buprenorphine

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

Over the past two decades, as fatal drug overdoses have risen precipitously, few professions have been hit harder by the crisis than the medical community. Physicians in particular have found themselves in the no-win position of being both blamed for the overdose crisis, which claimed more than 100,000 American lives in the past 12 months, while being tasked with containing it.

According to one dominant narrative, it was cavalier doctors who sparked the crisis in the first place, by overprescribing habit forming narcotic painkillers to millions of Americans after being softened up at lavish dinners and then duped by nefarious pharmaceutical reps using fudged data.

But that’s overly simplistic. For starters, it ignores the fact that the greatest spike in drug deaths came when doctors reigned in opioid prescribing after authorities started targeting so-called pill mills. This left tens of thousands of pain patients stranded and paved the way for the introduction of illicitly made fentanyl into the U.S. to fill unmet demands.

Narcotica co-host Christopher Moraff delves into this topic, asking how the medical community can work to restore trust from their patients who are justifiably suspicious of the U.S. healthcare system, speaking with doctors Ashish Thakrar and Ben Cocchiario, who both work for the University of Pennsylvania medical system in Philadelphia, a focal point of the overdose crisis. They cover everything from methadone prescribing to overfunding the DEA, all of it underlining the importance of patient autonomy.

Follow Ben Cocchiaro at UPenn
Follow Ashish Thakrar on Twitter @especially_APT

If you liked this episode, here are others you might enjoy:
Episode 46: Behind The Pharmacists’ Counter with Jessica Moreno
Episode 36: Moral Hazards and Naloxone, A Toxicologist’s Perspective
Episode 30: Getting Wrecked with Dr. Kim Sue

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

Episode 56: Drug Use During Disaster with Aaron Ferguson

Our planet is in crisis, plagued by an increase in wildfires, floods, hurricanes, freak storms and outbreaks of disease. As a result, we’re seeing more and more people isolated, left to fend for themselves, as the cracks in public infrastructure only seem to widen.

To use one prominent example, the state of Texas has been slapped with recurrent cataclysms and catastrophes of late, most recently the February winter storm that crushed the power grid, leading to food and water shortages, which left at least 111 people dead.

At Narcotica, we always wonder about what happens to people who use drugs whenever ecological disaster strikes. Co-hosts Zachary Siegel and Troy Farah talk with Aaron Ferguson, who works as an outreach provider in Austin, Texas and is also on the leadership team of the National Drug Users Union. (Aaron was also a our co-producer on the show for about 20 episodes and volunteered to help with sound editing this one as well!)

We discuss everything from the evolving drug trade in Texas to the cult-like mentality that can sometimes manifest in the addiction recovery community and much more.

You can follow Aaron Ferguson on Twitter: @sciencenotheism and watch The Methadone Manifesto, a recent webinar hosted by the Urban Survivors Union. Aaron also co-authored a piece in the National Academy of Medicine discussing some of the public health challenges addiction treatment services faced during the recent Texas storm.

Follow Narcotica on FacebookTwitter and support us on Patreon. Your support is appreciated! We’re on Spotify, iTunes, YouTube, Stitcher and more. Tell your friends about us!

If you liked this episode, here are others you might enjoy:
Episode 51: The Joy of Drug Use with Dr. Carl Hart
Episode 18: Drug User Unions – The Rebirth of Harm Reduction with Jess Tilley and Albie Park
Episode 42: Supervised Consumption is an Essential Service

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

Episode 43: Russian Roulette—Life, Death and Getting High in Putin’s Backyard

The last place you’d want to be dependent on drugs, besides the Philippines, North Korea or the United States, is probably Russia. To give just one example, the Motherland has long banned the use of medication-assisted treatment, such as buprenorphine or methadone, which has made recovery next to impossible for many users. 

Narcotica co-host Christopher Moraff takes a deep dive into Russian drug culture with Aleksey Lakhov, the deputy director of the charitable foundation Humanitarian Action in St. Petersburg. They discuss the culture of naloxone, synthetic drug use, heroin trends, the death penalty, legality of MAT and much more. Here’s the paper about HIV prevention mentioned in the interview and you can read more on this topic in Filter Magazine.

