Editorial Statement on the Criticism of Suboxone

To our listeners,

Crackdown’s recent episode (#27), titled “Cop Baked In”, was critical of the medication Suboxone (sublingual buprenorphine/naloxone) for its design, which (as a partial agonist) blocks feelings of euphoria from other opioids, and questioned the highly hyped rollout of new Suboxone prescribing guidelines in BC around 2016, when the province’s “overdose crisis” was declared a state of emergency.

That declaration was more than five years ago.

And yet, we continue to see rising numbers of overdose-related deaths, and a poisonous drug supply that doesn’t seem to respond well to our traditional models of Opioid Agonist Therapy (OAT) prescribing.

Crackdown has wanted to open the conversation about Suboxone for quite some time. Because, as it stands today, Suboxone is still considered (by many prescribers and healthcare/government-funded research orgs) to be the first line of treatment for persons diagnosed with opioid use disorder (OUD). This concerns us as we have received preliminary research data suggesting that Suboxone patients are more likely to discontinue treatment than those prescribed methadone. This is not surprising to us at Crackdown because for years we have heard people who use drugs saying that Suboxone does not work for them. 

As investigative journalists on the front lines of the war on drugs, we decided to use a personal narrative as well as qualitative research on youth’s experiences and perspectives on OAT to start a dialogue about something that we felt had not yet been discussed as a barrier to care. 

Since the publication of “Cop Baked In”, we have received positive feedback from drug users. We have also received negative comments from doctors and other prescribers across the country. This was expected, and we have certainly started a dialogue. 

For example, it has been suggested by one listener that we implied (or stated) that Suboxone is “ineffective”. There has been speculation that by starting a dialogue about Suboxone’s limitations, we may “harm people by scaring them away from a lifesaving treatment.” 

That same listener said, “Garth makes it seem like Suboxone does not work for anybody, not worth trying, or implementing as a policy response.

Another listener said our reporting “ludicrously claims that the buprenorphine molecule itself is coercive.”

A Twitter user even commented, “I guess I’m a basic bitch because I prescribe Suboxone to my patients.”

We received more comments in a similar vein.

The Editorial Board of Crackdown felt compelled to release a statement in response.

  • We did not describe Suboxone (or any treatment) as “ineffective.” I encourage critics to listen to the episode again, and really listen to the words we use. Because our language and the way we use it is intentionally designed to avoid sweeping generalizations. We ask questions; we don’t claim to have all the answers. Also, I (Reija Jean) attained periods of stability while on Suboxone. What we attempted to show was the difficulty that some can experience when trying to stabilize or re-stabilize after a period of using street supply. 
  • We do not believe that by raising concerns about a treatment like Suboxone that patients will be “scared to take it.” Many folks in our communities are already wary of Suboxone, because they’ve had bad experiences like precipitated withdrawal (have our critics ever been in precipitated withdrawal?). Every body is different, and will experience drugs differently. Furthermore, drug users are already talking about their experiences with each other. If prescribers want to close their ears to our concerns about Suboxone, we wonder why? Perhaps we are raising concerns because what we want and need is a range of OAT treatment options that are informed by drug users and what we want and need from our medication. Why does it seem like some care providers don’t want to hear it?
  • We did not claim that Suboxone or the buprenorphine molecule “is coercive.” But the lack of choice we are given and the disempowerment drug users experience in our relationships with doctors, nurses and prescribers is coercive. We told my (Reija Jean’s) personal story in which I felt Suboxone was my only option, that it was “better than methadone”, that it was “easier to come off of”, and a host of other claims that are not, it turns out, entirely accurate. I believed these things because that was the information given to me by healthcare providers and I felt coerced into accepting Suboxone or leaving with nothing.

