Crackdown Podcast . 2021-04-29 Crackdown Podcast . 2021-04-29

Episode 24: If It Wasn’t Drugs It Would Be Something Else

Garth talks with the best-selling writer and activist Desmond Cole about how police use Canada’s drug war as a pretext for violence against Black communities. Garth and Desmond also discuss the relationship between the movement to decriminalize drugs and the movement to defund and abolish the police.

Image: Desmond Cole sits on a bench in a community garden in Toronto. (Photo: Allie Graham)

Transcript

A complete transcript of this episode is available here.

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 24 is especially useful for exploring the following themes:

Racialized police violence in Canada
Racist origins of the war on drugs

Calls To Action

Support Malton People’s Movement against police brutality, Defund 604 Network in Vancouver, and Black Lives Matter Canada.

Works Cited

Benson Bruce L., David W. Rasmussen and David L. Sollars. 1995. Police Bureaucracies, Their Incentives, and the War on Drugs. Public Choice 83 (1/2): 21-45.
Chunn, Dorothy and Gavigan. 2004. “Welfare Law, Welfare Fraud, and the Moral Regulation of the ‘Never Deserving’ Poor.” Social & Legal Studies 13 (2).
Cole, Desmond. The Skin We’re In: A Year of Black Resistance and Power. Toronto, Canada: Doubleday Canada, 2020.
Gaetz. 2010. “The Struggle to End Homelessness in Canada: How We Created the Crisis, and How We Can End It.” Open Health Services and Policy Journal 3: 21-6.
O’Grady, Gaetz and Buccieri. 2013. “Tickets… and More Tickets: A Case Study of the Enforcement of the Ontario Safe Streets Act.” Canadian Public Policy 39 (4): 541-558

Credits

Crackdown is produced on Musqueam, Squamish and Tsleil-Waututh territory.

You can donate to Crackdown at patreon.com/crackdownpod.

Follow Crackdown and Garth Mullins on Twitter to get updates about the show.

Crackdown’s 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.

Today’s episode was conceptualized, written, and produced by Sam Fenn, Lisa Hale, Alex Kim, Ryan McNeil, and Garth Mullins.

Original score for today’s episode was written and performed by James Ash, Sam Fenn, Kai Paulson and Garth Mullins.

Crackdown Podcast . 2021-04-02 Crackdown Podcast . 2021-04-02

Episode 23: Cop Free Future

After 113 years, things might be changing in Vancouver as the city looks to decriminalize the simple possession of drugs. In episode 23, Crackdown takes a look at the birth of the drug war in Canada.

Image: Downtown Eastside alley scene. The site of Canada’s first recorded drug arrest. Colourful graffiti decorates the walls and dumpsters. (Photo: Alexander Kim)

After 113 years, things might be changing in Vancouver. Mayor Kennedy Stewart has written to the federal government, asking for an exemption from Canada’s Controlled Drugs and Substances Act. If he gets it, the city could decriminalize the simple possession of drugs.

In light of this announcement, Crackdown is taking a look at the birth of the drug war in Canada. When and why did it start? And what is it going to take to finally end it?

Interviewees

Lani Russwurm
Frank Crichlow
Meenakshi Manoe
Tonye Aganaba

Transcript

A full transcript is available here.

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 23 is especially useful for exploring the following themes:

Racist origins of the war on drugs in Canada
Racist discrimination and racialized violence by police in the war on drugs
Abolition of police

Works Cited

Albert Zugsmith (Director). (1962). Confessions of an Opium Eater. Photoplay Productions.
Beletsky, L., & Davis, C. S. (2017). Today’s fentanyl crisis: Prohibition’s Iron Law, revisited. International Journal of Drug Policy, 46, 156–159.
Brought Girls to Opium Den: White Degenerate Fled in Night Clothes From Hotel When Police Were About to Arrest Him. (1908, September 30). The Daily World.
Doezema, J. (1999). Loose women or lost women? The re-emergence of the myth of white slavery in contemporary discourses of trafficking in women. Gender Issues, 18(1), 23–50.
Eli Gorn and Todd Serotiuk (Director). (n.d.). Scared Straight. In The Beat . Galafilm Productions.
First Prosecution Under Opium Act: Mephistopheles Chau Committed for Trial for Selling Opium by Retail – White Women Were Witnesses. (1908, October 1). The Daily Province.
For Selling Opium: First Conviction in Vancouver – Chan Shan Gets Twelve Months in Jail. (1908, October 20). The British Colonist.
Hayle, S., Wortley, S., & Tanner, J. (2016). Race, Street Life, and Policing: Implications for Racial Profiling. Canadian Journal of Criminology and Criminal Justice, 58(3), 322–353.
Khenti, A. (2014). The Canadian war on drugs: Structural violence and unequal treatment of Black Canadians. International Journal of Drug Policy, 25(2), 190–195.
Laite, J. (2017). Traffickers and Pimps in the Era of White Slavery. Past and Present , 237(1), 237–269.
MacKay, R. (2018). The Beginning of Drug Prohibition in Canada: What’s Past Is Prologue. Queen’s Quarterly, 125(4).
Mackenzie King, W. L. (1908). Report by W.L. Mackenzie King, C.M.G., deputy minister of labour, on the need for the suppression of the opium traffic in Canada. S.E. Dawson.
Marcoux, J., & Nicholson, K. (n.d.). Deadly Force: Fatal encounters with police in Canada: 2000-2017. CBC News.
Michael Scott and Marrin Canell (Director). (1975). Whistling Smith. https://www.nfb.ca/film/whistling_smith/
Murphy, E. (1922). The Black Candle. Thomas Allen.
Musto, D. F. (1991). Opium, Cocaine and Marijuana in American History. Sci Am, 265(1), 40–47.
Price, J. (2007). “Orienting” The Empire: Mackenzie King and the Aftermath of the 1907 Race Riots. BC Studies , 156/157, 53–81.
Secrets of a Chinese Den. (1908, August 27). The Daily World .
St. Denis, J. (2021, January 13). Downtown Eastside Grieves Man Shot Dead by Police. The Tyee.
van der Meulen, E., Chu, S. K. H., & Butler-McPhee, J. (2021). “That‘s why people don’t call 911”: Ending routine police attendance at drug overdoses. International Journal of Drug Policy, 88, 103039.
Vancouver police get sonic crowd control device. (2009, November 10). CBC News.
Vancouver Police Unveil New Armoured Vehicle, But DON’T Call it a Tank. (2010, September 7). The Vancouver Sun.
Wynne, R. E. (1966). American Labor Leaders and the Vancouver Anti-Oriental Riot. The Pacific Northwest Quarterly, 57(4), 172–179.
Year’s Hard Labor for Chinese Keeper. (1908, October 19). The Daily World.

