drug policy

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 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 48: Moms And Methadone with Elizabeth Brico

Is there any class of people who receive more stigma, who get more shit and abuse for using drugs, than mothers? Probably not! For whatever reason, society really looks down upon mothers who use drugs. And too often, Child Protective Services use evidence of drug use, even prescribed drugs like methadone or buprenorphine, as a pretense for seizing children from parents, even when there are no signs of abuse or neglect.

At Narcotica, we believe in safe drug use no matter who it is. On this episode, Troy, Zach and Chris talk about how stigma against drug use is contributing to an overloaded foster care system, how so-called ‘fetal assault laws’ are used to control women and pregnant people, and the various ways the war on drugs can be used to dehumanize parents.

Our guest is Elizabeth Brico, a freelance journalist and author from the Pacific Northwest. Her work has appeared in Politico, Columbia Journalism Review, VICE, Undark and many others. She is also the mother of two little girls.

Follow Elizabeth Brico on Twitter @elizabethbrico

You can read some of Elizabeth’s work here: https://filtermag.org/motherhood-legally-terminated/

Sign Elizabeth’s petition to get her kids back: https://www.change.org/p/florida-department-of-children-and-families-reunite-the-brico-girls-ages-5-and-6-with-their-mama

If you liked this episode, here are others you might enjoy:
Episode 24: How To Get Abortion Pills
Episode 30: Getting Wrecked with Dr. Kim Sue
Episode 6: Speed Up, Slow Down Pt. 2 — Myth Evolution: From Crack Kids to Addicted Babies

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 / A.A. Aalto
Image: Wacky Stuff // edit: Troy Farah

Episode 47: Can Harm Reduction and Cops Coexist?

Something that never gets said enough is that the drug war is racist. This is not an opinion any more than it is an opinion that the American Civil War was fought over slavery. Both were crafted by racists to serve racist agendas of controlling people based on their skin color. It is why it is more urgent than ever that we dismantle this system of oppression, the so-called war on drugs, which would be perhaps better described as simply a war on people.

In many ways, prohibition is far more harmful to people than the drugs that are banned. Harm reduction is a philosophy and a practice that aims to fill in the gaps—if we can’t have a safe, regulated drug supply for heroin or meth like we do with alcohol or tobacco, sometimes even cannabis, then maybe we can make drug use more safe in other ways. Here’s some sterile syringes, here’s some naloxone, here’s a phone number you can call if you want to get counseling, etc… 

Narcotica hosts Zachary Siegel and Troy Farah talk with Haley Coles from Sonoran Prevention Works, a grassroots harm reduction non-profit in Phoenix, Arizona that works against some of the structural issues surrounding communities impacted by drug use in Arizona. The infrastructure of harm reduction in the Grand Canyon State is scarce compared to a lot of states—syringe access is still illegal, for example—so there’s a lot of room for growth. We discuss racial justice in the field of harm reduction, where the movement has fallen short, and how things can get better.

Follow Sonoran Prevention Works on Twitter @spw_az

You can read SPW’s BLM statement here: https://mailchi.mp/spwaz/black-lives-matter

If you liked this episode, here are others you might enjoy:
Episode 44: Reimagining Public Health and Racial Justice
Episode 42: Supervised Consumption is an Essential Service
Hot Spots 1 – 3 Arizona, Iowa and Nova Scotia

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

Image: PXhere // edit: Troy Farah

Episode 39: Pain Patients Are Still Fighting For Their Lives with Kate Nicholson

In 2016, the Centers for Disease Control and Prevention laid out guidelines for primary care doctors prescribing opioids to treat chronic pain. Essentially, these guidelines stated that opioids should not be the first line treatment for pain, and that other methods should be tried first. Which is perfectly sensible.

