Home Ask Ms. Harm Reduction Ask Ms. Harm Reduction: I’m Dopesick

Ask Ms. Harm Reduction: I’m Dopesick

Photo taken by Silvia Escario
Visual approximation of Ms. Harm Reduction back in the day. (Photo taken by Silvia Escario.)

Dear Ms. Harm Reduction,
I’m an escort with an Oxycontin habit. For the most part I can plan ahead and maintain, but sometimes supply runs out and I have to go to work when I’m in withdrawal. I serve a middle class clientele, and I’d lose clients if they found out I was a drug user. I’m also afraid some of them might even become violent if they discovered I was a “junkie.” How do I hide the tell tale signs of dopesickness while working?

Sniffling Isn’t Cute y’Know

Dear SICK,
Ms Harm Reduction knows all about the yen for dope. Ah, she remembers the old days, when she could make a croaker for a script for morphine, easy as pie. Golly gee, did she have herself an oil burner of a habit! But you don’t want Ms. Harm Reduction’s story you just need some advice.

Rub a bit of mentholated cream on the inside of your cute little nostrils. Not only will this help with those dratted sniffles, but it will also provide a pleasant aroma as counterpoint for the odor of elderly clients’ yeasty bodies. Popping some antihistamines will also ease your poor runny nose. Use some over the counter eye drops to help with tearing, and if it’s seasonally appropriate, wear sun glasses on your way into the appointment, as bright light will only make your watery eyes worse. Any yawning you might do can be excused with a story about burning the candle at both ends staying up late studying (or whatever your cover story about your “other profession” is).

Make sure to take advantage of some of the more helpful quirks of withdrawal. Does being dope sick give you hairtrigger orgasms, like it does for Ms Harm Reduction? Play it up, and laud the poor dear of a client for being such a magnificent lover. Does jonesing make you a bit silly, lightheaded, and chatty? Use that excess energy and that gaily lightheartedness to connect with your benefactor of the hour and have more fun with him. Play your cards right, and your paying suitor will be too charmed to notice the fact that your skin is goose pimpled.

Take care not to misinterpret her—Ms. Harm Reduction is in no way promoting the use of opiates. She herself had no fun taking the rap when the people came down on her, and that was before the age of mandatory minimum sentencing. But she knows all of you who have habits aren’t all going to kick them simultaneously, and she wants you to stay safe.

Ms Harm Reduction was quite the harlot in her youth, which she spent as a burlesque and taxi dancer. Now all she wants is to use her good time girl experience to help young lasses and lads in the same trade deal with issues around imbibing and living it up.


  1. Many sex worker rights activist have asked tissandass to stop running these stigmatizing stories. Maybe the advice should have been for the lady to clean up her drug problem as she is putting her clients at risk. Notice that Walmart doesn’t run stories about a FEW of their employees that are addicts so why you insist on portraying sex workers as addicts is problematic. Here is a FUN FACT, out of all the drug addiction in the US, sex workers make up just 5%, and I bet the same could be said about Walmart workers, cops, teachers or any other profession.
    We have told you over and over that this tone is OFFENSIVE to even the sex workers + actvists and while you CLAIM your audience is sex workers, no doubt these types of articles will be used at trafficking conferences to demand that we all stay criminalized.
    Can’t tissandass write about something besides DRUG USAGE and stop tying it in to sex work. There are tons of forums and platforms for drug usage, so why do you INSIST on tying this narrative into sex workers.
    Clients have the right to know if a provider is on drugs, or brings drugs to the appointment. Putting our clients in DANGER over our drug use is NEVER acceptable.

    • Um, the column is called “Ask Ms. Harm Reduction,” not “Ask Ms. High-and-Mighty Empowered Happy Hooker.”

