Living With An Opioid User: A Guide To Keeping Safe

Living With An Opioid User: A Guide To Keeping Safe

To keep someone who uses opioids safe, it's important to be understanding, show compassion and carry naloxone.

Image: North Carolina Harm Reduction Coalition

I am an opioid user who is currently not using. Hold the applause; this isn’t about my “triumph” or whatever you want to call it. The time came for me to stop and I did. How is irrelevant. While I haven’t been using for about six months I am in a relationship with someone who is currently still using intravenously and this means I have to accommodate that fact in my life.

This isn’t about how I cope with having opioids around when I myself am so close to my own dependency. It’s about how I help to keep my partner safe when using. It’s about being a better friend and companion to someone who is still walking the tightrope between wanting to use and not. It’s about caring with action instead of empty words, aggressive interventions, and a lot of vapid nomenclature that does a lot to sell rehab beds to confused families and nothing to help the needy.

This article was first published on Studio L. You can read the original here.

The reality is that my partner isn’t quite ready to put down the drugs that have sufficed to help them through some very dark times. I’m okay with that. Nobody told me when to quit and I can’t make that choice for them. I don’t much like them using. It scares me in an age when overdose deaths are a daily event and few are sympathetic enough to even do the right thing if that overdose happened. What would scare me more is not knowing, and not being able to help keep them safe.

This is about how I adapt to that risk in my partner’s life and how you can be a better help to the opioid user who might be in your life. It might be an intimate partner like it is in my case. It might be your grandparent or parent who has chronic pain issues and uses opioids either by script or by black market supply to manage that. It might be a friend. It might be you who is using and doesn’t know how to ask for help to remain safe. This is about how people can help each other navigate the risks and pitfalls of opioid drug use together and make sure we all get to the finish line alive.

Asking, Knowing and Keeping Aware

I could stigmatise my partner in a rather hypocritical fashion and tell them I insist they stop for my sake. I could cite my own use and complain that their use is a trigger. That would be an incredibly selfish thing to do and my concern for my partner overrides any such petty concerns. I just want them to be alive, and whatever I have to do to facilitate that I will do. The first part of that is knowing.

I have requested my partner inform me with each use as much as possible. When we are home together I am there. I see the process. I see the needle go in. I keep an eye on everything and am there with an overdose kit in the event something goes wrong. This isn’t always easy, but if you care that much about someone who is using you put your own emotional limitations aside and do what you have to for their sake. When we are in public and they have to slip off to a private space to use I time them. I have that process timed down to the minute with the stopwatch on my phone. I know how long it takes to prep and shoot, and anything more than two minutes over that I will come and check, even if that means walking into a public washroom or kicking down a damn door. Their safety matters. I’ll deal with any fallout later.

It probably sounds like that is difficult, given my own past use. It can be, but far more than it is difficult it gives me peace of mind that they will be there tomorrow, and many days afterwards, and when the time comes I’ll still be around to help them stop.

When I am not there in person we use a text message system. I get a text informing me they are prepping a shot, a text when that shot happens, and another one moments later to confirm that they are conscious and responsive. I know my partner well and know how they respond to a given dose. You learn these things if you pay close attention, and this means I can tell if there is a problem immediately.

Knowing their location even when I’m not there I can dispatch emergency services and hopefully save their life those times that I cannot be there to assist in person. It’s not as good as the personal touch, but it still means my partner isn’t using entirely alone and that buffer of safety lets me sleep a lot more soundly at night.

It’s not easy to have this conversation if you lack mature communication in your relationship - whatever that may be. But you need to overcome that and ask the user in your life to inform you when they use. You absolutely must tell them it is okay that they do, but that you want them to do so in a way that is less risky for both your sake. You have to be willing to deal with it when they do, keep an eye out for their safety, both from overdose and unwanted police interaction. If you don’t have the stomach for this I might suggest you step aside and ask someone else close to fill the gap.

Leaving an opioid user alone is potentially leaving them to die, and that isn’t done out of love, it is done out of selfish cowardice. I won’t mince words - what do you care more about, that person or your own squeamishness? Make a choice. A life hangs in the balance.

Get Trained and Carry Naloxone

Through a local public health service I have gone for training and received an overdose reversal kit. This includes naloxone, the syringes to rapidly inject it in the event of overdose, and some documentation letting any authorities know that I am both trained and allowed to carry these products without intervention from the law.

It’s a short process, and it isn’t much to ask if you really care about someone. It’s not only the user in your life you might save - if you carry that overdose kit you’ll be prepared in the event anyone around you overdoses, and in the midst of what we’re calling an “epidemic” despite the fact this problem has persisted for decades, that day might come for you. It’s like knowing CPR, but for opioids.