Here are some suggestions for listeners who found themselves reacting defensively to our episode:

  • Try to listen to me—the human, Reija Jean—tell my story. Listen to my words. Listen to the words used by our host Garth Mullins and by our scientific advisor Dr. Danya Fast. If you find yourself feeling upset, angry, or defensive, perhaps pause the episode and ask yourself, “Why do I feel this way? What is being triggered here?” Because those kinds of feelings are rarely about the external; generally, they come from somewhere deep inside ourselves—perhaps a feeling that remains unresolved. Who knows? Only you.
  • See if it is possible to listen to the episode with a different frame of mind. Experiment with different lenses. Such as, the lens of a person who actually has experience taking drugs like Suboxone, and the fear generated by folks who have experienced unexplained withdrawal-type symptoms post-lapse or relapse, as well as precipitated withdrawal. Try to put yourself in the body (as much as is possible) of the person who has undergone a series of medication changes and alterations, and the person who has hoped for a miracle cure—or just to feel joy, pleasure, or an absence of pain—who has been disappointed again and again. Consider what it is like to depend on a medication like Suboxone for your survival. Consider what it is like to get a prescription for this medicine, after a period of using street supply, taking it at home, and still feeling sick. Imagine you are sweating it out at home, with no support because it’s the weekend and your clinic is closed. There is nowhere to go. No family or friends. And your dealer, who can make you feel better in an instant, is just down the street.

Crackdown will not stop talking about Suboxone, or any other aspect of OAT. Ultimately, we want drugs that are preferred by us, not (only) by prescribers. We, as patients and end-users, deserve to be asked what we need and what is missing. We deserve to be treated like the subject-matter experts we are. Because, believe it or not, we know what we need. We know what is missing. Many of us understand the flaws in many of the methods that have been conducted by pharmaceutical companies. We know what research questions need to be investigated (like the effect of setting and care quality on withdrawal symptoms, or about what actually happens to the patient who takes a bupe to-go pack home).

How can we work together to address the social determinants of health, including equitable access to healthcare, housing and proper individualized medication support, so that we can finally stem the tide of this unprecedented flood of death?

Rather than complain about our reporting (or at least, in addition to complaining), why don’t you commit yourselves to trying to understand Suboxone’s limitations, as well as the limitations of other OAT treatments—many of which are not keeping up with today’s toxic fentanyl and (now) venomous benzodiazepine-laden supply.

Sincerely,

Reija Jean and the Editorial Board of Crackdown

P.s. 

Basic bitch or not, it’s not all about you.

Episode 27: Cop Baked In

Editorial Statement on the Criticism of Suboxone

Suboxone has a “cop baked in;” it produces very little euphoria and can stop you from getting high on other opioids. Some doctors and policy makers say this enables people to pursue a more meaningful life, but drug user activists worry this kind of war on euphoria will only lead to more overdose deaths.

Can Crackdown’s editorial board member Reija Jean use Suboxone to kick dope? Who will win the battle for her opioid receptors?

Image by Reija Jean

Note: Beans the cat is healthy and happy. Don’t worry about Beans. 

Image by Reija Jean

The phrase “cop baked in” was coined by Garth in a 2017 BCAPOM meeting. 

Interviewees

Reija Jean

Dr. Danya Fast

Policy Recommendations 

Nothing about us without us – drug users should be given power over the design and implementation of the pharmaceutical policies that dominate their lives. We are the experts and we deserve a real seat at the table. 

Drug users should have a real choice – not limited by the moral or political concerns of their physicians: Suboxone, Methadone, Dilaudid, prescription heroin, safe supply fentanyl, whatever. 

End the war on euphoria. 

Suggested Reading

Danya Fast, “Going Nowhere: Ambivalence about Drug Treatment during an Overdose Public Health Emergency in Vancouver,” Medical Anthropology Quarterly 35:2 (2021): 211. 

David Moore. “Erasing pleasure from public discourse on illicit drugs: On the creation and reproduction of an absence,” International Journal of Drug Policy 19 (2008): 353–358.

Helena Hansen, Caroline Parker and Jules Netherland. “Race as a Ghost Variable in (White) Opioid Research,” Science Technology and Human Values 45:5 (2020): 848-876.

Nancy Campbell and Anne Lovell. “The history of the development of buprenorphine as an addiction therapeutic,” Annals of the New York Academy of Sciences 1248 (2012): 124-139.

Valerie Giang, Thulien M, McNeil R, Sedgemore K, Anderson H, Fast D. “Opioid agonist therapy trajectories among street entrenched youth in the context of a public health crisis.” SSM Popul Health. 11 (2020):100609.

