Answer Addiction

Tag: harm reduction

  • Pandemic Presents New Hurdles, and Hope, for People Struggling with Addiction

    “There’s social distancing — to a limit…I think when someone’s life is in jeopardy, they’re worth saving. You just can’t watch people die.”

    Before Philadelphia shut down to slow the spread of the coronavirus, Ed had a routine: most mornings he would head to a nearby McDonald’s to brush his teeth, wash his face and — when he had the money — buy a cup of coffee. He would bounce between homeless shelters and try to get a shower. But since businesses closed and many shelters stopped taking new admissions, Ed has been mostly shut off from that routine.

    He’s still living on the streets.

    “I’ll be honest, I don’t really sleep too much,” said Ed, who’s 51 and struggling with addiction. “Every four or five days I get a couple hours.”

    KHN agreed not to use his last name because he uses illegal drugs.

    Philadelphia has the highest overdose rate of any big city in America — in 2019, more than three people a day died of drug overdoses there, on average. Before the coronavirus began spreading across the United States, the opioid overdose epidemic was the biggest health crisis on the minds of many city officials and public health experts. The coronavirus pandemic has largely eclipsed the conversation around the opioid crisis. But the crisis still rages on despite business closures, the cancellation of in-person treatment appointments and the strain on many addiction resources in the city.

    When his usual shelter wasn’t an option anymore, Ed tried to get into residential drug treatment. He figured that would be a good way to try to get back on his feet and, if nothing else, get a few good nights of rest. But he had contracted pinkeye, a symptom thought to be associated with the virus that leads to COVID-19, so the evaluation center didn’t want to place him in an inpatient facility until he’d gotten the pinkeye checked out. But he couldn’t see a doctor because he didn’t have a phone for a telehealth appointment.

    “I got myself stuck, and I’m trying to pull everything back together before it totally blows up,” he said.

    Rosalind Pichardo wants to help people in Ed’s situation. Before the pandemic, Pichardo would hit the streets of her neighborhood, Kensington, which has the highest drug overdose rate in Philadelphia. She’d head out with a bag full of snack bars, cookies and Narcan, the opioid overdose reversal drug.

    She’d hand Narcan out to people using drugs, and people selling drugs — anyone who wanted it. Pichardo started her own organization, Operation Save Our City, which initially set out to work with survivors of gun violence in the neighborhood. When she realized that overdoses were killing people too, she began getting more involved with the harm reduction movement and started handing out Narcan through the city’s syringe exchange.

    When Pennsylvania’s stay-at-home order went into effect, Pichardo and others worried that more people might start using drugs alone, and that fewer first responders would be patrolling the streets or nearby and able to revive them if they overdosed.

    So, Pichardo and other harm reduction activists gave out even more Narcan. A representative for Prevention Point Philadelphia, the group that operates a large syringe exchange program in the city, said that during the first month of the city’s stay-at-home order, they handed out almost twice as much Narcan as usual.

    After the lockdowns and social distancing began, Pichardo worried that more people would be using drugs alone, leading to more overdoses. But Philadelphia’s fatal overdose rate during the pandemic remains about the same as it was this time last year. Pichardo said she thinks that’s evidence that flooding the streets with Narcan is working — that people are continuing to use drugs, and maybe even using more drugs, but that users are utilizing Narcan more often and administering it to one another.

    That is the hope. But Pichardo said users don’t always have a buddy to keep watch, and during the pandemic first responders have seemed much more hesitant to intervene. For example, she recently administered Narcan to three people in Kensington who overdosed near a subway station, while two police officers stood by and watched. Before the pandemic, they would often be right there with her, helping.

    To reverse the overdoses, Pichardo crouched over the people who she said had started turning blue as their oxygen levels dropped. She injected the Narcan into their noses, using a disposable plastic applicator. Normally, she would perform rescue breathing, too, but since the pandemic began she has started carrying an Ambu bag, which pumps air into a person’s lungs and avoids mouth-to-mouth resuscitation. Among the three people, she said, it took six doses of Narcan to revive them. The police officers didn’t step in to help but did toss several overdose-reversal doses toward Pichardo as she worked.

    “I don’t expect ’em to give ’em rescue breaths if they don’t want to, but at least administer the lifesaving drug,” Pichardo said.

    In her work as a volunteer, she has reversed almost 400 overdoses, she estimated.

    “There’s social distancing — to a limit,” Pichardo said, “I think when someone’s life is in jeopardy, they’re worth saving. You just can’t watch people die.”

    Even before Philadelphia officially issued its stay-at-home order, city police announced they would stop making low-level arrests, including for narcotics. The idea was to reduce contact overall, help keep the jail population low and reduce the risk of the virus getting passed around inside. But Pichardo and other community activists said the decreased law enforcement emboldened drug dealers in the Kensington neighborhood, where open-air drug sales and use are common.

    “You can tell they have everything down pat, from the lookout to the corner boys to the one actually holding the product — the one holding the product’s got some good PPE gear,” said Pichardo.

    More dealers working openly on the street has led to more fights over territory, she added, which in turn has meant more violence. While overall crime in Philadelphia and other major cities has declined during the pandemic, gun violence has spiked.

    Police resumed arrests at the beginning of May.

    Now when she goes out to offer relief and hand out Narcan, Pichardo packs a few extra things in her bag of supplies: face masks, gloves and gun locks.

    “It’s like the survival kit of the ’hood,” she said.

    For those struggling with addiction who are ready to start recovery, newly relaxed federal restrictions have made it easier to get medications that curb opioid cravings and stem withdrawal. Several efforts are underway among Philadelphia-based public health groups and criminal justice advocacy organizations to give cellphones to people who are homeless or coming out of jail, so they can make a telehealth appointment and get quicker access to a prescription for those medicines.

    During the pandemic, people taking medication-assisted treatment can renew their prescription every month instead of every week, which helps decrease trips to the pharmacy. It is too soon to know if more people are taking advantage of the new rules, and accessing medication-assisted treatment via telehealth, but if that turns out to be the case, many addiction medicine specialists argue the new rules should become permanent, even after the pandemic ends.

    “If we find that these relaxed restrictions are bringing more people to the table, that presents enormous ethical questions about whether or not the DEA should reinstate these restrictive policies that they had going in the first place,” said Dr. Ben Cocchiaro, a physician who treats people with substance-use disorder.

    Cocchiaro said the whole point of addiction treatment is to facilitate help as soon as someone is ready for it. He hopes if access to recovery can be made simpler during a pandemic, it can remain that way afterward.

    This story is part of a partnership that includes WHYY, NPR and Kaiser Health News.

    View the original article at thefix.com

  • They Fell In Love Helping Drug Users. But Fear Kept Him From Helping Himself.

    Beeler worried that a failed drug test — even if it was for a medication to treat his addiction (like buprenorphine) — would land him in prison.

    She was in medical school. He was just out of prison.

    Sarah Ziegenhorn and Andy Beeler’s romance grew out of a shared passion to do more about the country’s drug overdose crisis.

