Opioids

Episode 91: Drug Surveillance Won’t Stop at Opioids with Liz Chiarello

May 25, 2025 Narcotica Criminal Justice, Episodes, Harm Reduction, Opioids, Overdose Crisis 0:55:15 0 Comments

Opioids are some of the best drugs ever invented. News flash! But that’s not something you’ll hear from the mainstream media anymore. No, the official message is that opioids are only problematic and even in the instances where they are prescribed by doctors, there’s this baggage, this stigma and shame attached to it. And no, recognizing the value of these drugs doesn’t make you a big pharma shill, in spite of drug companies that have exploited and yes, in some cases overprescribed these substances — but that’s a critique of capitalism, not chemicals that happen to mercifully act on our opioid receptors.

Of course, no one really outright says we need to ban all opioids. But in effect, that’s what we’re doing, banning them. Prescriptions of opioids have dropped significantly in the past decade, falling by 51.7% over 11 years, from 260.5 million in 2012 to 125.9 million in 2023. That hasn’t resulted in a significant drop in overdose deaths. Instead, the current climate, and attacks from the DEA has left many doctors now afraid to prescribe these drugs, even when necessary. And the rash of stigma against people who use opioids, licit or illicit, has not done anything to actually stop drug use. But these policies and attitudes do have an impact. Who has that harmed the most? Patients who need them.

On this episode, Narcotica co-host Troy Farah speaks with Liz Chiarello, an Associate Professor of Sociology at Saint Louis University where she conducts research at the intersection of healthcare and law. Her research centers on how cultural forces such as law, politics, and organizational policy influence decision-making in healthcare and the criminal-legal system. She is author of the recent book “Policing Patients: Treatment and Surveillance on the Frontlines of the Opioid Crisis.”

If you liked this episode, here are others you might enjoy:
Episode 84: How Drug Seizures Damage Public Health with Drs. Bradley Ray, Jennifer J. Carroll and Brandon del Pozo
Episode 65: Restoring Trust in Doctors Amidst The Overdose Crisis with Dr. Ben Cocchiaro and Dr. Ashish Thakrar
Episode 81: Harm Reduction Against the Prison-Industrial Complex

Follow Narcotica on Instagram, Facebook, Twitter, YouTube and support us on Patreon. We just opened a shop where you can order Narcotica merch: narcocast.myshopify.com Help keep this podcast ad-free! Your support is appreciated!

We’re on Spotify, iTunes, Stitcher and more. Tell your friends about us! Rate us! And thanks for your support!
Producers: Christopher Moraff, Troy Farah, Aaron Ferguson
Music: Glass Boy / Nomad1
Intro voice: Jenny Schaye
Image: via Flickr

Bonus Episode: When Nothing Changes Nothing Changes from Naturally Noncompliant

May 28, 2024 Narcotica Episodes, Opioids 0:32:08 0 Comments

Narcotica and Narcomedia are proud to share an exciting new sibling podcast, Naturally Noncompliant, which is about people who stand in line and fight for safe supply, especially methadone, the original safe supply. Methadone is the first frontier in this fight, and this show emphasizes the voices of patients and directly impacted people in that battle.

The material for this show stems from the “Naturally Noncompliant” call that takes place every other Thursday and is organized by the National Survivors Union, the national voice of people who use drugs.

During COVID-19 methadone clinics were allowed to relax the stringent rules that had been in place for many decades for the first time. Few of them did so, and our story and interview today center around the entrenched attitudes and ossification that has kept the very treatment systems tasked with helping from doing so. Imagine what everyone else is doing…

This is the first of a two part interview with Irene Garnett and Caty Simon.

Caty Simon has spent 20 years in the low-income rights, psychiatric survivors’ rights, sex workers’ rights, and drug users union movements. She is a leadership team member of and a sex worker liaison for National Survivors Union (NSU), the United States national drug users union.

Follow Naturally Noncompliant on iTunes, iHeart Radio, Spotify and more.

Episode 86: Why Naloxone Still Matters with Nancy D. Campbell

April 28, 2024 Narcotica Big Pharma, Episodes, Opioids 1:15:04 0 Comments

Naloxone is a miracle drug. Calling any drug a miracle can be problematic, but admittedly there are a few of them, in my opinion: penicillin, insulin, mifepristone and misoprostol, thorazine, viagra (cough, cough) and yes, naloxone. I think it qualifies as a miracle drug, something that works so well it is astonishing.

