Stan Liszewski broke onto the Arkansas scene as the vocalist of Terminal Nation, a band blending death metal and hardcore into an incandescent firestorm of high-tempo riffing and viscous breakdowns. Being at the center of the state's musical counterculture led to tangible success with Terminal Nation, but Liszewski took his position in the counterculture even further by joining Central Arkansas Harm Reduction.

As the co-chair of the organization, Liszewski oversees robust education, medical servies, and the distribution of resources like naloxone and fentanyl test strips – alongside countless other essentials to the community – free of charge. CAHR is an integral player in keeping vulnerable populations in their region safe, so we spoke with Liszewski about what inspired him to join CAHR, his work to date, and what he envisions for the future of a healthier Arkansas.

Can you tell me about your background in harm reduction?

I feel that my background in harm reduction shares aspects with many others in these circles, yet also has distinct parts. A little over a decade ago, my father had suffered from an overdose, and I was the first person on the scene as it was happening. I had a background in nursing and in first aid, but truthfully, I had no idea he was experiencing an overdose at the time. I reached out to emergency services and started CPR until they arrived. Thankfully, he is still alive and with us today; however, he is very fortunate. At this time, he had been clean and sober for many years. I was angry with him. I felt he had let himself down, let me down, and let all of his loved ones down.

However, I had to dissect those feelings and emotions and acknowledge my own internal biases. I felt he was being selfish at the time, but in retrospect, I was the one being selfish. He had a long road to recovery, and in living with him throughout that recovery time, I had to retrain my brain. Drug use, licit or illicit, is a complex and multifaceted issue. There is no "one size fits all" solution. His substance use at the time did not make him any less of a person. He is an incredible human being, and I would not be who I am today without him. I truly owe him so much. He was my father, and I was scared to lose him. Instead of turning to empathy or compassion, I turned to anger. He was not in the wrong; I was. That was probably the most significant influence on changing my entire perspective on drug use and discovering some of the core principles of harm reduction, before I even knew what harm reduction was.

When the Central Arkansas Harm Reduction Project was in its infancy, I was so fascinated to have something like that in Arkansas, of all places. It was exhilarating, it felt edgy, and it was 100% a counterculture movement. I would keep hotline contact cards at my band's merch table and tried to support them when I could; however, between being a family man, school, work, running a music festival, concert promotion, and playing in a touring band, I didn't have the capacity, but I wanted to do more. I felt that I needed to give back to an organization and a movement that does so much for so many people who are generally ostracized by society.

In early 2024, I was personally in a very dark place in my life. I was searching for purpose. I was notified that a board position has become available with the Organization, and the Organization is currently facing some significant challenges. Typically, I would've passed on the opportunity, convincing myself that I wouldn't have the time for something like this. However, I took a leap of faith, and I fell in love with it. As someone who naturally loves to push the envelope, once I found my stride in the Organization, it was off to the races. Within eight months of serving on the CAHR Board of Directors, I was elected Co-Chair alongside Deidre, my partner in crime. Here we are, eight months since becoming Chairs of the board, and the Organization has moved from barely surviving to thriving. We are constantly growing, educating, and challenging antiquated views on what harm reduction is and what it can be.

What's the overarching mission statement of CAHR?

The Organization was founded by and for people who have been impacted by drug use. We are here to provide support and compassion in a non-coercive, non-judgmental way. We recognize that everyone in life is on their own journey, and we respect their autonomy and decision-making process. Should they choose a path for recovery, we are happy to refer them to some of our incredible partners who can assist. If that is not something they're ready for, or if they aren't interested in going down that path, we are still here for them, without stigma or shame. While the term "harm reduction" often gets dissected, I think folks who may think they disagree with our methods don't realize that we have more in common than they want to admit. At the end of the day, we want dignity and a better quality of life for our community, we want fewer transmitted diseases, and we want fewer people dying. I question the intent of anyone who has significant opposition to that.

Can you take me through how your hotline and drop-in center works? Why is it important to make these resources accessible physically and face-to-face?

We live in a state where 41% of our population resides in rural areas. Many Arkansans face barriers to healthcare access that are rooted in transportation issues, economic disparities, a lack of resources in their region, and other factors. Simply put, this is a failure in our system. One of my favorite aspects of Harm Reduction is meeting people where they are, both in the figurative sense and in the literal sense. The hotline is a text-based service that allows people in Arkansas to connect with us, request the resources that we offer, be it safer sex supplies, contraceptives, naloxone, fentanyl test strips, or anything else. We will arrange a secure and discreet drop-off for them within a few days, eliminating many of the extra steps involved in obtaining the care they need.

Our newly opened drop-in center is located in the UAMS 12th Street Health & Wellness Center, also known as the Rainbow Clinic. Being open to offering evidence-based harm reduction services in their clinic is a genuinely groundbreaking movement in this state, and we are so honored and privileged to share a partnership with them. In addition to our harm reduction services, we offer primary care services, mental health services, dental services, and a robust, high-quality food pantry —all at no charge. It's truly a remarkable thing. It's no secret for one reason or another, PWUD don't want to share their substance usage with their physicians. We are looking to change that. Relationship building and face-to-face interactions are key in building a sense of trust with our clients. We are here to demonstrate that the physicians in this clinic are not here to judge or stigmatize, but rather to provide the highest quality care available, regardless of any personal choices a patient has made.

Can you talk about your work to saturate Central Arkansas with resources like naloxone and fentanyl test strips? Are you seeing tangible results in this fight against the overdose crisis?