    Ziegenhorn moved back to her home state of Iowa when she was 26. She had been working in Washington, D.C., where she also volunteered at a needle exchange — where drug users can get clean needles. She was ambitious and driven to help those in her community who were overdosing and dying, including people she had grown up with.

    “Many people were just missing because they were dead,” said Ziegenhorn, now 31. “I couldn’t believe more wasn’t being done.”

    She started doing addiction advocacy in Iowa City while in medical school — lobbying local officials and others to support drug users with social services.

    Beeler had the same conviction, born from his personal experience.

    “He had been a drug user for about half of his life — primarily a longtime opiate user,” Ziegenhorn said.

    Beeler spent years in and out of the criminal justice system for a variety of drug-related crimes, such as burglary and possession. In early 2018, he was released from prison. He was on parole and looking for ways to help drug users in his hometown.

    He found his way to advocacy work and, through that work, found Ziegenhorn. Soon they were dating.

    “He was just this really sweet, no-nonsense person who was committed to justice and equity,” she said. “Even though he was suffering in many ways, he had a very calming presence.”

    People close to Beeler describe him as a “blue-collar guy” who liked motorcycles and home carpentry, someone who was gentle and endlessly curious. Those qualities could sometimes hide his struggle with anxiety and depression. Over the next year, Beeler’s other struggle, with opioid addiction, would flicker around the edges of their life together.

    Eventually, it killed him.

    People on parole and under supervision of the corrections system can face barriers to receiving appropriate treatment for opioid addiction. Ziegenhorn said she believes Beeler’s death is linked to the many obstacles to medical care he experienced while on parole.

    About 4.5 million people are on parole or probation in the U.S., and research shows that those under community supervision are much more likely to have a history of substance use disorder than the general population. Yet rules and practices guiding these agencies can preclude parolees and people on probation from getting evidence-based treatment for their addiction.

    A Shared Passion For Reducing Harm

    From their first meeting, Ziegenhorn said, she and Beeler were in sync, partners and passionate about their work in harm reduction — public health strategies designed to reduce risky behaviors that can hurt health.

    After she moved to Iowa, Ziegenhorn founded a small nonprofit called the Iowa Harm Reduction Coalition. The group distributes the opioid-overdose reversal drug naloxone and other free supplies to drug users, with the goal of keeping them safe from illness and overdose. The group also works to reduce the stigma that can dehumanize and isolate drug users. Beeler served as the group’s coordinator of harm reduction services.

    “In Iowa, there was a feeling that this kind of work was really radical,” Ziegenhorn said. “Andy was just so excited to find out someone was doing it.”

    Meanwhile, Ziegenhorn was busy with medical school. Beeler helped her study. She recalled how they used to take her practice tests together.

    “Andy had a really sophisticated knowledge of science and medicine,” she said. “Most of the time he’d been in prison and jails, he’d spent his time reading and learning.”

    Beeler was trying to stay away from opioids, but Ziegenhorn said he still used heroin sometimes. Twice she was there to save his life when he overdosed. During one episode, a bystander called the police, which led to his parole officer finding out.

    “That was really a period of a lot of terror for him,” Ziegenhorn said.

    Beeler was constantly afraid the next slip — another overdose or a failed drug test — would send him back to prison.

    An Injury, A Search For Relief

    A year into their relationship, a series of events suddenly brought Beeler’s history of opioid use into painful focus.

    It began with a fall on the winter ice. Beeler dislocated his shoulder — the same one he’d had surgery on as a teenager.

    “At the emergency room, they put his shoulder back into place for him,” Ziegenhorn said. “The next day it came out again.”

    She said doctors wouldn’t prescribe him prescription opioids for the pain because Beeler had a history of illegal drug use. His shoulder would dislocate often, sometimes more than once a day.

    “He was living with this daily, really severe constant pain — he started using heroin very regularly,” Ziegenhorn said.

    Beeler knew what precautions to take when using opioids: Keep naloxone on hand, test the drugs first and never use alone. Still, his use was escalating quickly.

    A Painful Dilemma 

    The couple discussed the future and their hope of having a baby together, and eventually Ziegenhorn and Beeler agreed: He had to stop using heroin.

    They thought his best chance was to start on a Food and Drug Administration-approved medication for opioid addiction, such as methadone or buprenorphine. Methadone is an opioid, and buprenorphine engages many of the same opioid receptors in the brain; both drugs can curb opioid cravings and stabilize patients. Studies show daily maintenance therapy with such treatment reduces the risks of overdose and improves health outcomes.

    But Beeler was on parole, and his parole officer drug-tested him for opioids and buprenorphine specifically. Beeler worried that if a test came back positive, the officer might see that as a signal that Beeler had been using drugs illegally.

    Ziegenhorn said Beeler felt trapped: “He could go back to prison or continue trying to obtain opioids off the street and slowly detox himself.”

    He worried that a failed drug test — even if it was for a medication to treat his addiction — would land him in prison. Beeler decided against the medication.

    A few days later, Ziegenhorn woke up early for school. Beeler had worked late and fallen asleep in the living room. Ziegenhorn gave him a kiss and headed out the door. Later that day, she texted him. No reply.

    She started to worry and asked a friend to check on him. Not long afterward, Beeler was found dead, slumped in his chair at his desk. He’d overdosed.

    “He was my partner in thought, and in life and in love,” Ziegenhorn said.

    It’s hard for her not to rewind what happened that day and wonder how it could have been different. But mostly she’s angry that he didn’t have better choices.

    “Andy died because he was too afraid to get treatment,” she said.


    Beeler was services coordinator for the Iowa Harm Reduction Coalition, a group that works to help keep drug users safe. A tribute in Iowa City after his death began, “He died of an overdose, but he’ll be remembered for helping others avoid a similar fate.” (COURTESY OF SARAH ZIEGENHORN)

    How Does Parole Handle Relapse? It Depends

    It’s not clear that Beeler would have gone back to prison for admitting he’d relapsed and was taking treatment. His parole officer did not agree to an interview.

    But Ken Kolthoff, who oversees the parole program that supervised Beeler in Iowa’s First Judicial District Department of Correctional Services, said generally he and his colleagues would not punish someone who sought out treatment because of a relapse.

    “We would see that that would be an example of somebody actually taking an active role in their treatment and getting the help they needed,” said Kolthoff.

    The department doesn’t have rules prohibiting any form of medication for opioid addiction, he said, as long as it’s prescribed by a doctor.

    “We have people relapse every single day under our supervision. And are they being sent to prison? No. Are they being sent to jail? No,” Kolthoff said.

    But Dr. Andrea Weber, an addiction psychiatrist with the University of Iowa, said Beeler’s reluctance to start treatment is not unusual.

    “I think a majority of my patients would tell me they wouldn’t necessarily trust going to their [parole officer],” said Weber, assistant director of addiction medicine at the University of Iowa’s Carver College of Medicine. “The punishment is so high. The consequences can be so great.”

    Weber finds probation and parole officers have “inconsistent” attitudes toward her patients who are on medication-assisted treatment.

