Narcotica

Episode 39: Pain Patients Are Still Fighting For Their Lives

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 38: Dead People Don’t Recover — The Importance of Safe Supply

Public officials have been yelling from the rooftops that there’s an opioid epidemic. Yes, an obscene number of people are dying from overdoses, many of which involve opioids. But they’re not quite right. Researchers who really get what’s going on describe what’s happening to the U.S. drug supply over the last few years as a mass poisoning. Were it not for potent fentanyl analogues being sold in heroin markets, many, many lives would be spared. 

That’s where the concept of a safe drug supply comes in. Troy and Zach speak with Dr. Mark Tyndall, a professor of medicine at the University of British Columbia, and the founder of My Safe Project, a vending machine that dispenses hydromorphone pills, otherwise known as dilaudid. Mark says this program is saving lives. We cut through some of the bullshit arguments about diversion, “enabling” drug use and other pearl-clutching fears, but also talk about safe supply for stimulants and benzos, and how this program is already changing lives.

Follow Dr. Mark Tyndall on Twitter @DrMtyndall

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
Photo: PXFuel // Edit Troy Farah

Episode 37: Covering Culture and Drugs with Substance

It’s difficult to write about drugs without being steeped and schooled in the discourse. Cultural tropes and conventional wisdom dominates the space. Drugs are anthropomorphized as the enemy. People who use drugs are described as manipulative and selfish, unless, of course, they’re “clean.” Often there is little empirical research cited and the same old voices are quoted saying the same old thing. Writers may think they’re being empathetic when really they’re reinforcing stigma, criminalization, and the very narratives that propel dangerous policy in the first place. 

At Narcotica, we look out for people who do things differently and like to hear them out. For this episode, co-host Zachary Siegel sits down with culture writer and journalist Kate Knibbs, whose writing about drugs and harm reduction stands out as uniquely humanizing. Approaching drugs and harm reduction from culture angles, Kate’s work tells us about the way live now. Their conversation focuses on two stories Kate wrote while working at The Ringer. First, the bizarre story of a music blogger at Vice who was caught smuggling a lot of cocaine. Then, they shift gears and discuss a piece about supervised consumption sites. Kate and Zach both get deep, and talk about the aftermath of friends and loved ones who overdose, and the impulse to search for accountability and punish people.
Follow Kate Knibbs on Twitter and look out for her work at WIRED, where she’s now a staff writer. 

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
Photo: Nick YoungsonCC BY-SA 3.0Alpha Stock Images Edit Troy Farah

Episode 35: Holding Space — The Values of Trip Sitting

Magic mushrooms are having a bit of a moment. Some scientists are bending over backgrounds investing in psilocybin research, which is getting huge accolades from the FDA, while a decriminalization movement is slowly sweeping the nation. At least two towns have made psilocybin arrests the cops’ lowest priority.

But how do you prevent a mushroom trip from going sour? In this episode with author Michelle Janikian we enter the world of tripsitting, or watching over someone while they take powerful psychedelic drugs, in this case psilocybin mushrooms. Janikian is the author of the new book, “YOUR PSILOCYBIN MUSHROOM COMPANION: An Informative, Easy-to-Use Guide to Understanding Magic Mushrooms.”

**As with all our episodes, this is not medical or legal advice, it’s just a brief intro to the topic, please do your own homework and be safe.

Follow Michelle on Twitter: https://twitter.com/m00shian

Order “Your Psilocybin Companion” here: https://ulyssespress.com/books/your-psilocybin-mushroom-companion/

Some excerpts from the book:
https://doubleblindmag.com/how-to-trip-sit/

https://realitysandwich.com/325410/challenging-trips/

https://www.playboy.com/read/bliss-your-heart

Extra resources:
https://zendoproject.org/training/

https://www.decriminalizenature.org/

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 

Music: Glass Boy / Min Y Llan

Photo: Psilocybe tampanensis via Wikipedia / Edit Troy Farah

 

Episode 34: “Inside the Bloody War on Drugs”

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 33: Party and Play—An Intro to Chemsex

Aphrodisiacs are powerfully attractive for a reason. Sex is, after all, crucial to the survival of our species and it feels fucking amazing, so using chemicals that can make sex last longer, feel better or otherwise enhance the act is going to be like candy to a bunch of horny primates.

But the term chemsex—using drugs, or chemical enhancement, to prolong or alter sexual experiences—is actually specific to the gay community, or men who have sex with men. Drugs used have included methamphetamine, Viagra or sildenafil, cocaine, the anesthetic GHB, mephedrone (also known as ‘bath salts,’ although that’s a broad term), ketamine, and amyl nitrates or “poppers.”

Our guest today is David Stuart, who has spent decades as a fixture in London’s gay community. Stuart is an independent social worker and activist who actually coined the term ‘chemsex’ in the 1990’s. Stuart has witnessed the fundamental changes in the gay community as homosexuality has become more acceptable, but fleeting internet-based hook ups became increasingly ubiquitous, and in some cases fraught with potential medical and mental health risks.