      I, for one, find it completely refreshing that T&S is willing to go where so many “sex-work-positive” people fear to tread. I think many of us have a tendency to want to distance ourselves from the narrative of the poor, drug-addled hooker. And I think it’s great that there are so many sex workers who are able to work sober, who don’t rely on anything harder than caffeine to get through the day. But let’s be fucking real–there are lots of us who fall somewhere in the grey area, who have addiction or mental health issues that we keep quiet about because we don’t want to further stigmatize ourselves. T&S is one of the few websites I can think of that offers realistic harm-reduction tips for SW’s and acknowledges that we are a vast and varied group of people from different walks of life. If you are offended by the content, don’t read it.

      PS. LOLing forever at “putting our clients at risk.” Fuck clients. They put themselves at risk. They don’t deserve shit from us.

      • PREACH.
        Sex workers and drug users make up some of the most marginalized population in the world. Why should we abandon those who fall under both headings for some thin veneer of “respectability”?

    • If you’re offended that other people are making different choices with their bodies than you are with yours, you’re definitely in the wrong place.

      T&A writes about lots of things besides drug use. Try checking the front page.

    • I completely disagree with this sentiment. Sex worker rights activism needs to bring ALL of us along, whether we are happy, unhappy, drug users, sober, mentally ill, physically ill, perfectly healthy, or whatever the case may be.

      Tits and Sass not only creates a safe space for us to talk about and engage with all of the issues that may affect sex workers, but it also creates an opportunity to poke fun at ourselves or discuss issues in a light-hearted way.

      For example, I absolutely loved this T&S piece by Lori Adorable: https://titsandsass.com/dungeon-or-psych-ward-a-crazy-whore-explains-it-all/

      Her tongue in cheek approach to discussing mental illness and sex work made me feel a lot better about myself. As a sex worker who also struggles with mental health issues, the post made me feel less alone, and less like a freak.

      I think the whole point of T&S is to be supportive of all sex workers regardless of their individual circumstances or reasons for doing sex work. So what if only a small percentage of sex workers are drug users? I don’t use drugs myself, but I can see the incredible benefits of running this particular post, and I appreciate it being published here. I’m sure that some of the readers will find it helpful, and others may just find it interesting.

      I think you need to take your respectability politics elsewhere, quite frankly. We shouldn’t have to hide our true selves to gain rights. Sure, some sex workers are “happy hookers” who are “legitimate businesspeople” and so on and so forth. Not all of us are like that, though. Rather than throwing the so-called undesirables under the bus, how about just recognizing the fact that sex workers are a diverse group, and some of our stories are less than pretty? And just try to be there, and be kind, and be accepting, and be gentle? Life is hard – we don’t need to make it any harder by throwing judgments around.

      Keep doing what you do, T&S. I loved this post, just as I love most of the posts I read here. This resource has been so helpful to me, as I know it has been to others. I’m so grateful.

      • I am not in agreement with Bella, but I can actually see a small point in her posts: is T&S about and for sex workers, or is it about and for all the other things sex workers do? Is T&S publishing pieces about balancing the effects of OTHER life situations with one’s sex work?

        I agree with you that we should not “throw the undesirables under the bus” (hell, I am almost certainly someone’s undesirable!) but aren’t harm reduction models of drug use applicable to all drug users, not only the ones who are sex workers? These are things I wonder about. This post isn’t really sex worker specific, is it? So what makes it necessarily T&S material?

        I mean, I have a lot of other aspects of my life that while they affect my sex work life, are not really unique to sex work (in my case I have had to deal with controlling/hiding chronic illness symptoms for work, and even had chronic illness put me out of work for a very long while.) But would those things necessarily be T&S material? I don’t think they are really something I would come here to read about.

        • Well, the reason this is sex worker specific is because drug using full service workers have a particularly difficult time hiding withdrawal at work, because they’re in intimate contact with their clients, and they’re also at more risk of violence than drug users who are otherwise employed if their use is discovered. The idea behind Ask Ms Harm Reduction is to explore points at which issues of drug use and safer sex intersect with sex work. There are plenty of harm reduction tips that are specifically relevant to sex workers. Hell, we’re not even the first piece of sex worker media to tackle this issue. Born Whore/Juliet November’s We Got This check in zine had some great ideas about working while withdrawing from opiates as well.