    “Treatment providers, especially in our area, are still very much ingrained in an abstinence-only, 12-step mentality, which traditionally has meant no medications,” Weber said. “That perception then invades the entire system.”

    Attitudes And Policies Vary Widely

    Experts say it’s difficult to draw any comprehensive picture about the availability of medication for opioid addiction in the parole and probation system. The limited amount of research suggests that medication-assisted treatment is significantly underused.

    “It’s hard to quantify because there are such a large number of individuals under community supervision in different jurisdictions,” said Michael Gordon, a senior research scientist at the Friends Research Institute, based in Baltimore.

    A national survey published in 2013 found that about half of drug courts did not allow methadone or other evidence-based medications used to treat opioid use disorder.

    A more recent study of probation and parole agencies in Illinois reported that about a third had regulations preventing the use of medications for opioid use disorder. Researchers found the most common barrier for those on probation or parole “was lack of experience by medical personnel.”

    Faye Taxman, a criminology professor at George Mason University, said decisions about how to handle a client’s treatment often boil down to the individual officer’s judgment.

    “We have a long way to go,” she said. “Given that these agencies don’t typically have access to medical care for clients, they are often fumbling in terms of trying to think of the best policies and practices.”

    Increasingly, there is a push to make opioid addiction treatment available within prisons and jails. In 2016, the Rhode Island Department of Corrections started allowing all three FDA-approved medications for opioid addiction. That led to a dramatic decrease in fatal opioid overdoses among those who had been recently incarcerated.

    Massachusetts has taken similar steps. Such efforts have only indirectly affected parole and probation.

    “When you are incarcerated in prison or jail, the institution has a constitutional responsibility to provide medical services,” Taxman said. “In community corrections, that same standard does not exist.”

    Taxman said agencies may be reluctant to offer these medications because it’s one more thing to monitor. Those under supervision are often left to figure out on their own what’s allowed.

    “They don’t want to raise too many issues because their freedom and liberties are attached to the response,” she said.

    Richard Hahn, a researcher at New York University’s Marron Institute of Urban Management who consults on crime and drug policy, said some agencies are shifting their approach.

    “There is a lot of pressure on probation and parole agencies not to violate people just on a dirty urine or for an overdose” said Hahn, who is executive director of the institute’s Crime & Justice Program.

    The federal government’s Substance Abuse and Mental Health Services Administration calls medication-assisted treatment the “gold standard” for treating opioid addiction when used alongside “other psychosocial support.”

    Addiction is considered a disability under the Americans with Disabilities Act, said Sally Friedman, vice president of legal advocacy for the Legal Action Center, a nonprofit law firm based in New York City.

    She said disability protections extend to the millions of people on parole or probation. But people under community supervision, Friedman said, often don’t have an attorney who can use this legal argument to advocate for them when they need treatment.

    “Prohibiting people with that disability from taking medication that can keep them alive and well violates the ADA,” she said.

    This story is part of a partnership between NPR and Kaiser Health News.

    View the original article at thefix.com

  • How Germany Averted An Opioid Crisis

    How Germany Averted An Opioid Crisis

    Germany’s success with its multi-pronged approach illustrates that addiction is “a more complex problem” than the current American response has acknowledged.

    KHN correspondent Shefali Luthra reported this article from Germany as a 2019 Arthur F. Burns Fellow.

    HAMBURG, Germany ― In 2016, 10 times as many Americans as Germans died as a result of drug overdoses, mostly opiates. Three times as many Americans as Germans experienced opioid addiction.

    Even as the rates of addiction in the U.S. have risen dramatically in the past decade, Germany’s addiction rates have been flat.

    That contrast, experts say, highlights a significant divergence in how the two countries view pain as well as distinct policy approaches to health care and substance abuse treatment.

    Unlike in the United States, where these pills are commonly dispensed after surgeries and medical procedures, opioids have never emerged as a front-line medical treatment in Germany.

    “Among the most important reasons we do not face a similar opioid crisis seems to be a more responsible and restrained practice of prescription,” said Dr. Peter Raiser, the deputy managing director at the German Center for Addiction Issues.

    Doctors must first try alternative treatments, which the nation’s universal health insurance system typically covers. Before prescribing opioids, physicians must get special permission and screen patients to make sure they aren’t at risk for addiction.

    “Here in Germany, they prescribe opiates if all the other drugs don’t work,” said Dr. Dieter Naber, a psychiatrist and researcher at the University of Hamburg. “It’s much, much, much more difficult.”

    Analyses show that opioid painkillers in Germany are prescribed somewhat more than they were 30 years ago. But that boost hasn’t fueled abuse.

    Research published this spring shows that the number of Germans addicted to opioids has changed only slightly in the past 20 years. In 2016, 166,300 Germans experienced opioid addiction ― about 0.2% of the population. In 1995, between 127,000 and 152,000 Germans were believed to have used heroin, specifically; in 2000, the range of Germans addicted to opioids was estimated between 127,000 and 190,000.

    In the United States, in 2008, the government-administered National Survey on Drug Use and Health found that about 10,700 people took pain relievers or heroin for nonmedical purposes (even if they weren’t necessarily addicted). By 2016, about 2.1 million Americans ― 0.6% of the population ― experienced full-on opioid addiction.

    The contrast speaks to differences in how the two countries approach medical care. Because of Germany’s health system ― which emphasizes primary care and keeps cost sharing low ― people who are prescribed opioids are more likely to keep up with their doctors’ visits. If they exhibit warning signs of addiction, physicians have a better chance of noticing.

    To be sure, illicit drug use also occurs in Germany, and opioids are the main killer in drug-induced deaths. Still, the drug-induced mortality rate has gone down here, per the most recent European figures.

    Even when people here get addicted, they are far less likely to die as a result. In 2016, 21 per million Germans died from drug-induced overdoses (of which most were opioid-induced). That same year, 198 per million Americans died from the same cause.

    Experts said this speaks to differences in how the countries view the issue of addiction.

    Because of Germany’s generous public coverage, it is easier to get treatment ― which, in the United States, can be hard to find, and expensive if you don’t have a health plan that covers it.

    “Money regarding treatment is really not an issue here,” Naber said.

    That said, Canada and Scotland both insure everyone and still face substantial addiction rates.

    But, in Germany, drug addiction is treated with medication and “harm reduction” approaches, including so-called safe-injection sites ― people experiencing addiction take drugs under medical supervision, with clean needles to prevent the spread of disease. These facilities even have protocols in place to prevent overdose. Germany has more than 20 such sites, with four in Hamburg. The approach has “certainly reduced mortality,” Naber said.

    Such strategies are controversial in the United States. A federal judge ruled early in October against a Trump administration effort to block a safe-injection program in Philadelphia. The administration argued that such efforts enable and encourage addiction, and pledged to continue efforts to block safe-injection sites.

    But “harm reduction,” generally, and supervised injection, specifically, have been cited as best practices by the Organization for Economic Co-Operation and Development, a coalition of developed, mostly Western nations.

