naloxone

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

July 27, 2021 Narcotica Episodes 01:06:29 0 Comments

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 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!

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 47: Can Harm Reduction and Cops Coexist?

September 3, 2020 Narcotica Episodes 00:56:05 2 Comments

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 46: Behind The Pharmacists’ Counter with Jessica Moreno

August 17, 2020 Narcotica Episodes 00:47:27 0 Comments

You ever wonder what the hell pharmacists even do? To laypeople, pharmacists are the gatekeepers standing between us and our drugs. But they can be, and arguably, should be, much more than that. Even though just about everyone has experience with pharmacists, some good, some really bad, the profession is still a bit of a mystery. What’s going on behind the counter?
To answer this and more, Narcotica hosts Zachary Siegel, Christopher Moraff and Troy Farah talk with Jessica Moreno, a psychiatric clinical pharmacist based in Detroit, Michigan. We cover topics like why naloxone and birth control should be over-the-counter, how some pharmacists can be prejudiced against people who use drugs, and the role pharmacists play in society as the gatekeepers to prescription drugs.

Follow Jessica on Twitter @Jesslynnmoreno

If you liked this episode, here are others you might enjoy:
Episode 24: How To Get Abortion Pills
Episode 36: Moral Hazards and Naloxone, A Toxicologist’s Perspective
Episode 30: Getting Wrecked with Dr. Kim Sue

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: Thomas Hawk, Flickr // edit: Troy Farah

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

June 9, 2020 Narcotica Episodes 00:36:37 0 Comments

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 42: Supervised Consumption is an Essential Service

May 4, 2020 Narcotica Episodes 00:44:00 0 Comments

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

February 13, 2020 Narcotica Episodes 0:49:30 0 Comments

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 25: Banning Kratom Will Escalate the Opioid Overdose Crisis with Walter Prozialeck

July 29, 2019 Narcotica Episodes 00:47:41 0 Comments

Kratom, a strange plant from Southeast Asia has become one of the most controversial herbs in the United States. In this episode, Troy Farah breaks down the risks and potential benefits of this unique tree and why banning it would likely lead to a devastating increase in deaths in the opioid overdose crisis with Walter Prozialeck, a pharmacology professor at Midwestern University, who has a long-standing interest in herbal medicine, including marijuana and kratom. Topics discussed on this episode, recorded June 26, include why people use kratom, the pharmacokinetics of kratom alkaloids including actual overdose potential, cicadas infected with psilocybin-producing fungi, conspiracy theories about former FDA commissioner Scott Gottlieb, and much more.

Read Prozialeck’s paper here: https://doi.org/10.1016/j.drugpo.2019.05.003

Follow Narcotica on Facebook, Twitter 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, Ian Sutherland and Junglemire
Additional audio engineering: Troy Farah
Image Credit: Wikipedia / edit by Troy Farah

Episode 4: Supervised Consumption Breaks Rod Rosenstein’s Brain

September 16, 2018 Narcotica Episodes 00:39:21 0 Comments

In response to Deputy Attorney General Rod Rosenstein’s outrageous supervised consumption op-ed in the New York Times, the Narcotica team speaks with Laura Thomas, of the Drug Policy Alliance, who broke down the obstacles harm reduction workers face in opening a site in the United States. Thomas, who is deputy state director at DPA, has been championing supervised consumption sites for over a decade, because she knows what the data says: SCS save lives.

But how long until we see a facility in the U.S.? We discuss the status of many projects in Washington, New York, and California, and what kind of fight we can expect from the Department of Justice.

You can follow Laura on Twitter @LThomas and learn more about the Drug Policy Alliance at drugpolicy.org.

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!

If you liked this episode, here are others you might enjoy:
Episode 26: Housing As Harm Reduction
Episode 42: Supervised Consumption is an Essential Service
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 by Troy Farah

Episode 3: Remembering Dan Bigg, Naloxone Renegade

September 8, 2018 Narcotica Episodes, News 00:37:03 1 Comment

Dan Bigg, activist, visionary, and harm reduction pioneer, died on Tuesday, August 21, 2018. In this episode, Zach Siegel interviews journalist Max Blau, who has been researching the history of naloxone, about Bigg’s radical legacy.

You can follow Max on Twitter @MaxBlau

Follow Narcotica on 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!

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
Music: Glass Boy
Intro voice: Jenny Schaye
Image: Nigel Brunsdon