A Life-Saving Mission: The Importance of Harm Reduction

00:00 Introduction and Narcan Nate 03:25 Challenges in 12-Step Meetings 08:40 Harm Reduction and Narcan 09:40 The Importance of Narcan 16:03 Test Strips in Harm Reduction 19:34 The Presence of Xylazine in Drugs 22:46 Advocacy for Policy Changes 25:36 The Role of Good Samaritan Laws 27:20 Addressing the Fear of Arrest 30:03 The Need for a Safe Supply 31:30 Carrying Narcan/Naloxone 38:40 The Importance of Rescue Breathing

Whitney (00:01)

The sad reality is that we are losing tens of thousands of lives each year due to fatal overdoses. Unfortunately, we will likely always have some number of fatal overdoses. However, it does not need to be anywhere near the number it is today. We can do something about it, all of us. And the thing we can do is to support harm reduction. Now I recognize that harm reduction is not something that everyone supports or believes or thinks is a good idea. It’s a divisive topic. And so I’m going to ask that everybody listen to this episode with an open mind. If you are someone who historically has not been very interested or eager to support harm reduction. In reality, we’re all practicing harm reduction in our daily lives. When you wear a seatbelt or obey traffic laws, that’s harm reduction. Speed limits are harm reduction. When you wear a helmet or put a helmet on your child riding a bike, that’s harm reduction. In the simplest terms, harm reduction is just reducing the risk of a negative occurrence. There’s a lot of stigma though with harm reduction when it’s applied to substance use. And that stigma is causing deaths. As we talk with our guest today, just be open to maybe learning something new. I’m not saying you have to support harm reduction at the end, but maybe you’ll walk away with something that you hadn’t realized. And our guest today is the best person to have that conversation with. He has dedicated himself to sharing accurate information and resources to engage in harm reduction. In fact, his Nickname is Narcan Nate. One really should probably be harm reduction mate. It just doesn’t sound as good. So this guess is really going to help us all understand what we can do in a simple act, a simple willingness to maybe carry a certain Naloxone kit. That’s what we can start doing to reduce the number of fatal overdoses. Thank you all for listening in advance being willing to engage in this conversation with us. Stay tuned and get ready to be inspired as we continue to reduce the stigma.

Whitney (02:41)

Hello and welcome to Reduce the Stigma. Today I am talking with Nathan Smiddy, better known as Narcan Nate. And I’m excited for everyone to get to meet Nate. I have recently found him on Instagram and I think we’re gonna have a really great conversation. So Nate, thanks for joining me.

Nathan Smiddy (02:59)

Yeah, thank you for having me. I appreciate

Whitney (03:01)

I appreciate your time. Just from the little bit I’ve seen on social media, you are a very busy person. And so any of your time, I greatly appreciate it. But let’s dive in. Narcan Nate. I mean, it’s a little bit of a self -explanatory nickname, but maybe not. How long have you been Narcan Nate? Where did it come from? Tell me about your persona of Narcan Nate.

Nathan Smiddy (03:25)

Yeah. So I, when I started doing this work in 2019, I would go to like 12 step meetings and they would have like outside announcements, right? And I would always announce that like I had Narcan and give some statistics and things like that. And my buddy CJ, he used to call me, he would call me Nate with the Narcan is what he would tell you. That’s what he would say. And then one meeting, he just had this epiphany to call me Narcan Nate. And then ever since then, that’s all people called me because it just stopped and it’s just been that way ever since that was in like the middle of 2019 so it’s just stuck ever since like some people just call me Narcan that know me so It’s coming, narcan.

Whitney (04:06)

I mean, Narcan, the thing that saves lives, I think that’s an amazing thing to be known by. So that’s awesome. yeah. Yeah, definitely worse things to be called. But that’s interesting. So you were talking about it in 12 -step meetings, which historically aren’t the most welcoming for harm reduction ideas.

Nathan Smiddy (04:12)

Yeah, yeah, it’s not not a bad thing. It’s fun. Yeah, for sure. I caught some grief for sure. There’s been times where it’s, I mean, I’ve almost been in like some physical altercations over it and some 12 step meetings before.

Whitney (04:41)

And yet you’re, you’re keep bringing that message. I mean, that’s gotta be tough going into a space where, you know, abstinence is typically the focus for 12 steps and saying, Hey, let’s talk about, you know, overdose reversal and saving lives. And yeah, recognizing some people are going to continue using. How do you approach those conversations? Talk about like tough condos.

