“Is harm reduction enabling?” Myths vs reality (with Sarah Laurel)
About the Episode
You’ve probably heard it before: giving someone housing, food, or money while they’re using drugs is “enabling.” Or that using Suboxone or methadone means they’re not serious about recovery. In this episode, harm reduction advocate and person in recovery Sarah Laurel breaks down why those ideas are not only wrong—but dangerous.
Sarah shares how her mother’s steady support and her evolving relationship with her siblings helped shape her path to recovery, and why she chose abstinence while still championing harm reduction for others. She also talks about her work with Savage Sisters in Philadelphia—supporting people who’ve survived overdoses and helping families take meaningful, compassionate action.
If you’ve ever questioned what “help” really looks like, or worried that support means sacrificing boundaries, this episode is for you.
Guest: Sarah Laurel, founder of the nonprofit Savage Sisters
After recovering from substance use disorder, Sarah sought to offer resources to women like herself. What began organically grew into a program providing housing, street-based outreach and nationwide training with the start of Savage Sisters. Sarah is the recipient of several awards, including a Congressional Medal of Honor. She was featured on two Emmy award-winning episodes of Vice News and CBS News with Jessica Kartalija. Additionally, she created the first Xylazine training, delivering it both locally and nationally. Her advocacy for people who use substances, harm reduction, public health, and social justice has been consistent and groundbreaking.
This episode will help you:
Understand how isolation can push someone further into addiction
See how siblings can be supportive without compromising their own boundaries
Find connection in another sibling’s experience, reminding you you’re not alone
Watch Now
Episode Links
📘 SAVAGE SISTERS
LEARN MORE ABOUT HARM REDUCTION
SAFE USE HOTLINES
Resources
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Sarah: [00:00:00] We wanna keep the humanity in all of our loved ones alive. we're all worth saving. It's okay to love them along that journey.
Dominique: Welcome to FLOR For Love and Recovery, where I'm your host, Dominique Dajer. Sibling relationships can be so unique, but they can become more complex when there's drug or alcohol use involved. If you find yourself questioning how to help, you're not alone.
Dominique: Every month we bring together stories that empower you to better navigate your sibling's addiction, offer a sense of connection, and provide fresh perspectives on understanding substance use and how to protect your peace. Join me on this journey in restoring hope and healing.
Dominique: [00:01:00] When I first learned about the severity of my brother's addiction, it felt like abstinence was considered the only form of recovery, until I learned about harm reduction. But I didn't understand the various forms of harm reduction and the role that it plays in not only saving lives, but helping people find a recovery path that works just for them.
Dominique: So in this episode, we'll get into what exactly harm reduction is and we'll address some of the common misconceptions surrounding the addiction and recovery community today.
Dominique: To help us separate myth from reality, we have Sarah Laurel, who's the founder of the nonprofit Savage Sisters, a harm reduction and street outreach team based in the Philadelphia area.
Dominique: So Sarah, thank you so much for being on the show today.
Sarah: Thanks for having me.
Dominique: I'd love to open up and ask you to tell us a little bit about your personal story with substance use and recovery and the work that you and your team do at Savage Sisters.
Sarah: I am born and raised in South Philly and I have nine [00:02:00] siblings. And I don't have crazy trauma that I grew up with. Just your typical poor family. I was prescribed opiates for carpal tunnel and that led me down a pretty intense pathway that landed me unhoused, addicted to substances. I was an IV drug user.
Sarah: And I experienced some trauma physically and ended up in Jefferson Hospital for a few weeks and then was in a wheelchair. And that is how I started doing Savage. The name comes from a dress that I was cut out of and I still have it actually. It's right there, the savage dress. And, I just wanted to create a safe space for women in recovery, and then it evolved organically over time as I started [00:03:00] doing this work and some really incredible Philadelphia mentors in harm reduction taught me the way.
Dominique: I love to hear that and I love to hear that you're also like focusing on the community that you've been a part of for so long.
Dominique: You've been very vocal about your relationship with your mom during your substance use and what that looked like for you, and understanding that your mom played a very important role in the type of support and care that you got while you were in active use.
Dominique: Could you share with us a little bit about what the role was that your mom played and why it was so significant for her to be a part of your life during this time?
Sarah: Absolutely. so to give a little bit of background, my mother and I did not have a good relationship when I was growing up. We were not close. I had a lot of younger brothers and sisters. We did not have healthy communication. So when I started using substances, I [00:04:00] confided in her and I really wasn't sure how it was going to be received.
Sarah: I do have substance use history in my family and her brother passed away from an overdose, so. She understands substance use on a greater level. My grandfather was also 44 years sober when he passed away, so I did confide in her and was not sure how she would respond, and I. It was a huge blessing in my life that she jumped right in and tried literally every different way to support me.
Sarah: I was humbled and really grateful that she responded that way, and it started out with. So many different things. Talking about it being nonjudgmental, she was stunned that you could see the shock in her eyes when I was explaining to her what was going on, what I felt like, what my behaviors were.