The most important components are providing lifesaving resources and education to those who need them. However, in the world of harm reduction, you do have to play 3D chess. Since joining the board, one of my main goals has been to change the stigma and the perception of both drug use and harm reduction. The more we can normalize this and spread evidence-based information instead of fear-based scare tactics, the safer our communities can be. One of the most effective methods for changing the culture is to become omnipresent. Be everywhere. If people don't like you occupying their spaces, then take up more space. I've noticed that the more we are out in the community, the more people tell us they appreciate what we are doing. While I think there is still a long way to go, normalizing harm reduction and overdose prevention, but in a way that isn't rooted in punitive action, that is how we gain acceptance. Having tough, yet respectful conversations in places that may not always welcome our work is also critical. If you're not allowed into any spaces, it will be challenging to disseminate resources, raise awareness, and promote education.

Since becoming board Co-Chair, we have distributed thousands of doses of free naloxone and have become an unstoppable force. It's such a gratifying, yet jarring experience when someone stops me while I am out and tells me that the Fentanyl test strips they picked up from our table at an event found traces of fentanyl in a substance, and thus, we potentially saved their life. Look at our schedule. Look at our team. I think you'd be hard pressed to find an organization in central Arkansas that's putting in more legwork to meet people at where they're at, from Raves, to Metal Fests, to Comic Cons, to Drag Shows, and deliveries at unsheltered encampments, community meals, and everywhere in between – we leave no stone unturned, because overdose is just as omnipresent. The proof is in the pudding: CAHR has been meeting diverse populations where they are at, providing training, and distributing naloxone. So much so that people tell us that it saved their lives; consequently, overdose deaths in Arkansas have declined 25%. Many people are doing great things in Arkansas with similar missions to ours, but I'd like to think CAHR has played a part in that number.

Education is also a sizable component of CAHR – can you talk about the need to provide both resources and information so that the community is both equipped and informed?

Resources are great to have, but they are only as useful as the knowledge of the person using them. Knowledge is power, and we want to ensure that individuals are trained to utilize the resources we provide them. With nasal naloxone becoming more common and accessible, it is far easier to overcome the barrier to entry, making training far easier and making the actual act of reversing an overdose easier and less daunting. Fortunately, training for intranasal naloxone use is relatively simple and straightforward, often making it easy to put a fun spin on the training, which can make such a heavy topic a little more digestible.

How would you evaluate the harm reduction landscape in Arkansas from your perspective?

I am self-aware. I understand that harm reduction has its share of detractors. However, the interesting thing is that there tends to be a hyperfocus on only certain aspects of harm reduction. What many critics fail to realize is that recovery is a form of harm reduction. Abstinence is harm reduction. Is it the only aspect of harm reduction? Of course not. There tends to be a hyperfocus on what separates harm reduction from all other substance use treatment options, rather than focusing on our common denominators and what can bring us together. It's no secret that the work we do has been saving lives, serving the most medically marginalized populations, the most at-risk populations, and the most diverse populations. Simply by flying the harm reduction flag, we are excluded from a pool of funding and resources that organizations with a fraction of our impact receive. Although data from around the world indicates that harm reduction is an evidence-based, effective form of care, it still faces barriers to funding and support. While it can be frustrating, I understand that change happens through persistence and over time. While large portions of the modern world have accepted and acknowledged the data to support harm reduction, Arkansas isn't quite there yet. And frankly, that's okay. I look forward to the day the guard changes. As Marty McFly said, "I guess you guys aren't ready for that yet. But your kids are gonna love it."

Are there any gaps you see that can be filled when organizations like CAHR and End Overdose are working toward the same mission in Arkansas?

End Overdose is doing amazing things all over the country. I think a formal partnership in Arkansas could be an exciting tag team. CAHR has a deep local donor base that is passionate about what we do. We are composed of local folks who have their foot in the door of venues, restaurants, bars, events, conferences, and more. We are out here in the trenches doing the work, leveraging existing relationships, and building new ones. I think End Overdose & CAHR have the same mission, both with our strong suits. It would be interesting to see how a two-way partnership, capitalizing on each other's strengths, could tackle the overdose problem in Arkansas.

What's your ultimate vision for CAHR in the coming months and years?

While it may seem ambitious, I would love to have a Little Rock-based Harm Reduction clinic, something that's broadly accepted and would even receive referrals from others. To get full value out of some of this, it may require a push for specific legislative change. From the outside, that may seem quite ambitious in a city like Little Rock, Arkansas; however, the more we are out in the community, the more we see the need for services, and the more we know the support from people in our community, I think it comes down to just going for it. Furthermore, I hope to expand our services to be more mobile-based, enabling us to reach individuals in rural areas who may have trouble accessing standard care. Again, this may seem ambitious, but I am the ambitious type, and I've already carved out a path in my head to make it work, so now it's time to manifest.

Is there anything else you'd like to add?

I would like to thank you for your time. I appreciate the questions, thoughtfulness, and platform. If you like metal or hardcore and are so inclined, listen to my band Terminal Nation. A lot of the ethos I’ve brought into the harm reduction world were sparked there. Keep an eye on CAHR as we continue to expand. I understand that Arkansas presents its own challenges in this type of work, but I have lived in the South my whole life, and I love it here. We have wonderful people, and I believe that if you care about something, it's worth defending; I care about Arkansas, and I believe with my whole heart that Arkansas and the people here are worth fighting for. I've spent a lot of time internally struggling with the fact that our organization misses out on many funding opportunities because of the naming convention that contains a two-letter word. The thought has crossed my mind to maybe consider changing the name to fit the culture and open more doors for us. However, the fact that it's been so stigmatized is the antithesis of the culture. If you look at the bigger picture, if we changed we wouldn't be changing to fit the culture; we would be assimilating to antiquated views. The reality is that harm reduction doesn't need to try to adapt to the culture; harm reduction is the culture.

Visit Central Arkansas Harm Reduction here for more information

~Featured photo credit to Kurt Lunsford~