Nathan Smiddy (05:04)

I mean, for the most part, really don’t hear much about it. Usually, I think the conversation that almost led to being physical, there’s some other factors into it, but they just thought that it didn’t belong there and it thought it was a sales pitch or whatever. they got all in their feelings without ever having a conversation with me. And this dude was like some 20 year old timer who thought he was like put his sobriety time on the table and thought that it mattered to me and it didn’t make a shit to me. And you know, I just told him, I pretty much told him like, well, you’re going to have to have a steering committee if you want me to stop doing this. Like if someone can, it’s an outside announcement. If someone can talk about fucking Domino’s hiring, I can talk about fucking Narcan, you know, if you don’t like it, go fucking change it. Don’t bitch at me over it. You know, and I was like, obviously it makes you look like a fucking asshole to do that. And then I just left it at that and they never did anything about it, you know? And by this point, by that point anyway, it didn’t even matter because I wouldn’t even have to make the announcement. He would just come to me at the meeting and get it. So it really didn’t matter. This is also the same person that’s on like a board for this like this little meeting place and they don’t want to let like unhoused people in the fucking meeting. So like fuck that dude honestly. You can cut that out, but like fuck that dude. Yeah.

Whitney (06:26)

Wow, yeah. So that’s awesome. mean, going in and just getting Narcan out there. So that’s clearly a big mission of yours, at least what I’m gathering is just having Narcan available to people. So you’re at meetings, what else are you doing to get information out there, to get kits.

Nathan Smiddy (06:49)

Mmm. Why support like?I don’t know, maybe like 10 or 12 AA meetings that give out Narcan and like fentanyl test strips. And then, so I really don’t have to do it anymore. It’s just kind of like, people do it. I just supply them and then they do it. It’s kind of like how it’s turned over the years. But I do that. I let people, people that know me can pull up to my house, like as long as I’m not dead asleep, they can pull up and grab whatever supplies they want. I mail it anywhere in the U .S. I’ve mailed stuff internationally before. Last year I mailed out a hundred thousand test strips by myself. And then I mailed, I mailed and distributed like in my free time through a nonprofit, like 24 ,000 kits of Naloxone. And then that’s not counting like what I, whatever I gave out for my day job, you know? So all of that, the mailing and stuff was like either at cost or I’ll cover it typically with like the some of the test strips shipping was bulk towards the end. So like some packages would be like 30 bucks. And so I was like, you got to cover that. Like I can’t, there’s no way I can afford that and like have longevity. But some of that went to like Ireland and like, I don’t know, like every like a couple of countries overseas. Yeah.

Whitney (08:11)

That’s incredible.

Nathan Smiddy (08:14)

And then as a day job, a project manager for a harm reduction college in San Diego. I do like my main priority is to bring resources into like indigenous communities, whether it’s Naloxone or Fentanyl test strips, education, training people, capacity building and like kind of networking with them or going over the best practices, things of that nature. And we also have a liaison that kind of handles that as well. And I kind of make sure they’re up to date on their knowledge. And we do syringe services. We do drug checking with an FTIR machine. So all these are different.

Whitney (08:54)

So Narcan Nate is truly harm reduction Nate, just doesn’t sound as good. Yeah, yeah. That’s incredible. So rewinding a little bit, Narcan, like let’s, and then I want to go down through the other harm reduction things that you’re supporting and advocating for. For people who don’t know Narcan can reverse opioid overdoses. It’s a quick spray.

Nathan Smiddy (08:58)

Yeah, it just doesn’t match.

Whitney (09:23)

In the nasal, there are of course, you know, the version that you can inject into an individual, but the kind of mainstream right now is the nasal spray. What should people know beyond the facts? Like, okay, this is what Narcan is. Why should people care about it? Why should people know about

Nathan Smiddy (09:32)

I mean, it’s one of those things where it’s better to have it not needed than needed not have it. I mean, I’ve come across people overdosing when I least expected it. I remember I did an event and some people grabbed Narcan. They were like, I’ll just grab it just in case. And then like they hit me up a few days later and like, yeah, we narcan somebody at an AA meeting and I was like, yeah, let’s check out like you’ll get high and they go to meetings You know what? mean? Like it’s like we’re whatever, you know I’ve narcan people in porta potties before You just never know you know what I mean, so it’s a simple thing to do and it’s just caring about like human life, you know mean no one deserves to die because they did some drugs like you know, I mean and I’m an empathy for fellow humans. You know, and I don’t know, not everybody’s there. Not everybody has that empathy. Not everybody understands that they’re just as fallible as the next human. we’re all just going through this experience the best we can, you know? And yeah.

Whitney (10:43)

So I’m gonna hit you with some myths, some things that I frequently hear. I personally always have Narcan in my house. I try to keep it on me when I go to certain places, you know, if I’m like trying, going around the city, like on our paths and stuff. Been carrying it with me for, it’s like 2017 is when I first started carrying it. And so I’ve heard a lot of myths as well. I’m gonna hit you with the myth of how about I don’t use heroin. I don’t shoot up, why should I carry it? I don’t need it.