Combined with the buddy system I have spoken of earlier, an overdose kit is an insurance policy that allows you to keep the user in your life nearly 100 per cent safe. There are always possibilities that you can’t prepare for - hitherto unknown adulterants in their drug of choice comes to mind - but failing some exotic new chemical masquerading as the opioid it was sold as the presence of naloxone on the scene will ensure enough time for emergency treatment to arrive and prevent another needless death.

It’s the last line of defence and if you aren’t holding it for your loved one you can be fairly certain nobody is. You’re leaving them defenceless against a monster that strikes without warning or discrimination. Any user can be felled by a bad dose.

It’s funny that when I was using I never bothered with naloxone because I was always using alone. To be perfectly honest I didn’t give a rat’s ass if I did die, and on many a night when I was riding the line of safe doses I lost consciousness unsure if I would wake up again. It was a risk I was willing to take for me, but when seeing my partner using I simply couldn’t stand back and do nothing. I care much more than I fear now, and I do everything in my power for the person who lights up every morning as I wake beside them.

Hold the Door: Never Push Anyone Through

Part of what drives opioid users into the darkness is stigma. It’s a lack of acceptance. That makes people use alone, use in a risky way and end up fucking dead. It’s not acceptable. People are killed by the lack of compassion, or even outright aggression of others.

Every time my partner has been told they can’t do it, they can’t stop, they’re just a waste of life, it has pushed them further into the dark. I don’t support that approach. It never helped me, and I don’t think it genuinely helps anyone. "Tough Love" is a lie the lazy and uncaring tell themselves to excuse their own abuse of the marginalised. If your love is tough just keep it to yourself. Nobody needs your arrogant proclamations about how you’ll force them to change. We’d all be a lot happier if you just stopped speaking entirely.

I got involved with my partner after I had stopped and while they were still using. That drug isn’t “addiction” to me. It is no different than an insulin syringe, or an EpiPen for an allergy, or nitroglycerine for a heart condition. It is a medical reality in our lives and it is something I participate in managing the risk of because I consider it my responsibility. Just as I would with any other health issue I actively participate in making my partner safer and healthier, and that reduces their stress and my own.

It’s easier to stop when you don’t feel like a pile of living shit. It’s easier to make that transition when there is actually light at the end of the tunnel, real light, and not just a reduction in the amount of gaslighting and abuse that people might dish out. That acceptance has already had a strong impact on my partner’s use and they are moving faster towards the last hit than they have in a long time. Connection and not stigma is making a difference. It might seem like I am “enabling” but in reality I am accepting, and that makes my partner feel less like they need to use, and more like they want to stop.

My partner called themselves a “lifer” when we met. They assumed they would always need opioids to get through the darkness in their life left by past events. Now they talk about “when” and not “if” they stop using. My support has played a large part in that, because instead of feeling like a drug user first they feel like a person who happens to use drugs. That’s a very important distinction, and one which played a pivotal role in my own ability to accept before we even became intimate. To do any less but offer the same would be focusing in the wrong direction and would be evidence that I wasn’t ready for this relationship in the first place.

Just Be Informed

The most important thing is information. You can’t do anything to be there for the person who uses opioids in your life if you're in the dark. You need to ask about their use, see it for yourself, and do the research to know how you can be more help. You aren’t enabling, you’re ensuring their safety. With the constant stress of an overdose threat removed they can focus more on getting better so they don’t need to kill the pain anymore.

Is that too much to ask? If so, then you don’t really care about them as much as you care about yourself, and if that is the case you might as well just get the hell out of their life before you do more damage by focusing inwardly. Compassion doesn’t come with caveats. It doesn’t come with maybes or conditions. True love and compassion are boundless, and extend past even your own fear, anger and confusion. Compassion means asking “what can I do to help?” and meaning it, following through, and maintaining that support however long you have to.

I never ask my partner to stop. I never say “when” during the discussion about quitting, it is always “if”. It must be “if” because my partner is more important to me than my own petty fears and desire to see them put down that syringe for the last time. If it is an obligation it is done for the wrong reasons. If quitting is a choice, and one which is welcomed without question, but never a condition of your love, then it happens that much easier.

If there is an opioid user in your life and you really want them to live and flourish stop looking at them as a user and let them come to their own decision when they are ready. In the meantime just be there for them, watch over them, and always be ready to act to save their life should the sinister spectre of an overdose darken your doorstep.

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