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‘It’s Quit or Die Out Here’: Why I Run This Michigan Harm Reduction Support Group 

By |2022-05-31T11:12:39-04:00May 31st, 2022|Opinions|

I had a friend who smoked meth up until the day she died. Skyy was a transgender woman and a daily meth user for the entire time I knew her. When she was diagnosed with stomach cancer, she continued to use methamphetamine. In traditional recovery programs, it’s not possible to be friends with people who are using, but I decided to continue being her friend.

I was one of the only friends she had left when she died. In Harm Reduction, we don’t have to abandon our friends and family in need. We don’t have to make being clean a prerequisite to friendship. Friendship was all Skyy needed. She didn’t need me to help her get sober. She didn’t need me to help her stop doing meth. At times, I would even do it with her despite her being in the late stages of cancer — because I didn’t want her to feel alone, and because I myself was using methamphetamine at that time. Since that time, my substance use goals have changed, and I am practicing abstinence from meth. 

In our community, particularly here in Metro Detroit, we lack good Harm Reduction programs. These programs are vital to the survival of the people who choose to use substances. We deserve to be supported. Harm Reduction is a global movement that brings real, meaningful change to the substance use and misuse community. To call it substance abuse is counterproductive and it demeans the person.  

My own personal journey through substance use and misuse has helped me understand that there is no one-size-fits-all approach to substance use, misuse and management. Abstinence is not the only way to approach substance use goals. We believe in self-determination. This movement is not about prescribing a philosophy; it’s about meeting you where you are, and asking you to decide what your goals are. Without judgment. Harm Reduction is quite simple, really. The goal is ultimately to do less harm to oneself.  Less harm is useful for everyone.

Maybe Jeffery Montgomery would not have died alone had we, as a community, embraced Harm Reduction. I knew Jeffery many years ago, when he was the executive director of Triangle Foundation, now Equality Michigan. My brief friendship with him left a lasting impression, and I was sad to hear of his struggles with substances at the end of his life. I admired and respected him for the leadership and contributions he made to our community by standing up for victims of sexual violence and human trafficking, among many other human rights issues. Jeffrey’s story is why we, as a community, so desperately need Harm Reduction at Affirmations and more broadly in our community.  

I had heart valve replacement surgery in 2019. This surgery was a wake-up call to me, because I realized that I had caused the infection that destroyed my aortic heart valve when I was intravenously self-administering methamphetamine years earlier. I survived because I realized I had gone too far and decided to stop using this substance. I could not quit cold turkey because my depression was so severe as a result of years of continued use and misuse of that substance, that I had to slowly come off it. There is no guidebook on how to reduce meth use, and many doctors and therapists alike will tell you that it’s not a substance that can be managed. And yet, I managed to stop using it progressively.

The Stonewall Project in San Francisco introduced me to Harm Reduction. I joined support groups there. This resulted in me doing less and less harm to myself. I slowed things down. I learned to drink water, or at least eat something. I learned how to safely use needles to avoid infections like the one that I had contracted.  

Harm Reduction saved my life by bringing me out of my relationship with methamphetamine. I have all the respect in the world for 12-step, abstinence-based programs. But there has to be room for more than that. There are millions of people who do not fit into the AA model of sobriety. Where do we get support? Right now, there aren’t many spaces for people who choose to use substances to get support. It’s quit or die out here.

I choose to remember my past, but I refuse to fear substance use. Instead, I try to make better choices that don’t harm me to the point where I have to be afraid of relapsing. I am not afraid of relapse, because I have created a healthy relationship with most substances. There is no shock in coming into contact with them, which makes it easier to manage relapse.

Like many, I deserve to be supported even though I choose to use substances. That’s the human response to what is ultimately a personal choice. Substance use is a choice. And how you participate in that choice is only as good as how informed you are about it.  So, don’t prevent education on safe IV self-administration. Don’t abandon someone who might be in the midst of having a substance use crisis. And don’t demand that they meet you on your terms when they’re the ones who need help.

I have learned to replace methamphetamine with marijuana, magic mushrooms and other naturally occurring substances that are far less harmful than meth. And I’m satisfied with the results of this endeavor. I’m currently in a master’s program for cybersecurity, and I’m a very successful software engineer.

The key to using substances responsibly is access to drug-testing kits, access to Narcan (a life-saving medication that can reverse an opioid overdose) and access to education about what substances do, how they can be lethal and how they can be used responsibly. Armed with this knowledge, it is possible to be responsible and safely use substances.

This is why I have chosen the path of less harm, over no harm.

The Harm Reduction Clinic is every second and fourth Wednesday of the month at 5:30 p.m., and the Harm Reduction Support Group is at 6 p.m. on the same days. He encourages anyone struggling with substance misuse who wants to change their substance use goals, or just wants to hang out with other like-minded people, to drop into the clinic and take advantage of the many services offered there and share stories. Healthy snacks and water will be provided.

About the Author:

Amrit Kohli is a volunteer at Affirmations, a community activist, singer/songwriter ( and immigrant refugee from Kenya who thanks Affirmations for being willing to host a Harm Reduction clinic and support group at the center.
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