Nathan Smiddy (11:16)

Yeah, well, doesn’t, it’s not about you. People make it about them. Like you don’t narcan yourself, you know? So it’s not, it has nothing to do with you. It’s about caring for your fellow human being. It has nothing to do with.

Whitney (11:26)

Absolutely. How about, well, isn’t it dangerous? Couldn’t I overdose if like, or me or my kid, if my kid accidentally like uses

Nathan Smiddy (11:36)

No, you don’t. You’re not overdosed from narcan. I mean, you might get a headache from it if you dose yourself, but you’re not like nothing’s going.

Whitney (11:45)

And aren’t I at risk if I go over to someone if they had fentanyl in their system? Isn’t that like, by contact I can get impacted by it?

Nathan Smiddy (11:55)

Passive exposure isn’t a real thing. What happens to cops is a psychosomatic experience due to their training. There’s never been a confirmed case with toxicology of them and we could also like look at their levels and I don’t know that there’s a way to like tell what a passive level of ingestion is because it’s not really possible with it but we could compare their levels to someone who’s actually ingested fentanyl and see what their levels look like but it’s never it’s not possible you don’t get high off fentanyl being in the air, you don’t immediately overdose. It would take forever. I think that I know in like 90 minutes in an industrial setting, you get like 100 microgram dose, like no PPE. So that’s like, you’re not gonna overdose. And so most of these stores, they like immediately overdose and stuff like that. And that’s just, that’s not how it works. You don’t narcan yourself. It’s just, yeah, it doesn’t happen.

Whitney (12:49)

Yeah, exactly. And I’m so glad you went there to the first responder because we get these absurd media, like posts and news articles and stuff that are like, this cop or this EMT, you know, interacted with paraphernalia and had a contact overdose.

Nathan Smiddy (13:07)

Thank God that the dollar bill dude that just happened. you see that? yeah. Imagine if I said that like, yeah, I just got high because was on the

Whitney (13:15)

Yeah, right. And I love that you even on your, you have like a link tree on your link tree, you refer out to the, who is it, the American College of Medical Toxicity that says that there is not this danger of contact exposure, that these are, you know,

Nathan Smiddy (13:15)

Yeah, go to jail.

Whitney (13:39)

Misrepresented and that there have been calls for retractions because of the misinformation and the fact that it is contributing to a ton of stigma, a ton of avoidance of having this life -saving resource available.

Nathan Smiddy (13:53)

Mm -hmm. Yeah, there’s been a ton of retractions. The CDC even made a retraction as well,

Whitney (13:59)

I didn’t know that. Look at that. See, it’s just ridiculous because you get these people, you know, that’s what’s going to stick in someone’s head. well, that cop, you know, and nothing against the cop. I appreciate what they’re doing. What the spin on these things, though, is leading to loss of lives.

Nathan Smiddy (14:15)

Mm -hmm. Well, yeah, no one’s gonna respond to someone if they think they’re gonna die from a contact hire just being around it. So these people

Whitney (14:23)

Right, Yeah. And so then kind of going down the harm reduction railroad, let’s go to the test strips. Tell us about test strips. What kind are out there and available? Why are they beneficial?

Nathan Smiddy (14:32)

Mm. There’s an assortment of brands and things like that. There’s a lot of nuance around this conversation. I would say, and I don’t get paid to say this for the record, but I would say the best test strips are, excuse me, I’m trying to think, Grassroots Harm Reduction and Dan’s Safe, probably the two best test strips out there. The xylazine test strips are kind of wishy washy. They have a lot of, like a lot of things that make them false positives and things of that nature. But ultimately the idea is that you can test your substances and you can make an educated decision about, do I still want to take this or do I not want to take this? We have data showing that when people test their substances and they know what’s in their substances, it alters their use to a degree. And so people can use less, they can make sure someone’s with them, they can even toss it if they don’t want it. And so It’s just preventative measures to prevent the overdose from ever happening in the first place is what it’s there for. They’re somewhat expensive, and can be expensive once you buy them in bulk, but typically most cities or states have a way to get them. If anything, you can always go through NextDistro if you have no resources in your area whatsoever.

Whitney (15:53)

Yeah. And so let’s play another round of Bust the Myth. Test strips, doesn’t that just mean that I’m encouraging someone to use?

Nathan Smiddy (16:03)

People use drugs whether you encourage them or not. They don’t even need encouragement. They’re going to do drugs whether there’s test strips available or not. It’s just best practice to be able to make an educated decision on what you’re putting in your body.

