Opioid Dialogues


For 2017 and 2018, Impact is supporting dialogue about the Opioid Overdose Crisis with funding from the University of Victoria.

We have supported and developed various projects so far, and are working to build on and expand these efforts aimed at supporting open dialogue in the realm of this sometimes stigma and judgement-laden topic.

Impact’s Executive Director, Brian Gross, had already been reflecting on the connections between his experience as a gay young person in the 1980’s AIDS crisis and the current opioid crisis, and had written and circulated the following essay, which also accompanied the Opioid Dialogues funding application, which was successful:

Déjà Vu: The Overdose Crisis Looks a Lot Like the HIV Crisis

By Brian Gross BFA, MFA, MC As Executive Director of a British Columbia agency addressing substance use-related risk and harm amid the growing opioid overdose crisis, I’ve had a frontline view of both the carnage and the brave, tireless efforts of professionals.

Having been a “gay” teen in the mid-80s, when Gay-Related Immune Deficiency (GRID) was finally renamed Acquired Immune Deficiency Syndrome (AIDS)—a small, but important step away from a moralistic and toward a “harm reduction” (though the term wasn’t in wide use yet) approach, I’ve also developed a sense of déjà vu.

In 1988, my brother played a role in developing one of the first multitrack digital recording systems. So, at age 19, I had the opportunity to play around in the studio at his office, composing a sound collage with a progression of lyrics that went like this:

Well, it started in the newspapers.
And then it was just someone I knew of.
And then it was friends of friends of friends…
And then it was my friends!
I hope it doesn’t get any closer!

Like with experiencing an overdose, the social tide was pretty black and white on the issue of acquiring HIV. You didn’t have to “hope” it wouldn’t get any closer. If you just didn’t have homosexual sex (or—now—use drugs), there was no way it would.

Is that so difficult?

It took quite a while, but AIDS began to shed its “gay disease” stigma—or perhaps more importantly, “gay” people started to shed the “AIDS” stigma. The stigma was tangled up in stereotypes and judgements about the nature of gayness, like “careless,” “hedonistic,” “depraved.”

I put the words above in quotations because they were used to describe me at the time. I even used them to describe myself. While those words have been disentangled to a large extent from “homosexuals” over the intervening three decades (or at least from white ones—AIDS has always had many faces, some of which have been and continue to be largely overlooked), one could argue they are very much now tangled up in social views on “drug users” (which isn’t to say they weren’t before).

Was I “careless”? I certainly had a lot of sexual partners. At the end of 1992, when the high-publicity devastation of the AIDS crisis was still in full bloom, I reflected on the year, making marks on paper for each person I could remember being sexual with over the 365 days. There were over 500 marks. Do I think this was the “right” way to act… at all… let alone in the midst of the height of the AIDS crisis?

How do I make sense of such “careless, hedonistic, and depraved” behaviour? Even if I used protection almost without fail (which I did), having sex that often and under all the conditions that I did—I was aware of condoms breaking nearly a dozen times. I had to also assume additional condoms had broken with the “strangers” I was having sex with who may not have told me about the failures.

But I again put the word “strangers” in quotations because, though there were rare occasions where the people I was having sex with may have seemed little more than disembodied phalluses and orifices to me… I actually fell softly, deeply, painfully, hopelessly in love over and over again. I craved connection (or at least the endogenous opioids it can evoke), while also dreading it… because I felt incapable of maintaining it. When I talked, I felt like nothing I said made sense. As hard as I tried, my words could not explain or even navigate my behaviours (dubiously assuming that producing words is not also a behaviour). I felt exposed, hypocritical, inadequate when I had verbal intercourse. But with physical intercourse, there were no contradictions; there was no sense to make of it. The only “sense” that sex arguably made was in the role it played sustaining the human race. I had long ago discarded that one—both when I sensed the race was heading like lemmings toward a calamity of overpopulation, and then further when I accepted my homosexuality.

Could I have found another way than sexual intercourse to experience the connection I craved, particularly given the deadly context of the AIDS crisis? The fact is that, in that historical context, even disclosing one episode of homosexual intercourse posed complications. It could render nearly all social/linguistic intercourse problematic.

Admittedly, “problematic” is not the same as “impossible.” It was theoretically possible that I could have attained the connection I was looking for socially/linguistically, even while being upfront. But I can confidently say I was very brave with my “problematic” disclosures. The responses my candor elicited, however, were typically traumatic (even if I may not have recognized them as such at the time—since the experience was so socially normalized)—therefore still frustrating even my diligent attempts to experience connection in other-than-physical/sexual ways.

As I write this, I’m on a plane from my birthplace in the United States to my home in Canada. In 2005, my Indonesian partner and I immigrated from the United States because his visa was expiring and the US government didn’t recognize our relationship. Now, in 2017, the two young guys in the seats in front of me are resting their heads intimately on each other in full view of all the passengers on the plane. While perhaps still sticking out—it would be hard to say their public intimacy is any longer “problematic” or that it inevitably raises the spectre of HIV/AIDS, the way it would have at an earlier time. So, I’ll pivot from homophobia and the HIV crisis to “drug user stigma” and the current overdose crisis.

Fortunately (at least for the purposes of my first-hand account of the two, often-intersecting issues), at the same time that I was hoping HIV “wouldn’t get any closer” due to my inability to refrain from homosexual behaviours, I was also tangled up in drug use behaviours. For me (and many of my contemporaries—a great many of whom are gone), the strain of the fear of AIDS combined with the trauma of being told that if we got it, it would be our own dumb (or worse) fault, made substance use an appealing (if stigma-compounding) option. It arguably dulled our overwrought nervous systems, allowing us to function well-enough to attain what connection we could, as our circumstances might allow.

While risk of death was present with drug use then (and I had many friends who died just so)—until recently, drug use was seen as perhaps more akin to the days when syphilis, gonorrhea, and herpes were the usual sex risks—before the dawn of AIDS.

Today, annual overdose deaths have eclipsed HIV-related North American deaths at any time in history (though, with population growth, per capita overdose deaths may yet have some ground to cover—which, unfortunately, it looks like they soon will). If you question that the social tide of blaming drug users for this crisis is any different than the tide against homosexuals during the HIV crisis, I invite you to find any article about the overdose crisis with a public comments section below it. It’s not fentanyl (arguably the cognate to the HIV virus) or the drug war (arguably the cognate to systemic homophobia) that are being blamed for the tidal wave of deaths. It’s those careless, hedonistic, depraved drug users.

I watch my brave, authentically caring colleagues toil in this crisis, often feeling little support for either themselves or their clients from a public that is either mostly silent or glibly facile with its “They’re getting what they deserve” responses. Writing this is my attempt to acknowledge and thank them. In the AIDS crisis, “gay” men were mostly left to fend for themselves. My substance use services colleagues are the “Dykes on Bikes” and PFLAG (Parents and Friends of Lesbians and Gays) of the overdose crisis.