opioid overdose crisis

Episode 67: Methadone in the Time of Covid with Danielle Russell

Harm reduction programs like syringe access, supervised consumption or even just handing out condoms on the street, can be some of the only access to healthcare some people encounter. Definitely not all, but some people who use drugs routinely shun going to the doctor—not because they don’t care about their health, but because our for-profit healthcare system treats almost everyone who uses an illicit substance like complete shit. And people who use drugs have been treated like pariahs long before the covid pandemic, but things got way worse once the virus came to town.

Previously on Narcotica, co-host Chris Moraff did an episode all about how doctors need to work harder to rebuild the patient-trust relationship. And many medical professionals are doing that work, which makes such a huge difference. It’s hard to understate how valuable it can be to receive nonjudgmental medical care that doesn’t hinge on absolute abstinence.

That episode, number 65, which we encourage you to listen to after this one, came from the perspective of two amazing doctors, Ashish Thakrar and Ben Cocchiario. However, on this episode, we want to talk to someone from the other side of the aisle to get a different viewpoint from someone with lived experience in this area.

Why would you go to a healthcare provider for an infection or injury if you’re going to be lectured about your drug use, even if it has nothing to do with why you’re there? Or you might be forced to hand over your urine or have your possessions rifled through by a nurse. Even for people that don’t use illegal substances, our healthcare system is a nightmare to try and navigate. It only gets worse if you happen to self-medicate or enjoy chemicals that aren’t sanctioned by the FDA.

Narcotica co-host Troy Farah speaks with Danielle Russell of Phoenix, Arizona, who is currently a justice and social inquiry PhD student at Arizona State University. She studies how the criminalization of substances used for personal pleasure has become a key issue and tool for social control, contributing to the ongoing legacy of racialized criminalization and mass incarceration in the U.S. Having personally experienced many of the harms that impact people who use illicit drugs, she is passionate about mutual aid and working to change the structures that impose harms on the bodies of drug users. Her research interests are oriented towards community-based participatory research.

Follow Danielle on Twitter @DopefiendPhD and you can read the study she co-authored here:
https://pubmed.ncbi.nlm.nih.gov/33461838/

If you liked this episode, here are others you might enjoy:
Episode 65: Restoring Trust in Doctors Amidst The Overdose Crisis with Dr. Ben Cocchiaro and Dr. Ashish Thakrar
Episode 48: Moms And Methadone with Elizabeth Brico
Episode 56: Drug Use During Disaster with Aaron Ferguson

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Producers: Christopher Moraff, Troy Farah, Zachary Siegel
Co-producer: Garrett Farah / Troy Farah
Music: Glass Boy / Holly Mangler
Intro voice: Jenny Schaye
Image: Noun Project // 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 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 32: How Synthetic Drugs Conquered the Globe with Ben Westoff

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

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