Whitney (16:15)

And that’s it, right? Like people think like, it’s not gonna say, and maybe in some cases there’s the whole like, okay, I’m gonna not use this substance because it’s cut stronger than I realize. I’m like, maybe I recently had an overdose, you know, and reversal and things like that. So you’re thinking about it. But it’s to be able to take action. Like it could be making sure a friend’s available or having Narcan in the area, you know, having these different approaches so that the person, yes, if they’re going to engage, they’re going to engage whether we make, we’re passing out test strips everywhere, right? And so, and that’s okay. That’s there. They have that autonomy. What we’re saying is let’s keep them alive as well. And so if this action is going to happen, ensure that it happens in that way that that person can be okay or reduce the risk of the fatal overdose because no one gets better if they’re

Nathan Smiddy (17:10)

Yeah. Yeah.

Whitney (17:12)

Yeah. And so you mentioned xylazine. That is certainly, you know, been trending for a while now. What are you seeing? What should people be aware of about what’s going on? I know you’re out in California, so this may only be reflective of your area, but what are some things that people aren’t realizing about xylazine?

Nathan Smiddy (17:32)

Well, I think that I don’t even know that it’s realizing us that like we find out how this works is like we’ll find out after a drug has been in our local market, so to speak for X amount of time and then it takes our response is going to take like a year or two to respond and by that time we’re like way too far behind and we’re just playing catch -up the whole time. This is typically like how this works with like prohibition and new drugs in the market, etc. but I think it’s more so it’s not even knowing. It’s more so like doctors learning how to treat the withdrawal or places testing for it to figure out in your area if it’s like actually in the drugs or how to treat the necrotic wounds or if someone with necrotic wounds wants to go to treatment or detox, that wound has to be healed before they ever let them in because they’re not going to let them in because they’re a liability. And so there’s all those things like that. That goes into it as well. meaning, typically on this side of the coast, we usually just see like xylazine and opioids. That’s typically the idea is it is supposed to be an opioid because it gives it legs, right? It feels better, it lasts longer, et cetera. But the further you go down the supply chain, like meaning further East, you could find it in drugs that it’s not supposed to be in. It can be contaminated for X amount of reasons. And so just because you’re a non -opioid user, you might still come across xylazine at some

Whitney (19:04)

Yeah. I think that’s a big thing that people who aren’t more intimately aware of, you know, the interaction, like the cutting of drugs and stuff that they miss that, you know, or maybe they’re not thinking about it for themselves or maybe not being as like mindful of maybe a loved one who’s using something. And can you talk a little bit more about how, you know, it can get into things that you’re not expecting xylazine to be in or fentanyl?

Nathan Smiddy (19:34)

Well, so, I mean, a lot of times the media likes to say that the cartels are doing it and things like that. And there was a pilot study done in Mexico and we determined that the cartels don’t do that. It’s bad for business. Like if you get caught doing that, they will kill you. It’s pretty much what the pilot study determined. And then Vice even went down there and did an interview around the same area and they got the same thing. Like, we’ll kill you if you that, So honestly,

We don’t know how drugs really get contaminated. The thing that we know the most is that a lot of times dealers sell more than one substance and they have bad quality control and they don’t clean the scale or the surface or the area. Fentanyl is just a white crystalline powder. So if you have cocaine and you don’t label your bags, you’re going to mix it up. So that’s the things that we do know. A lot of times a lot of things like we we don’t know and it’s okay to say that there has been people in orgs that tried to make bulk purchases along like key distribution routes being like 55 and 80 but the DEA and Hit the high intensity drug traffic. Yeah hit that they’re like no you can’t do that It’s illegal and like they were just gonna buy the they wanted the goal the idea was to buy drugs at this these points and to see at what point were these drugs getting contaminated and was it getting contaminated in bulk to figure out where it was happening at. But they wouldn’t let them do it. And obviously they’re not, yeah,

Whitney (21:02)

Mm -hmm. Why wouldn’t you allow that?

Nathan Smiddy (21:19)

Those eagle buying drugs is

Whitney (21:23)

And was it government agents? Like who was it that wanted to buy?

Nathan Smiddy (21:26)

It was some nonprofit agencies, but there were some people there that were pretty high up as far as in regards to policy and things of that nature. They’re they were known, you know, I mean, they they’re on calls with like hit on the DEA and like all these other key

Whitney (21:44)

Yeah. See, that’s like, and I want your thoughts on this more than I want to say my own. Right there, right? This is an innovative approach of let’s figure this out. And then the laws get in the way of taking action to do something that could be very life saving. And I’m not trying to dismiss, let’s just say screw it to the laws. They cause some challenges at times such as, hey, yeah, we get it. We’re not gonna buy the drugs to use that. Like we are trying to address the problem. are taught, know, everyone’s talking about an opioid epidemic. Well, here’s a way that we could potentially address that. That gets into policy, as you mentioned. Can you tell us like, my understanding is you’re involved, you’re an advocate, you’re advocating for policy changes and things like that.

Nathan Smiddy (22:23)

Well, I mean, dirt, I mean, it really depends on where you live. I mean, locally, I would find out like what

Whitney (22:39)

What are some of the movements that are beneficial or that we need to be pursuing a little bit more?