Credits

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

Thanks to everyone involved in People With Lived Experience of Drug Use National Working Group of the Canadian Research Initiative in Substance Misuse or CRISM. This includes Frank Critchlow, Michael Nurse, Jade Boyd, Alex Betsos and Karen Turner.

Thank you to Tonye Aganaba for allowing us to use their songs “Make this House a Home” and “CC”.

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

This episode was conceptualized, written, and produced by Sam Fenn, Lisa Hale, Alex Kim, Ryan McNeil, and Garth Mullins.

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

Crackdown Podcast . 2021-02-04 Crackdown Podcast . 2021-02-04

Episode 22: We’re Not Afraid of Needles Around Here

Image: *Crackdown* Editorial Board member Dean Wilson receives a vaccine for COVID-19. (Photo: Alexander Kim)

In the midst of a pandemic and overdose crisis, members of Crackdown’s Editorial Board are relieved to be getting the COVID vaccine. But we don’t just trust the government, so we’re doing our homework. For years, drug users have looked at medical and public health interventions critically, assessing things for ourselves. Drug users are particularly vulnerable to COVID and its new variants. We need to get that vaccine in our arms now. But there is so much disinformation floating around.

On episode 22, Dr. Kimberly Sue, Medical Director of the Harm Reduction Coalition, answers our questions about COVID19 and the politics of vaccination.

Transcript

A complete transcript for this episode is in preparation and will be published here when ready.

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 20 is especially useful for exploring the following themes:

Vaccine hesitancy among marginalized people

Crackdown Podcast . 2020-12-29 Crackdown Podcast . 2020-12-29

Episode 21: Control

Activist Kali Sedgemore and anthropologist Danya Fast tell a story about the government’s desire for control—the way its attempts to detain and manage drug users often backfire.

Image: Patty and Joe’s room at “Anthony House”. A small TV wrapped in plastic sits on a desk by the window. In the window there is a poster of a tropical beach scene. There is also a futon with emerald-green bedding and a stainless steel sink in the room. The walls are plain, painted neutral colours. (Photo: Patty)

Activist Kali Sedgemore and anthropologist Danya Fast tell a story about the government’s desire for control—the way its attempts to detain and manage drug users often backfire.

BC’s Premier, John Horgan, has recently reiterated his support for the controversial Bill 22. Under the proposed bill, doctors could involuntarily detain people under the age of 19 at hospitals for up to seven days after an overdose—even if their parents or guardians don’t agree. In some circumstances, hospitals could even use physical restraints to keep young people from leaving.

Bill 22 is an example of the way that the desire to protect drug users—in particular young drug users—often becomes a desire to control them. Supportive housing can feel like prison. Hospitals can be dangerous and racist places, particularly for Indigenous people. And harm reduction programs can feel cold and institutional. And when programs become too controlling, they repel—and even threaten—the very people they’re meant to help.

Garth interviews Kali Sedgemore in a parking garage. (Photo: Sam Fenn)

VANDU, Crackdown, the BC’s Chief Coroner, the Representative for Children and Youth, the BC Civil Liberties Association, the Pivot Legal Society, the Canadian Drug Policy Coalition, and the Union of BC Indian Chiefs have all spoken out against Bill 22. At a press conference, Kukpi7 Judy Wilson of UBCIC noted the government’s history of forcibly removing Indigenous kids from their families and putting them in residential schools.

“So we see the bill as really concerning,” Wilson said. “We don’t need to be going to call out for help and then worry if we’re going to be detained.”

“That’s not going to work for us.”

Transcript

A complete transcript of this episode is available here.

Works Cited and Further Reading

BC Housing. 2013. “Project Report: Single Room Occupancy Renewal Initiative.” https://www.infrastructurebc.com/files-4/documents/PBC_SRO.pdf.
Canadian Institute for Health Information. 2016. “Hospitalizations and Emergency Department Visits Due to Opioid Poisoning in Canada.” Canadian Centre on Substance Abuse. https://secure.cihi.ca/free_products/Opioid%20Poisoning%20Report%20%20EN.pdf.
CBC Radio. 2020a. “BC Children‘s Hospital Chief Medical Officer Supports the Province’s Legislation That Would Allow Hospitals to Hold Youth after an Overdose.” The Early Edition with Stephen Quinn . https://www.cbc.ca/player/play/1758272579652.
CBC Radio. 2020b. “Bill 22 Opposition.” The Early Edition with Stephen Quinn . https://www.cbc.ca/listen/live-radio/1-91-the-early-edition/clip/15789166-july-27-2020-bill-22-opposition?subscribe=true.
Dembicki, Geoff. 2009. “Fears of APEC-Style Clash in 2010.” The Tyee, February 16, 2009. https://thetyee.ca/News/2009/02/16/APECGames/.
Fast, Danya. 2014. “Mapping Senses of Place in an Urban Drug Scene.” Medical Anthropology Theory 1 (1). https://doi.org/10.17157/mat.1.1.209.
Fast, Danya. 2016. “‘My Friends Look Just like You:’ Research Encounters and Imaginaries in Vancouver’s Urban Drug Scene.” Medical Anthropology Theory 3 (2). https://doi.org/10.17157/mat.3.2.343.
Fast, Danya. 2017. “Dream Homes and Dead Ends in the City: A Photo Essay Experiment.” Sociol Health Illn 39 (7): 1134–48. https://doi.org/10.1111/1467-9566.12563.
Fast Danya. 2019 “Evidence-Based Intervention and the Protection of Life in a Broken Promiseland.” Seminar. 5th Cascadia Medical Anthropology Seminar. Vancouver, Canada. November 20. http://www.cascadiaseminar.org/wp-content/uploads/2019/11/Cascadia-Medical-Anthropology-Seminar-2019-Abstracts.November-14-2019.pdf
Fast, Danya. “Living in the Best Place On Earth.” Accessed December 28, 2020. https://www.livinginthebestplace.org/.
Fast, Danya, Jean Shoveller, Will Small, and Thomas Kerr. 2013. “Did Somebody Say Community? Young People’s Critiques of Conventional Community Narratives in the Context of a Local Drug Scene.” Human Organization 72 (2): 98–110. https://doi.org/10.17730/humo.72.2.86005462778382u2.
Giang, Valerie, Madison Thulien, Ryan McNeil, Kali Sedgemore, Haleigh Anderson, and Danya Fast. 2020. “Opioid Agonist Therapy Trajectories among Street Entrenched Youth in the Context of a Public Health Crisis.” SSM – Population Health 11: 100609. https://doi.org/10.1016/j.ssmph.2020.100609.
Goodman, Ashley, Kim Fleming, Nicole Markwick, Tracey Morrison, Louise Lagimodiere, and Thomas Kerr. 2017. “‘They Treated Me like Crap and I Know It Was Because I Was Native’: The Healthcare Experiences of Aboriginal Peoples Living in Vancouver’s Inner City.” Social Science & Medicine 178: 87–94. https://doi.org/10.1016/j.socscimed.2017.01.053.
Hahn, Judith A., Kimberly Page‐Shafer, Paula J. Lum, Philippe Bourgois, Ellen Stein, Jennifer L. Evans, Michael P. Busch, Leslie H. Tobler, Bruce Phelps, and Andrew R. Moss. 2002. “Hepatitis C Virus Seroconversion among Young Injection Drug Users: Relationships and Risks.” J INFECT DIS 186 (11): 1558–64. https://doi.org/10.1086/345554.
Harnett, Cindy. 2020. “Premier Wants Law Allowing Detaining of Youth Who Overdosed.” Times Colonist, December 22, 2020. https://www.timescolonist.com/premier-wants-law-allowing-detaining-of-youth-who-overdosed-1.24258747.
Krüsi, Andrea, Danya Fast, Will Small, Evan Wood, and Thomas Kerr. 2010. “Social and Structural Barriers to Housing among Street-Involved Youth Who Use Illicit Drugs.” Health and Social Care. https://doi.org/10.1111/j.1365-2524.2009.00901.x.
Legislative Assembly of British Columbia. 2020. Bill 22 – 2020: Mental Health Amendment Act, 2020. https://www.leg.bc.ca/parliamentary-business/legislation-debates-proceedings/41st-parliament/5th-session/bills/first-reading/gov22-1.
Miller, Cari L., Patricia M. Spittal, James C. Frankish, Kathy Li, Martin T. Schechter, and Evan Wood. 2005. “HIV and Hepatitis C Outbreaks Among High-Risk Youth in Vancouver Demands a Public Health Response.” Can J Public Health 96 (2): 107–8. https://doi.org/10.1007/bf03403671.
Pedersen, Wendy, and Jean Swanson. 2010. “Pushed Out: Escalating Rents in the Downtown Eastside.” Carnegie Community Action Project. http://www.carnegieaction.org/wp-content/uploads/2016/08/ccap2010hotelreportweb.pdf.
The OGI-UBC Research Team. 2009. “Olympic Games Impact (OGI) Study for the 2010 Olympic and Paralympic Winter Games: Pre-Games Results Report.” The University of British Columbia. https://open.library.ubc.ca/cIRcle/collections/facultyresearchandpublications/52383/items/1.0132646.
Turpel-Lafond, Mary Ellen. 2020. “In Plain Sight: Addressing Indigenous-Specific Racism and Discrimination in B.C. Health Care.” November 2020. https://engage.gov.bc.ca/addressingracism/.