    “We know harm reduction works in terms of dealing with the problem of mortality,” said Dr. Andres Roman-Urrestarazu, a researcher at the University of Cambridge who studies addiction in the global context.

    He added that Germany’s success with its multipronged approach illustrates that addiction is “a more complex problem” than the current American response has acknowledged.

    The Arthur F. Burns Fellowship is an exchange program for German, American and Canadian journalists operated by the International Center for Journalists and the Internationale Journalisten-Programme.

    Germany’s health system ― which emphasizes primary care and keeps cost sharing low ― people who are prescribed opioids are more likely to keep up with their doctors’ visits. If they exhibit warning signs of addiction, physicians have a better chance of noticing.

    To be sure, illicit drug use also occurs in Germany, and opioids are the main killer in drug-induced deaths. Still, the drug-induced mortality rate has gone down here, per the most recent European figures.

    Even when people here get addicted, they are far less likely to die as a result. In 2016, 21 per million Germans died from drug-induced overdoses (of which most were opioid-induced). That same year, 198 per million Americans died from the same cause.

    Experts said this speaks to differences in how the countries view the issue of addiction.

    Because of Germany’s generous public coverage, it is easier to get treatment ― which, in the United States, can be hard to find, and expensive if you don’t have a health plan that covers it.

    “Money regarding treatment is really not an issue here,” Naber said.

    That said, Canada and Scotland both insure everyone and still face substantial addiction rates.

    But, in Germany, drug addiction is treated with medication and “harm reduction” approaches, including so-called safe-injection sites ― people experiencing addiction take drugs under medical supervision, with clean needles to prevent the spread of disease. These facilities even have protocols in place to prevent overdose. Germany has more than 20 such sites, with four in Hamburg. The approach has “certainly reduced mortality,” Naber said.

    Such strategies are controversial in the United States. A federal judge ruled early in October against a Trump administration effort to block a safe-injection program in Philadelphia. The administration argued that such efforts enable and encourage addiction, and pledged to continue efforts to block safe-injection sites.

    But “harm reduction,” generally, and supervised injection, specifically, have been cited as best practices by the Organization for Economic Co-Operation and Development, a coalition of developed, mostly Western nations.

    “We know harm reduction works in terms of dealing with the problem of mortality,” said Dr. Andres Roman-Urrestarazu, a researcher at the University of Cambridge who studies addiction in the global context.

    He added that Germany’s success with its multipronged approach illustrates that addiction is “a more complex problem” than the current American response has acknowledged.

    The Arthur F. Burns Fellowship is an exchange program for German, American and Canadian journalists operated by the International Center for Journalists and the Internationale Journalisten-Programme.

    View the original article at thefix.com

  • Better is Better: Stories of Alcohol Harm Reduction

    Better is Better: Stories of Alcohol Harm Reduction

    Unlike most recovery groups, abstinence (sobriety) is not a requirement for HAMS. HAMS encourages all positive change, from abstinence to moderation to safer drinking.

    The following is an excerpt from HAMS’ (Harm Reduction, Abstinence and Moderation Support) new book, in which members tell their stories of success and struggles along the way. Find more information about HAMS at the end of this excerpt.

    Jessica’s Story

    I had been a heavy drinker for 10 – 20 years. The increase in my drinking happened gradually, but then one day I became very ill after drinking and realized I could have been going through withdrawal. Yet it didn’t sink in and I continued on my path to destruction.

    I work in drug addiction so I wasn’t oblivious to harm reduction, but the consensus where I live is that it doesn’t work, and everyone pushes AA. I didn’t want to go to AA and felt I couldn’t because I am in a very public position in my career in the addiction field. So I started to Google around and came across the HAMS website, but I didn’t join yet. 

    Then in December of 2016 I took a bad turn. I had been binge-drinking on a public holiday, and I was very sick, but I had to go into work on Monday. That’s when I finally joined HAMS. It was the first time I ever expressed to anyone, even myself, that alcohol had become a problem. Being able to do that in a safe environment was very important to me. There were so many people on so many different paths, including many who had been abstinent for years or moderating successfully, as well as those who had serious problems. 

    I was a member of HAMS for several months before I embarked on a taper. It had its limitations because I work long hours and I don’t drink during work so obviously with the consumption of alcohol I used to have during my hours off work it was very difficult to taper while not drinking for 12 hours a day. But tapering works. I did a long taper – perhaps it was more psychological than physical, but I live alone and I didn’t want to risk DTs.

    I tried moderating, but it didn’t work for me. Once I start to drink, there is no stop button. So I made the decision last year to be alcohol-free. Once I tried moderation again, but drank way too much. It wasn’t even stress or trauma: I just thought I deserved a treat so I tried it again, but once I started I kept going. I contacted a doctor I knew from Facebook who was a specialist in addictions and who I knew would keep my confidence, and he prescribed an at-home detox with Ativan. Unfortunately, I still had to go to work, and I don’t know how I managed but I did. So I came to the conclusion last year that I need to be alcohol free because this moderation thing does not work for me. 

    I found the HAMS Facebook group very helpful because sleeping has always been a problem for me, and it was especially acute when I first stopped drinking. I am in Central Europe, so when I couldn’t sleep at night, everyone in the US was up. When I couldn’t sleep at 2 or 3 am my time, there was always someone in the group I could talk to. I’ve made a lot of good friends in HAMS, and we usually don’t even talk about alcohol. We talk about other things in our lives. My mantra has always been that I am much more than my alcohol problem, so talking with HAMS friends about things other than alcohol keeps me focused on the life I have beyond alcohol. 

    Another thing I like about HAMS is how many members are female. Women have a very different experience with alcohol than men do, and I feel that most treatment is geared to men. Women often have more at stake: a woman I know went to the ER because she was in withdrawal, and they called child protection services on her. I didn’t want to join AA because as a female, I didn’t want to be preyed upon by the men there. Women are so vulnerable, especially when we first stop drinking. I know of many women who have been taken advantage of by men in AA. That doesn’t happen in HAMS. I’ve never felt pounced upon or been contacted in any inappropriate way. 

    The support in HAMS has made it possible for me to become alcohol-free. The fact that it is international, I can get support any time day or night, and I don’t have to worry about my identity being exposed in the country where I work, have all been important. I want us to continue to grow and help people all over the world see that changing your drinking really is possible. With HAMS, no matter who you are or where you live, you are never alone. 

     

    HAMS – Harm Reduction, Abstinence and Moderation Support – is an over 5,000-member group of people worldwide who are working to change their drinking. Unlike most such groups, abstinence (sobriety) is not a requirement for HAMS. HAMS encourages all positive change, from abstinence to moderation to safer drinking. Members are encouraged to set their own goals and make a plan for achieving them. HAMS provides confidential, 24/7 online support through closed Facebook groups, including a 1,000-member group for women only. Members interact with each other from the privacy of their own homes, and no judgement is allowed – just support and encouragement. HAMS provides support for those who want to set their own goals, think for themselves, and improve their drinking.