Works Cited

Alan Cowan, Braude MC, Harris LS, May EL, Smith JP, Villarreal JE. “Evaluation in nonhuman primates: Evaluation of the physical dependence capacities of oripavine-thebaine partial agonists in patas monkeys,” in Narcotic Antagonists (1974): 427–438, Raven Press, New York.

British Columbia Centre on Substance Use and B.C. Ministry of Health. “A Guideline for the Clinical Management of Opioid Use Disorder,” (2017).

B.C. Coroners Service. “Illicit Drug Toxicity Report: Fentanyl-Detected Suspected Illicit Drug Toxicity Deaths, 2012-2021” (2021).

Danya Fast, “Going Nowhere: Ambivalence about Drug Treatment during an Overdose Public Health Emergency in Vancouver,” Medical Anthropology Quarterly 35:2 (2021): 211. 

David Moore. “Erasing pleasure from public discourse on illicit drugs: On the creation and reproduction of an absence,” International Journal of Drug Policy 19 (2008): 353–358.

Helena Hansen, Caroline Parker and Jules Netherland. “Race as a Ghost Variable in (White) Opioid Research,” Science Technology and Human Values 45:5 (2020): 848-876.

John Lewis. “Nathan B Eddy Award Lecture: In Pursuit of the Holy Grail,” Proceedings of the 60th Annual Scientific Meeting of The College of Problems of Drug Dependence, Inc. (1998): 7-13.

Marteau D, McDonald R, Patel K. “The relative risk of fatal poisoning by methadone or buprenorphine within the wider population of England and Wales.” BMJ Open 5:5 (2015):e007629.

Megan Kurz, Jeong Eun Min, Laura Dale, Bohdan Nosyk. “Assessing the determinants of completing OAT induction and long term retention: A population-based study in British Columbia, Canada” Canadian Centre on Substance Use and Addiction Issues of Substance Conference (2021): F6.3.

Nancy Campbell and Anne Lovell. “The history of the development of buprenorphine as an addiction therapeutic,” Annals of the New York Academy of Sciences 1248 (2012): 124-139.

Valerie Giang, Thulien M, McNeil R, Sedgemore K, Anderson H, Fast D. “Opioid agonist therapy trajectories among street entrenched youth in the context of a public health crisis.” SSM Popul Health. 11 (2020):100609.

Episode 26: Artificial Energy

On last month’s show, we looked at the history of the Brain Disease Model of Addiction. That’s the idea that drug users have a chronic, relapsing brain disease. The reward system in our brain is wired wrong and that’s why we want to get high.

On today’s show: a different theory. Academics call it the “social adaptation” model of addiction. This is the idea that people take drugs because they are useful. There’s something about the world that makes drug use more appealing, rational, or necessary.  

This is true for lots of drugs. But on episode 26 of Crackdown, we look specifically at crystal meth. 

Further Reading

Geoff Bardwell, Taylor Fleming, Alexandra B Collins, Jade Boyd, and Ryan McNeil. 2018. Addressing Intersecting Housing and Overdose Crises in Vancouver, Canada: Opportunities and Challenges from a Tenant-Led Overdose Response Intervention in Single Room Occupancy Hotels. Journal of Urban Health.

Jade Boyd, Lindsey Richardson, Solanna Anderson, Thomas Kerr, Will Small, Ryan McNeil. 2018. Transitions in income generation among marginalized people who use drugs: A qualitative study on recycling and vulnerability to violence. Int J Drug Policy.

William Damon, Ryan McNeil, M-J Milloy, Ekaterina Nosova, Thomas Kerr, and Kanna Hayashi. 2018. Residential Eviction Predicts Initiation of or Relapse into Crystal Methamphetamine use Among People who Inject Drugs: A Prospective Cohort Study. Journal of Public Health

Matthew Desmond. 2012. Evictions and the Reproduction of Urban Poverty. The American Journal of Sociology.

Danya Fast, Thomas Kerr, Evan Wood, and Will Small. 2014. The multiple truths about crystal meth among young people entrenched in an urban drug scene: a longitudinal ethnographic investigation. Soc Sci Med.