Credits

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

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 find a complete transcript for today’s show, as well as photographs and links to further readings, at patreon.com/crackdownpod. While there, consider giving us a few bucks. It helps a lot.

Our editorial board is: Samona Marsh, Shelda Kastor, Greg Fresz, Jeff Louden, Dean Wilson, Al Fowler, and Laura Shaver.

Rest in Peace Dave Murray and Chereece Keewatin.

Today’s episode was conceptualized, written, and produced by Sam Fenn, Alexander Kim, Alex de Boer, Danya Fast, Ryan McNeil, and Garth Mullins.

Danya Fast’s research is supported by the Canadian Institutes of Health Research, the Vancouver Foundation, The Sick Kids Foundation, and the Michael Smith Foundation for Health Research.

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

Our credits music was “Pinkjet Pussy” by Randy and the Pandoras. You can buy this song on 100 Block Rock, a compilation of music produced by Downtown Eastside artists.

Crackdown Podcast . 2020-10-05 Crackdown Podcast . 2020-10-05

Episode 20: Cut Off

In 2015, Crackdown editorial board member, Jeff Louden, was on morphine pills for his chronic pain. When Jeff's doctor unexpectedly cut down his medication, he turned to the street to outrun dopesickness.

Jeff Louden gives the middle finger at an editorial board meeting. (Photo: Alexander Kim)

In 2015, Crackdown editorial board member, Jeff Louden, was on morphine pills for his chronic pain. The medication allowed Jeff to find some stability and avoid Vancouver's increasingly dangerous drug market. But, when Jeff's doctor unexpectedly cut down his medication, he turned to the street to outrun dopesickness.

Five years later, Garth Mullins investigates what happened to Jeff. What can it tell us about North America's so-called "overprescribing crisis?"

Transcript

A free transcript of this episode is available here.

Guests

Jeff Louden is a member of Crackdown's editorial board and is from the Curve Lake First Nation.
Laura Shaver is a member of Crackdown's editorial board and is the President of the BC Association of People on Methadone.
Christy Sutherland is a family doctor, the medical director at the Portland Hotel Society, and the Physician Lead at the BC Centre on Substance Use [BCCSU].
Helena Hansen is a doctor and Professor and Chair of Translational Social Science and Health Equity at UCLA.
Bryan Quinby is the host of the podcast Street Fight. You can follow Bryan on Twitter here.
Stefan Kertesz is a physician and a Professor in preventative medicine at the University of Alabama at Birmingham. You can follow Dr. Kertesz on Twitter and listen to his podcast, On Becoming a Healer here.
Dawn Rae Downton is a writer and journalist. You can read her National Post article, "My Year on Death Row," here.

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 20 is especially useful for exploring the following themes:

Critical account of the so-called “overprescribing crisis” in North America
Marketing of new medications to doctors by pharmaceutical companies
Race and the development/marketing of medications
Consequences of mass deprescribing trends