Follow Aleksey Lakhov on Twitter @Alexei_L

Follow Narcotica on Facebook, Twitter and support us on Patreon. Your support is appreciated! We’re on Spotify, iTunes, YouTube, Stitcher and more. Tell your friends about us!

Producers: Christopher Moraff, Troy Farah, Zachary Siegel
Co-producer: Garrett Farah
Music: Glass Boy / Poddington Bear
Image: Flickr / edit: Troy Farah

Episode 36: Moral Hazards and Naloxone, A Toxicologist’s Perspective with Ryan Marino

An opioid overdose can be a terrifying experience. When too much of a  drug like heroin or fentanyl floods the brain, it can cause your  breathing to stop. Sometimes you wake up, sometimes you don’t. But  there’s a miraculous drug called naloxone or brand name Narcan that can  reverse an opioid overdose and save your life.  

Today’s guest is Ryan Marino, an emergency room physician and medical  toxicologist at Cleveland University Hospitals. We discuss moral  hazards about naloxone, one of the most important drugs on the planet,  but also buprenorphine, competitive antagonists for benzos and  stimulants, and dispelling drug myths on social media. 

How to Get Naloxone by Zachary Siegel in VICE

Also visit: naloxoneforall.org

Follow Ryan on Twitter.

Follow Narcotica on Facebook, Twitter and support us on Patreon. Your support is appreciated! We’re on Spotify, iTunes, YouTube, Stitcher and more.
Tell your friends about us!


Producers: Christopher Moraff, Troy Farah, Zachary Siegel
Co-producer: Garrett Farah
Music: Glass Boy / Min Y Llan

Photo: Naloxone via Wikipedia / Edit Troy Farah  

Episode 23: Bring Back Prescription Heroin! with Travis Lupick

With perhaps the exception of fentanyl, no drug is seen as more dangerous or controversial than heroin. But when you look at decades of medical literature, it’s clear that heroin, also known as diacetylmorphine, is just another opioid, and it has a place in medicine. On this episode, Troy Farah and Zachary Siegel discuss the controversial idea of prescription heroin with Canadian journalist Travis Lupick, author of Fighting for Space.

You can follow Travis Lupick @tlupick Twitter here.

Follow Narcotica on FacebookTwitter and support us on Patreon. Your support is appreciated! We’re on Spotify, iTunes, YouTube, Sticher and more. Tell your friends about us!

Producers: Christopher Moraff, Troy Farah, Zachary Siegel
Co-Producer: Aaron Ferguson
Music: Glass Boy and Aaron Ferguson
Image Credit: Wikipedia / Edit by Troy Farah

Episode 19: Debunking Bupe Diversion Myths with Molly Doernberg

If you ask many, many people whose lives have been upended by opioids, buprenorphine is a life saver. It can literally cut the risk of a fatal overdose by half or more in folks who have an opioid addiction. Also known as Subutex or Suboxone, buprenorphine is one of the three FDA approved medications to treat what’s formally known as opioid use disorder. It’s a partial agonist at opioid receptors, relieving cravings but with far less risk for overdose than other opioids like heroin, which are full agonists.

Zachary Siegel, Troy Farah and Christopher Moraff speak with Molly Doernberg, a grad student at Yale School of Public Health, who co-authored a recent paper called “Demystifying buprenorphine misuse: Has fear of diversion gotten in the way of addressing the opioid crisis?” which was published in the journal Substance Abuse last April. They discuss what buprenorphine is, why people take it, and why stigma and fears that buprenorphine may be used illicitly are actually contributing to more overdose deaths.



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Read Doernberg’s paper here: https://doi.org/10.1080/08897077.2019.1572052 and follow her on Twitter.

Producers: Christopher Moraff, Troy Farah, Zachary Siegel
Co-Producer: Aaron Ferguson
Music: Glass Boy and Aaron Ferguson
Image Credit: Chris Moraff / Edit by Troy Farah