Nathan Smiddy (22:53)

Good Samaritan laws are, I would find out what your naloxone access laws are because some states you can’t give out naloxone still without a doctor or physician being present. Some states, maternal test strips are illegal. You know what mean? That’s, and that’s just like bottom, that’s not even like, that’s just like the bottom of the barrel right there. It’s just basic, basic shit. And pretty much every state has Good Samaritan law besides Maine. Maine has the best good Samaritan law out of any state. And so, I mean, to get involved, I think you would need to either look at drug policy alliance and see what they’re doing, or if you have a local org, see what bills and stuff they’re supporting, what they’re not supporting. And I think, ultimately, I think it’s education, too, to understand how laws affect the drug trade and supply, which triples down to affecting the people that we love and how that plays a part in it. And then even so, there’s so much to it. Even so, going and looking at other countries and looking at what they’ve done and how they’ve been successful. And then it would be going and looking at the US and seeing, if we implemented these things, how would that look? And why haven’t things been as successful here? And why is that? So that would be just systemics around things that are here that other countries really don’t have to deal with. We don’t have one fully funded armor deduction program in this country.

Whitney (24:30)

And when you say one fully funded harm reduction program, what would what exactly do you mean by

Nathan Smiddy (24:36)

I mean, they’re not every org. And so they’re like getting grants and they’re hoping that when that grant runs out, they have another grant to cover the time between when they were to get the next grant. they’re just like playing off shoestring funding. And it’s typically, typically it can go bad. I mean, a lot of places make it. But they’re all, you know, obviously they’re all like scouring for grants and funding. And it’s just like chump change funding. A lot of people are underpaid, undercompensated for it. And yeah, it’s just not the way it should be. And obviously we don’t have like, we don’t have the infrastructure to have the best potential outcome with harm reduction practices in this country too. I don’t really think, I don’t even like to say that it’ll be like we have harm reduction because we really don’t have harm reduction. We have like a fraction of harm reduction.

Whitney (25:36)

Yeah. And then you mentioned Good Samaritan laws and that Maine has the best one. What does that one look like? I’m not familiar with

Nathan Smiddy (25:45)

I’m pretty sure it’s, you’re covered if you’re, if whether you’re in possession or not, you’re, you’re covered if you’re the one calling or if you’re the one that’s overdose. And I’m pretty sure they don’t, I’m thinking that they don’t violate you if you’re on probation, like for sure. So.

Whitney (26:04)

Okay, wow. And for anyone who doesn’t know why this is relevant, and Nate, please feel free to hop in and add to this. But from my knowledge, what I’ve learned talking to people, if there is an overdose, there’s a fear of calling for help, because who responds? Well, it can be a cop who shows up, whoever the first, you know, responder is in the air, that’s closest. And if you are engaging in an activity that’s illegal, there’s the fear that you will be arrested. So there is that kind of trepidation of, I call and risk being arrested, being thrown in jail, or do I wait this out to see if the person will be able to come back on their own? And so that can lead to a lot of people either calling and like running and like leaving the scene just so that they don’t get in trouble, but their friend maybe does get help or not calling. And that can be an extremely detrimental, you know, hindrance. What else is important to know about, you know, the role that strong Good Samaritan laws play?

Nathan Smiddy (27:20)

I mean, I think you really covered it. That’s basically it. That and some people, think it’s also a thing that’s not talked about a lot, people that don’t use, they’re not used to that sort of life. This is not their thing, just a bystander. They’re worried about giving medication and an adverse reaction or what if they do CPR. They’re worried about a liability or a lawsuit is what they’re worried about. So that’s another thing that it protects for taxing ants.

Whitney (27:52)

Right, right. Okay, right. So if you deliver some sort of care, even if you’re not a professional, you’re protected by that Good Samaritan Law.

Nathan Smiddy (27:59)

If you’re a, it’s different. If you’re a professor because you’re held to a standard, if you have a license, it’s different.

Whitney (28:05)

But if I’m walking down the street and I offer someone care in this situation that we’re talking about, obviously every state’s different, but in general, there can’t be anything negative that occurs to you if you’re just the passerby. However, if you are someone who may be using it with a friend, you could be. If you still have paraphernalia on you, if you have supply on you, and I know there are a lot of cases being charged and then convicted for people being charged with manslaughter and for the death of someone that they were using alongside of simply because maybe they were the one who supplied it that day. And that also is causing a lot of issues, right? We’re not talking about maybe, I don’t think anytime in jail is just a little bit of time, but we’re not talking about like a violation for a weekend. We’re talking about people being charged for their friends’ deaths.

Nathan Smiddy (29:04)

Mm -hmm. Yeah, sorry.