Works Cited

Bohnert, Amy S. B. 2011. “Association Between Opioid Prescribing Patterns and Opioid Overdose-Related Deaths.” JAMA 305 (13). https://doi.org/10.1001/jama.2011.370.
Case, Anne, and Angus Deaton. 2015. “Rising Morbidity and Mortality in Midlife among White Non-Hispanic Americans in the 21st Century.” Proc Natl Acad Sci USA 112 (49). https://doi.org/10.1073/pnas.1518393112.
College of Physicians and Surgeons of British Columbia. n.d. “Practice Standard: Safe Prescribing of Opioids and Sedatives.” Accessed October 5, 2020. https://www.cpsbc.ca/files/pdf/PSG-Safe-Prescribing.pdf.
Dowell, Deborah, Tamara M. Haegerich, and Roger Chou. 2016. “CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016.” MMWR Recomm. Rep. 65 (1). https://doi.org/10.15585/mmwr.rr6501e1er.
Downton, Dawn Rae. 2018. “My Year on Death Row: Inside Canada’s ‘Other Opioid Epidemic,’” August 23, 2018. https://nationalpost.com/feature/my-year-on-death-row.
Dunn, Kate M. 2010. “Opioid Prescriptions for Chronic Pain and Overdose.” Ann Intern Med 152 (2). https://doi.org/10.7326/0003-4819-152-2-201001190-00006.
Executive Office of the President of the United States. 2011. “Epidemic: Responding to America’s Prescription Drug Abuse Crisis.” National Criminal Justice Reference Center. https://www.ncjrs.gov/pdffiles1/ondcp/rx_abuse_plan.pdf.
Fischer, Benedikt, Wayne Jones, Mark Tyndall, and Paul Kurdyak. 2020. “Correlations between Opioid Mortality Increases Related to Illicit/Synthetic Opioids and Reductions of Medical Opioid Dispensing - Exploratory Analyses from Canada.” BMC Public Health 20 (1). https://doi.org/10.1186/s12889-020-8205-z.
Garloch, Karen. 2017. “‘Dr. Feelgood: Dealer or Healer?’ Tells Story of Doctor Who Now Lives in Charlotte.” The Charlotte Observer, January 1, 2017. https://www.charlotteobserver.com/living/health-family/karen-garloch/article124076879.html.
Glauser, Wendy. 2013. “Pharma Influence Widespread at Medical Schools: Study.” Canadian Medical Association Journal 185 (13). https://doi.org/10.1503/cmaj.109-4563.
Hansen, Helena, and Julie Netherland. 2016. “Is the Prescription Opioid Epidemic a White Problem?” Am J Public Health 106 (12). https://doi.org/10.2105/ajph.2016.303483.
James, Jocelyn R., JoAnna M. Scott, Jared W. Klein, Sara Jackson, Christy McKinney, Matthew Novack, Lisa Chew, and Joseph O. Merrill. 2019. “Mortality After Discontinuation of Primary Care–Based Chronic Opioid Therapy for Pain: A Retrospective Cohort Study.” J GEN INTERN MED 34 (12). https://doi.org/10.1007/s11606-019-05301-2.
Jick, Hershel. 1970. “Comprehensive Drug Surveillance.” JAMA 213 (9). https://doi.org/10.1001/jama.1970.03170350023005.
Joseph, Andrew, and Shraddha Chakradhar. 2020. ““Faced with Fears of OxyContin Misuse, Sales Reps Touted Its Safety.” STAT News , January 9, 2020. https://www.statnews.com/2020/01/09/prescriber-fears-oxycontin-misuse-purdue-pharma-sales-reps-misleadingly-played-up-safety/.
Kaplovitch, Eric, Tara Gomes, Ximena Camacho, Irfan A. Dhalla, Muhammad M. Mamdani, and David N. Juurlink. 2015. “Sex Differences in Dose Escalation and Overdose Death during Chronic Opioid Therapy: A Population-Based Cohort Study.” PLoS ONE 10 (8). https://doi.org/10.1371/journal.pone.0134550.
Kertesz, Stefan G., Ajay Manhapra, and Adam J. Gordon. 2020. “Nonconsensual Dose Reduction Mandates Are Not Justified Clinically or Ethically: An Analysis.” J Law Med Ethics 48 (2). https://doi.org/10.1177/1073110520935337.
Los Angeles Times. 2016. “OxyContin Press Release, 1996,” May 5, 2016. https://documents.latimes.com/oxycontin-press-release-1996/.
Lupick, Travis. 2018. “Downtown Eastside’s Dr. Christy Sutherland Named One of Canada’s Top Family Physicians of 2018.” The Georgia Straight, October 22, 2018. https://www.straight.com/life/1154481/downtown-eastsides-dr-christy-sutherland-named-one-canadas-top-family-physicians-2018.
Mark, Tami L., and William Parish. 2019. “Opioid Medication Discontinuation and Risk of Adverse Opioid-Related Health Care Events.” Journal of Substance Abuse Treatment 103. https://doi.org/10.1016/j.jsat.2019.05.001.
Markon, Jerry. 2007. “Pain Doctor Is Guilty of Drug Trafficking.” Washington Post, April 28, 2007. https://www.washingtonpost.com/wp-dyn/content/article/2007/04/27/AR2007042702204.html.
Merrill, Richard A. 1999. “Modernizing The FDA: An Incremental Revolution.” Health Affairs 18 (2). https://doi.org/10.1377/hlthaff.18.2.96.
Michael G. Michael G. DeGroote National Pain Centre. 2010. “Canadian Guideline For Opioid Use For Pain.” National Opioid Use Guideline Group . April 30, 2010. http://nationalpaincentre.mcmaster.ca/opioid_2010/.
National Center for Injury Prevention and Control. 2018. “2018 Annual Surveillance Report of Drug-Related Risks and Outcomes.” Centers for Disease Control and Prevention, U.S. Department of Health and Human Services.
Netherland, Julie, and Helena Hansen. 2017. “White Opioids: Pharmaceutical Race and the War on Drugs That Wasn’t.” BioSocieties 12 (2). https://doi.org/10.1057/biosoc.2015.46.
Oliva, Elizabeth M, Thomas Bowe, Ajay Manhapra, Stefan Kertesz, Jennifer M Hah, Patricia Henderson, Amy Robinson, Meenah Paik, Friedhelm Sandbrink, and Adam J Gordon. 2020. “Associations between Stopping Prescriptions for Opioids, Length of Opioid Treatment, and Overdose or Suicide Deaths in US Veterans: Observational Evaluation.” BMJ. https://doi.org/10.1136/bmj.m283.
Perry, Samuel, and George Heidrich. 1982. “Management of Pain during Debridement: A Survey of U.S. Burn Units.” Pain 13 (3). https://doi.org/10.1016/0304-3959(82)90016-1.
“Purdue Pharma LP v Kentucky (2007).” n.d. Accessed October 5, 2020. https://www.documentcloud.org/documents/6595442-PurdueKentuckyCallNotes.html.
Richert, Lucas. 2009. “Pills, Policy Making and Perceptions: Inside the FDA During The.” Canadian Review of American Studies 39 (1). https://doi.org/10.1353/crv.0.0031.
“State of Tennessee v Purdue Pharma, L.P.” 2018. Tennessee State Government. May 15, 2018. https://www.tn.gov/content/dam/tn/attorneygeneral/documents/foi/purdue/purduecomplaint-5-15-2018.pdf.
Sun, Eric, and Jena Anupam. 2017. “Distribution of Prescription Opioid Use Among Privately Insured Adults Without Cancer: United States, 2001 to 2013.” Ann Intern Med 167 (9). https://doi.org/10.7326/m17-1408.
Tierney, John. 2007. “Trafficker or Healer? And Who’s the Victim?” The New York Times, March 27, 2007. https://www.nytimes.com/2007/03/27/science/27tier.html?ex=1177560000&en=5b5b33d313ff8f11&ei=5070.
“Timeline of Selected FDA Activities and Significant Events Addressing Opioid Misuse and Abuse.” n.d. U.S. Food And Drug Administration. Accessed October 5, 2020. https://www.fda.gov/drugs/information-drug-class/timeline-selected-fda-activities-and-significant-events-addressing-opioid-misuse-and-abuse.
Tompkins, D. Andrew, J. Greg Hobelmann, and Peggy Compton. 2017. “Providing Chronic Pain Management in the ‘Fifth Vital Sign’ Era: Historical and Treatment Perspectives on a Modern-Day Medical Dilemma.” Drug and Alcohol Dependence 173: S11–21. https://doi.org/10.1016/j.drugalcdep.2016.12.002.
United States General Accounting Office. 2003. “OxyContin Abuse and Diversion and Efforts to Address the Problem.” December 2003. https://www.gao.gov/assets/250/240884.pdf.
“U.S. Opioid Prescribing Rate Maps.” n.d. Centres for Disease Control and Prevention. Accessed October 5, 2020. https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html.
2010. “The New Face of Heroin Addiction.” ABC News . http://abcnews.go.com/2020/video/face-heroin-addiction-12009941.