Taylor Fleming, Will Damon, Alexandra B Collins, Sandra Czechaczek, Jade Boyd, and Ryan McNeil. 2019. Housing in crisis: A Qualitative Study of the Socio-Legal Contexts of Residential Evictions in Vancouver’s Downtown Eastside. International Journal of Drug Policy.

Mary Clare Kennedy, Ryan McNeil, M-J Milloy, Huiru Dong, Thomas Kerr, and Kanna Hayashi. Residential Eviction and Exposure to Violence Among People Who Inject Drugs in Vancouver, Canada. The International Journal of Drug Policy.

Ryan McNeil, Taylor Fleming, Alexandra B Collins, Sandra Czechaczek, Samara Mayer, and Jade Boyd. 2021. Navigating Post-Eviction Drug Use Amidst a Changing Drug Supply: A Spatially-Oriented Qualitative Study of Overlapping Housing and Overdose Crises in Vancouver, Canada. Drug and Alcohol Dependence.

J Wittmer, and Parizeau K. 2018. Informal Recyclers’ Health Inequities in Vancouver, BC. New Solutions: A Journal of Environmental and Occupational Health Policy.

On “Indian Residential Schools”

Garth: This month Crackdown’s Editorial Board is thinking of all the Indigenous children who were snatched up by the RCMP and forced to live in residential schools. These were really prison camps run by religious fundamentalists, contracted by the Canadaian state. Many of these children never came home. Many were buried in unmarked graves, over a thousand of which have been found recently on the sites of former residential schools. There will be more.  

I think about my niece and nephews. Their Mooshum was abducted to a residential school in Manitoba. He was a red road, east van legend. Residential school trauma transmits down the generations like electricity. This is no “dark chapter of Canadian history,” like politicians say. It’s the whole fucking book, right up to the present page. And there’s a direct line from residential schools to the over-representation of Indigenous people in coroners’ overdose death stats.

There’s a 24 hour residential school crisis line at 1-866-925-4419.

Credits

Crackdown is made on the territories of the Musqueam, Squamish and Tsleil-Waututh nations. 

Thanks this month to JJ Rigsby at VANDU and Trey Helten for walking us through this topic. Thanks as well to Sean Dope.

Additional thanks to Brianne de Man of the Binner’s Project, as well as Richard Henry and Ken Lyotier of United We Can.

Our editorial board is: Samona Marsh, Shelda Kastor, Greg Fess, Jeff Louden, Dean Wilson, Laura Shaver, Reija Jean. Rest in Peace Dave Murray and Chereece Keewatin.

This episode was conceptualized, written, and produced by Sam Fenn, 

Alex de Boer, Danya Fast, Ryan McNeil, and Garth Mullins. Sound design by Alexander Kim. 

Original score was written and performed by Garth Mullins, James Ash, Sam Fenn, and Kai Paulson. 

Stay safe. Keep six.

Episode 11: The Year That Nothing Happened

Dean Wilson—a Crackdown editorial board member and  elder statesman of Vancouver’s drug user movement—thinks 2019 might be his most disappointing year as an activist. “We’ve accomplished absolutely fucking nothing, I’m incredibly depressed about it,” he recently told Garth Mullins. 

“2019, will be known to me as the year that nothing happened.” 

Dean’s right. We haven’t had a big win in a while. And 2019 feels a bit like a depressing blur. But it was also a year where we fought back. In the last Crackdown episode of the year, we tell four stories about surviving the drug war. Each story is one small moment–something that might otherwise be forgotten. Maybe these stories can tell us something about where we are now—and what we need to do in 2020. 

A full transcript of this episode will be available in a couple of days.

Today’s episode featured the song “Fuck You Pigs” by Trey Helton’s band The Fuck You Pigs. You can listen here: 

Jeff Louden’s arm, covered in Tagaderm. Photo by Garth Mullins.

Jeff Louden on Fentanyl Substitution Therapy. 

“I understand there are a lot of questions in regards to the Fentanyl [Substitution Therapy] program after the airing of December’s Crackdown. 

I am on 700 mcg/hr right now and find it works a fuck lot better than anything else I’ve tried. I’m on it for chronic pain. I’ve also spent many years wired to down. But as you know, finding good heroin is a nightmare. Because fentanyl is cheaper to make, dealers are now selling it instead and making a killing because they charge the same price as down. 

