NORTHAMPTON — Several days ago, the Harm Reduction Hedgehogs 413 got a call about an overdose.
That evening, a man reported that his wife had taken opioids after back surgery and drank wine, the group’s co-founder Jess Tilley recalled. He realized she was overdosing, but “he was terrified of calling the police because he thought they would arrest her,” said the group’s other co-founder, Albie Park.
Tilley talked him through rescue breathing over the phone. The family had Narcan in the house, and when an outreach worker arrived, the woman was revived, and the outreach worker was there to help. “It’s terrifying to watch someone you love overdose,” Tilley said.
Harm Reduction Hedgehogs 413, or HRH413 for short, is an organization that does outreach to drug users in western Massachusetts, advocates for changes to drug laws, and created a model for support meetings called Harm Reduction Works.
The group responds to overdoses when someone feels calling 911 isn’t an option for them. Under state law, someone who overdoses and seeks medical attention will not be prosecuted for possession of a controlled substance, but some people have reasons for being nervous — some people who call are worried about losing their housing, or are college students worried about losing a scholarship, Tilley said.
HRH413 was founded by Park, who lives in Easthampton, and Tilley, who lives in Northampton. Tilley used to work for the Cambridge Needle Exchange and does consulting work. Park, educated as a social worker, worked as a counselor at The Stonewall Project in San Francisco, a drug and alcohol treatment program that uses a harm reduction approach, before he moved to western Massachusetts.
The National Harm Reduction Coalition defines harm reduction as “a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use.” It’s also a social justice movement to respect the rights of people who use drugs, the coalition says. Park and Tilley, the HRH413 founders, have decades of experience practicing harm reduction and saw the need to form the organization.
“Harm reduction at its heart looks around and sees whatever the system isn’t doing and the way it makes people suffer and we try to do something about that,” Park said. He added, “We gotta help ourselves — that’s the spirit of harm reduction. It’s a movement.”
The group has received grants from RIZE Massachusetts and AIDS United and gets its name from Tilley’s experience raising hedgehogs, which she says on the group’s website “are all prickly on the outside but soft and gushy underneath and they have four little feet, like boots to the ground … kind of like harm reductionists.”
When Tilley was more than five years sober, she said it would have been “social suicide” to say she felt like using drugs in a 12-step program like Narcotics Anonymous. “I was considered to be an upstanding member of NA,” she said. She felt like she couldn’t talk about it, she started to use again, and she almost died, she said.
An alternative approachTilley and Park wanted to develop an alternative type of support meeting, and they developed a script for Harm Reduction Works.
“The reality is, substance use disorder is complex,” Park said. “People come in needing help at all sorts of places.”
Park and Tilley are happy the 12-step programs exists and it does work for some people. “We are ecstatic about that. We don’t challenge it. We don’t deny it. We celebrate that,” Park said. But, “it doesn’t work for everyone.” For Tilley, “I probably would be dead without Narcotics Anonymous,” she said.
With strict abstinence programs, Tilley said, “People were falling into the gap and dying,” she said, adding that abstinence can be part of harm reduction and both types of programs want the same outcome: for people to be healthy and alive.
When the duo held their first meeting in March 2019 at Northampton Recovery Center, they didn’t know how it would go.
“That first meeting blew my mind,” Tilley said. “What was so prevalent in that room was the amount of grief and anger that our community had and (they) wanted an answer and wanted to get involved.”
Park added, “the amount of grief in our community as a direct result of opioid death is astounding ... it’s not just one person. Everyone who dies ... there’s a family, there’s friends, there are coworkers.”
There also are people who are abstinent who come to meetings and erasing stigma is a major goal. At an early meeting, Tilley recalled one of those people saying to her: “I’m so thankful for the first time I don’t have to say I’m an alcoholic, I’m an addict.”
Over the past two years, the Harm Reduction Works meetings grew and Tilley said participants had to stop doing introductions because they took too long. When the pandemic drove the meetings online, it fueled the group’s growth. There are people from Vancouver, Arkansas, Georgia, New York, and California attending meetings or starting their own, Park and Tilley said. A schedule of meetings can be found at https://linktr.ee/hrw.
“Friendships have evolved from this from all over the country, and we’ve got international interest,” Park said.
Avi Yocheved, a counseling student in Oregon, started coming to virtual meetings after she heard Tilley and Park interviewed on Narcotica Podcast, a show about drugs and drug users. Harm reduction, she said, “really helped me, and I think saved my life.”
Initially, Yocheved started going to Narcotics Anonymous meetings. “I found it somewhat helpful because you get to talk to other people,” she said. But, “I soon found it very limiting because the vision they had, they wanted me to say, ‘I’m never going to drink or use drugs again.’”
Yocheved started seeing a counselor who took a harm reduction approach. Instead of saying “we have resources here when you want to quit,” she recalled, the counselor asked if she needed safer use supplies and spent many sessions talking with her about her trauma and mental health issues.
“I didn’t have to wait until I hit rock bottom,” she said of getting support. “Eventually I was at a place where I didn’t want to be doing street opiates anymore.”