So many people fought so hard and for so long to have access to naloxone. It wasn’t always so available like it is in some places today. But the way that we are treating opioid overdose antagonists is changing. Many companies have price-gouged their way into profiting and exploiting a vulnerable population. They are bringing in naloxone analogs that they claim are more effective, without much evidence, but they do have serious side effects. And because the drug supply is only getting more and more unpredictable, with many non opioids entering the mix like xylazine and benzo analogs, naloxone may not help with overdoses of this kind. How can we navigate this shifting landscape?

Narcotica co-hosts Chris Moraff and Troy Farah speak with Nancy D. Campbell, author of the books Discovering Addiction and OD: Naloxone and the Politics of Overdose. She is a historian of science who studies addiction research and treatment at RPI, Rensselaer Polytechnic Institute in Troy, New York, including at the U.S Narcotic Farm in Lexington, Kentucky.

Learn more about Nancy D. Campbell here.

Read “OD: Naloxone and the Politics of Overdose” here: https://doi.org/10.7551/mitpress/12054.001.0001

If you liked this episode, here are others you might enjoy:
Episode 36: Moral Hazards and Naloxone, A Toxicologist’s Perspective with Ryan Marino
Episode 65: Restoring Trust in Doctors Amidst The Overdose Crisis with Dr. Ben Cocchiaro and Dr. Ashish Thakrar
Episode 73: Oh No! Not Naltrexone! with Nancy Curran

Follow Narcotica on Instagram, Facebook, Twitter, YouTube and support us on Patreon. We just opened a shop where you can order Narcotica merch: narcocast.myshopify.com Help keep this podcast ad-free! Your support is appreciated!

We’re on Spotify, iTunes, Stitcher and more. Tell your friends about us! Rate us! And thanks for your support!
Producers: Christopher Moraff, Troy Farah, Zachary Siegel, Aaron Ferguson
Music: Glass Boy / Nomad1
Image: Image via VCU Capital News Service / Flickr // edit: Troy Farah
Intro voice: Jenny Schaye

Episode 82: Drug War Activism and the Future of Harm Reduction with Louise Vincent

April 20, 2023 Narcotica Episodes, Opioids 01:12:18 0 Comments

The Drug War is more brutal than ever. Overdose deaths are still shattering records, there’s talk of war with the cartels, increased penalties are just making things worse, there’s little money for harm reduction programs or addiction treatment, yet plenty of cash for prisons, cops and the DEA, weird new drugs are appearing that no one knows how to handle and on and on. Meanwhile, the harm reduction movement is going through some massive changes, some good, some bad. But what we know for sure is that it’s critical for people to come together, stand up and demand a stop to the destructive force that is prohibition.

On this episode, the crew interviews Louise Vincent, director of the NC Survivors Union in North Carolina and on the leadership team of the National Drug User Union, an organization of former and active drug users who have come together to provide services for a community that is under-represented and underserved. Narcotica’s Chris Moraff, Zach Siegel and Troy Farah talk with Louise about xylazine, drug testing, using portable oxygen tanks to reverse cocaine overdoses (yes, really!), methadone access, the importance of drug user unions, why drug sellers are a community service, what it was like being on Last Week Tonight and so much more.

We’ve been trying to get Louise on for over a year and are really excited to share this episode with everyone. Thanks for listening. Expect more new episodes from us soon.

Learn more about NC Survivors Union at http://ncurbansurvivorunion.org/

Learn more about Louise’s story here: https://drugpolicy.org/drugsellers/louise

If you liked this episode, here are others you might enjoy:
Episode 62: Policing Pleasure — The Intersection of Sex Work and Drug Use with Tamika Spellman and Caty Simon
Episode 56: Drug Use During Disaster with Aaron Ferguson
Episode 67: Methadone in the Time of Covid with Danielle Russell

Follow Narcotica on Instagram, Facebook, Twitter, YouTube and support us on Patreon. We just opened a shop where you can order Narcotica merch: narcocast.myshopify.com Help keep this podcast ad-free! Your support is appreciated! We’re on Spotify, iTunes, Stitcher and more. Tell your friends about us! Rate us! And thanks for your support!
Producers: Christopher Moraff, Troy Farah, Zachary Siegel, Aaron Ferguson
Music: Glass Boy / Nomad1
Image: Vocal NY via Flickr // edit: Troy Farah
Intro voice: Jenny Schaye

Episode 80: A Messy History of Methadone with Dr. Zoe Adams

December 31, 2022 Narcotica Addiction, Episodes, Opioids 01:16:58 0 Comments

At Narcotica, we’ve often talked about how methadone is one of the most over-regulated substances on the planet. It’s not a perfect drug — nothing is — but it helps a lot of people. So why is it so hard to access?

