opioid overdose crisis

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

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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