But when it came to dosing and duration, these guidelines — not laws — guidelines, started to become widely misinterpreted. We don’t need to get in the weeds of morphine milligram equivalents here, but what wound up happening across the country is that doctors, medical boards, and even legislators took the guidelines as black letter law. And clearly mistook the intended audience for the guidelines: primary care providers. Not pain management specialists, primary care providers. The one you might go see for a wellness check up or if you have strep throat.

Why is all this important? Aren’t prescription opioids, after all, the very substance that ignited a massive wave of overdose deaths across the country? It’s not so simple. Well intended efforts to reduce everyday people’s exposure to high doses and long durations of opioids started to hit the wrong target: patients with chronic, intractable, debilitating pain.

And we have an excellent guest, civil rights attorney, writer, and advocate, Kate Nicholson. Kate has been a critical asset for the pain community, who has been speaking up about how policy intended to help is actually causing more harm. She has consulted on several Democratic presidential candidates, including Bernie Sanders, Julian Castro and even Joe Biden.

Follow Kate Nicholson on Twitter @speakingabtpain

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 / Garrett Farah / A A Aalto
Photo: U.S. Air Force photo illustration/Tech. Sgt. Mark R. W. Orders-Woempner // Edit Troy Farah

Episode 34: “Inside the Bloody War on Drugs” with Antony Lowenstein

President Richard Nixon ignited the War on Drugs in 1971 by declaring drugs “public enemy No. 1.” Over the ensuing decades, the U.S. has turned the Drug War into a vital feature of its vast empire, exporting a drug policy of militant enforcement and harsh criminalization in Mexico, Latin America, South America, and beyond. Exactly how this war plays out––its victims, villains, and profiteers––is the subject of journalist Antony Lowenstein’s vivid new book, “Pills, Powder, and Smoke: Inside the Bloody War on Drugs.” On Today’s episode, co-hosts Troy Farah and Zachary Siegel interview Lowenstein about what he saw on his journey chronicling the Drug War in countries like the Philippines, Australia, Honduras, and the U.S., among elsewhere.

You can follow Antony Lowenstein on Twitter and buy his book here.

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: Aaron Ferguson 
Music: Glass Boy / Monplaisir
Photo: Linnaea Mallette / Edit Troy Farah

Episode 30: Getting Wrecked with Dr. Kim Sue

Doctors are often blamed for prescribing America into the opioid crisis. Their reckless actions, relying on opioids to relieve just about every morsel of pain, ignited the deadliest overdose crisis in history, so we’re told. Of course, the narrative around doctors is much more complex than that.

But one truth is inescapable: Without doctors prescribing methadone and buprenorphine, and taking care of some of the most marginalized people in the health care system, like incarcerated women, there is no end to the crisis in sight. Meet Dr. Kimberly Sue, the medical director of the Harm Reduction Coalition, and a leader in addiction medicine. Dr. Sue wrote a new book, Getting Wrecked: Women, Incarceration, and the American Opioid Crisis. In this episode, co-host Zachary Siegel interviews Dr. Sue, and they talk about women’s self-determination, the brutality of incarceration, and they imagine a world where women are treated humanely, not criminalized. 

Buy Dr. Sue’s book: https://www.ucpress.edu/book/9780520293212/getting-wrecked
Follow Dr. Sue on Twitter: https://twitter.com/DrKimSue

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: Aaron Ferguson
Music: Glass Boy, Pictures of the Floating World

Episode 28: Antibiotic Resistance and Doping at the Olympics with Mike Pearl

Antibiotic resistance and doping at the Olympics are two pretty unrelated ideas, but they’re both covered in the new book ‘The Day It Finally Happens’ by author and journalist Mike Pearl, who sat down in Narcotica co-host Troy Farah’s kitchen.

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 22: Changing the Narrative with Maia Szalavitz and Leo Beletsky

On this episode Narcotica highlights a new project from the Health in Justice Action Lab at Northeastern University called Changing The Narrative, which aims to correct flawed narratives about drugs, debunked myths, old tropes, and stigmatizing language in mainstream media.