On this episode, the crew (Zachary Siegel, Chris Moraff and Troy Farah) speak with Dr. Zoe Adams, an internal medicine resident at Massachusetts General Hospital, whose thesis was a narrative history of methadone. It’s a long, strange chronicle, from its development in Germany, to becoming a mainstay in Nixon’s War on Drugs, but what’s most surprising is how little has changed. Learn about why this drug is so scrutinized, stigmatized and what people are doing to make it more available.

Follow Zoe on Twitter at: @zoe_m_adams

Read Zoe’s thesis here: https://elischolar.library.yale.edu/ymtdl/4049/

If you liked this episode, here are others you might enjoy:

Episode 73: Oh No! Not Naltrexone! with Nancy Curran

Episode 65: Restoring Trust in Doctors Amidst The Overdose Crisis with Dr. Ben Cocchiaro and Dr. Ashish Thakrar

Episode 67: Methadone in the Time of Covid with Danielle Russell

Episode 48: Moms And Methadone with Elizabeth Brico

Follow Narcotica on Instagram, Facebook, Twitter, YouTube and support us on Patreon. We just opened a shop where you can order Narcotica merch: narcocast.myshopify.com Help keep this podcast ad-free! Your support is appreciated! We’re on Spotify, iTunes, Stitcher and more. Tell your friends about us! Rate us! And thanks for your support!

Producers: Christopher Moraff, Troy Farah, Zachary Siegel, Aaron Ferguson

Music: Glass Boy / Nomad1

Intro voice: Jenny Schaye

Episode 73: Oh No! Not Naltrexone! with Nancy Curran

June 25, 2022 Narcotica Addiction, Episodes, Opioids 01:08:35 0 Comments

Naltrexone, also known by its brand name, Vivitrol, is an opioid antagonist that kicks opioids off of opioid receptor in the brain, not unlike naloxone. But thanks to a combination of overprescription, unscrupulous marketing practices and ubiquitous use over more effective alternatives, naltrexone is a very controversial drug. In fact, a common reaction is Oh no! Not naltrexone!

Of course, naltrexone has some benefits and many people say their life has been saved by it. And at Narcotica, we don’t believe any drug is “bad” or “evil.” So where does this substance fit into the broader scheme of things? We’ve spoken about naltrexone many times on this show, but never this indepth before.

Narcotica co-hosts Zachary Siegel and Troy Farah speak with Nancy Curran, a nurse practitioner who has been practicing for 5 years in an OBOT clinic in the Lowell Massachusetts area, treating both opioid and alcohol use disorders. She prescribes buprenorphine (both Suboxone and Sublocade), as well as naltrexone (Vivitrol). She also treats patients who need Hep C treatment. Nancy is passionate about advocating for and educating her patients on their medication options, as well as their rights.

They discuss the history of hallucinogenic opioids, the shrewd and quasilegal marketing practices of Alkermes, Inc., how naltrexone stacks up against buprenorphine and methadone, why stigma persists against people who take certain opioid use disorder drugs but not others, the difference between addiction and dependency, some basic opioid receptor science, and much, much more.

Follow Nancy on Twitter at: @cashboygo

More background on naltrexone and the XBOT Studay can be found here and here. We also recommend reading Walter Sneader’s book: Drug Discovery, A History and also Nancy Campbell’s book OD: The Politics of Overdose.

You can read Zach’s article on Four Good Days and more here: https://www.nytimes.com/2021/05/11/magazine/addiction-movies.html

If you liked this episode, here are others you might enjoy:
Episode 19: Debunking Bupe Diversion Myths with Molly Doernberg
Episode 30: Getting Wrecked with Dr. Kim Sue
Episode 36: Moral Hazards and Naloxone, A Toxicologist’s Perspective with Ryan Marino

Follow Narcotica on Instagram, Facebook, Twitter, YouTube and support us on Patreon. We just opened a shop where you can order Narcotica merch: narcocast.myshopify.com Help keep this podcast ad-free! Your support is appreciated! We’re on Spotify, iTunes, Stitcher and more. Tell your friends about us! Rate us! And thanks for your support!

Producers: Christopher Moraff, Troy Farah, Zachary Siegel
Co-producer: Aaron Ferguson
Music: Glass Boy / Nomad1
Intro voice: Jenny Schaye
Image: edit: Troy Farah

Episode 68: Is The Drug War Getting Better… Or Worse? with Zach Siegel, Chris Moraff and Troy Farah

March 3, 2022 Narcotica Episodes, Opioids, Overdose Crisis, Psychedelics 01:10:13 0 Comments

On this episode, Narcotica co-hosts Zachary Siegel, Chris Moraff and Troy Farah interview each other, riffing on one question: Is the drug war getting better… Or worse? They cover everything from nitazenes, Dopesick, the Drug User’s Liberation Front, banning psychedelics like DiPT, benzo dope, West Virginia, buprenorphine, psychedelic exceptionalism, drug testing, crack pipes, supervised consumption sites in NYC and much, much, more.