Sarah: And it was a real [00:05:00] 180 from the corporate professional that I had become. So after we got past the shock value of what I was doing. she stuck by my side and I mean, hours and hours of sitting with me through intake processes, hospitals going in and out of treatment, going to jail. She visited me regularly.
Sarah: She always answered my calls. And then finally when I was, you know, running in Kensington. She always picked up. I always called from a random number. I didn't have a cell phone. And I would tell her what was going on in my life. And we had gotten to this place where my family really didn't want me using substances, and I kind of gave up and was like, well, I'm going to do this.
Sarah: And I remember one of my brothers saying, well, don't come if you're gonna be using drugs. And I said, then I won't come. You know, I had gotten to this place where I was no longer going to lie to my family, and I felt like they were. Going to have to get used to it or lose [00:06:00] me. And the only person that stayed and was like, okay, well let's get a meal together.
Sarah: Let's have a conversation. Let me fill you in on what's been going on with the family. Was my mom. Up until today, she's always been my biggest support system.
Dominique: I love to hear that. I've actually, you know. The sibling dynamic and like the family dynamic has resonated with me and my brother who's been struggling for some time. And a lot of the feedback that I've gotten from outside sources is that no one's ever going to change because of one relationship they have.
Dominique: And I think what I've seen time and time again is actually the complete opposite, is that. People might not necessarily change because someone is telling them to do so, but there is so much influence that these relationships can have, whether it's like familial or personal or if you're doing street outreach.
Dominique: What have you've seen to play like a very important or positive role in someone's life when they're in active [00:07:00] use.
Sarah: Staying connected. Just staying connected in a non-coercive manner. Being that there's so much controversy around how do we respond, how do we behave, how do we support? the humanity that comes from just coming down and meeting people exactly where they are and not having this shocked face or saying, oh, you look like you need help, and just saying, how can I help that free of judgment, free of enforcement and just asking individuals, what is it that I can do to support you? I've seen it across so many different relationship levels, parents, siblings, friends, family members, and just community members, and I think we have the capacity to do that. We just haven't been trained by society to do that with our community members or family members.
Sarah: We've been told that we have to control them.
Dominique: Right. There's a lot of like relearning and like unconditioning that we have to do like [00:08:00] within ourselves on that.
Dominique: When we're talking about harm reduction, I think there's a lot of different definitions of harm reduction floating around, could you explain what exactly harm reduction is and why it's so stigmatized today?
Sarah: So by definition, harm reduction is public health policies that reduce the negative impact of potentially dangerous behaviors, and that means disease prevention and access to healthcare, access to housing. Some of those negative behaviors could be substance use, they could be survivor sex work. They could be a number of things.
Sarah: And when I say substance use, don't forget that alcohol is included in that. So we have to remember that legality of substances doesn't change the way that we address the reduction of harm when it comes to those substances. I think it's become this very bastardized term in, and it's politicized as well.
Sarah: Really, it's just understanding [00:09:00] that people are going to do certain things. They're going to use substances, they're going to have sex, and we wanna make it as safe as possible so that they don't have long-term consequences. Obviously there's always risk involved. We're not, you know, removing harm completely.
Sarah: We're just reducing it.
Dominique: Something that I always share when it comes to harm reduction is like we practice harm reduction in different forms every single day, right? Like, it's not just pertaining to substance use, it's pertaining to like putting on your seatbelt when you get in the car or airbags in your car, and things like that.
Dominique: There's always a risk, but we wanna reduce it as much as possible. So thank you for sharing that, especially from like the public policy point of view.
Dominique: I wanna move into talking about some like the top misconceptions that are just floating around the community. So for these specific myths, I actually posted a poll in a couple of different Facebook groups that I'm in around harm reduction and recovery. And I asked people to vote on what are some of the top myths that they hear the most. And [00:10:00] I wanna go through a couple of them, and would love to hear like what the reality version of each of those is.
Dominique: Myth one, "harm reduction normalizes and encourages people to keep using drugs." What's the reality on that?
Sarah: Using drugs is normal, that people don't wanna acknowledge that everybody uses drugs, whether it's caffeine, nicotine, alcohol, or illicit substances. Everybody that I know uses some form of, substances at a certain time. There's also pharmaceutical substances. So I think we need to stop pretending like substance use isn't normal. The same way back in the day, abstinence when it came to sex was taught and it was this very taboo subject, but everyone has sex.
Dominique: It makes me think about like back to health class in school. It's like everyone's practicing or preaching like not to have sex. And it's like at the end of the day, there's still gonna be teenagers [00:11:00] having sex, but like, let's reduce the chance of them getting hurt, the chance of them getting pregnant or the chance of like transferring STDs.
Sarah: We have to get rid of those pearl clutching moments where we're so offended by this transparency. Be authentic and be honest with our community members, and we can actually make change if we're that way.
Dominique: I think it's the same ideology, but it's how we're putting it into practice and all these other areas, including with drug and alcohol use, like this very stigmatized area.
Dominique: Myth two, "showing compassion or maintaining connections and providing basic human needs such as food or shelter or housing is considered quote, 'enabling.'"
