justice and harm reduction." He explains: "That term, 'problematic substance use,' is a term used more and more in Canada and elsewhere to acknowledge that not all drug use is drug abuse. For those who work with folks dealing with alcohol and drug problems, it's the problematic use of substances that you focus on." And the term "harm reduction"? What does it mean in the world of social work? "First it means approaching people who are using drugs and alcohol in a non-judgmental way. Rather than trying to get people to stop using drugs altogether, which is the approach that's been used for decades here in the United States, it's more effective to assist people in reducing the harm that comes from their use of drugs. "The most effective way to reduce harm is to stop using drugs, so complete abstinence is part of the harm reduction spectrum. But it also includes assisting people to move toward safer ways to use alcohol or other drugs." A simple -- and non-controversial -- example of harm reduction currently in practice is any program encouraging a designated driver for a group out on the town drinking. The movement, modeled after a similar Scandinavian program, was first put forward in the U.S. in the early '90s with a mass media campaign. It recognizes a basic fact, that people who are drinking will inevitably drink to excess and put lives at risk. Instead of trying in vain to prohibit drinking, an experiment Americans failed at early in the 20th century, the idea is to reduce the harm caused by drinking. American history tells us of the disaster that followed the 18th Amendment prohibiting alcohol, and of its eventual appeal. One could argue that the prohibition of various illicit drugs has been no more successful, but it's what we have right now. "The federal government approaches illicit drugs in a zero-tolerance, abstinence-only way," notes Swartz. "One way it does that is by only funding abstinence-only drug programs. It's really the exception in the international community -- and it's also not always true at the state level. For example, needle exchange programs are a form of harm reduction. The thinking is that HIV and Hepatitis-C are common in injection drug users. Trying to get these drug users to stop using their drugs has not been tremendously effective. So, how can we reduce the rates of HIV and AIDS and Hepatitis-C? One way to do that is to make sure people use clean needles. There is a lot of research to suggest that this works. The federal government will not pay for that, but the state of California will." Interim Eureka Police Chief Murl Harpham has drawn fire in recent weeks after lashing out at local drug treatment programs that he says "enable" users. After a series of letters pro and con in the Times-Standard, Harpham submitted a "My Word" opinion piece clarifying his position. While softening his position on "meaningful" treatment (even complimenting the Crossroads rehab program), he added the county's needle exchange program, Prop. 36 (the treatment-not-jails law) and the "harm reduction program" to his list of drug-abuse enablers. Harpham dismisses needle exchange as ineffective: "I deal with these people all of the time down in the brush. For six years I was dealing with them. They still share needles in the encampments. They all use the same needle. Each one of our police cars has a sharps container because we come in contact with needles so much. They're out there everywhere. It's crazy." For the old school, streetwise cop who walked a beat, the notion of harm reduction is not a solution. "It's not something that's going to stop the drug problem. It encourages them to continue their drug use while they're supposedly on treatment, with the theory being you'll eventually wean yourself off. The way out [of drug abuse] is not in enabling these people. That's the way I understand harm reduction. People need to be accountable for what they do. That's something we lack in our society today. "I think it all started in the '60s with the drug culture. The media glamorized it with all those Cheech and Chong movies and LSD, marijuana and stuff like that. All that turned a lot of people on to drugs in our society. I honestly believe that a lot of genes were changed. And now those people who were doing all that experimenting, their kids are the ones we're dealing with who are having all these problems." For Swartz it's a matter of compassion. "Another premise of harm reduction is this: How can we keep people alive long enough for them to choose abstinence?" Swartz says he can "understand the perspective of the interim police chief, but I don't think his views reflect the overall EPD. Needle exchange would not be possible without some support from the police and public officials." Swartz is among those who would like public officials to take a major leap on drug policy to reduce overdoses. "The major reason drug users overdose from heroin is the uncertainty in the purity of the supply," he says. "They're used to a particular purity and know the quantity to take, then they get a batch that's of a much higher purity, take the same amount they've been taking, and that leads to an overdose. That's a direct result of prohibition." Other countries, including Sweden, Denmark, Great Britain, Australia and British Columbia in Canada, have adopted harm reduction programs that include heroin maintenance. "It sounds far out from the American perspective," says Swartz, "but the way it works is, people will go to a clinic and a physician will give them pharmaceutical quality heroin, which is an incredibly safe drug. What's not safe is the kind of crap people get on the streets. It's pure quality and it's administered in a safe way. It sort of reflects what we do in the states with methadone maintenance. That's been going on since the mid-1960s. That's a form of harm reduction." While it has been discussed intermittently for years, Humboldt County still has no methadone program. "There's a lot of opposition to it here, for a couple of reasons. There's the moral idea, which fuels a lot of drug policy. That sees it as substituting one drug for another. They're not using heroin, but they're using methadone, which is an opiate, an addictive narcotic, and it could be abused. The idea is that instead of having someone become addicted to something else we should help them break free of all drugs. It's the idea that some drugs are worse than others and that people just shouldn't use drugs, whatever they are." The other related hurdle is the age-old NIMBY factor. No one wants a methadone clinic, or any sort of drug treatment facility, in their neighborhood. The Meeting No one seemed to be bothered by the Tuesday evening gathering of the Placebo Harm Reduction Collective, announced only by a placard outside the meeting room showing Happy. Co-op shoppers wheeled their carts past, unaware of the drama inside. James finished his introductions. Nancy was next to speak. "I'm here because my son died of a drug overdose," she began, adding, "It changed my life forever." She discussed her son's depression and associated self-medication, his need to "feel right in his skin." Another in the circle, a woman in a red hat who said she's in training to be a drug counselor, began by describing the allure of getting high. "I did drugs all my life. That's what I was good at. I loved it, loved the escape, the fun." Her path took her from speed and alcohol to indulging in "shrooms and X" while on Dead tour, then on to crack and heroin. Now she's moved beyond drugs thanks to buphenorphine, a treatment similar to methadone. "It kept me from getting sick, which is really why heroin addicts keep at it," she said. "After a while, you don't really get high -- you just don't feel sick. "Now I feel great," she concluded. "I know I can be happy." The testimonies continue from a cross-section of Humboldters. A well-dressed gent spoke of meth causing his family "to go upside-down in our finances." A 20-something man noted that he "paid the price" for his drug and alcohol abuse and "ended up living on the street." Saying that he'd been clean "for a while now," he noted that he'd been coming to the collective's meetings since the beginning. "It helps me, gives me something to look forward to," he concluded. When it came back to James, he slipped into A.A.-speak. "I'm James and I've been sober six weeks now," he began. "I know I feel better because of these meetings." The demons are at bay for James, at least for the time being. As this story goes to press, he's still sober. And he's not alone. - --- MAP posted-by: Beth Wehrman