    HAMS’ original book, a science-based, step-by-step guide to changing your drinking, can be found at How to Change Your Drinking by Kenneth Anderson. HAMS website is https://hams.cc/ and Facebook groups include HAMS: Harm Reduction for Alcohol, HAMS for Women, Alcohol Harm Reduction, and Alcohol Free Hamsters, a group for those who choose abstinence.

    View the original article at thefix.com

  • Overdose Deaths: Not an Epidemic or a Crisis, and Not by Accident

    Overdose Deaths: Not an Epidemic or a Crisis, and Not by Accident

    Overdoses are not mysterious, they result from predictable causes like criminalizing drug use, ineffective policies, poverty, lack of stable housing, and persistent racism.

    Opioid-related overdoses are not a crisis or an epidemic, and should not be described as either. Both words stigmatize the victims of a phenomenon that is not happening by accident. Such overdoses have been steadily increasing throughout the United States and are especially high in Appalachia (where we both work). Yet overdoses are not a natural or mysterious phenomenon. They result primarily not from individual, but from larger structural factors — criminalization of drug use, ineffective social policies, poverty, lack of stable housing, historical and persistent racism, and other forms of systemic oppression — which are all the result of deliberate policy decisions.

    We are told by the media, CDC, and state governments that the region where we live and work is ground zero for a drug “crisis.” Yet those same entities contribute to the problem through policies, funding allocations, and covering-up of underlying systemic causes. We must shift our language to reflect this. Substance use and overdose happen in predictable contexts and disproportionately affect marginalized communities.

    Terms Like “Epidemic” and “Crisis” Cause Alarm and Hysteria, Stigmatizing People Who Deserve Compassion

    More than 67,000 people in the United States died from opioid-related overdose in 2018. Alarmist headlines, even well-intended reports, do not justify an inaccurate framing. We advocate instead for the use of the term impact, or other language that indicates the underlying roots of suffering, instead of epidemic or crisis.

    Epidemic is most accurately used to describe infectious or viral spread of a disease within a population over a short period of time. Substance use, even for the relatively low 18% of people who use “chaotically,” does not meet this criteria. People who overdose or suffer negative consequences of substance use may be more socially or genetically vulnerable to a substance use disorder but in basic epidemiological principles, that does not an epidemic make. Calling structural violence that leads to specific overdose patterns an epidemic or a crisis feeds into a hysteria that marginalizes drug users and their loved ones. Both words take the focus away from the underlying causes of suffering; naturalizing it and leaving the conversation at a surface level without motivating real change. 

    We both work in and study harm reduction and overdose prevention in North Carolina: a microcosm of opioid-related deaths and specific patterns of suffering repeated elsewhere in Appalachia and throughout the country. Daily, we observe the dynamics of economic policies, limited healthcare access, and stigmatization that impact people already at greater risk for substance use and overdose. Later in this essay we discuss how it plays out in North Carolinians’ overdose risks — making it more likely they and their loved ones will be blamed if they do.

    How Misguided Drug Policies Blame the Victims While Ignoring the Causes

    Like the thousands of lives lost to fentanyl poisoning in the context of increased drug use criminalization today, there was nothing natural about the thousands of lives lost to alcohol poisoning during prohibition a century ago; or the increase in deaths and drug-related arrests that ravaged inner-cities during the government-manufactured “crack era” of the 80s and 90s. Consequences of drug use, like mass incarceration, have never been a natural disaster. Instead, policy responses to drug use tend to create systemic storms that rage in vulnerable communities. This is a classic example of blaming the victims of problems while ignoring the causes.

    If a “crisis” is happening to those around you, you may feel bad for them, you may vote for a politician who promises to address it — but you probably won’t ask how the same politicians or political system contributed to creating it, or how arresting and jailing poor and Black and Brown people will fail to fix it. Overdose deaths in the U.S. have always been both a symptom and outcome of discriminatory policies. 

    Suffering is further exacerbated by punitive policies such as drug-induced homicide laws that increase overdose deaths, weaken Good Samaritan legislation intended to reduce overdose, and criminalize drug users and their loved ones. For example, opioid de-prescribing mandates in 19 states appear to result in an increase in heroin overdose deaths. And, healthcare policy is an oft-overlooked aspect of overdose prevention — states that did not expand Medicaid (which increases coverage of treatment) are disproportionately states with higher overdose and substance use.

    Mainstream media portrays sympathetic stories of the middle-class sons and daughters of urban politicians dying of overdose, while the stigmatized partners and friends of poor Appalachians who disproportionately die of overdose from drugs often laced with fentanyl fear being arrested under ‘drug-induced homicide’ and ‘death by distribution’ laws if they call 911. The ways that drug users are talked about serve political agendas that further contribute to patterns of suffering.*

    We must acknowledge and address what is missing, obscured, and ignored when we promote an inaccurate framing of drug use as a “crisis” or “epidemic,” rather than something caused by policy decisions. Who is disproportionately blamed? Who is left out of the conversation? 

    When we fail to address how a combination of economic, political, biological, behavioral, genetic, and social factors intersect within the lives of drug users and their wider communities, we legitimize the use of simplistic and punitive approaches to complex issues. Where we live and work, North Carolina policy makers used the 2016-2017 increase in drug overdose deaths to justify an argument for harsher punishments despite a wealth of research that shows that such approaches increase the very health consequences they claim to reduce. Further, these approaches do nothing to address economic disparities in North Carolina where 13 of 100 counties have experienced rates of poverty at 20% or higher for the last three decades. They do nothing to address the lack of Medicaid expansion or limited employment and economic growth — all upstream drivers of overdose and suffering.

    Simply put, an increase in overdose deaths is not the result of society’s inability to get tough on crime, or even the need for more biomedical treatment. Rather, overdose deaths persist due to an unwillingness to acknowledge that treatment expansion and more or harsher punishment fail to address gaping social wounds. 

    Communication: Start Using Language That Reveals the Roots of Unequal Suffering

    As long as policymakers, politicians, and journalists continue to use inaccurate terms like “opioid crisis/epidemic,” opportunities are missed to discuss and address the causes and effects of substance use and overdose. We advocate for talking instead about “opioid impact” or “overdose impact.” A more neutral term like impact is less stigmatizing and hyperbolic, and thus less marginalizing for those directly affected. Impact is also more flexible — not all drug use is harmful, nor leads to substance use disorder, illness, or overdose. Impact is a more accurate and flexible term to allow for discussion of people’s lived experiences with substances.

    Even so, it may not go far enough. As a parallel example, public pressure and justice-oriented advocacy shifted public conversation and journalistic style from talking about human beings as “illegal” to “undocumented.” But referring to these same folks as “economic refugees” would be even more accurate and less stigmatizing. Similarly, impact is a more useful term than “crisis” or “epidemic” when referring to patterns of opioid-related overdose and substance use-related illness. And, terminology that clearly unmasks the deeper roots of unequal suffering would be even better.