Dominique: What's the reality?
Sarah: It's a human right to have access to shelter. And this is a first world country. So prioritizing those basic human needs of food and shelter and healthcare access should always be [00:12:00] a, a pillar of every community. And when we speak negatively about it and use the word enabling in it with that negative connotation, it makes no sense to me.
Sarah: Why wouldn't we want to enable somebody to have a home? Why doesn't every human deserve a roof over their head, especially in this modern day. This is, this should not be a controversial topic. Housing, healthcare, and food. Those are not luxuries. They're human rights.
Dominique: Absolutely. One of the common things that I've heard around this quote, enabling, which I also don't like to use, but I feel like it's so ingrained in like traditional thinking, is people need to quote, "hit their rock bottom" before they're willing to make some kind of change. So providing things like food or shelter or whatever other form of support is actually hindering them from that [00:13:00] process.
Dominique: Does it actually have a role in enabling someone and encouraging them to continue using and not quote, hit their rock bottom?
Sarah: A couple of things here. First of all, rock bottom is death, in my opinion. Not some tragic thing. A lot of people try to use my story because I went out a second story window and you know, had, was in a wheelchair and they're like, that's your rock bottom story. No it's not. I was in a very low place for a long time and I have a lot of friends who didn't lose their housing and didn't go to jail.
Sarah: Had food, had jobs and their lives were unmanageable and they needed real help and support. So when we teach this narrative of rock bottom, we're almost inviting chaos and trauma into people's lives by saying, "it's not that bad yet." It's as bad as you want it to be. And we have to allow people to have that story and the idea that depending on what substance you use that you no longer deserve, food and [00:14:00] shelter is archaic and cruel. I don't understand how they correlate to each other. I think that we need to step away from that mentality and we need to step back into the humanity. I don't want anybody to have to hit rock bottom. I want them to know that they have resources and support and I want them to have shelter.
Dominique: Absolutely. I love that you mentioned it's a basic human right.
Dominique: When someone is ready to start their recovery journey and looking at treatment options, maybe detoxing right away isn't right for them, or they're not sure like what the right path is.
Dominique: There are so many more options than traditional inpatient like mat, right? Medically assisted treatment. There's suboxone, there's methadone, there are several other approved medications.
Dominique: What is your general perception on how getting off MAT is typically even harder than other drugs? A lot of people discourage it for that reason, but what's the [00:15:00] reality in that?
Sarah: Different people have different experiences, so when it comes to MAT, it is a lifesaver for people who are coming off of illicit substances, that it's a toxic drug supply. So for them to transition into MAT, it's safer for them. And then that journey of stepping off of it if and when they get there, is different for every person.
Sarah: Acute withdrawal symptoms happen from sSRIs antidepressants, they happen from any type of substance that you take on a consistent basis. The ones that are centered around opioid use disorder get so much more attention and negative feedback.
Sarah: I think it's interesting because it is the safest thing for our friends. You know, it's the gold standard. Of course they're going to experience some negative physical effects when they come off of any substance. I do think that it is used by abstinence [00:16:00] only teachers to prevent people from utilizing it.
Sarah: I'm not a medical professional. So I would defer to medical professionals and say, "what do you recommend?" According to them, they recommend it and you can taper down slowly. And it saves lives. I know it saved many of my friends' lives, so I'm in full support of it, and I think that we need to stop utilizing negative experiences to try to deter people from getting access to it.
Dominique: Um, Which brings us like the next myth-- for folks who are using mat, do you feel that using MAT actually hinders their opportunity to be abstinent from drugs or alcohol, or do you feel like it actually aids them in that process if that's something that they're looking to do?
Sarah: If they're looking to be abstinent, I think that's the key point here is what is it that they want for their lives? 'cause there's some people that will be on MAT for years. but if we're Going off of this example that this person wants to get off of illicit [00:17:00] substances, get onto MAT and then become abstinent, I don't think that it would hinder them at all.
Sarah: In fact, I think it would help stabilize them and get a foundation set up in their lives where they have mental health support, they have community support, and start recreating a life that really feels good to them and then they can slowly make that transition.
Dominique: That makes total sense. it's more of like a stepping stone rather than like an end all be all for everybody.
Sarah: Yeah, and I wanna point out, I have 11 houses, so I've had a lot of people kind of under our care in the housing program over the years and. I've talked to my friends a lot about this. I think it's very interesting that both from the societal viewpoint and our own internalized stigma, you're talking about people who may have been using substances chaotically for five years, 10 years, 15 years, sometimes 20 to 30 years.
Sarah: If you spent 20 years using substances, you have to give yourself time to go through different steps to recreate your life. We as a [00:18:00] society cannot put this unrealistic expectation on them to just be abstinent in heartbeat. This is a process. We cannot put the expectation on them to get everything together within six months.
Sarah: It's not healthy, and what we see people returning and it becomes lethal because they don't have this foundational beginning that gives them the time to process this because it's a huge shift in their reality, in our reality.