Their conclusion? You’ll have to listen to find out. OK, not really: Like many things, it’s a mix of both progress and backsliding. Narcotica’s founders discuss their current frustrations and what’s giving them optimism in America’s longest running war, a conflict directed at people. Maybe the end is in sight after all.

Follow Chris Moraff on Twitter: @moraffreports
Follow Zach Siegel on Twitter: @ZachWritesStuff
Follow Troy Farah on Twitter: @filth_filler

If you liked this episode, here are others you might enjoy:
Episode 27: What’s the Most Dangerous Drug?
Episode 58: How Racism Fuels The Drug War with Kassandra Frederique
Episode 51: The Joy of Drug Use with Dr. Carl Hart

Follow Narcotica on Instagram, Facebook, Twitter, YouTube and support us on Patreon. Help keep this podcast ad-free! Your support is appreciated! We’re on Spotify, iTunes, Stitcher and more. Tell your friends about us! Rate us! And thanks for your support!

Producers: Christopher Moraff, Troy Farah, Zachary Siegel
Co-producer: Garrett Farah / Troy Farah
Music: Glass Boy / Holly Mangler
Intro voice: Jenny Schaye
Image: Noun Project // edit: Troy Farah

Episode 67: Methadone in the Time of Covid with Danielle Russell

February 8, 2022 Narcotica Episodes, Opioids, Overdose Crisis 00:58:10 0 Comments

Harm reduction programs like syringe access, supervised consumption or even just handing out condoms on the street, can be some of the only access to healthcare some people encounter. Definitely not all, but some people who use drugs routinely shun going to the doctor—not because they don’t care about their health, but because our for-profit healthcare system treats almost everyone who uses an illicit substance like complete shit. And people who use drugs have been treated like pariahs long before the covid pandemic, but things got way worse once the virus came to town.

Previously on Narcotica, co-host Chris Moraff did an episode all about how doctors need to work harder to rebuild the patient-trust relationship. And many medical professionals are doing that work, which makes such a huge difference. It’s hard to understate how valuable it can be to receive nonjudgmental medical care that doesn’t hinge on absolute abstinence.

That episode, number 65, which we encourage you to listen to after this one, came from the perspective of two amazing doctors, Ashish Thakrar and Ben Cocchiario. However, on this episode, we want to talk to someone from the other side of the aisle to get a different viewpoint from someone with lived experience in this area.

Why would you go to a healthcare provider for an infection or injury if you’re going to be lectured about your drug use, even if it has nothing to do with why you’re there? Or you might be forced to hand over your urine or have your possessions rifled through by a nurse. Even for people that don’t use illegal substances, our healthcare system is a nightmare to try and navigate. It only gets worse if you happen to self-medicate or enjoy chemicals that aren’t sanctioned by the FDA.

Narcotica co-host Troy Farah speaks with Danielle Russell of Phoenix, Arizona, who is currently a justice and social inquiry PhD student at Arizona State University. She studies how the criminalization of substances used for personal pleasure has become a key issue and tool for social control, contributing to the ongoing legacy of racialized criminalization and mass incarceration in the U.S. Having personally experienced many of the harms that impact people who use illicit drugs, she is passionate about mutual aid and working to change the structures that impose harms on the bodies of drug users. Her research interests are oriented towards community-based participatory research.

Follow Danielle on Twitter @DopefiendPhD and you can read the study she co-authored here:
https://pubmed.ncbi.nlm.nih.gov/33461838/

If you liked this episode, here are others you might enjoy:
Episode 65: Restoring Trust in Doctors Amidst The Overdose Crisis with Dr. Ben Cocchiaro and Dr. Ashish Thakrar
Episode 48: Moms And Methadone with Elizabeth Brico
Episode 56: Drug Use During Disaster with Aaron Ferguson

Follow Narcotica on Instagram, Facebook, Twitter, YouTube and support us on Patreon. Help keep this podcast ad-free! Your support is appreciated! We’re on Spotify, iTunes, Stitcher and more. Tell your friends about us! Rate us! And thanks for your support!

Producers: Christopher Moraff, Troy Farah, Zachary Siegel
Co-producer: Garrett Farah / Troy Farah
Music: Glass Boy / Holly Mangler
Intro voice: Jenny Schaye
Image: Noun Project // edit: Troy Farah