    A person using drugs is not a disease vector nor the precipitator of a crisis. What we witness in communities like Philadelphia, Austin, and Asheville are not drug-related epidemics or naturally occurring crises. The harms impacting these communities are symptoms of destructive social policies that ensure the most vulnerable populations remain vulnerable, shamed, and disproportionately suffering from the very problems for which they are blamed. 

    So where do we go from here? We can start by answering this with another question: How might our conversations, and thus policy and response efforts change, if we use language that reveals the structural roots of suffering instead of further contributing to stigma and hysteria that shames the people who are most directly affected?

    View the original article at thefix.com

  • Safehouse Founders Talk Overdose Prevention Sites’ Recent Victory, Future Challenges

    Safehouse Founders Talk Overdose Prevention Sites’ Recent Victory, Future Challenges

    The Philadelphia-based organization was given the green light to open the first overdose prevention sites in the U.S.

    Soon after a judge ruled in their favor, the organization set to open the first ever overdose prevention sites in the United States reflected on their recent victory in an op-ed.

    This month, a federal judge ruled that Safehouse may go ahead with efforts to open two sites (also known as harm reduction sites or supervised injection facilities) in Philadelphia. The ruling was a clear victory over the federal government, which argued in court that the proposed facilities violated a provision of the Controlled Substances Act.

    “Opioid users would be free to come to the sites and inject their products with clean needles, and health workers would be on hand to make sure no one overdoses. At no point would we distribute or even touch controlled substances; the user would bring them to our facility. This isn’t a substitution of treatment, but it is safer than having people use drugs alone or on the streets,” wrote the three founders of Safehouse, the organization that proposed to open the sites, in a Washington Post opinion piece.

    They would be the first such (legal) facilities in the United States.

    We Could No Longer Wait As The Death Toll Continued To Rise

    Ed Rendell, a former governor of Pennsylvania, Jose A. Benitez, executive director of Prevention Point Philly and Ronda B. Goldfein, executive director of the AIDS Law Project of Pennsylvania founded Safehouse because “we could no longer wait as the death toll continued to rise almost unabated,” they wrote.

    The face of Philadelphia’s drug crisis is Kensington, a neighborhood so notorious for its drug problem that The New York Times called it “the Walmart of Heroin” in a feature last year. 

    Rendell, Benitez and Goldfein noted that 1,217 people in Philadelphia died of opioid overdoses in 2017. “The problem was, of course, that most people who overdose do so alone, and even if naloxone was on the table next to them, they couldn’t administer it because an overdose renders a person unconscious,” they wrote.

    Safehouse’s mission is to save lives, which overdose prevention sites have proven to do in Canada and about 120 other such sites around the world.

    “It is important to note that we, like other harm reduction advocates, do not believe supervised injection sites are the answer to the opioid crisis… but we do know that supervised injection sites will save lives,” they wrote.

    With the momentum from their recent victory in court, the founders say, “We hope it will be one of many across the country.”

    Suits Followed By Countersuits

    This month, U.S. District Judge Gerald A. McHugh ruled that the facilities were not in violation of federal law, as the federal government tried to argue in court.

    Pennsylvania prosecutors and the Department of Justice filed a civil lawsuit against Safehouse in February, trying to stop the organization from moving forward with opening the facilities, which had the endorsement of local officials including Mayor Jim Kenney.

    In suing Safehouse, the government argued that the facilities would violate the “crack house” statute under the Controlled Substances Act, which made it a crime to “knowingly open, lease, rent, use, or maintain any place, whether permanently or temporarily… for the purpose of unlawfully manufacturing, storing, distributing, or using a controlled substance.”

    Safehouse countersued in federal court, which concluded with the judge’s recent ruling.

    McHugh said in his decision that it was clear that overdose prevention sites were not intended targets of the Congress in 1986 when they created the “crack house” statute.

    “There is no support for the view that Congress meant to criminalize projects such as that proposed by Safehouse,” McHugh wrote. “Safe injection sites were not considered by Congress and could not have been, because their use as a possible harm reduction strategy among opioid users had not yet entered public discourse.”

    McHugh determined that Safehouse’s mission did not clash with the law. “The ultimate goal of Safehouse’s proposed operation is to reduce drug use, not facilitate it, and accordingly, [the “crack house” statute] does not prohibit Safehouse’s proposed conduct.”

    Despite their victory, the founders—Rendell, Benitez, and Goldfein—acknowledged in the Washington Post op-ed that the fight is far from over.

    “While we may have won that first legal battle, we still have hurdles to clear,” they wrote.

    “We hope that our victory emboldens other cities to venture into setting up their own harm reduction sites. While our federal ruling is not binding on other jurisdictions, we believe its logic and reasoned interpretation will help proposed facilities in places such as New York, San Francisco, Boston, Seattle and Denver when and if they face court challenges,” they wrote.

    View the original article at thefix.com

  • Drug Policy Alliance Creates Harm Reduction-Based Guide For Drug Education

    Drug Policy Alliance Creates Harm Reduction-Based Guide For Drug Education

    The new drug education curriculum is based on harm reduction principles and is available for free to high school teachers.

    Teachers now have access to a harm reduction-based guide to teaching kids about drugs.

    The Drug Policy Alliance created a new drug education curriculum for high school teachers—available online for free download—that doesn’t rely on demonizing drugs and alcohol. Instead, the curriculum is based on harm reduction principles—an alternative to abstinence-only drug education programs like the original version of D.A.R.E.

    The DPA, a non-profit organization that promotes drug policy reform, explained the difference: “For example, abstinence-only education may tell young people that they should refrain from using drugs because they could overdose. Harm reduction drug education explains how to recognize the signs of drug overdose, how to respond and how to get help if they fear that a friend is overdosing.”

    Safety First: Real Drug Education For Teens

    The package of 15 lesson plans (PowerPoint slides included)—titled Safety First: Real Drug Education for Teens—goes over material that is familiar to traditional drug education curricula like Alcohol & Other Depressants, Vaping & E-Cigarettes and Cannabis.

    But other lessons, like Mental Health and Coping and Health & Policy, feel new to generations who were raised on D.A.R.E.

    Sasha Simon, Safety First program manager for the DPA, told Benzinga that the organization saw the need for a comprehensive, alternative drug education program.

    “Safety First was created in response to a lack of accurate, science-based and compassionate drug resources in schools,” she said. “With nearly 70,000 people dying of accidental overdose last year alone, it is essential that our young people develop the necessary skills to navigate their risks. Not only will it protect them while in school, but will serve as a foundation for them to foster healthy attitudes and habits around drugs that they will carry with them throughout their lives.”

    Testing the Curriculum on Students

    The Safety First curriculum was piloted in New York City and San Francisco, and produced positive results, DPA said.

    They observed in the much larger San Francisco trial, where over 600 students were taught the curriculum, that students demonstrated increased knowledge of harm reduction, drugs and alcohol, and how to detect and respond to a drug-related overdose.

    View the original article at thefix.com

  • Yang, Beto Discuss Unusual Solutions to The Opioid Epidemic

    Yang, Beto Discuss Unusual Solutions to The Opioid Epidemic

    The presidential candidates made the case for marijuana legalization and opioid decriminalization during a recent debate.

