kensington

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 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 42: Supervised Consumption is an Essential Service

The covid-19 crisis has exposed many weak spots in our culture and the need for radical change. It has revealed which workers are really essential—hint: it’s not executives keeping this late-stage capitalist economy afloat—and that we need to pay these workers a living wage. It has revealed that yes, healthcare is a human right and that contributing to public health is, shockingly, essential to keep everyone healthy. 

And perhaps most relevant to this show, the covid-19 crisis has demonstrated the utmost importance of supervised consumption sites, or places where people can use drugs under medical supervision. We have numerous episodes in the past on this issue, so check out our archives if you aren’t already familiar: Episode 31, Episode 26 and way back on Episode number 4. 

We have two guests today: Sterling Johnson, a housing lawyer, who is well known among Philly harm reductionists and has been fighting for a supervised consumption site for years, and Matthew Sheppeck, an organizer with the Philadelphia Tenants Union, a harm reductionist, and addiction outreach specialist that works with homeless drug users in the Kensington region of Philadelphia. 

We discuss everything from housing as a human right, whether cops should carry naloxone, representation in harm reduction institutions and the importance of supervised consumption spaces, but why they need to reflect the needs of people who use drugs. We also discuss the coronavirus pandemic that is overshadowing everything and how that is changing so much about harm reduction.

Follow Sterling Johnson on Twitter @LB_Sterling and Matthew Sheppeck on Instagram @Sheppecksees.

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 / Pictures of the Floating World
Image: Wikimedia / edit: Troy Farah
One correction: At the 21:30 mark, Zach incorrectly quoted Gov. Andrew Cuoma. There were 263 positive infections at Rikers, not deaths. We regret the error.

Episode 26: Housing As Harm Reduction

Sarn is a Pathway to Housing participant in Philadelphia via Chris Moraff

The Kensington neighborhood in Philadelphia is often described as “ground zero” in the overdose crisis. The New York Times Magazine gave Kensington’s open air drug market the dubious title, “The Walmart of Heroin.” Of course, if you take a tour of Kensington without a DEA agent nearby, you might meet someone like Sarn, who after years of unstable housing and chaotic drug use, now has his own place to live. Operating from a Housing First model, organizations like Pathways to Housing are fighting the tides of endemic poverty, homelessness, and addiction. On today’s show, the crew interviews Sarn and Matt Tice, of Pathways to Housing, about how “Housing First” is a critical response to Philly’s overdose crisis.

Follow Matt Tice on Twitter and learn more about Pathways on their website.

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, Aaron Ferguson
Image: Christopher Moraff, Troy Farah

Episode 1: Opioid of the Masses

Episode 1 of Narcotica is here! In the first segment Zachary Siegel does some mythbusting around overdosing by touching fentanyl; Troy Farah gives a nuanced take on what’s driving the overdose crisis; and Christoper Moraff talks with experts and drug users about the disease-model of addiction.

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!

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: Jon Ehrens
Music: Glass Boy
Intro voice: Jenny Schaye
Image: Public domain photo