"As a drug user, it's a humiliating and degrading process to get treatment" — Devin's Story

Devin knows the ways that stigma, anxiety, and PTSD can intertwine to create barriers.

A dedicated community advocate and Marxist-Leninist who considers the harm reduction community to be their home, Devin enjoys reading, gaming, listening to shoegaze, and loves “good-hearted company with good people.”

They also identify themselves as an intravenous drug user who was experiencing the fallout of severe trauma and grief at the time of their incarceration inside Penobscot County Jail in 2019. Like many people who end up inside, they were experiencing a mental health crisis compounded by events that would push most people to their breaking point.

“It was a really rough time period in my life,” Devin explained. “I was dealing with PTSD and panic attack disorder, as a result of being pistol-whipped and attacked with a gun, the overdose of my best friend, the incarceration of my parents, and a car accident.”

In this interview, Devin uses their lived expertise and compassion for their harm reduction community to show why access to mental health care is so critical — and not just any mental healthcare, but mental healthcare free of stigma.

I exchanged a series of emails with Devin in December of 2020 about their experiences in the community and inside Penobscot County Jail.

“Honestly, I don’t know what would've been good to help keep me out of jail. Probably access to mental health treatment free of stigma.”

In our email exchanges, Devin described the time surrounding their arrest, when they had a “break from reality” that led to their incarceration.

“I was going through all the mentioned trauma at the time [of my arrest] and that could've been what caused the break from reality, along with my IV meth use. I still have issues with

doctors and therapists, even if I now understand that my behavior and thought processes were mostly irrational at that time. I’ve experienced episodes of psychosis, with hallucinating symptoms like rashes and being delusional in thinking that I was dying of *insert autoimmune disease or cancer here* and no doctor could convince me otherwise.

“I had a constant anxiety that I had a chronic illness, which put strain on my relationships and made me look like I was attention-seeking, when in reality, I was suffering from anxiety that would, at times, become delusional thought processes.

“As a drug user it's a humiliating and degrading process to get treatment, and life in general is just a humiliating process because of how stigma works in our society.”

“Honestly, I don’t know what would've been good to help keep me out of jail. Probably access to mental health treatment free of stigma. "I’ve got severe anxiety and don’t like going to the hospital because I've gone in the past for things that were all in my head. I’ve got illness-related anxiety so I try to stay away from hospitals because of the way they treat hypochondriacs and people who use drugs.

“Housing is also an important one, because the homelessness and the trauma-- it [..] definitely amplifies any stress you have for sure.”

What does it mean for health care to be “free of stigma,” I asked?

"Free of stigma meaning less humiliating processes to recovery, free of prohibitionist dogma that hurts those who use drugs, "Devin replied. "[We] can't really control how individuals in the medical system treat us, but we can at least make sure that trainings in school and during employment address some of these issues to start working against that.

“As a drug user, it's a humiliating and degrading process to get treatment and life in general is just a humiliating process because of how stigma works in our society.”

"It’s like pulling teeth to even see the psychiatrist, and it's like they have figured out what they want to prescribe you beforehand."

Of course, when the community doesn't provide the needed mental healthcare, those needs don’t just go away. When crisis leads to incarceration, those mental health problems end up being experienced behind bars, where there are even fewer resources.

I asked Devin to explain more about the mental health system inside PCJ. What was it like to try to get treatment there?

“The mental health care goes like this,” they explained. “You put in a request to see the med team. The request goes in and it takes a week or two to even see the doctors there. I was prescribed Remeron [an antidepressant] after putting in two to three requests.

“They have a team of three to four people who meet with you, and they ask what's going on and prescribe you a medication for it. They tend to have medications they prefer to prescribe. "Like for depression, Remeron is a very common medication they prescribe there because it works for insomnia and depression. That's about it for actual mental health treatment there. They don’t have mental health groups or therapists you can see regularly. The place is very outdated and old and doesn't have much for the inmates at all.”

“Those going through detox are left to fight through it themselves without mental health support or actual medical support.”

I was curious about withdrawals and medical care for people in withdrawal in PCJ. I asked Devin if they’d seen people going through untreated withdrawal when they were in the jail in 2019. Had they seen anyone get any medical care for withdrawal?

“People going through withdrawal have it bad,” Devin said. “MAT [Medication-assisted treatment for substance dependency] isn't a thing at PCJ, unlike Two Bridges, one of the private jails in the state. Thos

e going through detox are left to fight through it themselves without mental health support or actual medical support or medications, usually, to assist them.”

Though some progress has occurred at PCJ over the last few years in terms of access to Medication-Assisted Treatment in the form of suboxone for those who already have prescriptions, people who take legally-prescribed methadone to treat drug dependency will still have their methadone stopped upon admission.

Devin confirmed the common experience of witnessing untreated methadone withdrawals in the jail. “Another buddy of mine, Tim*, was coming off methadone, and it's one of the worst, if not the worst opiate, in my opinion, to come off of. He had to have us bring his dinner and lunch trays, because his hands were shaking so bad he'd drop them otherwise.”

As with other interviewees for the Storytelling Project, I asked Devin what their priorities were for Penobscot County and the jail itself. A “full overhaul of the criminal justice system” was needed, they said. Devin’s story shows how the harm isn't confined to jail itself — it shows up in all the ways that society, including the medical establishment, perpetuate stigma against people who are experiencing mental illness or use drugs.

“Lots needs to be done differently,” said Devin, describing the issues with Penobscot County Jail.

“Ensuring that contact between those in jail and advocates within the community is important,” Devin said. “Pushing for better mental health treatment and MAT drugs, opposed to a multimillion dollar expansion and building replacement would be great, if City Hall actually brought those things up.” • *Names changed

Portrait by Elizabeth Schule. Interview and editing by Zeraph Dylan Moore.