chris moraff

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

Follow Narcotica on Instagram, FacebookTwitter, 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: Aaron Ferguson
Music: Glass Boy / Nomad1
Intro voice: Jenny Schaye
Image: Stockvault // edit: Troy Farah

Episode 61: Undoing Drugs—Harm Reduction’s Early History with Maia Szalavitz

We’re truly living through a disaster. Drug overdose deaths rose nearly 30 percent in 2020 to a record high 93,000. This is no longer an “opioid” crisis. What I mean is, 2020 overdose deaths linked to stimulants, especially methamphetamine, also broke records. The other key development here is the further entrenchment of illicit fentanyl in the drug supply, it’s a contamination at mass-scale. At this point, we’re in a poisoning crisis driven by one thing: prohibition.

But harm reduction is the movement that continues to push back against draconian drug policy, even when the odds seem against us. Longterm listeners of this show will be familiar with how harm reduction saves lives, but how did this movement get started in the first place?

To learn more, all three Narcotica co-hosts —Zachary Siegel, Troy Farah and Chris Moraff—speak with author Maia Szalavitz, whose new book Undoing Drugs—The Untold Story of Harm Reduction and the Future of Addiction—is available now. We discuss the struggles of syringe access in the early days to the present, the challenges of being a functioning drug user, and how harm reduction can help address policy changes beyond drugs.

Follow Maia on Twitter @maiasz

Follow Narcotica on FacebookTwitter, 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!

If you liked this episode, here are others you might enjoy:
Episode 22: Changing the Narrative with Maia Szalavitz and Leo Beletsky
Episode 51: The Joy of Drug Use with Dr. Carl Hart
Episode 20: The Pitfalls of Mainstream Harm Reduction with Eliza Wheeler

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

Episode 60: Perinatal Panic—Drugs, Pregnancy and Stigma with Ria Tsinas, Joelle Puccio and Erika Goyer

One area where drug stigma especially persists, even among harm reduction advocates, is the prejudice against mothers and pregnant people who use drugs. Even some people in syringe exchange or who work in drug policy are against the idea of people with the capacity for pregnancy, (i.e. anyone with a uterus), using pretty much any drugs for any purpose.

It’s not clear why the principles of harm reduction that we extend to almost everyone else suddenly stop when it involves a fetus or a uterus. But the lives of pregnant people are no less important than anyone else who uses drugs, and the same attitudes of stigma, abstinence-only and surveillance don’t work here either—they just make the situation worse.

Narcotica co-host Troy Farah speaks with not one, but three guests from the Academy of Perinatal Harm Reduction, a non-profit that focuses on people with the capacity for pregnancy, who also happen to use drugs. They are:

Ria Tsinas, based in Portland, Oregon, who works at Outside In as a syringe exchange specialist and community health worker. She is also the mother of a wonderful kid.

Erika Goyer, based in Austin, Texas, Advocate at National Perinatal Association and co-founder at Academy of Perinatal Harm Reduction. She is also a parent.

And Joelle Puccio, a travel nurse who is sometimes based in Seattle, Washington and works as a voard of directors at The People’s Harm Reduction Alliance.

Learn more at perinatalharmreduction.org/

Follow Joelle on Instagram @joellepuccio
Follow Ria on Instagram @gtsinas
Follow Erika on LinkedIn

Follow Narcotica on FacebookTwitter, 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!

If you liked this episode, here are others you might enjoy:
Episode 48: Moms And Methadone with Elizabeth Brico
Episode 30: Getting Wrecked with Dr. Kim Sue
Episode 24: How To Get Abortion Pills Feat. Lynn Paltrow and Francine Coeytaux

Producers: Christopher Moraff, Troy Farah, Zachary Siegel
Co-producer: Garrett Farah
Music: Glass Boy / done with fish
Intro voice: Jenny Schaye
Image: Pixabay edit: Troy Farah

 

Episode 58: How Racism Fuels The Drug War with Kassandra Frederique

Few social justice groups have put in as much work to end the war on (people who use) drugs like the Drug Policy Alliance. Since 2000, DPA has been behind some landmark drug reforms, such as leading a campaign to enact major reforms of New York’s notorious Rockefeller drug laws, assisting in a public education campaign that saw Uruguay legalize cannabis in 2013, not to mention funding and drafting the Oregon drug decriminalization measure that passed last year. According to the organization, DPA has played a pivotal role in roughly half of the campaigns that have legalized medical marijuana in the U.S.

Narcotica co-hosts Zachary Siegel, Chris Moraff and Troy Farah speak with Kassandra Frederique, the executive director of DPA, who has been with the organization since 2009 as an intern. We discuss everything from racist policing, cannabis reform laws, and the future of drug policy reform.

This interview was recorded around the time of the Derek Chauvin trial, so some states, like New Mexico, had not yet legalized adult-use cannabis.

You can follow Kassandra Frederique on Twitter: @Kassandra_Fred and learn more about Drug Policy Alliance’s work at drugpolicy.org

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 44: Reimagining Public Health and Racial Justice with Dr. Ricky Bluthenthal
Episode 30: Getting Wrecked with Dr. Kim Sue
Episode 11: Beyond Borders — How the U.S. Exports Dangerous Drug Policy with Sanho Tree

Producers: Christopher Moraff, Troy Farah, Zachary Siegel
Co-producer: Aaron Ferguson / Troy Farah
Music: Glass Boy / Aaron Ferguson / Nomad1
Intro voice: Jenny Schaye
Image: Pixabay 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 55: Street Sampling Synthetics, from Carfentanil to Xylazine with Alex Krotulski

Amid a wave of synthetic drugs in recent years, Kensington, Pennsylvania has emerged as the locus for a different kind of experimentation, through a new generation of freelance entrepreneurs. Their bathtub chemistry is often guided by trial and error—leaving doctors, public health officials and harm reductionists struggling to understand the latest side effects.