Whitney (29:05)

And I

Nathan Smiddy (29:07)

There was the guy here that got charged, I think he got like, first degree manslaughter for just handing the bag to somebody and they died because the guy, the dealer didn’t know the guy, it was his friends. He just middle -man a bag and got like, first degree manslaughter. Like, you know what I mean? It’s fucking insane.

Whitney (29:23)

And it doesn’t, you know, doesn’t

Nathan Smiddy (29:25)

That guy just lost his friend and his fucking life.

Whitney (29:32)

Yes, exactly. It’s not good. This isn’t the big time dealers. These aren’t the people bringing it into the country. It’s someone, it’s someone that you know, you were just best friends with or occasional friends, whatever it is. But like, that’s not going to end the opioid epidemic. And I think, you know, at least from my perspective, the belief that we can just arrest and charge and punish people we do not want to use is just so harmful.

Nathan Smiddy (30:03)

Yeah, well, I mean what alcohol prohibition creates. It created the biggest organized crime syndicate in US history. I mean, you know, so we’re just literally just reliving history every

Whitney (30:16)

Yeah, and then it’s, you know, it could easily go on a soapbox of what’s the difference between alcohol and other substances, right? I mean, somebody chose alcohol to be okay and everything else not. but alcohol kills too. Drunk driving. 

Nathan Smiddy (30:32)

Fentanyl does. Alcohol kills more people globally than fentanyl does.

Whitney (30:38)

Yes, right. Like people aren’t realizing that they’re not thinking about it because it’s not that fast, immediate kill killer, right? It’s more like a long -term cirrhosis of the liver. Maybe, yes, they’re definitely the deaths while intoxicated, but it’s more long -term. And whereas, this scary thing. And yeah, fentanyl is freaking scary and we should be scared of it and we should be afraid of and we should be providing resources so that those who come into consuming it are able to live and go on with their lives. Yeah, man. And so, you other things that are going, you talked about other countries, there’s definitely, you know, a lot of other countries doing different things. We have Canada who has safe injection sites.

Nathan Smiddy (31:16)

Yeah.

Whitney (31:30)

We have completely different systems in other countries, like the Netherlands and everything. But what are you seeing as kind of, you know, if we could all unite between one kind of harm reduction approach, test strips, syringe exchange, safe consumption, what have you, what would be kind of your ideal?

Nathan Smiddy (31:55)

Well, I mean, here’s the thing, like even with all that, like we’re not going to make a difference until we have like a safe supply until we just like legalize drugs and tax drugs. You know what I mean? Cause that’s the killer is it’s an unsanctioned drug supply, no quality control. You know what I mean? And, obviously like we’ve not learned that we have to look at our society and be like, why is there such a high demand? Why do these people just want to get obliterated on drugs? Most people use drugs, they don’t have any consequences. They don’t develop chaotic use. They’re weekend warriors. They go on coke benders on the weekend, they go to work, and they really don’t have a fucking issue. Maybe later on, their heart’s bad, but they don’t really attain consequences. For example, It’s really expensive to survive right now. So a lot of people are working two and three jobs. Well, they’re probably doing stimulants to be able to work. So just an example of systemic and societal issues. But none of that’s gonna matter if we don’t have safe supply because ultimately that’s what is killing people is an unsafe supply. Meaning, safe injection sites will help, safe supply would help, access to resources, continuum of care. I would say a complete revamp of our health policies here and insurance policies and our approach to public health in general. This for -profit approach is insane. For example, cancer treatment here costs $400 ,000, but I can go to Japan and get it for $44 ,000. So it’s like a classes thing here. So there’s all these variables that go into this, that exacerbate this. And that’s why I said people need to understand things here that other countries just don’t have to necessarily deal with that, it is just here.

Whitney (33:53)

Yeah, and I can’t help but think, you know, we tend to believe that our approach in America is, you know, a little bit better than other countries. We’re really not doing well with our approach to this.

Nathan Smiddy (34:01)

Yeah. Our approach is cops and if like jail or like consequences with law enforcement had like an implication on public health, we would have the best public health outcomes out of any country. I stole that from Ryan Marino, just so you know, but he said that one time and it like lives rent free in my head.

Whitney (34:32)

Yeah, well, I it’s gonna live rent free in my head too, because you’re right, like we have no evidence that it works. It’s just the most accepted approach. 

Nathan Smiddy (34:44)

Yeah. Well, yeah. What people like think it works and it doesn’t work. I mean, some people, some people will, you know, they think it’s their life in jail, but I don’t think it’s because maybe they have a God moment. I don’t know what they have, but I feel like most of the people that I know that went to jail or prison, they were like, I don’t want to come here and deal with all the bullshit in here is pretty much like what happened. It wasn’t because they just, it was like what’s going on on the inside. And they were like, yeah, I don’t want to have to deal with this ever again.

