overdose deaths

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 68: Is The Drug War Getting Better… Or Worse? with Zach Siegel, Chris Moraff and Troy Farah

March 3, 2022 Narcotica Episodes, Opioids, Overdose Crisis, Psychedelics 01:10:13 0 Comments

On this episode, Narcotica co-hosts Zachary Siegel, Chris Moraff and Troy Farah interview each other, riffing on one question: Is the drug war getting better… Or worse? They cover everything from nitazenes, Dopesick, the Drug User’s Liberation Front, banning psychedelics like DiPT, benzo dope, West Virginia, buprenorphine, psychedelic exceptionalism, drug testing, crack pipes, supervised consumption sites in NYC and much, much, more.

Their conclusion? You’ll have to listen to find out. OK, not really: Like many things, it’s a mix of both progress and backsliding. Narcotica’s founders discuss their current frustrations and what’s giving them optimism in America’s longest running war, a conflict directed at people. Maybe the end is in sight after all.

Follow Chris Moraff on Twitter: @moraffreports
Follow Zach Siegel on Twitter: @ZachWritesStuff
Follow Troy Farah on Twitter: @filth_filler

If you liked this episode, here are others you might enjoy:
Episode 27: What’s the Most Dangerous Drug?
Episode 58: How Racism Fuels The Drug War with Kassandra Frederique
Episode 51: The Joy of Drug Use with Dr. Carl Hart

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!

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 65: Restoring Trust in Doctors Amidst The Overdose Crisis with Dr. Ben Cocchiaro and Dr. Ashish Thakrar

November 19, 2021 Narcotica Episodes, Overdose Crisis 01:05:20 0 Comments

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, 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!

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 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 45: Overdose Is Tragic, Not Murder with Morgan Godvin

July 8, 2020 Narcotica Episodes 01:03:53 0 Comments

When Morgan Godvin was 24, she sold her best friend Justin a gram of heroin. This wasn’t out of the ordinary. Both of them often used together and hooking each other up was essentially seen as a favor, to keep one another from experiencing withdrawal sickness. 

But this one time proved to be fatal. Justin would later be found dead from an overdose, and Morgan was on the hook for supplying it, getting caught up in the wave of drug-induced homicide cases where prosecutors go after users, who are often friends and loved ones of the victim. Morgan was convicted of “drug delivery resulting in death” by the federal government and spent 5 years incarcerated at the Dublin Federal Prison outside of Oakland for Justin’s death. Since she’s been released, Morgan has used her experience and voice to push back against America’s ultra-punitive response to everyday social problems like addiction, including raising awareness about drug-induced homicide prosecutions.

In this episode, Narcotics co-hosts Zachary Siegel and Troy Farah talk with Morgan about everything from syringe access in Tijuana to solitary confinement to being queer and using drugs in prison. But overall, this conversation centers on drug-induced homicides and the way these draconian laws are inflicted on people.

Follow Morgan on Twitter @MorganGodvin

You can read Morgan’s piece “Money Changed Everything For Me In Prison” in The Marshall Project.

Learn more about drug-induced homicide laws at the Health In Justice Lab’s portal.

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: Pixabay // edit: Troy Farah

Episode 44: Reimagining Public Health and Racial Justice with Dr. Ricky Bluthenthal

June 26, 2020 Narcotica Episodes 00:55:56 1 Comment

There are several health crises occurring around the U.S. and the world right now: overdose deaths, a pandemic, police brutality and violence… While these crises may all feel distinct one from one another, they are actually deeply entwined and can be understood through a lens of racial justice. Overdose deaths disparately impact people of color, as does Covid-19. People of color, especially Black men, find themselves on the blunt end of police brutality and excessive use of force.

To talk about the theme of racial justice across public health, policing, and harm reduction, Zach and Troy were honored to speak with veteran researcher Dr. Ricky Bluthenthal, who has been a harm reduction researcher for decades, writing some of the foundational evaluations of syringe exchange programs. Right now, he’s the associate dean for social justice at University of Southern California’s School of Medicine. We talk about syringe access programs, policing homelessness, “socialism” in public health and so much more.

Follow Ricky Bluthenthal on Twitter @DrPtw
Here is more info on SIF MA: https://sifmanow.org/

Also, here’s the GoFundMe for Aubri Esters: https://www.gofundme.com/f/in-honor-of-aubri-esters

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: Zachary Siegel // 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