Credits

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

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.

Special thanks this month to: Maria Higginbotham, Owen Williamson, Maria Hudspith and Buck Doyle. Thanks also to Dr. Stefan Kertesz who has been answering annoying questions from our team for months now. Dr. Kertesz has asked us to let you know that he “represents his own views and not those of any of his employers.”

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

Today's episode was conceptualized, written, and produced by, Alex de Boer, Alex Kim, Lisa Hale, Ryan McNeil, Sam Fenn, and Garth Mullins.

Original score for today's episode was written and performed by Garth Mullins, Sam Fenn, and James Ash.

Crackdown Podcast . 2020-08-31 Crackdown Podcast . 2020-08-31

Episode 19: Losing Hope

On today’s show Garth interviews Tim Slaney. Tim is a harm reduction worker at the supervised consumption site in Lethbridge, Alberta – one of the busiest in the world. And the government is shutting it down.

Image: Supervised injection room at ARCHES in Lethbridge, Alberta. (Photo: Tim Slaney)

August 31, 2020.

Today is International Overdose Awareness Day, but so what? Who needs to be made aware? Who among us can’t see the corpses piling up from this endless war?

And just when you think things can’t get much bleaker, they do.

Transcript

A complete transcript for this episode is in preparation and will be published here when ready.

Credits

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

This month we lost a good friend, warrior and activist - Wade Crawford - from Six Nations. RiP Wade

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

Crackdown’s senior producer is Sam Fenn. Our producers are Lisa Hale and Alexander Kim.

Our science advisor is Ryan McNeil. Assistant Professor & Director of Harm Reduction Research at the Yale School of Medicine.

Garth Mullins is our host, writer and executive producer. You can follow him on twitter @garthmullins.

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

Music from the ARCHES Mic Club featured in this episode:

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.

Crackdown Podcast . 2020-07-16 Crackdown Podcast . 2020-07-16

Episode 18: Blue Metal Fence

In March, People vanished. The city looked like a ghost town. But on the Downtown Eastside, the sidewalks were still packed. People still lining up for food. And lining up to get into supervised injection sites. Vancouver’s biggest tent city--Oppenheimer Park-- had never been so full.

Image: Oppenheimer Park, empty and surrounded by blue metal fence. (Photo: Alexander Kim)

The first thing that the plague brought to Vancouver was exile.

Transcript

A full transcript of this episode is available here.

Links

The Homeless Idea podcast https://thehomelessidea.ca/

The Right to Remain research project http://www.righttoremain.ca/

Credits

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

This month we lost a good friend, warrior and activist - Wade Crawford - from Six Nations. RiP Wade

Thank you to the Red Braid Alliance for Stewart Squat audio. Thank you to Global News Vancouver and CTV News Vancouver for newscast audio.

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

Crackdown’s senior producer is Sam Fenn. Our producers are Lisa Hale and Alexander Kim.

Our science advisor is Ryan McNeil. Assistant Professor & Director of Harm Reduction Research at the Yale School of Medicine.

Garth Mullins is our host, writer and executive producer. You can follow him on twitter @garthmullins.

Original score written and performed by Sam Fenn, James Ash and Garth. Our theme song was written by me 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.

Crackdown Podcast . 2020-06-12 Crackdown Podcast . 2020-06-12

Episode 17: Class Action

People on methadone in B.C. are suing the government and a pharmaceutical company for decisions which may have contributed to the overdose crisis. Laura Shaver is the lead plaintiff in a new proposed class action lawsuit against British Columbia’s College of Pharmacists, the Ministry of Health, and the pharmaceutical corporation Mallinckrodt. She’s seeking damages for harms related to the switch from compound methadone to Methadose in 2014.

People on methadone in B.C. are suing the government and a pharmaceutical company for decisions which may have contributed to the overdose crisis. Laura Shaver is the lead plaintiff in a new proposed class action lawsuit against British Columbia’s College of Pharmacists, the Ministry of Health, and the pharmaceutical corporation Mallinckrodt. Laura - who is also on Crackdown’s editorial board - may wind up representing all of the province’s methadone users. She’s seeking damages for harms related to the switch from compound methadone to Methadose in 2014.

The Notice of Civil Claim was filed on June 1st by Vancouver-based attorney, Jason Gratl. It says that Mallinckrodt, the College, and the Ministry knew, or ought to have known, that the switch was dangerous. The Notice claims these defendants were “downplaying or denying the risks of switching from Compounded Methadone to Methadose.”

The Notice echoes the work of Vancouver’s drug user activists--including Garth Mullins and Laura Shaver--who have maintained for years that Methadose is significantly inferior to the old compound methadone. If the civil claim goes to trial, it will be the first time these allegations are tested in court.

On episode 17 of Crackdown, Garth talks to Laura and Jason about the pending case.

Mallinckrodt did not respond to our requests for comment in time for broadcast. The BC College of Pharmacists and the Ministry of Health both declined to comment due to the civil suit.

Transcript

You can find a transcript for today’s episode here. Crackdown believes that transparency is a cornerstone of journalism. For that reason, we have made our transcripts as detailed as possible, with footnotes sourcing how and where we have found our information. We also highlight the sections of our episodes that contain analysis, opinion or advocacy.

Vancouver’s Most Deadly Month

Our update on Methadose comes just as the Vancouver Coroner’s Office has released some very grim statistics. According to a report by BC’s Coroners Service, the province saw 170 suspected illicit drug toxicity deaths in May. That is the highest monthly total ever. These people were friends and family, colleagues and comrades.

References:

Disclosures

Garth and Laura are both members of the B.C. Association of People on Methadone and have actively campaigned against the switch to Methadose for years.

Jason Gratl has represented both Garth and Laura in previous cases.