Whitney (35:10)

Right, right. And there’s just a lack of recognition of the person and it becomes so much more about the acts than who the person is. And I was on a panel, man, back in 2017 and it was talking about Narcan distribution. I facilitated Narcan distribution upon release program at our county jail. And someone said, you know, well, I hear that because of all these Narcans being handed out, we’re seeing a rise in people having more than one overdose. And I looked at the person and I was trying so hard to be like, you know, diplomatic about it. I’m on this council or panel and I said, well, yeah, you’re going to have someone who experiences more than one overdose because they’re living. They’re alive. I would much rather have someone who continues to live and yeah, maybe they continue using, maybe they have another overdose and we have to then use Narcan again. They’re alive. If you have someone who dies, you’re not gonna have any additional overdoses from that person because they are dead. You will have nothing else from them. So what’s your point here? Like, why is that something? Why aren’t we just looking at how do we keep people alive?

Nathan Smiddy (36:31)

Yeah. Yeah, that’s a really annoying narrative to put. But yeah, there’s no… They probably think there’s Lazarus. They think people do Lazarus parties too. I don’t know if you know what that is or not, but… So that’s where people think that people go and purposely…

Whitney (36:46)

No, I haven’t heard that term.

Nathan Smiddy (36:51)

Overdose because they have Narcan available and they just do like a bunch of drugs like that so people think like lies with parties are real they’re not but yeah there’s no like access to to naloxone doesn’t people don’t just do drugs because they have like a they call it like a safety net that’s just dumb like no one wants to overdose like no one like it sucks like it’s not fun and getting Narcan sucks so like you don’t want to do.

Whitney (37:13)

Yeah, yeah. so for the, was, let’s go here. We talked about education and people now are more aware of Narcan, but there are some things to know if you are going to be the person distributing or, you know, using it or giving it to someone. What are some of the things that are important to know? Cause you mentioned like, you know, it’s awful to go be revived with Narcan, but what are some of those other things that maybe don’t come in the

Nathan Smiddy (37:46)

I mean, I think it’s always good to notice that like if someone like and this is probably a rare thing but my friend is a diabetic and she’s also on like methadone so she always comes into my mind when I think about this but if her sugar tanks and she passes out someone like people now think anytime something and someone is not responsive, it’s always an overdose, no matter what. So if I was to go and Narcan her, it would put her in immediately precipitated withdrawal on top of that, and then it wouldn’t even do anything for her because she just needs to fucking insulin, you know what I mean? So she just needs to be hit with a pin or shot with insulin. So I always try to think about looking for bracelets and stuff like that on people, you know what I mean? That’s what I try to do. I always keep that in my head because of her. And then it doesn’t tell you to rescue breathe in the pamphlets or on the box or anything like that. And that’s the most important part of the process.

Whitney (38:38)

Can you explain what rescue breathing is?

Nathan Smiddy (38:40)

Yeah, I mean, the rest of the reason is essentially just supplementing oxygen for that. So you’re like breathing for that person, hoping that they don’t suffer any irreversible brain injury because that can happen within like six minutes of an overdose. And people can survive the overdose still within the oxygen administration, but they can be brain dead on coming. And so they don’t live really.

Whitney (38:57)

And so that’s just the breathing part. Like think about what you’re imagining for CPR. It’s just the breathing, not like the chest compressions. One thing that I always, whenever I have been in a situation where I’m educating someone on Narcan, that I always wanted to make sure people realized was, like you said, if someone has opioids in their system and the naloxone is distributed, they are going to go into withdrawal.

Nathan Smiddy (39:15)

Mm -hmm.

Whitney (39:35)

What that does is it basically pulls the opioid off the brain receptors, but it doesn’t like rid the body of it. It kind of, the opioids are still in the body. So the person can then experience another overdose whenever those receptors or the opioids reattached to the receptors. And so you have, it can’t just be like, okay, I revived someone and whatever, like walk away. You have to monitor them because there could be a second overdose or just like other complications. And I don’t think people always realize

Nathan Smiddy (40:05)

Yeah, I think it’s best practice. I always tell people to like to stay with them. I think clinical it’s like six to eight hours. But I think it’s a one in 20 ,000 chance that the opioids reattach to receptors and they fall back out. So it does happen, you know what I mean? But I think it’s just good to monitor them, you know what I mean? But I know that the data shows that we definitely need a better continuum of care. Post, like Post ever does care for sure.