The [Vancouver Fentanyl Substation Treatment] program is very new. There are only eight people on it. If you are interested, bug your doctor. 

Before starting this, I was on 1600 ml of slow release oral morphine, which didn’t really work. I still had to do a quarter of down most mornings just to function. The doctors know I have a high tolerance, so I started out on 300 mcg/hr [of fentanyl patches] and 10 Dilly 8’s [hydromorphone 8mg]. Every week you can get a 50 mcg/hr raise until you are comfortable. The largest patch is only 100 mcg/hr, so it took a couple months to get a comfortable dose. Don’t panic though, that’s what all the Dillies are there for, so you don’t suffer. 

As far as I know, I’m on the highest dose. Everyone is different. The patches are changed on Mondays, Wednesdays and Fridays. The patches are supposed to be good for 72 hours, but I call bullshit. When you first start out it takes 12 hours for it to start working. It stores up in your fat cells. I wonder if you get real fat on it then go on a crash diet, if you will get fried. “ 

Sam Fenn interviews Samona Marsh and Kevin Yake upstairs at the Vancouver Area Network of Drug Users. Photo by Alexander Kim.

Garth Mullins sits with Ollie.  Photo by Dexter McMillan. 

This episode discusses suicide. If you are struggling with thoughts of suicide or know someone who is, you can reach out for help here: 

READING LIST:

CREDITS:


Crackdown is produced on the territories of the Musqueam, Squamish and Tsleil-Waututh Nations.  

Thank you to Nathan Crompton, Ivan Drury, Andrea Woo, Samara Mayer, and Andrew Ivsins.

Our Editorial Board is: Samona Marsh, Shelda Kastor, Greg Fess, Jeff Louden, Dean Wilson, Dave Murray, Al Fowler, Laura Shaver.  Rest in Peace Chereece Keewatin. 

Crackdown‘s host, writer and executive producer is Garth Mullins. 

Crackdown’s senior producer is Sam Fenn. 

Crackdown‘s producers are  Alexander Kim, Lisa Hale, Polly Leger and this month, Alex de Boer.

Crackdown‘s science advisor is Ryan McNeil, now of Yale University.

All of the music on today’s program was composed, preformed, and produced by Sam Fenn, Jacob Dryden, Kai Paulson, James Ash and Garth Mullins. Our theme song was written by Garth and  Sam with accompaniment from Dave Gens and Ben Appenheimer.  

We make this podcast with funds from the Canadian Institutes of Health Research and the Social Sciences and Humanities Research Council of Canada. And from our Patreon supporters. You can support us at Patreon.com/crackdownpod

Follow us on twitter @crackdownpod. Our website is: crackdownpod.com.

Episode 10: Passing the Marker

In 2018, Scotland had a higher rate of drug-related deaths than Canada or the U.S. — even though fentanyl hasn’t taken over the U.K.’s drug supply. In Episode 10, CRACKDOWN crosses the Atlantic to try and figure out what’s going on.

A full transcript for this episode is available here

Sources: Scotland and Glasgow; Canada; B.C and Vancouver; US 

READING LIST

CREDITS 

We would like to thank the following for their help in Scotland: Martin Coyle, Gary, Robbie, Cas, Babs, and Michelle.

Jason Wallace and Kirsten Horsbru from the Scottish Drugs Forum.

Peter McDade.

Andrew McAuley from Glasgow Caledonian University.

Mark McGhee from the band Girobabies .

Amanda Craig.

Donna Boyd.

Everyone at Sunny Govan Community Radio, 103.5 FM in Glasgow. You can listen online at sunnyG.com.

And Val D’oro Chippy.

Garth Mullins is Crackdown‘s host and executive producer.Crackdown is produced by Alexander Kim, Lisa Hale, Sam Fenn, Polly Leger and this month Cal Murray.

Crackdown’s Editorial Board is: Samona Marsh, Shelda Kastor, Greg Fess, Jeff Louden, Dean Wilson, Laura Shaver, Dave Murray, and Al Fowler. Rest In Peace Chereece Keewatin.