Abolition, justice & anti-racism resources

There have been mass arrests across the U.S. and protesters are sitting in jail right now. Community bail funds get people out and prevent them from languishing in pre-trial detention. The cash bail system disproportionately affects BIPOC and low-income communities, and community bail funds are fighting to end the practice entirely. You can contribute here: https://www.communityjusticeexchange.org/nbfn-directory

Breonna Taylor was killed by Louisville police, who broke into her apartment on a “no-knock warrant” in March. Cate Young (@battymamzelle) put together this list of actions you can take for justice for Breonna https://msha.ke/30flirtyfilm/

Regis Korchinski-Paquet died on May 27 after Toronto police came to her family’s apartment. https://www.gofundme.com/f/justice-for-regis

George Floyd memorial fund: https://ca.gofundme.com/f/georgefloyd

Chantel Moore, a Tla-o-qui-aht woman, was killed by RCMP in New Brunswick on June 4th during a “wellness check.” You can support her family here: https://ca.gofundme.com/f/support-for-family-of-chantel-moore

Readings

Policing Black Lives: State Violence in Canada from Slavery to the Present by Robyn Maynard
https://robynmaynard.com/policing-black-lives/
The Skin We’re In: a Year of Black Resistance & Power by Desmond Cole https://www.penguinrandomhouse.ca/books/536075/the-skin-were-in-by-desmond-cole/9780385686341
Anti-Racist Resource Guide by Victoria Alexander: https://docs.google.com/document/d/1a-lzdtxOlWuzYNGqwlYwxMWADtZ6vJGCpKhtJHHrS54/edit
It’s Long Past Time to Talk About Policing of Black Women in Canada by Robyn Maynard
https://www.thestar.com/opinion/contributors/2020/05/29/its-long-past-time-to-talk-about-policing-of-black-women-in-canada.html
Resources for a future without police https://www.mpd150.com/resources/
VANDU: As VPD budget spirals out of control, defunding police is our community alternative to drug war
https://www.straight.com/news/1332066/nathan-crompton-vpd-budget-spirals-out-control-defunding-police-our-community
We must defund the police: it is the only option by Sandy Hudson https://www.macleans.ca/society/life/we-must-defund-the-police-it-is-the-only-option/?utm_medium=organic&utm_source=Twitter#Echobox=1591316503

Credits

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

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

Crackdown’s senior producer is Sam Fenn. Our producers are Lisa Hale and Alexander Kim. Our science advisor is Ryan McNeil, Assistant Professor & Director of Harm Reduction Research at the Yale School of Medicine.

Today’s episode was fact-checked by Polly Leger.

Garth Mullins is Crackdown’s host, writer and executive producer. You can follow Garth on twitter @garthmullins.

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

Crackdown is produced with funds from the Canadian Institutes of Health Research, the Social Sciences and Humanities Research Council of Canada, and our Patreon supporters.

Crackdown Podcast . 2020-05-19 Crackdown Podcast . 2020-05-19

Episode 16: Goodbye Dave

Dave Murray was a veteran drug user activist. He was a mentor to the next generation of organizers, including Garth. He’s pretty much the reason why there is a prescription heroin program in Vancouver today. And he was our friend.

We were working on an episode about the housing crisis during the pandemic. But a couple weeks ago, Crackdown lost another member of our editorial board: Dave Murray.

We can’t all get together to mourn him right now, to remember him and tell stories. Like we did with Chereece last year. We’ll get to it eventually, when the quarantine lifts, but until then, we’ll do it here.

Dave was an intellectual – with taped up glasses and newspaper tucked under his arm. But he was also bold as hell.

He helped us launch this podcast. In fact, Dave was there before we even had a name. He was a soft-spoken guy, and he made sure Crackdown got off on the right foot.

Dave used heroin for decades. He was part of these two prescription heroin trials in Vancouver: NAOMI was the The North American Opiate Medication Initiative. And SALOME was the Study to Assess Longer-term Opioid Medication Effectiveness.

The prescription heroin was great – but when the studies were done, people were back to grinding for dope on the street.

So Dave organized with other participants of those studies – he was part of a legal challenge to force the government to let them keep getting prescribed heroin after the studies were over.

Dave broke a path that will – one day – mean anyone wired to down can get a prescription for heroin.

More recently, Dave was sick. He was also heartbroken to lose his brother Les to overdose in late 2018.

Garth spoke with Dean Wilson – of our editorial board, and Ann Livingston. Both close friends of Dave.

Safe journey home, Dave. Take care, buddy.

Transcript

A complete transcript for this episode is available here.

Links

You can read obituaries by Travis Lupick and also by Guy Felicella, Dean Wilson and Matt Bonn.

Ann Livingston has created a Facebook page with lots of Dave’s speeches.

You can read research co-authored by Dave here.

Thanks to Gordon Katic and Travis Lupick for tape of Dave gathered in 2017 for a documentary called The Heroin Clinic.

Credits

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

Our Editorial Board is: Samona Marsh, Shelda Kastor, Greg Fresz, Jeff Louden, Dean Wilson, Al Fowler, and Laura Shaver.

Rest in Peace Chereece Keewatin.

Rest in Peace Dave Murray. Good-bye Dave.

You can support us at Patreon.com/crackdownpod. Special thank you to our Patreon supporters – new ones and those who’ve been with us from the start. That helps keep us going.

Crackdown’s senior producer is Sam Fenn. Our producers are Alexander Kim and Lisa Hale.

Our science advisor is Ryan McNeil. Assistant Professor & Director of Harm Reduction Research at the Yale School of Medicine.

Garth Mullins is host, writer and executive producer. You can follow him on twitter @garthmullins.

Original score written and performed by Sam Fenn, James Ash and Garth Mullins. Our theme song was written by Garth and Sam with accompaniment from Dave Gens and Ben Appenheimer. You also heard a bit of one of Dave’s favourite songs: Van Morrison’s Into the Mystic.

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.

Crackdown Podcast . 2020-04-05 Crackdown Podcast . 2020-04-05

Episode 15: Apocalypse Prescribing

It’s a grim time. Vancouver just saw the largest spike in fatal ODs since last year. But there’s also a glimmer of hope: the government has finally agreed to provide us with safer prescription alternatives to street drugs. On Episode 15, we dig deep into the new policy and tell the story of advocacy that made this possible.

Drug users in British Columbia are facing two overlapping public health emergencies: COVID-19 and the overdose crisis. Now that countries are closing their borders–the price of street drugs have also started to rise.

It’s a grim time. Vancouver just saw the largest spike in fatal ODs since last year.

But there’s also a glimmer of hope: the government has finally agreed to provide us with safer prescription alternatives to street drugs. If you have a “Substance Use Disorder” in British Columbia, you can now access a bunch of prescription opioids, benzos and stimulants –something we’ve been demanding for years. So far, this doesn’t include diacetylmorphine (heroin), cocaine or prescription fentanyl. And it is unclear whether or not the new policy will remain in place after COVID-19 has passed.