Dominique: Absolutely. And I think there's a lot of misconceptions that you're replacing one substance with another. the addiction form and the dependence form are two totally different concepts.
Dominique: You using this approved medication to actually help you in your recovery, you being dependent on it is not making you addicted to it. without having that strong foundation., not having this tool or this resource in your life anymore might encourage someone to go back to use.
Dominique: Do you feel like that's [00:19:00] something that there's a lot of misconceptions around?
Sarah: Yes, I do. I think a lot of people, again, because of the way things have been taught for so many years, I. They prioritize this idea of abstinence. And I say this as an abstinate person I would not recommend it to everybody. I think we need to have autonomy in paths that we choose.
Sarah: and I also think we have to hold space for people coming from different backgrounds and different experiences and needing different tools. And I'm completely dependent on wifi, Right. Like completely dependent on caffeine. I need a cup of coffee in the morning. I think that we need to stop using it as a weapon.
Sarah: It's a tool. We as community members can also mind our own business and let people talk to medical professionals about their healthcare choices and their recovery processes. It would be a lot better. It's when people without lived [00:20:00] experience with these crazy opinions start preaching those opinions as law.
Sarah: These are not laws. These are simply opinions. Everyone has them. We have to defer to the medical professionals and also allow people to make whatever choices they make, whether it's dependency or not.
Dominique: Right. The important thing is that people need to feel empowered in whatever decision or choice that they're making in their health.
Dominique: That's been the experience with my brother. is like you know, he's much younger, so he's done things to appease my parents.
Dominique: None of that actually works because unless he's willing or he's feeling like he actually has agency over his life and his health. Those decisions are not gonna have as much weight to them as if he actually, decided to make those changes on his own.
Dominique: You could have influence, but at the end of the day, like, this person needs to be ready and willing to make whatever change it is that they decide whether it's abstinence or not.
Sarah: Yeah, absolutely.
Dominique: One of the other things that I want to talk about is not necessarily just the myths, but how exactly families can start [00:21:00] practicing harm reduction, to support their loved one. Some families want their loved one to just stop using, and there are some families who actually want to just help them make any progress in any kind of change.
Dominique: For families who wanna be supportive but don't necessarily know where to start, what does practicing harm reduction look like in their day-to-day life?
Sarah: It can look different for different people. It would be a good idea to look into substance use and mental health to understand a little bit better. Obviously, if you don't have those lived experiences, it won't be the same, but you can still be supportive. I think that we need to teach people if they don't know how to set boundaries and that setting boundaries yourself, you don't have to be a victim, you don't have to be a doormat. Being a doormat is not the pathway to harm reduction. Having healthy boundaries for yourself and saying, this is not something I can do. And being firm in those boundaries because that will empower you [00:22:00] to feel like you're in a healthy relationship.
Sarah: When you make boundaries and then you continuously break them, it sets on this chaotic relationship. So setting healthy boundaries that feel good for your soul is an important thing, and finding ways that you can communicate.
Sarah: So if it's once a week by if it's asking them to check in, just so you know that they're okay if it's.
Sarah: Working with them to find safe shelter. Maybe they're not ready to go into treatment, but they just need safe shelter. And that would also. Be something that you can positively help them with. There's a, a multitude of things, and it's all dependent on what your capacity is. Understanding what's my capacity, how can I be there for them?
Sarah: Go to lunch with them the same way that you would with a friend or a brother or sister. You're not hanging out with them every day, six hours a day. You're seeing them once a week, once a month, checking in with them. How's life? How you know what's going on? I'll give an example.
Sarah: In my family, I have a younger sister and I [00:23:00] just sat down with her to talk about. Harm reduction. If you're going to drink what type of alcohol has higher content, what that can do to you? Never
Dominique: get
Sarah: get behind the wheel with somebody who's been consuming. Always take an Uber or get a ride.
Sarah: Never use alone. Always have one person that you feel safe and comfortable telling them what you're consuming, whatever it is. If it's pills, if it's hallucinogens, if it's alcohol, if it's marijuana, whatever substances. Have one person who knows exactly what you took. So in the case of an emergency, they can relay that to medical professionals.
Sarah: Testing substances before utilize them. Going slow, starting off with a little bit to see how your body responds and reacts to it. Because if you go heavy in the beginning, it could be deadly. obviously not a lot of people wanna have these conversations with teenagers, but we have to. We know that they're going to use substances. So let's give them all the facts and information so that they can do it as safely as possible.
Sarah: She was really receptive to that. One of the best conversations I [00:24:00] had with her was saying, why do you drink? Why do you like to drink at this rate? And she said, I don't feel comfortable in social settings. That's gonna give me an opportunity to say, have you considered therapy? For anxiety or mental health support and figuring out what that looks like because you're not always gonna be able to drink in a social setting.
Sarah: So how do we create healthy coping mechanisms so that yes, you can use substances, but also you can learn how to exist in society in a healthy way.
Dominique: I think what you just hit on is like the perfect balance between like you're maintaining that relationship, right? We talked about the power of connection, and I think that's something that it's so important to have these healthy relationships with other people is because you then you can talk about the resources that are out there.