    • Bella, look at your walmart comparison. Would you deny a walmart worker drug treatment or information about staying safe? Is there any profession other than sex work where drug users are encouraged not to get help? If any abolitionist ever brings this up to you at a conference, tell them we have to help our own drug users because society makes help twice as inaccessible for criminalized, stigmatized people without health insurance.

    • Where are these “many” activists, who told T&S “over and over”? I checked the comments to the previous Harm Reduction column, and it is just you repeating this argument and making claims about some sort of massive support behind it. At the same time, at least 12 posters expressed nuanced support for this column and highlighted multiple reasons for it, including how it ties with social justice. A similar dynamics is already unfolding in this comment section.

      As for the unfortunate potential for abolitionists&conservatives misusing these articles, yes, I agree that this is a risk. But the same argument extends to all negative experiences in sex work. I know I read about the pressure to produce happy stories and hide negative experiences, about fear and judgment that followed disclosure of experiences that fit stereotypical “damaged” narratives. The discussions that followed these stories, as far as I remember, made a call for diversity, for encouraging all stories to come forward. Because otherwise we betray the very social justice advocacy that we are supposed to be about.

    • None of the recommendations endanger customers in any way, but maybe that’s just your latest anti-drug talking about due to that google exec’s accidental overdose, which he clearly made his own choices about (really hard to forcibly inject somebody without restraints or at least heavy intimidation, so yeah not likely in the least). Oh gee. Clients have zero right to know anything about the private lives of the sex workers they hire – and the LW was looking for ways to hide withdrawal symptoms FFS – though they sure do want to. Seems the real way to sell out sex workers is to give that to them. I guess we should all be telling them our legal names too, and doing anything they want to give them more power and leverage. Vom vom vom.

    • How is this worker endangering her client or putting her client at risk? Why does a client have a right to know if a worker uses drugs? I don’t think my client (or any employer) has any right to know what I alone do with my body.

      T&S does not “portray sex workers as addicts.” Rather, it acknowledges that some sex workers are drug users. This is realistic and respectful. Do you think that T&S pretend that no sex workers ever use drugs? I do not.

    • I am curious about where you are getting your FUN FACT. I am unaware of any government agency or nonprofit or legitimate think tank/research group which collects (or is even capable of collecting) data about the professions/jobs of drug addicts. This sort of research is impossible, not only for logistical reasons, but because it would be a gross violation of….god, the mind reels, all sorts of research ethics. It might even be illegal. It certainly couldn’t be done at a university by a scholar, even on a microscopic level–the IRB would never pass it.

      I think you just pulled that FUN FACT out of your ass.

      Regarding “putting clients in danger”–well, I won’t go so far as to say “fuck em,” because I’ve had some great ones and they are my bread and butter, after all, but I’ve had dozens of clients sessions with me drunk or high, or use drugs during the session. I don’t care as long as they are functional and behave themselves. I’ve also had many, many clients want me to partake of their drugs with them (I always pass bc I never liked drugs other than alcohol). I bet every SW here has similar experiences.

      I myself do not give a fuck if these articles, or any other on this blog, or even the accounts of horror-story sessions that I write about on MY blog (full disclosure: I’m a fetish worker, so I don’t incur as much risk as full-service workers, and I acknowledge that), are used by at trafficking conferences. Many of the people who attend such conferences already have their minds made up, and for ideological reasons (and sometimes opportunistic $$$). They will NEVER accept decrim or even the realities of our lives in SW coming from our own mouths, the people who do SW! They fucking fabricate horror stories (thousands of American children a year trafficked in the sex trade in the USA, for example). They will fabricate horror stories no matter what we publish or do or how we present ourselves. And no account of any sex worker is respected and accepted by the antis unless it’s a “prodigal son” type narrative or lurid lies like Stella Marr put out.

      (as an aside,

  2. Thanks for this useful column! Only sex workers know what harm reduction for sex workers looks like. Generic advice for drug users can’t replace knowledge specific to the job and our safety issues.