On Episode 15, we dig deep into the new policy and tell the story of advocacy that made this possible. We ask Minister of Mental Health and Addictions Judy Darcy why this wasn’t done at the start of the overdose crisis. We also speak with editorial board members Laura Shaver and Dean Wilson about getting their new meds. And we talk with Guy Felicella about writing the new clinical guidelines.

Transcript

A full transcript of this episode is available here.

Call to Action

Get access to the drugs you need through B.C’s new clinical guidelines

Talk to your doctor, and bring a link to the guide if you can.

GET THE PDF HERE

The new guidelines DO NOT cover heroin, fentanyl, or cocaine.

Drugs Available

oral hydromorphone (DIlaudid / Dillies).

M-Eslon

Dexedrine

Methylphenidate (Ritalin)

A range of benzos, including xanax/clonazepam.

There are options for smokers and drinkers too.

What do the new Health Canada guidelines actually mean?

Your pharmacist can extend a prescription
Your doctor can call over the phone to extend or refill a prescription
You can get it delivered at home
You can get carries up to 23 days
They don’t have to watch you take it

If you don’t have a doctor

If you’re in B.C., you can call:

Rapid access addiction clinics (RAACs) may be able to provide telehealth support.
Victoria: 250-381-3222
Vancouver: 604-806-8867
Surrey: 604-587-3755
Rapid Access to Consultative Expertise (RACE) for Addictions is available Monday-Fri 8am-5pm for consultation and support: http://www.raceconnect.ca/
Local calls: 604-696-2131
Toll free: 1-877-696-2131

(https://yale.app.box.com/v/COVID19HarmReductionGuidance)

BE AWARE that some early symptoms of withdrawal and COVID-19 infection are similar. These include fever and muscle soreness. If symptoms include a persistent cough, it could be COVID-19.

YOU ARE AT AN INCREASED RISK OF BECOMING SERIOUSLY ILL OR DYING because

COVID-19 infection will worsen breathing impacts of opioids, benzos, and alcohol
Opioid withdrawal may worsen breathing difficulties
Smoking, including drugs like crack or meth, makes breathing problems worse

DIFFICULT TO INHALE: If you smoke drugs, like crack or meth, cigarettes or vapes, COVID-19 infection will make it more difficult to inhale smoke. Smoking drugs, cigarettes, or vapes will worsen breathing problems.

IF YOU THINK YOU’RE GETTING SICK: Avoid going to your local harm reduction and addictions programs – HAVE THEM DELIVER SUPPLIES TO YOU. Tell them you are sick so they can take steps to keep themselves safe.

BE PREPARED FOR INVOLUNTARY WITHDRAWAL: Be ready to go through involuntary withdrawal. Your dealer might get sick or the drug supply might be disrupted. Try to be prepared by stocking up. Talk to a medical provider about starting methadone or buprenorphine. Make sure you have all the necessary medications, food, and drinks needed to help detox. Try to have protein-based and electrolyte drinks like Pedialyte or Ensure on hand.

STOCK UP ON THINGS YOU MAY NEED TO MANAGE YOUR SUBSTANCE USE AND PRACTICE HARM REDUCTION.

DRUGS: If you have money and are able, stock up on your drug(s) of choice before things deteriorate. AVOID BINGEING on drugs that you are stockpiling so you have access to a supply. Try to buy from people you trust and have as many WAYS TO CONTACT DEALERS in your area as possible.

ALCOHOL: If you have an alcohol use disorder, the money, and are able, stock up on enough alcohol to last a few weeks. AVOID BINGEING on stockpiled alcohol so that you have access to enough to avoid alcohol withdrawal, and things like seizures. One way to do this is by MANAGING YOUR ALCOHOL USE by consuming an amount of alcohol equivalent to one can of beer, 1.5 ounces of rum, or 5 ounces of wine hourly as needed. Try to avoid bootleg alcohol.

HARM REDUCTION SUPPLIES: Be prepared for the POSSIBILITY OF SYRINGE EXCHANGES AND DRUG TREATMENT PROGRAMS CLOSING DOWN. If you are able, stockpile enough harm reduction supplies to last you a few weeks – longer if you are at higher risk of infection or complications. This includes things like: naloxone, syringes, cookers, pipes, and straws. Get a Sharps container to get rid of used syringes. If you can’t get one, use something like a plastic laundry detergent bottle or soda bottle. Label these bottles “SHARPS CONTAINER”. Do not recycle them.

NALOXONE: Stock up on naloxone in the event of an unintentional overdose. Emergency services are likely to take longer than usual during a pandemic.

METHADONE & BUPRENORPHINE: Check with your medical provider to see if services might be changing. Ask your program and provider if you can have take homes or more and longer refills on your medications. This means that you don’t have to go to your provider to get new doses after your first collection. IF YOU HAVE A PRE-EXISTING CONDITION that puts you at greater risk of infection, LET YOUR PROGRAM KNOW.

REMEMBER THAT PRACTICING HARM REDUCTION CAN HELP YOU TO AVOID COVID-19 INFECTION AND ADDITIONAL STEPS CAN HELP TO REDUCE YOUR RISK OF GETTING SICK

DON’T SHARE YOUR DRUG USE SUPPLIES: Injecting equipment; crack or meth pipes; rose or spoons (for smoking crack or freebasing), straws or other nasal tubes (for inhaling/snorting); bongs, vapes, joints; and drinks.

AVOID INJECTING ALONE: The illicit drug supply continues to be toxic. Be careful about the risk of overdose. Try not to use alone, especially if you inject drugs like heroin, fentanyl, or drugs that might have come into contact with them. There are a couple of things you can do to try to stay safe: (1) You can reduce your risk of COVID-19 infection by staying at least six feet away from other people, coughing or sneezing into your arm, avoiding touching your face, and washing your hands for at least 20 seconds with soap and water. (2) If you have a phone, call someone, preferably nearby, and ask them to stay on the line while you are injecting so they can act or call 9-11 (or the medical emergency phone number in your country) if you become unresponsive.

IF YOU RUN OUT OF SYRINGES: These can be disinfected and help prevent HIV and Hep C with 1:10 DILUTED BLEACH. If there’s a lot of blood, rinse once with water to remove it. If not, skip this step and rinse once with bleach. Load bleach fully into the syringe and keep it there for two minutes. Then expel it. Then rinse twice with clean water. If you don’t have bleach, at least three rinses with clean water can work almost as well. Dull syringes can be sharpened using the striker on a matchbook. Rinse after sharpening to remove any particles in the syringe.

IF YOUR SYRINGES ARE NO LONGER SAFE, you have a few options but be aware that these might be difficult with COVID-19 or make symptoms worse:

1. SNORT IT – Chop them into a powder finely and sniff slowly. It works but not as well as injecting does.

2. BOOTY BUMP IT – Dissolve with citric or ascorbic acid, put in a NEEDLELESS SYRINGE and squirt it up your bum/anus. Onset takes longer but you need less and the high lasts longer.