Dominique: You can bridge that gap between what's going on for them on a day-to-day basis and what other forms of support are there.
Dominique: I was talking to my brother a week or two ago and asked him a very similar question. I asked him what is the most [00:25:00] challenging about making any kind of change in your substance use?
Dominique: And he said, right now it's the only thing that makes me feel good or makes me feel happy. And we were able to talk about all the other things that had made him happy and how he might be able to get back to doing those things again. Right. And like all of that, all of those answers meant that there was some kind of path of treatment or recovery that he could start even if it was even if he was still using.
Dominique: We talked about, and I just learned about this, which I thought was amazing, is Safe Spot, which is a hotline that's helps people use safely. So that way if they go unconscious or if they're not around other people, that they can actually, call the paramedics if needed.
Dominique: And when I told him about that, he was stunned. He was like, that's so cool because. He's always felt so stigmatized around substance use that to know that there are resources out there, whether or not he uses them. But just knowing they're out there, I think has given him a little bit more, hope and confidence [00:26:00] in knowing that he can make changes even if it's not tomorrow.
Dominique: I think that's just the importance of like having these types of relationships and conversations with our loved ones.
Sarah: I agree. It's a great opportunity to stay open and connected to them and safe spot, never use a loan hotline. Those things have existed. Unfortunately, they're not well known because people don't like to market anything having to do with actively using substances. But it's, it's a lifesaver.
Sarah: And it's so crucial that our, our community knows about it. I'm so excited that you told him that. I think that's good information and hopefully he can share it with his friends.
Dominique: yeah, exactly. That's, that's the hope is, letting him know like, there are options. for you, right? Like, You don't necessarily have to choose one thing or another. We talked a little bit about the different forms of harm reduction MAT, hotlines, et cetera.
Dominique: Of course, overdose prevention and overdose resuscitation is super important. My [00:27:00] brother actually OD'ed a couple of months ago for the third time, and this time he refused medical attention and my mom was with him and there were other people as well, but I think it was a very scary experience because I don't think many of them had been in a position where someone has overdosed and they are refusing medical attention.
Dominique: So they kind of left this big open question as to " like. what do we do now?" Does he just continue to go about his day. How can you support someone who has survived an overdose? What are the best things that you can do in that moment?
Sarah: so
Sarah: I have some unique experiences with this. There's a multitude of things that you can do. It depends on what your capacity is. I have reversed hundreds of overdoses and I have never had somebody wake up and say that they would go to the hospital. They've always refused it. I've been reversed and there's no way I was going to a hospital. I immediately woke up. I was sick and I [00:28:00] was afraid, and there was people screaming around me. So we have to hold space for the fact that when people are coming out of an overdose, they're coming back from death.
Sarah: And what does that feel like? What does that look like? Hold space for that. Give them a moment. Don't shout in their face. Back up six feet. Lower your tone and just say, hi, my name's Sarah. Are you okay? And give them a minute, ask if they know their name. If they refuse medical attention, ask if you can sit with them for a moment, quietly let them get their bearings and then say, Hey, this is what happened.
Sarah: You experienced an overdose. I. For the next 20 to 90 minutes, the Naloxone in your system is gonna be kind of blocking those opiate receptors, but if you consume again, you're at a higher risk for overdose. So do you mind if I sit with you? If you want to use again, most people, myself included, wanted to use right again because we felt sick from the Naloxone.
Sarah: So one thing we do Streetside is say, can we monitor you while you use? They're allowed to do [00:29:00] it in our neighborhood right outside. So they, if they allow it, some of them say, absolutely not. Get away from me. If somebody openly says, I don't want you around me, give them that space, they're entitled to that.
Sarah: I will say, will you take this Narcan? Put it somewhere visible on you. Don't use behind a locked door. And make sure that if, if something does happen, it's easy to detect that you have Naloxone nearby. And we give them those tips. We also tell them to hydrate. We them, do you wanna call your mom?
Sarah: Sometimes people are really scared. And when you wake up and you don't know what's going on. Talking to somebody that kind of gives you that comfort. your parent, your partner, your family member. And if they want that, we give, you know, we allow them to make that phone call.
Sarah: Sometimes sitting with them, if you have that capacity can be, a real act of human kindness for somebody who just experienced something really traumatic.
Dominique: Absolutely. I think ensuring that people aren't feeling isolated in this very traumatic experience, especially if this is something that they're experiencing for the first [00:30:00] time. I can totally empathize with that. When my brother did overdose, I was with him a couple hours later and asked him, you know, like how he was feeling and what was going on for him. And he was just like I don't really wanna talk about it right now. And totally fair. Right? I probably wouldn't want to either. But he did this like really cute thing where he like grabbed my hands and he was like, yes, Dominique, like I am holding your hand right now.
Dominique: And it was such a small thing, but I think in that moment it showed like your presence is enough. Sometimes you don't need someone to do all these things for you, right? You don't need the lecture. You know what your resources are. But sometimes just having someone who is not there to judge you and just listen to you and just, just sit there with you for a minute, I think can be so powerful.