    Democratic presidential candidate Beto O’Rourke spoke about marijuana as a replacement for opioid pain pills during the Democratic primary debate on Tuesday (Oct. 15), while fellow candidate Andrew Yang expressed his support for decriminalizing opioids and opening safe injection sites. 

    O’Rourke shared a story about a veteran he had met who was addicted to heroin. He suggested that if the man had access to marijuana, he wouldn’t have become hooked on opioids, according to Marijuana Moment. 

    Marijuana Legalization

    “Now imagine that veteran, instead of being prescribed an opioid, had been prescribed marijuana, because we made that legal in America [and] ensured the VA could prescribe it, expunge the arrest records for those who’d been arrested for possession and made sure that he was not prescribed something to which he would become addicted,” O’Rourke said. 

    Asked directly whether marijuana is part of the answer the the opioid crisis, O’Rourke answered, “Yes it is.”

    As O’Rourke was speaking, Yang said, “Yes, preach Beto.”

    Decriminalizing Opioids

    During the debate, Yang expressed his support not only for legalizing marijuana, but for decriminalizing opioids, including heroin. 

    He said, “We need to decriminalize opioids for personal use. We need to let this country know this is not a personal failing, this was a systemic government failing. Then we need to open up safe consumption and safe injection sites around the country because they save lives.” 

    Yang continued, “We have to recognize [addiction] is a disease of capitalism run amok.”

    He pointed out, “There was a point where there were more opioid prescriptions in the state of Ohio than human beings in the state of Ohio, and for some reason the federal government thought that was appropriate.”

    Public Health Issue

    Yang said that because the government was complicit in the over-sale of opioids, it needed to support people who are now addicted to opioids. 

    “If the government turned a blind eye to this company, spreading a plague among its people, then the least we can do is put a resource into work in our communities so that people have a fighting chance to get well, even though this is not a money problem,” he said. “We all know this is a human problem. Part of helping people get the treatment that they need is to let them know that they’re not going to be referred to a prison cell, they will be referred to treatment and counseling.”

    Other more mainstream candidates including Bernie Sanders and Elizabeth Warren have supported harm reduction policies as well. 

    View the original article at thefix.com

  • "Dope World" Takes a Globe-Spanning Deep Dive into Our Relationship with Drugs

    "Dope World" Takes a Globe-Spanning Deep Dive into Our Relationship with Drugs

    Vorobyov investigated drug use and culture in 15 different countries on five continents, from the coca plantations of Colombia to the mean streets of Moscow.

    With the release of his new book, Dope World: Adventures in Drug Lands, Niko Vorobyov has become the Anthony Bourdain of drugs and the worlds they inhabit, a modern day Hunter S. Thompson. By interviewing cartel members, big-time drug dealers, street guys, gang members, and even government officials, Vorobyov seeks to understand humanity’s bond with drugs. 

    Before our interview, Vorobyov told me about one surreal night in the mountains of Sinaloa, Mexico, where he and his buddy had traveled for a meeting with one of El Chapo’s relatives. Deep in cartel territory, with posted guards everywhere brandishing AK’s and AR-15’s, where one wrong move could mean death, El Indio, the guy who owned the ranch, threw a sushi party. 

    Vorobyov remembers all these guys standing around with assault rifles slung over their shoulders eating sushi. One of the gun-toting sentries even came over to Vorobyov and started chatting to him about movies. He came away with the feeling that El Chapo’s family were pretty normal, if you forgot about the guns.


    Tributes to Malverde, the Sinaloa patron saint of narcotraficantes.

    The Fix: Why did you decide to examine every angle of the drug war and how has the drug war affected the whole world?

    Niko Vorobyov: There’s a lot of great books about this already — Chasing the Scream is one of my favorites — but they take a very Anglo-centric point of view. I wanted to explore other places that we don’t hear about so much like Russia, Japan, and the Philippines. Some people like to say it’s all America’s fault and that they started this whole mess with Richard Nixon, but it goes back way before that, all the way to China and the Opium Wars. Right now, America’s legalizing weed while Russia, China, and the Philippines are fighting the drug war the hardest.

    Why do you think you got involved with drugs in the first place?

    Growing up I was quite a weak person with low self-esteem, so I kinda thought if I acted in a certain way, that would help me accept myself; that drugs and criminal activity would get me friends and respect and all that. I started getting a lot into the underground rave scene and became a student drug dealer. And once you start moving in those circles it’s quite easy to make connections and meet a supplier. From then on, I worked my way through ups and downs till I had a small crew running weed, coke, and MDMA through the hallowed halls of East London universities. 

    But I got reckless and ended up doing a 2½ year prison stretch which really changed my outlook on life — it made me question who I was and what I was doing here. Sitting in a cell on 24-hour lockdown I read everything I could about the history of drugs and drug bans, how and why they were forbidden, and what the consequences of that may be. When I got out, that led me on a journey across 15 different countries on five continents, from the coca plantations of Colombia to the mean streets of Moscow.

    Looking back now, how did your early drug use and even prison prepare you to write Dope World?

    I’ve always had an anti-authoritarian streak; I’ve hated others telling me what to do, especially if it was “for your own good.” Of course I’ve taken drugs — if I haven’t, would that make me more [qualified] or less qualified to write about this topic? I keep reading articles where you can tell they’ve never dabbled in any psychedelic pleasures because none of them have a clue what they’re on about. Looking back, I wasn’t really very political before I went to prison because it’s easy to feel detached when it’s happening to someone else. 

    But when you’re locked in a cell for 23½ hours a day and there’s not enough staff because someone wanted to save a few pennies, you start to see all these abstract ideas are life-or-death shit. And when you see all these poor, working-class people or ethnic minorities while the government’s laughing all the way to the bank — the UK’s one of the biggest legal weed exporters in the world — it makes you ask what’s wrong with this picture. 

    You interviewed Freeway Rick Ross. What did that teach you about the crack era in L.A. and across the nation?

    The first thing you need to know is the real Rick Ross is not a rapper – that Rick Ross actually batted for the other team as a prison guard. Freeway Rick Ross was the biggest crack kingpin on the West Coast in the 80s and early 90s — this dude supplied the Bloods and the Crips. Ricky’s a tough man to get ahold of; he was actually on his own book tour as I was trying to reach him, so I’m glad he came through. Where his story gets really interesting is when he was involved in the Contra cocaine scandal. 

    The CIA was allowing the Contra rebels in Nicaragua to smuggle coke into the U.S. for buying more firepower and fighting communism back home. Freeway Ricky unknowingly took the Contra’s coke and cooked it up into crack before selling it in South Central, without realizing he was just a small pawn in a chess game of global politics. I’m not really a conspiracy nut, but it’s amazing that this whole scandal came to light—how the Agency knowingly used a foreign army pumping crack into the hood — and it makes you think about what else they might’ve done that we don’t even know about. 