Last year, a concerned toxicologist from the nonprofit Center for Forensic Science Research & Education (CFSRE) at the Fredric Rieders Family Foundation, the academic and research arm of NMS Labs outside Philadelphia, conceived of a new testing program. It employs sophisticated mass spectrometry to reveal the composition of retail-level street drugs.

Alex Krotulski, an associate director of the CFSRE, spoke to Narcotica co-host Chris Moraff about everything from synthetic cannabinoids like 5F-APB to carfentanil to xylazine.

You can follow Alex Krotulski on Twitter: @alexkrotulski and read Chris’s report on this subject in Filter Magazine.

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!

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

Episode 50: Sicarios and Supply Side Economics with Stewart Scott

On this episode, we discuss how Mexico became a flashpoint of the war on drugs, broader trends in American foreign policy and drug policy, as well as the evolution of synthetic drugs as the main category of illicit narcotics. Our guest is Stewart Scott, a security analyst who for years penned one of the best annual assessments of Mexico’s evolving cartels for Stratfor and has since transitioned to Torchstone Global, a private security consulting firm. 

Scott has worked in the trenches of intelligence and security for 35 years and began his career in army reserve and National Guard intelligence before spending 10 years as a special agent with the U.S. Department of State’s Diplomatic Security Service. 

During the height of the drug war’s surge under Ronald Reagan and George H.W. Bush, Scott was assigned to protect a Colombian judge who had signed an arrest warrant for Pablo Escobar. In 1993 he traveled to Bogota to help the Colombian government investigate a car bombing at a school supply market.

You can follow Scott on Twitter @stick631 and learn more at torchstoneglobal.com

If you liked this episode, here are others you might enjoy:
Episode 11: Beyond Borders — How the U.S. Exports Dangerous Drug Policy
Episode 31: Supervised Consumption: Narcotica Breaks Down Safehouse Ruling with Av Gutman
Episode 34: “Inside the Bloody War on Drugs”

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!

Producers: Christopher Moraff, Troy Farah, Zachary Siegel
Co-producer: Garrett Farah
Music: Glass Boy / Chandiliers
Intro voice: Jenny Schaye
Image: Pixabay // edit: Troy Farah

Episode 31: Supervised Consumption: Narcotica Breaks Down Safehouse Ruling with Av Gutman

Safehouse is safe, for now. On Wednesday Oct. 2, a federal judge in Philadelphia ruled that a supervised injection site proposed by the nonprofit Safehouse would not violate a provision of the Controlled Substances Act, known as the “Crack House” statute, authored by none other than Democratic presidential frontrunner, Joe Biden. On today’s episode, hosts Troy, Chris, and Zach are joined by Philadelphia Inquirer’s Abraham Gutman. Gutman has been cranking out fiery editorials in support of harm reduction, criminal justice reform, and tons of other topics for Philly’s biggest newspaper. He breaks down the complicated legal, political, and social implications of the Safehouse ruling and what comes next. 

You can follow Gutman on Twitter and read his work here

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: Aaron Ferguson 

Music: Glass Boy 

Photo: Holden Blanco 

 
 
 
 
 
 

Episode 20: The Pitfalls of Mainstream Harm Reduction with Eliza Wheeler

via Troy Farah

In this episode, Chris and Zach sit down with Eliza Wheeler of the Harm Reduction Coalition in San Francisco. Wheeler has been working in harm reduction, distributing syringes and naloxone directly to people who use drugs, for over two decades. She’s seen a lot of progress in her lifetime. But as harm reduction goes mainstream, Wheeler sees how easily the bedrock values and principles of the movement can be compromised and coopted by political forces. Zach, Chris, and Eliza talk about how funds for naloxone get in the wrong hands, how syringe exchanges deal with NIMBYism, and how the heart of her harm reduction philosophy is bodily autonomy.

Follow Narcotica on FacebookTwitter and support us on Patreon. Your support is appreciated!

Follow the DOPE Project ‏and the Harm Reduction Coalition 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

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.



Follow Narcotica on FacebookTwitter and support us on Patreon. Your support is appreciated!

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

Episode 13: Beyond Borders – “Drug War Capitalism”

For the last installation of Narcotica’s Beyond Border series, Zachary Siegel interviews Dawn Paley, journalist and author of “Drug War Capitalism.” Paley’s scholarship and research situates paramilitarized drug violence in countries from Colombia to Honduras in historical, political, and economic context. On the show she discusses how the War on Drugs benefits big businesses across the hemisphere. Paley has reported about the War on Drugs from Mexico, South America, and Central America for The Nation Magazine, and recently finished her Ph.D. from the Autonomous University of Puebla in Mexico.

Follow Narcotica on FacebookTwitter and support us on Patreon. Your support is appreciated!

Producers: Chris Moraff, Troy Farah, Zachary Siegel
Music: Glass Boy