    And while sex workers may only constitute 5% of drug users, that doesn’t mean drug users constitute only 5% of sex workers. It means there are more drug users in the world than whores, which is not terribly surprising.

    Not that we need a moral majority to talk about drugs, but tossing around that stat like it means that sex workers don’t use drugs is just silly.

  3. How on earth could anyone work sick? I am sweaty. I have goosebumps. I’m doubled over in pain and my asshole is bleeding from shitting rocks. I’m also puking. I had to miss work at the strip club tonight because my dealer is out of town. I’m doomed till tomorrow.

    • Hey there. I hear you. My personal experience of working sick (before I started at a methadone clinic) was mostly about timing it towards the beginning of withdrawal, though that didn’t always work. And Ms Harm Reduction definitely forgot to address the sweatiness, which I usually dealt with by slathering deodorant all over my body (no favor for my odor sensitive senses, but whatever.) I also took Immodine if I felt diarrhetic and antihistamines if I felt nauseous (but not too many of the latter because they can really dry out one’s system, which feels doubly bad when one is sick.) All that said, I would be doing one hour long call at most when I was sick, just enough to get back on my feet and get well to work later that night, not several in a row, and certainly not an 8 hour plus long strip club shift. And obviously, if you don’t immediately need the money to maintain your habit and have any other option, you should stay in! But sometimes people just have no other choice, which is why were happy to feature this column.

  4. I don’t know how helpful this is, but if you potentiate (with grapefruit juice made from concentrate, caffeine or alcohol), you can make your supplies last a lot longer and cut down significantly on the amount that you take.

      • Sure. 🙂 I take oxycontin (slow release) or oxynorm (which is instant). With the slow-release tabs they don’t start working for at least an hour. If you want them to kick in earlier than that, I’d recommend biting (dissolving doesn’t work with certain coatings), but make sure you only do this if you use this amount reasonably often. If you try this and are opiate naive (if you haven’t used the drug in a while and your tolerance has fallen) this could be a very bad idea. If you bite or crush it, you’ll start to feel the effects in about half the time.

        Potentiation is the method by which we can increase the drug’s efficacy (either the duration or the strength of the high) by increasing one’s metabolism. A glass of concentrated grapefruit juice works best (I hate the taste of it so I usually use quite a small amount, about 2 dl), particularly if you drink it about 1-2 hours before taking the drugs. Quinine (found in tonic water) is also quite good, so is tea and coffee. Because we’re making the drugs seem stronger than they actually are by pre-messing with our metabolisms or brain chemistry in a way that makes their effects stronger, we don’t need to use as much to get the same high. I find that if I potentiate with grapefruit juice every time (or as often as possible) I only need about half of what I usually take and supplies last that much longer.

        A few other things are also good potentiators, like benzos. However, obviously the other rules about not mixing opiates with other things still apply (such as barbs). If you’re interested in learning more, there are certain forums that are fairly open to this kind of experimentation where people have documented their effects at attempting to potentiate with various substances at length. However, the ones I mentioned are fairly standard and the ones most people know about.


        These threads are quite helpful. 🙂 Intro to terminology: Swim refers to “Someone who isn’t me” drugs-forum is also quite a helpful site in general and you can ask questions there.

        Also: Do not potentiate with pro-drugs (such as codeine). Pro-drugs are drugs that work by being metabolised into other drugs. If you increase your metabolism after consuming codeine, you’ll just burn through it faster.

        Source: I’ve been taking oxy for pain management of endometriosis/adenomyosis for about four years and have a vested interest in not getting my tolerance too high/developing a physiological dependency so I try to have oxy-free days every four or five days. It helps that I can’t get high very well/often because of the pain.

        • I knew the stuff about Oxycontin use but the pontentiation information is totally new to me! I do want to remind TAS readers to be very careful mixing depressants (opiates, alcohol, benzos, Ambien, etc.) together, as combined they will enhance each other’s effects, and one’s respiration and metabolism will slow, sometimes risking overdose. I mean, obviously this is a good potentiation method but the risks must be considered. However, the other stuff is great harm reduction info in that it can allow users to both buy and use a smaller supply of drugs with the same effect. Thank you so much! And I love the Bluelight forums–it’s been a while since I looked through them.

