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Contingency Management

May 01, 2025
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The first time I heard the term "Harm Reduction" was from a straight male meth dealer.

I was later in my active use when my mom brought me to West Virginia to get my life together.

This guy needed someone who could 'hit a vein,' and I needed free drugs. So, our relationship was transactional and chaotic.

(You'll have to wait for my book to hear more about that shit show.)

The first time we used together, I saw him lay out a case holding fresh needles, cotton swabs, and alcohol wipes. 

I watched in confusion as he prepared a needle for me. 

"What is this?" I asked him.

He went on to show me packets of fresh sterile water, how to prepare the site for injection, and then he ran the meth mixture through cotton.

I was confused. Is this how the straights do it? 

After years of intravenous meth use with hordes of gay men, I had never once seen any safety precautions used. 

He even introduced me to the local needle exchange, something I had never heard of. 

Perhaps this is only my experience?

But, why did it take a straight man to show me how to safely inject? Why were none of the gay guys doing this? 

I don't have an answer for this. But, for me, this experience was one of many showing me the stark differences in meth use characteristics between men who have sex with men and straight-identifying men.

This also showed me that we must provide harm reduction education and services to our LGBTQIA+ community. And today you'll hear about one of those services.

I'm happy to use this podcast as a platform to advance the cause. 

Enjoy today's episode with Tyrone Clifford! 


Listen to the podcast HERE

Watch the podcast HERE


Understanding Harm Reduction

Harm reduction isn't a separate approach to recovery—it's an umbrella that encompasses all approaches. Whether you're practicing abstinence or managing your use, you're engaging in harm reduction.

"Abstinence is harm reduction. What better way to reduce the harm than to abstain completely." - Tyrone Clifford, Program Manager of PROP at San Francisco AIDS Foundation

Key principles of harm reduction include:

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