Our science adviser is Ryan McNeil from the Department of Medicine at the University of British Columbia Original score written and performed by Sam Fenn, Jacob Dryden, Kai Paulson, James Ash, Cal Murray and Garth Mullins. Our theme song was written by Garth Mullins and Sam with accompaniment from Dave Gens and Ben Appenheimer.

Funding for Crackdown comes from the Social Sciences and Humanities Research Council and the Canadian Institutes of Health Research.

You can follow us on twitter @crackdownpod.

You can send us an email at info@crackdownpod.com.

New episodes air on the last Wednesday of the month.

September Update

We don’t have a full documentary this month – for a pretty good reason. 

Our senior producer and his partner had a baby a bit over a week ago. Congratulations Sam and Patricia. It’s so nice to have a little new life – especially when things have been bleak.  

Sam and I have been working on something you’ll hear next month. A follow up to episode 2 – “Change Intolerance.” In that episode, we explained how everyone on methadone got switched onto a big pharma formulation in 2014. That left loads of us dope sick and topping up from a contaminated drug supply. 

Overdoses and deaths followed and I’m pretty sure we’ve lost thousands this way.

Sam & I followed up Laura Shaver’s big question from that episode – Why? Why did the government make this decision? Why didn’t they listen to us when we said it was a mistake? 

Crackdown requested documents under the Freedom of Information Act. Much of what we got back was redacted – censored. But the documents that we CAN see – they tell a story. We’ll have that for you at the end of October. 

And in November, we’ll have a documentary on the crisis in Scotland. We were in Glasgow in late August. 

Finally a bit of personal news. Back in the day, I messed up school because I spent all my time grinding to get up cash for heroin. This month I went back. I’m taking another run at higher education. So in a few years, hopefully I’ll get to say to cops: “Actually, that’s DOCTOR Mullins, officer.” Fingers crossed. 

See you soon. Keep six. 

Episode 6: Room 821

What happens when your options are being kicked out on the street or living in a room filled with mould, trash and rats? Episode 6 of Crackdown looks at how the housing and overdose crises are intertwined, and what happens when tenants fight back.

A full transcript for this episode is available here.

Battle of the Balmoral Block Party, June 11, 2017. (Photo: Garth Mullins)
Jay Slaunwhite moved into the Balmoral Hotel in 2014. (Photo: Sam Fenn)

If you want to learn how to use Naloxone to reverse an overdose, you can get training here: naloxonetraining.com.

This story features a profile of Vancouver’s Downtown Eastside SRO Collaborative as well as their Tenant Overdose Response Project. Find out more here

CALL TO ACTION

The housing crisis and illegal evictions disproportionately impact people who use drugs. The BCCSU is calling on the City of Vancouver and the Government of British Columbia to:

(1) Include people who use drugs in policy-making decisions around low-income rental housing. Nothing for us without us;

(2) Track evictions from private and non-profit housing to help identify potentially problematic landlords;

(3) Revise the Residential Tenancy Act to protect and meet the needs of the most vulnerable tenants;

(4) Change to opt-out arbitration for evictions and fund community legal advocates to support vulnerable tenants;

(5) Enforce standards and maintenance by-laws and issue real penalties, including expropriation for the worst offenders;

(6) Require a higher threshold for evicting tenants from non-profit housing;

Download the BCCSU’s new report summarizing these recommendations, “Evictions in Vancouver’s Downtown Eastside: Policy failures and ways forward.”

READING LIST

CREDITS

Garth Mullins is Crackdown‘s host and executive producer.

Crackdown is produced by Alexander Kim, Lisa Hale, Sam Fenn, Polly Leger and Gordon Katic.

Production help from Alex de Boer and Sharon Nadeem.

Consulting from Samantha Pranteau, Jay Slaunwhite and Al Fowler. Glen Mofford, author of “Along the E&N: The Historic Hotels of Vancouver Island” gave us some Balmoral history.

Crackdown’s Editorial Board is: Samona Marsh, Shelda Kastor, Greg Fess, Jeff Louden, Dean Wilson, Laura Shaver, Dave Murray, and Al Fowler. Rest In Peace Chereece Keewatin.

Our scientific adviser is Ryan McNeil from the BC Centre on Substance Use.