Whitney (40:36)

Yeah. And you know, I’ve never experienced withdrawal. I’ve heard it described and it sounds absolutely horrific and like something I never want to experience. So don’t expect someone if you are there after somebody has been given some, you know, opioid or overdose reversal medication, don’t expect them to be all cheery. They’re going to feel awful. And so, If you’re trying to then talk to them about going into treatment or something like that, I think it’s also important to recognize that they’re not physically not going to be feeling that great. And they just went through a life threatening situation. I’m sure there are going to be people out there who go, well, you know, they did it to themselves. No, that’s like Nate said, no one is using for the goal of overdosing. So recognize what this person just went through, recognize that if they are still using they probably have something else going on, like you said, the stuff on the inside. So let’s be more respectful about that experience and not just say, see, you gotta go to treatment, man. man, no, let’s talk to the person. Let’s just treat them like a human that they are.

Nathan Smiddy (41:45)

Mm -hmm. Yeah, I would agree.

Whitney (41:49)

So as we are kind of wrapping up, before I get to my final questions, I want to just ask you, is there anything else, you are doing so many amazing things, anything else you’d like to share with our audience?

Nathan Smiddy (42:00)

Not that I can think of. If I go and distribute at like shows and stuff like that, know what I mean? Like underground shows, illegal shows. mean, do that. That’s probably the coolest thing.

Whitney (42:13)

That’s pretty cool. Can you tell us a little bit about what that is without anything that would give indication as to where you’re doing

Nathan Smiddy (42:20)

Yeah, I mean pretty much just in LA they have a huge history of like illegal shows whether it’s EDM or like punk shows or whatever and they just do them under a bridge in an alley, in a wherever and I just like show up and give out Narcan test strips as gay people.

Whitney (42:37)

Yeah, that’s wonderful. mean, you’re truly going to where it’s or potentially needed and getting it out there. That’s really one of the best things people can do is just, I don’t know, my approach is if I’m carrying it, obviously one, I want to be able to save someone if I come across that situation, but it also reduces the stigma of accepting a Narcan kit. If more people are carrying it, you know, there would be no stigma of carrying an EpiPen. So why is there Sigma carrying a narcan kit? Let’s just have it available everywhere because anyone can be the lifesaver. Anyone can be essentially a hero for lack of better word. So let’s just, you’re getting it out there and making sure it’s more accessible. And that’s what everyone can be doing is just, you know, getting it, check how you can at your state level. You know, I live in a state that has a statewide prescription, standing prescription. I have gone to the pharmacy and just gotten kits and then handed them out as well. There are lots of health departments distributing them. Like just having it available. You never know when you’re gonna need it. So I just think it’s great that you’re getting it out there in different ways, in different settings and just spreading that awareness. So thank you. Man, thinking about the numbers, 100 ,000 last year you distributed, the amount of lives you’ve probably contributed to saving is astronomical.

Nathan Smiddy (44:07)

Yeah, I guess yeah potentially

Whitney (44:10)

Yeah, and you’re like us. I’m not worried about the number. I’m worried about just getting it out there and making sure people can save lives.

Nathan Smiddy (44:17)

Yeah, yeah, that’s all I think about. Yeah, I don’t think about the numbers or anything. I just do the work.

Whitney (44:22)

That’s man, we need more people like you, Nate. So how can people connect with

Nathan Smiddy (44:29)

On Instagram, it’s narcan underscore nate. On TikTok, it’s narcan underscore nate. If you want to be, do the professional thing, you can find me on LinkedIn at Nathan. My name is Nathan Smitty. You can find me on there.

Whitney (44:43)

Great, we’ll have all of your contact information in the show notes. And as we wrap up, I’m going to ask you my question I ask everyone. If people can only take one thing away from our conversation today, what would you like it to be?

Nathan Smiddy (44:59)

Everyone should carry Naloxone or Narcan. That’s the easiest thing we could all do. The easiest thing they could do, the simplest thing they could do.

Whitney (45:09)

Yeah, absolutely. Check out your state where you can get it. Again, you holding it does not mean anything about you other than the fact that you care. That’s what it means. If you carry a Narcan kit, you’re showing that you care. So carry it, reduce the stigma of carrying it, reduce the stigma of it being available to people. This is true. We saw a little bit of a decline. I believe in 2023 if I am recalling my numbers correctly, and that’s because we’re having more of these approaches. let’s just, again, keep people alive because people can’t get better or achieve their goals, whatever life they want to live, if they’re dead. So get the Narcan Naloxone kits, be aware, learn about your Good Samaritan laws, maybe advocate if it’s not the greatest Good Samaritan law. And just keep spreading awareness and education, everybody. Like this is what we can do. So Nate, thank you so much for coming on today. I enjoyed our conversation and it was, yeah, it was fun.

Nathan Smiddy (46:15)

Yeah, thank you for having me. I appreciate you reaching out. Totally enjoyed it.

Whitney (46:18)

Absolutely. All right, well everybody, thank you so much for listening. Please share, comment, subscribe, get this message out there so we can continue reducing stigma surrounding substance use, mental health, and all the other challenging life experiences we all go through. Thank you for listening.