Dominique: If and when they're ready to make any kind of changes, like they'll have that support system.
Sarah: Yeah, I mean, In any other medical emergency, nobody stands around and screams at people and tries to get them to do things. If it a heart attack, you would be like, "oh my goodness, are you okay?" But for [00:31:00] some reason, when it's an overdose, people are like, we have to force them to do something. And it, it's not actually effective.
Sarah: So most of the time, if they let us sit with them, I talk to them about completely. Irrelevant things, their favorite show, what they were doing earlier that day. And that gives me the opportunity to make sure that they're cognitive, to make sure that they didn't lose oxygen to their brain.
Sarah: Are they coherent? Are they capable of going back and forth with me in a conversation? This is the only medical emergency where people have so much of an opinion on how we can get them to do what we want them to do. And it's a little odd.
Dominique: People in that situation are kind of operating, I think from a place of fear, right? Like there's, when it's their loved one, right? It's deeply personal. There's this fear that kind of takes over them. Of course they wanna help this person, but it's more so like, or I'm scared of this person like dying. Right. And they're trying to prevent that, but at the end of the day, it's like we need to prioritize like who this person is and what exactly they want. Like they need to have some kind of agency [00:32:00] over their decisions in their life.
Sarah: Absolutely. And, and how effective has anyone been in forcing anyone? It doesn't stop us from trying, and I've done it 100% with my siblings. I've sat down and been like, you're gonna do what I say, or it's over. It's our natural instinct. It's maternal, it's sibling, it doesn't matter. So it makes a lot of sense. I also think when it comes to family, the most effective people are not family. Because we have too much of a stake. We have too much invested in this human. We love them so much. So when it comes to those resources and those things, sometimes it's best coming from an outsider because they're not as invested and they're not going to be as desperate.
Sarah: I was desperate with my siblings to get it, you know, I was desperate for them to live because I loved them so much, and I have the opportunity as a non-family member in Kensington to be like, take it or leave it.
Dominique: Yeah. Like these are their choices and they can make them, they, they have the right to do so.
Dominique: [00:33:00] Going back to setting boundaries, many families might not really know where to start, and I think these boundaries that get set usually start as like ultimatums thinking, you know, if I do A, B, or C, like it will result in X, Y, and Z, and that's not necessarily the case. What are some like mindset changes that families can make to help them wrestle with the idea of setting boundaries? Whether it's having their loved ones stay at home with 'em, or practicing safe use at home, how can they explore like what feels right to them, in the early stages of harm reduction.
Sarah: Depends on their relationship with that person.
Sarah: I, I work in harm reduction. I havebut when it comes to my home, my home is my safe space and everybody is entitled to that.
Sarah: I won't allow someone to stay here, but I will help find them housing.
Sarah: The most objections that we get is that things go missing. There's money, there's always like a financial thing, Right. And so they wanna protect what's theirs. We all have a right to do [00:34:00] that.
Sarah: I have a lot of parents that will call me and be like, all she ever does is ask for money. Okay. You can add some levity to it. I know it's frustrating, but you can be like, no, you're not getting any money. Like, don't even ask me about money, but like, the moon's full tonight, whatcha gonna do?
Sarah: There's ways that you can shift the conversation, but you can have those boundaries in place where it's like, it's a no for me. And keeping that when it comes to money or. If they've had things go missing in their house, "I will meet you somewhere. But Right now my house is like my center for peace and I have to keep it that way."
Sarah: I know a lot of people who allow for safe use in the house. There's boundaries around that. You gotta tell me when you're gonna use so I can check on you if I don't know that you're using. I might not check on you and I don't want you to be unresponsive. We talk about the never use alone hotline, the Safe Spot hotline.
Sarah: When we talk to family members, if you don't wanna put them out on the street and you're comfortable with it, allowing them to talk to you about that substance use. Disclosing the substance use is so [00:35:00] powerful because it's such a secret. We keep it so quiet and secretive and that's why people die in the safety of their homes, on the comfort of their pillow.
Sarah: 'cause they're not telling anybody about it and they're using secretly and then nobody knows to check on them. So it's a really empowering thing to say, Hmm, you know what, it's okay if you use, it's not gonna like drive me crazy. I, I feel comfortable with it. But I just need you to disclose it. I need you to be transparent about that with me, and that builds trust.
Sarah: And I know that there's this long standing thing that like, you can't trust somebody using drugs. I have many friends who use drugs and I trust them. I allow them into my home. I mean, they don't live here, but they come in. I trust them. I think that's a common myth.
Sarah: Now, you may have an individual experience, but if you wanna learn how to build trust, then you give opportunities for that and it may look different for different people. We have to get into a place where we're comfortable being firm in our boundaries and we're feeling like we have to shift them to make else feel comfortable or [00:36:00] safe.
Sarah: Also as a person who used to use drugs. I understand when people need to set those boundaries, and I may get an attitude, I may be sassy, but I fully do understand why those boundaries are in place.
Dominique: Just starting like to practice any kind of harm reduction in a black hole without having any concepts of what your boundaries are can be confusing.
