Episode 37: Drugstore Cowboy

The exterior of Vancouver’s Carnegie Library at Main Street and Hastings Street in 1903. The Carnegie is a large, Victorian-style, granite-faced building with an ionic corner portico and dome. For decades, this location has been known as “pill corner” – a place where people buy and sell pharmaceutical drugs. (Photo by Major Matthews, Vancouver Archives)

Diversion: a cold, technocratic word for when we give, trade or sell our prescribed meds to someone else. A ghost story, whispered among doctors and now, a moral panic, hollered by right wing politicians.

But really, everyone’s shared their meds. I’ve done it and I bet you have too – as an act of mutual aid, solidarity or maybe survival. But doctors have created all kinds of measures to try to stop it. And politicians have spread lies as part of a pretext to stamp out safe supply before it ever really gets started.

In this episode we follow a guy named Pockets, as he finds relief in heroin and eventually gets prescribed Dilaudid and Methadone. Surrounded by death, in the time of fentanyl and benzodope, Pockets starts to share his safe, regulated meds to help save lives. And he’s punished for it.

We also hear from professors Thomas Kerr and Geoff Bardwell who talk about their research on diversion, which provides an alternative, evidence-based, perspective on the highly controversial practice.

Transcript:

A complete transcript of this episode will be uploaded here when ready.

Call to Action and Political Demands: 

• Carries for anyone prescribed opioids who wants them. No more liquid handcuffs.

• No more piss tests for anti-diversion purposes. No more doctors or pharmacists acting like cops.

• Use evidence-based research (not drug war propaganda) to educate doctors and prescribers on why people share or sell drugs. 

• We need a safe, regulated supply of the drugs people actually want and need.

• Let us co-write all drug policies. Nothing about us without us. 

Learning Outcomes:

Crackdown episodes are frequently used as educational tools by teachers and community organizers. Please let us know if your class or group listens to our work!

Episode 37 is especially useful for exploring the following topics:

• Prescription drug “diversion.”

• Anti-diversion drug policies.

• The rising backlash against prescription opioids.

• Low retention rates for Methadone programs.

• The overdose crisis: political rhetoric versus evidence-based research.

Works Cited

Baker, Paula. 2016. “B.C. Declares Public Health Emergency after Significant Increase in Drug Overdoses.” Global News, April 14, 2016. https://globalnews.ca/news/2639028/b-c-declares-public-health-emergency-after-significant-increase-in-drug-overdoses/. 

Bardwell, Geoff, Andrew Ivsins, M. Eugenia Socías, and Thomas Kerr. 2021. “Examining Factors That Shape Use and Access to Diverted Prescription Opioids during an Overdose Crisis: A Qualitative Study in Vancouver, Canada.” Journal of Substance Abuse Treatment 130: 108418. https://doi.org/10.1016/j.jsat.2021.108418.

Bardwell, Geoff, Will Small, Jennifer Lavalley, Ryan McNeil, and Thomas Kerr. 2021. “‘People Need Them or Else They’re Going to Take Fentanyl and Die’: A Qualitative Study Examining the ‘Problem’ of Prescription Opioid Diversion during an Overdose Epidemic.” Social Science & Medicine 279: 113986. https://doi.org/10.1016/j.socscimed.2021.113986.

Barker, Brittany, Thomas Kerr, Paul Nguyen, Evan Wood, and Kora DeBeck. 2015. “Barriers to Health and Social Services for Street-Involved Youth in a Canadian Setting.” J Public Health Pol 36 (3): 350–63. https://doi.org/10.1057/jphp.2015.8.

BC Liberal Caucus. 2023. “David Eby Silent as Youth Access Drugs from Government-Sanctioned Vending Machines.” January 25, 2023. https://www.bcliberalcaucus.bc.ca/2023/01/david-eby-silent-as-youth-access-drugs-from-government-sanctioned-vending-machines/. 

BC Coroners Service. 2023. “Illicit Drug Toxicity Deaths in BC January 1, 2012 – December 31, 2022.” BC Coroners Service, 2023. https://www2.gov.bc.ca/assets/gov/birth-adoption-death-marriage-and-divorce/deaths/coroners-service/statistical/illicit-drug.pdf.