    At the same time, the Feds were going down hard on the inner city to fight the so-called crack epidemic. Congress passed the Anti-Drug Abuse Act 1986 which meant that mostly black and brown people who were caught with five grams of crack got the same sentence as someone with half-a-kilo of regular blow. Freeway Ross ended up getting life, while none of the top players who approved the Contra plan wound up going to jail. That tells you everything you need to know about the hypocrisy, racism, and corruption in the war on drugs.

    In the book, you write about LSD in Tokyo. Can you talk about that?

    So the chapter on Tokyo is all about meth, LSD, and synthetics. I mostly fucked with the Yakuza (Japanese organized crime) and found out how they roll with being among the top meth dealers in Asia. But there was another group that was also quite interesting — a cult named Aum Shinrikyo or “The Supreme Truth,” which in 1995 carried out the deadliest terrorist attack in Japan, poisoning 13 people on the Tokyo subway with sarin gas. Like the CIA used to do in the 50s, the cult used LSD as part of their brainwashing. Maybe being on psychedelics made their wacky conspiracy theories believable. 

    Of the places you visited, which had the worst addiction problems? 

    When I was in Lisbon, the head of an NGO showed me a video of how this neighborhood used to look like. In the 1990s, Casal Ventoso was one of the biggest open-air drug markets in Europe and it really looked like a nightmare version of The Wire or a cheap movie set of the bad side of town. Dystopian scenes; crowds of ragged-looking addicts shuffling past crumbling buildings and filthy, trash-ridden streets. One guy was missing his arm. Portugal had a major heroin crisis — something like 1% of the population was addicted — but it’s precisely because their crisis was so bad that they managed to push through reforms and de-stigmatize addicts.

    Of the places I’ve been to now, it’s hard to say — everywhere has its problems — but probably the most widespread I’ve seen was in Kerman, an Iranian city near the Afghan border. It seemed like every household had at least one member smoking opium, or taryak, and you can see people lighting up pipes or spoons in the archways of the old market. Iran’s a very religious country and opium’s tolerated more than booze. But I’d say every other young person drinks, and there’s a rising alcohol problem because they’re too scared of getting help.


    Vafoor, or opium pipe, in Kerman, Iran.

    When do you think the world will stop criminalizing addiction?

    I think we’re slowly moving in that direction. The police in some parts of the UK have stopped targeting low-level user-dealers. A lot of the people I’ve talked to are cops, and as a former drug dealer that’s not a conversation I expected to have six or seven years ago! Then you’ve got someone like Boris Johnson inhaling a South American nose remedy, and he’s gone on to be leader of a country that used to own half the world. 

    I’m not saying they’re connected, but we’re starting to realize taking drugs doesn’t always lead to the worst-case scenario. A couple of months ago Malaysia, which was putting convicts to death, announced they’re following Portugal and decriminalizing drugs which means that you won’t end up in jail for having a gram in your pocket. And that’s a very conservative country; much more conservative than, say, Ohio. So I think there’s hope.

    What did you learn the most during your travels and writings?

    I think the most important thing is no matter how much you read, you’ll never truly know how the world works from your bedroom (or in my case, my cell). You’ve got to go to places and talk to people. Listen to them, even if they’re chatting complete bollocks, and try to understand why they think the way they do. We try to put everything in boxes — good or bad, left or right — but our world is too complicated for that. My agent called my book a fucked-up travel guide. I hope I’ve inspired someone to check out these places, if I haven’t scared the shit out of them already.

    There’s a sense that this is it, you’re fucked now. No one’s coming to get you. When you and I get stressed now we can take a walk; go outside; talk with our friends; but when you’re in prison, you’re stuck alone in a tiny cell till they let you out, and you start going crazy. When I was inside there were so many cutbacks they didn’t have enough staff to run the show properly, so sometimes we’d be locked up 23½ hours a day— suicides went sky-high that year.

    What takeaways do you want readers to have after reading your book?

    Look, you might not like the idea of your little cousin bouncing off the walls after a line of Bolivian marching powder. My mum read the book and she was fucking mortified. But dopeworld is everywhere, from scuzzy housing projects to the highest echelons of power, so we’ve got to find a way of living with it, otherwise families will keep getting torn apart and the bodies will keep piling up, whether it’s through prisons, gangs, or ODs. We’ve tried drug war, now let’s try drug peace.

    Search results from the dark web.

    View the original article at thefix.com

  • Harm Reduction Educator Who Trained Thousands To Use Narcan Loses Addiction Battle

    Harm Reduction Educator Who Trained Thousands To Use Narcan Loses Addiction Battle

    Kevin Donovan died on September 28 at the age of 40.

    The Syracuse harm reduction community is mourning the loss of advocate and educator Kevin Donovan, who died in late September of an apparent overdose.

    According to his obituary, “He lost his battle with addiction following a long-term recovery.”

    Donovan trained many in his community how to administer Narcan, a brand of naloxone, the opioid overdose-reversing drug.

    Saving Lives

    Will Murtaugh, executive director of ACR Health, said that more than 500 people that were trained by Donovan used their Narcan training. “That means, 500 people’s lives were reversed,” he said, according to WRVO.

    ACR Health is a community health center with a syringe exchange and a Drug User Health Hub which offers a range of prevention and sexual health services to people of all ages. Donovan was also the founder and director of Healing Hearts Collaborative, an opioid overdose prevention program.

    Kevin’s work was informed by his own experience in recovery. “To remove the stigma of the disease, he openly shared his struggles with addiction to educate others of treatment options, and he was a staunch advocate for the use of Narcan,” read his obituary.

    Colleagues Speak Out

    According to Murtaugh, Kevin did not seek help at his time of need despite having a supportive community around him.

    “We’re all hurting a little bit, because he knows we were here for him and he could’ve come to us anytime and got that support,” he said. “This is a typical overdose. We’ve had many of them. People end up using alone, and they die alone, because they don’t have those supports around them that they need. We try, and Kevin did too, to educate everyone. Do not use alone. Do a test shot. Make sure that there is Narcan in the house.”

    ACR Health lost two other staff members in 2016 and 2017.

    The center supports having supervised injection facilities, also known as overdose prevention facilities, to give people a place to use under medical supervision where they can access treatment if they feel ready.

    Safe Consumption Sites

    A federal judge recently ruled that such facilities would not violate federal law, which the current administration tried to argue against in court. An organization in Philadelphia was on the other side of the legal fight. It now has the green light to move forward with plans to establish what would be the first overdose prevention site in the United States.

    In May, Donovan was featured by WRVO for giving the Narcan training that saved a woman’s life. The woman became unresponsive inside a local business and staff members responded by administering Narcan. She was revived by the time EMT arrived.

    “What made me really happy was their willingness to share their story, and to say, this is a positive thing we want to do for our community,” said Donovan at the time. “That’s a life. The stigma is so bad, sometimes this stuff happens, and people don’t want to share it, or want anything to do with it in the public vision.”

    Kevin Donovan died on September 28 at the age of 40. He is survived by his son Rowan, his parents, brother and extended family.

    View the original article at thefix.com