Episode 21: Ethically Documenting Drug Use Activism with Nigel Brunsdon

Sometimes, you’ll be reading a great piece on the drug overdose crisis that is just ruined by a crappy stock image of a gigantic syringe and a mountain of what is obviously flour or someone nodding out on the sidewalk. On this episode, Narcotica explores what accurate, tactful drug imagery should look like.

The team speaks with Nigel Brunsdon, the official/unofficial photographer of the modern day harm reduction movement, who is joining us via from the UK. He has shadowed the Chicago Recovery Alliance, Harm Reduction International, and many others on the front lines of the so-called drug war. His photos of the workers, advocates, people who use drugs, and the academics are loaded with grief, emotion, hope, and solidarity. He explains balancing privilege, relationships and representation of impacted communities through drug war photojournalism.

Follow Nigel on his website nigelbrunsdon.com and check out harmreductionphilosophy.com for more on how harm reduction works as an ideology.

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

We talk a lot about this image that we used from Nigel for Episode 3, memorializing harm reduction activist Dan Bigg. Here it is for reference:


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

Episode 16: The Crew Interviews the Crackdown’s Garth Mullins

Canada’s Downtown Eastside in Vancouver is known around the world as a city of pain and trauma. That’s not the whole story. Vancouver has produced trailblazing harm reduction activists and scholars who have changed the fabric of drug user health care. The Crackdown is a podcast that features some of the bravest activists who are pushing the envelope in drug policy. In this episode, Chris, Troy, and Zach interview Garth Mullins, host of The Crackdown, about what spawned the show, the differences between American and Canadian drug policy, and what journalism looks like when it is owned and produced by drug users. Check out The Crackdown.

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

Producer: Christopher Moraff, Troy Farah, Zachary Siegel
Music: Glass Boy and Aaron Ferguson
Co-Producer: Aaron Ferguson — https://soundcloud.com/knowmad1

Episode 11: Beyond Borders — How the U.S. Exports Dangerous Drug Policy with Sanho Tree

America practically invented prohibition, or at least popularized it to the point where nearly every country models itself after U.S. drug policy. The results have been nothing short of disastrous. Troy Farah talks with foreign policy expert Sanho Tree about how the ‘Land of the Free’ have exported draconian drug laws, enslaving the rest of the planet. This discussion covers poppy fields in Afghanistan, Central American migrants fleeing gangs, the Bolivian model for cocaine regulation, death squads in the Philippines and how Trump’s wall is just more bad drug policy.


Follow Sanho Tree on Twitter.

Follow Narcotica on Facebook, Twitter and support us on Patreon. Your support is appreciated!

Producer: Troy Farah
Image credit: Alastair Rae, Flickr / Edit by Troy Farah
Music: Inaequalis and Glass Boy

Episode 5: Speed Up, Slow Down Pt. 1

With all the focus on opioids, Narcotica has decided to launch a series on stimulants called “Speed Up, Slow Down.” In the first installment, Zachary Siegel takes a critical look at how media depicts meth and cocaine use. He interviews two users about how stimulants actually help them function. Then, he talks to Sheila Vakharia from the Drug Policy Alliance about harm reduction, and Kat Humphries from the Harm Reduction Action Center about her “Methamphetazine” that features art from Denver stimulant users.

Download link for the zine.

More info on harm reduction for stimulants here. Follow Sheila Vakharia: @MyHarmReduction

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!

If you liked this episode, here are others you might enjoy:
Episode 38: Dead People Don’t Recover — The Importance of Safe Supply with Mark Tyndall
Episode 33: Party and Play—An Intro to Chemsex with David Stuart
Episode 20: The Pitfalls of Mainstream Harm Reduction with Eliza Wheeler

Producers: Christopher Moraff, Troy Farah, Zachary Siegel
Music: Glass Boy
Intro voice: Jenny Schaye
Image: Composite of Wikimedia images by Troy Farah