You can follow David Stuart on Twitter and learn more about him at https://www.davidstuart.org/

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 / Monplaisir
Photo: Linnaea Mallette / Edit Troy Farah

Episode 32: How Synthetic Drugs Conquered the Globe

On today’s show, co-host Zachary Siegel interviews Ben Westhoff about how he gained access to a clandestine lab in China, the prominent role that America’s War on Drugs has played in producing deadlier, more potent drugs that no user actually really wants, and finally, that in order to save the lives of people using drugs, the US must adopt innovative harm reduction strategies that have been tested around the world, like supervised injection sites and drug checking.

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

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 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 25: Banning Kratom Will Escalate the Opioid Overdose Crisis

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 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, Ian Sutherland and Junglemire
Additional audio engineering: Troy Farah
Image Credit: Wikipedia / edit by Troy Farah

Episode 24: How To Get Abortion Pills Feat. Lynn Paltrow and Francine Coeytaux

What does abortion access have to do with the war on drugs? EVERYTHING. On this episode, we talk about some of the most controversial drugs of them all, drugs that are often overlooked in the debate about reforming drug policy: abortifacients, drugs that induce miscarriage, ending pregnancies. Specifically, misoprostol and mifepristone. We speak with Lynn Paltrow, the founder and executive director of National Advocates for Pregnant Women and Francine Coeytaux co-founder of Plan C Pills, co-founder of the Pro-Choice Alliance for Responsible Research, and a founder of the Pacific Institute for Women’s Health.

If you need to obtain abortion pills, for any reason, for yourself, for your mother, for your sister, or your neighbor, go to PlanCPills.org or AidAccess.org.

You can order these drugs discreetly and they will arrive at your door with your Amazon packages and student loan bills. Here are also abortion funds in states where regressive laws are threatening a woman’s right to choose:

https://abortionfunds.org/fund/yellowhammer-fund/
https://abortionfunds.org/fund/gateway-womens-access-fund
/
Here’s a great list from Bustle: https://www.bustle.com/p/11-abortion-funds-in-alabama-georgia-kentucky-other-states-you-can-donate-to-rn-17895282
You can find Lynn Paltrow on Twitter at @LynnPaltrow and advocatesforpregnantwomen.org
Learn more about Francine Coeytaux in this New York Times piece.


You can find Lynn Paltrow on Twitter at @LynnPaltrow and advocatesforpregnantwomen.org
Learn more about Francine Coeytaux in this New York Times piece.

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
Additional audio engineering: Troy Farah

Episode 23: Bring Back Prescription Heroin!

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 21: Ethically Documenting Drug Use Activism

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 20: The Pitfalls of Mainstream Harm Reduction

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

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 18: Drug User Unions – The Rebirth of Harm Reduction

In this episode, Zach and Troy interview two veteran harm reduction activists: Jess Tilley and Albie Park. Jess and Albie have organized on behalf of drug users for decades, building community to ensure that no one has to die a preventable overdose death. You’ll learn about how they met, how they work, and what policies and ideas they are currently prioritizing. You’ll also hear about what they envision for the future of harm reduction in the midst of, in Jess’s words, an “overdose apocalypse.” Zach and Troy mostly let them do the talking. Enjoy.

Harm Reduction Hedgehogs /@HRH413/Media Toolkit

Produced by Aaron Ferguson, Troy Farah, and Zachary Siegel

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 15: Accurate, Compassionate Drug Journalism with Filter Magazine

Mainstream media doesn’t really ‘get’ drugs, but there’s one place that has consistently gotten it right: Filter Magazine. Narcotica hosts Christopher Moraff, Zachary Siegel and Troy Farah talk with Filter’s co-founder and editor-in-chief Will Godfrey. This conversation covers a lot of ground on media literacy and compassionate reporting on drug use.

Full disclosure: all three of us at Narcotica have worked with Godfrey in some way. But we completely support the work that Filter is doing, which is what we hope Narcotica accomplishes: responsible, scientific, and compassionate reporting on drugs.

Learn more about Filter Magazine on their website and follow Will Godfrey on Twitter.

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

Producer: Christopher Moraff / Troy Farah
Image credit: Eduardo Verdugo
Music: KieLoKaz, Glass Boy and Aaron Ferguson
Co-Producer: Aaron Ferguson — https://soundcloud.com/knowmad1

Episode 14: Harm Reduction Dies in Darkness—Jeff Deeney

Few would disagree with the notion that the United States government has dropped the ball on responding to the opioid crisis, particularly the threat posed by illicitly manufactured fentanyl in the heroin supply. That’s the basis of a new piece called “The Fentanyl Failure,” a Washington Post investigation into the Obama Administration. Only, there’s just one problem: the sources used by the Washington Post are angry drug warriors and zealous prosecutors who are mad that Obama didn’t let them lock up enough dealers. In this episode of Narcotica, co-host Zachary Siegel and special guest Jeff Deeney deconstruct the Washington Post’s exposé. They discuss the ways in which the supply-side narrative is for Serious People while harm reduction activism and interventions that actually save lives are still to the side in policy debates.  Follow Jeff Deeney.

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

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

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