          • I just wanted to add some information regarding mixing that comes from a psychopharmacology class I recently took:
            The greatest risk of mixing alcohol and benzodiazepines is not so much due to enhancing each others effects, but because they compete for the same enzymes when they are metabolized out of the body. Which means that each drug remains attached to their respective receptors longer and at higher percentage, because they are not removed with the same efficiency as when they are taken in isolation. So when taken together, not only do they act in similar ways by depressing the nervous system, but the biological effect of each drug becomes kind of equivalent to that of taking a higher dosage.

        • Grapefruit juice doesn’t potentiate by increasing your metabolism. It actually slows the body’s rate of clearing some drugs. This, for example, is why it is sometimes advised not to take it with hormonal contraceptives. It increases the availability of some drugs by increasing the amount of that drug that stays in the blood stream.

          Basically, when you drink GF juice, you are slightly slowing the rate at which you metabolize some drugs (NOT speeding it up) and they will stay active in your blood for longer.


          Giving inaccurate advice is NOT harm reduction. In fact interactions with grapefruit juice can be dangerous, so let’s be accurate.

          • So drinking grape juice would be in effect like taking more drugs? Or, rather, taking the same amt of drugs with a slower metabolism? I guess it’s still helpful in that the method may allow some people to save money, but thank you for pointing out the risks.

  5. Addendum: Unlike the bad old days, in which one had to do a stint at the Federal joint in Lexington in order to be admitted to a medically assisted detox, Ms Harm Reduction is told that nowadays if a gal (or lad, or individual) wants to kick there are plenty of 7 day methadone detox set ups which set aside state beds for those without health insurance. Of course, not everyone’s ready to kick right away, even evading the cold turkey route, but just a word to the wise.

    • Sadly its a lot like kicking in prison. At least where I am from. Your better off doing it at home. They only give you Tylenol and occasionally a trazadone if you are lucky. At least at home youycan smoke weed and have your plush bedding.

  6. Chiming in to add my voice to the chorus of commenters who appreciates this column!

    I’m also curious to know if Ms. Harm Reduction fields questions about issues other than drug use? I know the concept of harm reduction originally applied to just that, but I’ve also seen it used to refer to all sorts of safer working methods, including reducing likelihood of STI transmission, screening without use of technology, etc.

    • Glad you asked! Actually, this was originally going to be a double header column, with the second question dealing with negotiating condom use with clients plus how to obtain HPV vaccines, but we decided to save that one for later. So stay tuned for a sexual health related installment of Ms Harm Reduction.

    • (And so, yes, to answer your question, we totally agree that harm reduction encompasses much more than drug use, and Ms Harm Reduction’s told me she wants to cover a wide variety of subjects.)

  7. I am a squeaky clean mid to high end worker and I have no problem with the harm reduction columns here. Methinks the people expressing outrage perhaps are reflecting their own moral conflict in regard to the industry in a classic case of the lady doth protest a little too much!

  8. This is about keeping sex workers safe. Period. Regardless of their personal circumstances. Who are we (as a client of sex workers) to judge life choices of others. Not our place. If we as consumers really believe in equal justice – then we should stand up for the rights of sex workers all of the time and stop hiding in the shadows where we try and push our providers? People deserve to be safe – period.

  9. Hi! This column, as well as all of the extremely well written on-point comments, have me “hooked” on something other than the opiates I use to maintain my “drug fucked” state: Tits and Sass! I love it! Please keep the questions and answers coming, be they about drugs, condoms, clients, or snotty-mz-know-it-alls-who-seem-to-only-speak-for-themselves-and-not-the-group-or-greater-good!
    Sorry to keep it brief, but I am off to endanger my client by making his secret fantasy a reality, while in an altered state. Golly, I hope what I do in private doesn’t take away from him ogling my “tits-and-_ass”!


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