Original score written and performed by Sam Fenn, Jacob Dryden, Kai Paulson, James Ash and Garth Mullins. Our theme song was written by Garth and Sam with accompaniment from Dave Gens and Ben Appenheimer.

Funding for Crackdown comes from the Social Sciences and Humanities Research Council and the Canadian Institutes of Health Research.

You can follow us on twitter @crackdownpod.

You can send us an email at info@crackdownpod.com

New episodes air on the last Wednesday of the month.

c 1926
c 1940-1948 (Photo: Jack Lindsay)
Inside the pub. c 1940
Balmoral Hotel doorway at 159 East Hastings Street, June 20, 1995 (Photo: City of Vancouver)

Episode 5: The Portugal Paradox

In 2001, Portugal decriminalized the simple possession of drugs. Ever since it has become a  beacon for progressives, activists, and drug users around the world. On episode 5 of Crackdown, Garth goes to Portugal to figure out whether the country has found a solution to North America’s overdose crisis.  

Garth interviews Rui Coimbra Morais on the way to an unsupervised injection facility in Barrio Cerco, near Porto. 
An unsanctioned supervised consumption site near Porto, Portugal. 
Garth and Magda at IN-Mouraria in Lisbon. 
The methadone van in Lisbon. 
Garth recording narration in an apartment in Lisbon. 

Credits

Garth Mullins is Crackdown‘s host and executive producer.

Sam Fenn and Lisa Hale were this month’s lead producer.

Crackdown’s Editorial Board is: Samona Marsh, Shelda Kastor, Greg Fess, Jeff Louden, Dean Wilson, Laura Shaver, Dave Murray, and Al Fowler. Rest In Peace Chereece Keewatin.

Crackdown is produced by Garth Mullins, Sam Fenn, Alexander Kim, Lisa Hale and Gordon Katic. 

Our scientific adviser is Ryan McNeil from the BC Centre on Substance Use.

Special thanks to journalist and translator Enrique Pinto-Coelho for his help telling this story. You can follow Enrique on twitter here and you can hire him here. 

Thanks as well to the Portuguese Canadian journalist Susana Ferreira. Check out here longform piece about Portugal’s drug reforms in The Guardian here

The music for this episode was written by Garth Mullins, Sam Fenn, and Jacob Dryden.

Thanks as well to Rui Coimbra, Diana Castro, Renato Pinto, Sara Tuppen Veloso, Joana Canedo, Sofia Pereira, and Sonia Ferreira for helping our team while we were in Portugal. 

Funding for Crackdown comes from the Social Sciences and Humanities Research Council and the Canadian Institutes of Health Research. 

You can follow us on twitter @crackdownpod.

You can send us an email at info@crackdowpod.com.

New episodes air on the last Wednesday of the month.

Credits

Garth Mullins is Crackdown‘s host and executive producer.

Sam Fenn and Lisa Hale were this month’s lead producer.

Crackdown’s Editorial Board is: Samona Marsh, Shelda Kastor, Greg Fess, Jeff Louden, Dean Wilson, Laura Shaver, Dave Murray, and Al Fowler. Rest In Peace Chereece Keewatin.

Crackdown is produced by Garth Mullins, Sam Fenn, Alexander Kim, Lisa Hale and Gordon Katic. 

Our scientific adviser is Ryan McNeil from the BC Centre on Substance Use.

Special thanks to journalist and translator Enrique Pinto-Coelho for his help telling this story. You can follow Enrique on twitter here and you can hire him here. Thanks as well to the Portuguese Canadian journalist Susana Ferreira. Check out here longform piece about Portugal’s drug reforms in The Guardian here. Thanks as well to Rui Coimbra, Diana Castro, Renato Pinto, Sara Tuppen Veloso, Joana Canedo, Sofia Pereira, Sonia Ferreira, João Santa Maria, and Maria João Brás for helping our team while we were in Portugal. 

The music for this episode was written by Garth Mullins, Sam Fenn, and Jacob Dryden.

Funding for Crackdown comes from the Social Sciences and Humanities Research Council and the Canadian Institutes of Health Research. 

You can follow us on twitter @crackdownpod. You can send us an email at info@crackdowpod.com.

New episodes air on the last Wednesday of the month.