Content Warning: This article discusses drug use, heroin addiction, and trauma. John Makohen, a seasoned substance use counselor and author of *A Heroin User’s Guide to Harm Reduction*, shares his lived experience of life on the streets, the risks of drug use, and the lessons that shaped his journey toward recovery.

Are you stuck in survival mode? When Survival Becomes A Diagnosis, refers to a state of ongoing stress and survival mode that can cause various mental and physical health problems. This happens when the body's natural stress response, known as the fight-or-flight response, stays active over time, impacting different bodily systems and mental functions. While survival mode is a normal stress response, long-term activation can lead to negative effects.