Dominique: The important thing is like getting clear on what your boundaries are, and I think once you've identified those, then you can begin to explore harm reduction practices that fit or align with your values and your boundaries.
Sarah: Yeah, absolutely.
Dominique: I wanna talk about your relationship with your siblings. You brought that up a little bit earlier on. You said you're one of nine. I think something that we've already touched on is like the power of sibling relationships and like how relationships like ebb and flow, especially when there is substance use. I would love to know a little bit more like how has your relationship with your siblings evolved during your addiction and during your recovery?
Sarah: Oh, that's a loaded question. I, [00:37:00] am, we're very close. And we have been, you know, we grew up in a small house and they've lived with me and then seen me kind of spiral
Sarah: and
Sarah: I've stayed on all of their sofas and brought some chaos into their lives, to the point where they've set some strong boundaries.
Sarah: Most of my brothers set some pretty intense boundaries. With some of my younger sisters, specifically Mac, she's a lot younger than me, so I cut her umbilical cord, taught her to read. She was like my little baby, and then saw me in this very dark place.
Sarah: I think it was very difficult for her to see that happen to me. And then I work with four of my siblings. So that has changed and that has developed, and we have talked about so many different experiences that we've had. And sat down and discussed, you know, this is what you [00:38:00] did, this is how it made me feel.
Sarah: I've had to swallow some of that and I've had to take a lot of accountability for certain things. And in the past seven years, we've been able to rebuild that relationship together and explore both recovery and harm reduction together.
Sarah: Because as I was developing and starting to do harm reduction, I was working with my family and seeing how we inadvertently did harm reduction together, unintentionally, let and developed this program where we wanna support people, and how to set boundaries and how to be compassionate and understanding and making sure that you feel safe as well.
Sarah: My brother and I in particular, Adam, the one who helped me with the nonprofit, was and is, person that I'm closest with.
Sarah: You know, we talk 35 times a day. He's not one of us. I say he's, went to college, got a degree, is [00:39:00] just, you know, got married, owns a house like he did. He, know, he is, he is like, great, you know, and I'm just out here like running down Kensington to have like a maniac. So,
Dominique: sure you're not.
Sarah: The dynamic is so, it's so interesting, you know, and then my sister Mac is a lawyer.
Sarah: She's an immigration lawyer. So again, I had these, the two younger ones that I, I probably harmed the most in my substance use now I am closest with in my recovery. And Mac helped start the nonprofit with me and Adam. It's a really cool thing to have them there supporting me, seeing the work that we do and talking about how, you know, this experience has been for them.
Sarah: I would never want to echo their experience, but I think a sibling experience is incredibly unique. There's a bond, there's a level of love, and it's guttural instinct to
Sarah: want to protect your siblings. There's a connection that is unlike anything and so [00:40:00] being able to live and learn and grow and evolve with them has been incredible, and also to hear their experiences because my message is my experience, but to hear their experiences and then use that.
Sarah: When I interact with people people I use that to connect with them, or instead of talking to them and say, you should talk to my brother, you should talk to my sister. Moms will call me and I'll say, you should talk to my mom. I'm not a mom. You so like I can't tell you what it's like to have an unhoused person using drugs.
Sarah: I can't tell you how to set boundaries, but my mom does. So it's, it's a really important tool and I think it's an under acknowledged experience. Everybody talks about the moms and the dads or the kids. Nobody talks about the siblings, and it's excruciating.
Dominique: Absolutely. I think especially if you're thinking about siblings that may have grew up or lived in the same household is like a lot of the times you might have been privy to the entire experience, right?. I think that's why sibling bonds are so unique, is because you might have experienced the exact same thing, or [00:41:00] maybe not, but you react to them and grow up in completely different ways. All your siblings seem to have taken very different paths, and at the end of the day, like you guys can still come together now, and bond over, like what your experience is, what your relationship has been like.
Dominique: Now you guys are talking a little bit more like how you've been affected by the sibling use and the sibling relationship over time. Where in the recovery process did those conversations start to happen?
Dominique: Were those like very early on? Were they, you know, when you start started to build Savage Sisters, like what was that process like for people who might be curious?
Sarah: It took some time. It definitely took some time, for me to be in a mental head space to, to digest it their experience, because in the beginning I was very, unstable emotionally and mentally. I may have appeared like I had it together, but my head was crazy, you know? So I waited a few months, I think it was around nine months into my recovery journey, and it has [00:42:00] continued.
Because I'm so close with them, I have healthy communication with them now. If things pop up whenever they crop up, we talk about it. And I've become defensive at times, and then I've had to go back in and say, okay, I'm ready to hear now.
Sarah: When you're investing into a relationship with anybody and there's this healing process that has to take place because you've, you've witnessed this pain, you've witnessed this struggle, you've also had your own. It's never done it, there's always time to sit down, hold space for that experience, digest it, process it, and then maybe to the table.