Now, Yocheved is pursing a degree in counseling with the goal of becoming an advocate for people who use drugs. She’s been going to Harm Reduction Works meetings for several months. “I wish that everyone in every city had a local Harm Reduction Works meeting,” she said.
‘Holes in the system’The Harm Reduction Hedgehogs 413 also has a number of paid outreach workers — people who have experience with drugs — and some volunteers that do work in Berkshire, Hampshire and Hampden counties. The group recently had eight people working for it, and has had as many as 14 members, Tilley said.
“They carry, primarily, safe supplies,” Tilley said. “Anything that’s going to decrease HIV, hepatitis, any blood-borne pathogens.” Last year, the group distributed a million syringes, about 80% of which were returned, according to Tilley. They also give out fentanyl test strips and carry hand warmers and tents for houseless people, she said.
The group also will help transport people to a detox bed. “One of the major holes in the system is someone can get a detox bed … and they can't get there,” Park said.
Amid one public health crisis, another one has been forgotten, Tilley said. “It seems like in the midst of COVID, the overdose crisis has been forgotten. Our overdose rates have started to rise. People who I never thought would relapse would relapse.”
According to the Massachusetts Department of Public Health, “opioid-related overdose deaths in Massachusetts increased slightly in the first nine months of 2020 compared with the same time last year.”
‘I can’t lose a child to abstinence’The group has been doing a lot of work with mothers, Park said. “There is a whole bunch of moms that know this whole tough love thing that they’ve been told to do does not work," he said.
Six years ago, Leah Finch’s son, Sean Finch, died in a substance-related car crash. It was his twentieth birthday, and he was leaving a fraternity party at UMass. “I couldn’t even look at the toxicology report at the time,” she said.
“(It’s) six years later so I can talk about it,” she said, “but it changed everything.”
In the years since, Finch, an Easthampton resident, has changed the way she approaches dealing with her children’s substance use, like with her son who has substance use disorder.
“My initial approach was really super hard like if you show up and you’ve been drinking you need to leave,” she said. “Now my approach would not be that way at all. And every situation I make a decision instead of having a hard line now. That takes a lot more work.”
The “tough love” approach and saying you’ll let your kid sleep on the street, she said, “maybe it makes some people stop, but it doesn’t make everyone stop.”
Park and Finch are close friends, and he introduced her to harm reduction. It took a while, but eventually, she decided, “I can’t lose a child to abstinence.”
“When he needs help he can call me. … he knows he can call me and I’ll be there no matter what. That’s very counter to popular culture which has been: let people hit rock bottom. Bottom has become death,” Finch said.
Finch now volunteers with HRH413 and has helped start a Harm Reduction Works meeting for parents and caregivers. “When you’re a mom and your kid suffers, you have to be able to try to set some boundaries. But at the same time, you never stop caring for your child.”
Her volunteering includes driving people to detox and her house has become a storage space for supplies like tents that HRH413 gives to houseless people who need them.
Before the pandemic, she would host wine and cheese nights for parents. “Parents don’t know what’s really going on in school … cocaine was going around Northampton High School a few years back.” They would talk about how to talk to your kids about drugs and get parents talking to each other. “We believe connection is the opposite of addiction,” she said “That’s something people in harm reduction would say.”
Some people think Finch is jaded, she said. “There has been a little bit of pushback,” she said.
But, the harm reduction approach has been helpful for Finch and her son. “He has a girlfriend and a nice home and he’s able to be employed,” she said. “He’s still here — most of his friends aren’t.”
Finch carries Narcan in her purse, and gives it to her kids, too. About a year ago, her son helped save someone’s life with Narcan in downtown Northampton, she said. “It was worth all my talks to them,” she said.
Jessica Blanchard, a former nurse and now teacher, lives in southwestern Georgia in Dougherty County and had an experience similar to Finch. Her daughter uses drugs and she’s been going to Harm Reduction Works meetings for several months after she found out about them on Facebook. “I go every Tuesday. That’s like my church,” she said.
“I’m the mother of a daughter with an addiction to heroin,” Blanchard said. “I had tried the tough love. Tough love didn’t work.” Her daughter couldn’t come home until she was sober, for example.
“While I held that stance, my daughter overdosed seven times,” Blanchard said.
She changed her approach and started ordering needles off of Amazon.com and giving her daughter Narcan. “If you’re going to do this can you just not die?” she said. Since her approach changed, “I hear from her every day,” she said. “Her use is much less chaotic; she has not overdosed again.”
Blanchard also has started regularly packing up her Jeep and driving around her area to give drug users safer use supplies.
Not everyone has been accepting of Blanchard’s approach. “We do anything other than tough love we’re accused of enabling which is such a bull crap word,” she said. “I’ve lost all my friends.” But, she’s been able to find community at Harm Reduction Works meetings. “You go into a meeting you automatically feel a connection,” she said.
Finch encouraged anyone interested to come to the Harm Reduction Works meetings. “Everyone is welcome whether you’re using, not using, lost a friend … You’re welcome to come to the conversations.”