Frank, David, Pedro Mateu-Gelabert, David C. Perlman, Suzan M. Walters, Laura Curran, and Honoria Guarino. 2021. “‘It’s like ‘Liquid Handcuffs’: The Effects of Take-Home Dosing Policies on Methadone Maintenance Treatment (MMT) Patients’ Lives.” Harm Reduct J 18 (1). https://doi.org/10.1186/s12954-021-00535-y.

Gerson, Jen. 2023. “Q&A, Part 2: ‘Our Fatal Overdose Numbers Have Gone down Dramatically off the Peak.’” The Line, January 13, 2023. https://theline.substack.com/p/q-and-a-part-2-our-fatal-overdose.

Kinney, Duncan. 2023. “Marshall Smith Says B.C. High Schools Are Being Flooded with Duffel Bags of $1 Government Morphine: No Evidence to Back up Claim.” Progress Report, February 15, 2023. https://www.theprogressreport.ca/marshall_smith_tells_obvious_lie_about_high_schools_being_flooded_with_duffel_bags_of_1_government_morphine.

McEachern, Jasmine, Lauren Adye-White, Kelsey C. Priest, Eloise Moss, Lauren Gorfinkel, Evan Wood, Walter Cullen, and Jan Klimas. 2019. “Lacking Evidence for the Association between Frequent Urine Drug Screening and Health Outcomes of Persons on Opioid Agonist Therapy.” International Journal of Drug Policy 64: 30–33. https://doi.org/10.1016/j.drugpo.2018.08.006.

McElrath, Karen. 2018. “Medication-Assisted Treatment for Opioid Addiction in the United States: Critique and Commentary.” Substance Use & Misuse 53 (2): 334–43. https://doi.org/10.1080/10826084.2017.1342662.

Phillips, Mark, Kora DeBeck, Timothy Desjarlais, Tracey Morrison, Cindy Feng, Thomas Kerr, and Evan Wood. 2014. “Inability to Access Addiction Treatment Among Street-Involved Youth in a Canadian Setting.” Substance Use & Misuse 49 (10): 1233–40. https://doi.org/10.3109/10826084.2014.891618.

​​Poilievre, Pierre. 2022. “Everything Feels Broken.” YouTube. November 20, 2022. https://www.youtube.com/watch?v=UvvMfwUkXrM.

Urquhart, Catherine. 2023. “Youth May Be Buying Opioids from B.C. Drug Vending Machines, Recovery Centre Warns.” Global News, January 24, 2023. https://globalnews.ca/news/9433341/drug-vending-machine-youth-concerns/.

Van Sant, Gus. 1989. Drugstore Cowboy. Directed by Gus Van Sant.

Wyton, Moira. 2022. “Experts Reject BC’s Safe Supply Claims.” The Tyee, March 3, 2022.https://thetyee.ca/News/2022/03/03/Experts-Reject-BC-Safe-Supply-Claims/.

Credits:

Our editorial board is: Samona Marsh, Shelda Kastor, Jeff Louden, Dean Wilson, Laura Shaver, Reija Jean. And, rest in peace, Dave Murray, Greg Fresz and Chereece Keewatin.

This episode was conceptualized, written, and produced by Sam Fenn, Alexander Kim, Alex de Boer, Lisa Hale, Thomas Kerr and Garth Mullins.

Crackdown’s academic director is Ryan McNeil. 

The music in today’s episode was written and performed by Thomas Kerr, James Ash, Sam Fenn, and me. 

Sound design by Sam Fenn.

This was the last episode we produced with Alex Kim, who’s moved on to a new job. Alex, we’ll miss you lots and the show won’t be the same without you! Thanks for all you’ve done for the show and for the drug user movement. 

If you like what we do, support us at patreon.com/crackdownpod.

We’d like to say goodbye to a few people who were important to us and our community. Rickie Araki , Flora Munro, Myles Harps and Sarah Speight. RIP also to Tara A. Kelly, daughter of Grand Chief Doug Kelly, who you heard in episode 12. 

Thanks for listening. Stay safe and keep six.