From Heroin to Harm Reduction: How I Built a New Life (And You Can Too)

December 1, 2025 

John Makohen, Author

Tom O'Connor, Publisher

I went from surviving on the streets with a 40-bag-a-day habit to building a life I never thought possible — and I'm sharing how you can, too. A cold seeps into your bones when you're sleeping on the streets of Manhattan in the dead of winter. It's the kind of cold that makes you wonder if you'll wake up at all.

I know, because I lived it. I spent years chasing heroin, burning bridges, and convincing myself that I was beyond saving. When you're that deep in addiction, hope feels like a foreign concept — something that happens to other people, not to you.

At my worst, I was homeless, sick, and running on nothing but desperation and dope. I was scamming, stealing, and surviving by the slimmest margins, utterly detached from the idea that any future was possible.

And yet, somehow, I clawed my way out. Not all at once, not cleanly, and not perfectly. But step by step, I built something new.

This is about that journey — what worked, what didn't, and how harm reduction helped me rebuild my life in a way that stuck.

If you're struggling or think you might be past the point of no return, I want you to know this: you're not. And you don't have to do it alone.

The Myth of "Rock Bottom"

People love to talk about "hitting rock bottom" as if it's some magical turning point — like once you hit it, you wake up with a sudden epiphany and change everything. But let me tell you something: rock bottom is different for everyone, and it's not always the wake-up call people think it is.

For me, rock bottom wasn't just one moment. It was a series of moments — some terrifying, some mundane, but all pushing me toward the realization that I couldn't keep going like this.

• I was watching people around me overdose and die, while I waited for it to be my turn.

• It was hurting people I loved and knowing, even as I did it, that I was destroying every last shred of trust they had in me.

• It was sitting in a jail cell, withdrawing so hard I thought I might die.

And still, I didn't wake up one day and decide to change. The truth is, I wanted to quit and didn't want to leave a thousand times before recovery snuck up on me. That's where harm reduction came in.

Harm Reduction Saved My Life

Most of the time, when people talk about addiction recovery, they push the all-or-nothing model — go to rehab, get clean, stay clean.

If you relapse? You failed. If you don't want to quit altogether? You're not ready. But for many of us, that black-and-white thinking keeps us stuck.

I tried the "quit cold turkey" thing. I tried rehab. I tried 12-step programs. Each time, I'd last a little while before slipping back into old habits, feeling like a failure, and spiraling even harder.

Then, I learned about harm reduction. Harm reduction isn't about forcing abstinence. It's about meeting people where they're at and giving them the tools to stay alive and as safe as possible while they figure out their next steps.

It was the first time I felt like I had options.

• I didn't skip days at the methadone program I attended.

• I met with my counselor, who supported me without judgment.

• I switched to clean needles so I wouldn't end up with infections or Hepatitis C.

• I connected with people who didn't judge me but instead helped me find safer ways to use while I worked toward cutting back.

At first, I didn't think any of this mattered — I thought if I wasn't completely sober, I wasn't changing. But little by little, these small steps gave me a chance, actually, to build a life instead of just barely surviving.

Another recovery story you may like: The Power of Recovery: A Journey, A Mission, A Movement 

How I Slowly Rebuilt My Life

Harm reduction gave me breathing room.

It gave me the chance to think beyond my next fix, to start making different choices without the weight of shame and failure hanging over me. Here's what that process looked like:

1. Redefining Recovery on My Terms

For a long time, I thought recovery meant being 100% sober, forever. And sure, for some people, that's the goal. But I had to let go of the idea that there was only one right way to do this. I started by setting small, realistic goals:

• Cutting back my use instead of quitting cold turkey.

• I prioritize my physical health by eating regularly, staying hydrated, and visiting clinics for regular check-ups.

• Finding some stability, even if it wasn't perfect.

2. Finding Community and Support

I had burned many bridges and knew I couldn't do this alone. But I also knew I wasn't ready for traditional recovery spaces that centered around complete sobriety. Instead, I connected with harm reduction groups — people who understood where I was at and didn't judge me for it. That made all the difference. 

Having people who supported me no matter what, who celebrated small wins instead of expecting perfection. That gave me hope.

3. Addressing the Root Causes

Drugs weren't my only problem. Trauma, mental health struggles, and deep-seated shame were fueling my addiction.

Once I started stabilizing, I had to face all the reasons I had turned to heroin in the first place. Therapy helped. Medication helped. Finding purpose in something bigger than myself helped.

If You're Struggling, Here's What I Want You to Know

I won't sugarcoat it — this shit is hard. It's messy, nonlinear, and full of setbacks. However, if you're reading this, you're already considering change. That matters. You don't have to be perfect. You don't have to quit everything all at once. You have to start.

Here's How You Can Start Today:

• Track your use. Please write it down, and notice patterns.

• Explore harm reduction. Find a local needle exchange, use test strips, and carry Narcan.

• Reach out to someone who gets it. Whether it's a harm reduction worker, a friend in recovery, or an online community — talk to someone.

• Set one small goal. Not a huge, scary goal — just one small step forward.

I didn't think I'd make it this far. I didn't want to get sober. I wanted to live and use it when I wanted. But somehow recovery snuck up on me. I thought I was too far gone. But I wasn't.

And neither are you.

You don't have to have it all figured out today. Just take the next step, and then another. One day, you might wake up and realize you built a life you never thought possible. I did. And so can you.

I want to say this and say it loudly: Harm reduction doesn't have to be a means to an end—abstinence. Harm Reduction is its own pathway. If you choose to use it for the rest of your life, that is fine, and harm reduction can ensure that you can pursue this safely with the least possible harm to your life, family, and loved ones.

Final Thoughts

Recovery isn't a straight line; it doesn't look the same for everyone. But no matter where you are or how deep you think you're buried, there's a way forward.

Harm reduction saved my life. It gave me a fighting chance when I thought I had none. And if you're struggling, I hope it gives you one too.

You deserve more than just survival; you deserve a future. And I promise — it's not too late to build one.

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John Makohen also authored two influential books: A Heroin User's Guide to Harm Reduction: Staying Alive in the Age of Fentanyl and Xylazine and Resilience: Building Strength in Early Recovery. The first is a bold, honest survival manual for people who use drugs in today's overdose crisis. The second book is a straightforward guide with practical strategies for building strength and confidence during early recovery.

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