Sarah: And that's happened a lot with my brothers and sisters. I don't think it's ever going to change. I think there's always going to be things that need to be addressed. But I didn't do it until about nine months. I don't think I would've been ready to hear all the negative stuff and it was negative.
Sarah: Trust me, I had stolen cars, money, passports, like it wasn't a good vibe. and I always say this to family [00:43:00] members, give them time to stabilize. Trust me, we will be capable of having that healthy communication and acknowledging your experiences. But in the very beginning, may not be healthy.
Dominique: Yeah, there's a bit of like managing expectations that has to go on. is there anything that your siblings have done or you wish. That they would have done during your active use or early recovery to support you along the way?
Sarah: A couple of my brothers, I wish that they had stayed in touch with me. My family is Irish, Iranian, and Palestinian, there's a weird energy there. And there was like, you know, for instance, you know, some of my brothers kind of copied what my dad did, which was to say, you've shamed the family.
Sarah: You know? They've come around and they've, we have a good relationship now, but that energy just seeped into my skin and in my soul, and I already hated myself. I was [00:44:00] already in so much pain. So to feel that I had not only disappointed them, but that I was no longer worthy of their love, attention, concern, empathy, was devastating for me. And there were small ways that they would like show love.
Sarah: There was a very dramatic time where I had stolen a truck and went to my brother's apartment, and the cops came, like lots and I was hiding on the roof. He was like, the cops are here. I'm gonna go downstairs.
Sarah: And I didn't trust him. It was one of the brothers that was like, not really supportive of me, and I was like, I don't trust him. So I went up on the roof and I hid, and then I came down like two days later, I was outta my mind and my suitcase was there and inside my suitcase, was a note and all it said was, I would've never given you to the cops. Love, and then he put his name and that was something that meant something to me. Like, okay, you're not gonna turn me in.
Sarah: But those experiences, I still carry them with me. I love them. I have good [00:45:00] relationships with them, but I will never forget that when, I was in so much pain and they were like, "I don't even care. Your pain means me because you're an inconvenience to me at this point." and I'll never forget that.
Dominique: There's a lot of people who say like, I'll be there for you when you're sober, but I can't be there for you now. And I think at the end of the day, there's tons of different ways that siblings and families in general can really be there for their loved one, in a way that works for them without compromising their mental health or their wellbeing.
Dominique: So I you've shown like different sides of like how siblings have been there for you and like what that role has been like. So, thank you for that.
Sarah: it's all about perspective, and there are inconveniences. There are painful experiences. It can be really difficult to witness somebody that you love. That kind of pain or doing so many negative things. They could be criminal, they could be, emotionally traumatizing, whatever that looks like.
Sarah: It's difficult to be on the receiving and [00:46:00] also the spectator end of that. And so remembering that it's okay to set boundaries for yourself and that you may need therapy because of it. I think we often get into this space where the entire focus is on, well, this person's making really bad decisions, so they're the one that needs help.
Sarah: But really we all need support and help in different ways. And to be able to acknowledge that to be a healthier communicator in that relationship and to not eat the guilt of it and say, you know, I just feel so bad and trying to be a people pleaser and be like, I just feel so bad. I have to let them do all of these things in order to maintain the relationship.
Sarah: Um, It's okay, you know, to hold space and it's okay to be frustrated. All the emotions that come with it. I've talked to so many parents who are like, "I'm so fed up, I'm so frustrated. I'm so angry. I'm so ashamed and embarrassed." Every single emotion that comes along with living and being alive [00:47:00] this process.
Sarah: None of them are wrong or bad, and we need to talk about them. You find somebody safe that you can open up to, that's not gonna judge you. For me some of that was my siblings. I had Mac and Adam and I had my mom. When you can really invest in those relationships in meaningful ways, they don't have financial ways. They don't have to be every day for six hours a day, but meaningful. Tapping in, checking in, tuning into your family members and just saying, "how are you?"
Sarah: If everything's terrible, and it's okay if it is, "I love you." "Just know that I love you and I'm here to support you," and that's enough. It doesn't have to always be this grandiose gesture.
Sarah: Most of the time it's the smaller ones. It's just acknowledging that they exist and that you love them. Helps us to feel seen and helps us to hold onto our humanity until we get the the [00:48:00] encouragement internally to make a shift in or to make healthier choices. We wanna keep the humanity in all of our loved ones alive. we're all worth saving.
Sarah: And if you're related to somebody like you mentioned earlier, you know what they've seen, experienced, been through, it's okay to love them along that journey.
Dominique: Absolutely. Thank you so much, Sarah. I really appreciate you coming onto the show and sharing your personal story. Sharing the work that you guys are doing at Savage Sisters. And just sharing more perspectives around harm reduction and what families can do today and as they navigate their own boundaries and whatever that might look like for them.
Sarah: Awesome. Thank you.
Dominique: Thanks for listening to this episode of For Love Recovery. If you enjoyed this episode or know somebody who might, please leave a comment and share it. You can also join our Facebook group, Siblings For Love of Recovery, if you're looking to have deeper conversations around your sibling's use [00:49:00] of drugs or alcohol. And remember, where there is hope, there is healing.