3. SWALLOW IT – Heroin/fentanyl will go via your liver BEFORE reaching your brain, resulting in a morphine effect – but stopping withdrawal.

4. SMOKE IT – Smoke drugs instead of injecting but keep in mind this can be hard to do with some drugs.

CLEAN YOUR SMOKING SUPPLIES: Use mouthpieces and pipe covers on your smoking supplies when possible. Frequently clean these mouthpieces and pipe covers using an alcohol-based cleaner (like Purell or some other brand) or wipe (minimum 60% alcohol concentration).

WIPE DOWN DRUG PACKAGES: Use an alcohol-based cleaner or wipe to immediately wipe down your packages. If your dealer carries drugs in their mouth, ask them if they can stop doing this. If they won’t, be careful handling the packages and do the cleaning as advised above. Remember that antibacterial washes don’t kill viruses but are better than nothing, especially if they contain alcohol.

DO NOT PUT DRUG BAGS OR WRAPS IN YOUR MOUTH, VAGINA OR ANUS: If you must carry drugs in your body, clean vigorously with an alcohol-based cleaner both before and after you take it out.

WASH YOUR HANDS with soap and hot water vigorously for at least 20 seconds (but longer if you can) every time you come into contact with others, after handling money and after you get your drug packages. Paper towels are preferred for drying hands, or at least use a clean towel. If you cannot wash your hands, clean your hands with an alcohol-based cleaner or wipes (minimum 60% alcohol concentration) – like the ones distributed by harm reduction programs.

PREPARE YOUR DRUGS YOURSELF: Don’t handle or touch other people’s drugs or equipment and don’t let them touch yours. Avoid buying and splitting packages of drugs with others during this pandemic, if possible, to limit the number of people handling drugs. If you must split the drugs, make sure the person who touches the drugs washes their hands.

REMEMBER that people who use drugs and the people in their lives commonly have weaker immune systems, respiratory (breathing) problems, and other conditions that place them at a higher risk of getting COVID-19 infection. Help keep everybody safe by following this advice.

Created in collaboration by the Yale Program in Addiction Medicine, Global Health Justice Partnership, and Crackdown. Adapted with thanks from a document produced by 3D Research.

Works Cited

BC Centre for Disease Control: Harm reduction information for people who use substances in the context of the COVID-19 outbreak.
BC Centre for Disease Control: Weekly overdose data, March 22-March 28, 2020
Canadian Association of People who Use Drugs. Safe Supply Concept Document. February 2019
CBC News: B.C. releases plan to provide safe supply of drugs during COVID-19 pandemic. March 26, 2020
Coronavirus Is Leading to Shortages of Fentanyl And Meth. Deborah Bonello. Vice.com. March 19, 2020
COVID-19: Open letter from DTES frontline workers to Horgan, Dix, Henry, Daly, Stewart, and Darcy—we need more, now. By Concerned registered nurses and frontline workers of the DTES. Georgia Straight, March 31, 2020.
Fleming, T., Barker, A., Ivsins, A. et al. Stimulant safe supply: a potential opportunity to respond to the overdose epidemic. Harm Reduct J 17, 6 (2020).

Credits

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

You can support us at Patreon.com/crackdownpod.

Our Editorial Board is: Samona Marsh, Shelda Kastor, Greg Fresz, Jeff Louden, Dean Wilson, Dave Murray, Al Fowler, and Laura Shaver.

Rest in Peace Chereece Keewatin.
Crackdown’s senior producer is Sam Fenn. Our producers are Lisa Hale and Alexander Kim. With help from Polly Leger.

Our science advisor is Ryan McNeil. Assistant Professor & Director of Harm Reduction Research in the Yale School of Medicine.

Garth Mullins is Crackdown’s host, writer and executive producer. You can follow him on twitter @garthmullins.

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

Crackdown Podcast . 2020-03-19 Crackdown Podcast . 2020-03-19

Episode 14: Emergency Measures

Governments are taking drastic measures to try to slow down the spread of #COVID-19 – declaring emergencies, shutting down businesses and sealing borders. But what about drug users? We have been facing a deadly public health emergency for years, with no drastic measures taken. Will they forget us again this time?

Image: A latex-gloved hand raises a microphone. (Photo: Garth Mullins)

Since the first coronavirus case was confirmed in British Columbia, around 150 people have died from a contaminated drug supply. Four people have died from COVID-19. Now we face both crises at once.

Many drug users in our community are middle aged. And the life can really put years on you. Many of us have COPD or are immunocompromised. The pandemic could cut through us like a scythe.

Transcript

A transcript of this episode is available here.

Demands

Ensure patients can access medication while socially distancing. Give people take home doses. Stand down rules about witnessed ingestion of opioids and opioid agonists (like methadone). Waive requirements for doctors visits and urine screenings.
Pass legislation to make pharmaceutical drugs universally free at the point of service.
There are already shortages of slow-release oral morphine (Kadian). Countries need a strategic opioid reserve. Domestic production of opioids and opioid agonists must be a priority. In WW2, governments ordered car plants to retool and make tanks.
House everybody immediately. Alternatives are needed to crowded shelters, SROs, vehicles, and couch surfing. Unoccupied housing in cities around the world should be expropriated and redistributed to vulnerable people and families. Immediately open hotel rooms for housing.
Declare an immediate moratorium on evictions, suspend rents and halt all mortgage default foreclosures. (Vancouver Tenants Union, ACORN, The BC Government Employees Union)
Legislate paid sick leave for all workers, including paid leave for all workers who are quarantined, or self-isolating. (Vancouver Labour & District Council)
Cancel student debt.
Give everyone an immediate basic income payment. Increase income assistance and disability to a living wage. Expand access to unemployment insurance to include contract workers, freelancers, and people who work in illicit markets. (The Vancouver Tenants Union, BC Federation of Labour (BCFED), ACORN)
Change labour legislation to require employers to provide paid sick leave. Penalize any employer that puts workers in danger of contracting COVID-19 or harms efforts to contain the spread of the pandemic.
Law enforcement should immediately stand down on all drug law enforcement for the duration of the COVID-19 pandemic and beyond. People currently held on drug charges and non-violent offenses should be released immediately. Social distancing is almost impossible inside and people often aren’t given access to basic sanitary items.
Provide a safe supply of drugs. Having to score every day makes self-isolation impossible. There are reports of shortages of fentanyl and meth in the U.S.

We’ve lived through one public health emergency for 5 years already. We’ve been through sharply increasing fatality stats, rationing, scarcity, discrimination, false media reports, panics, controls on our movements, sickness & deaths of loved ones. And we’ve used harm reduction to try to survive.

Now many of us feel anxious. And many also feel a sense of detachment and fatalism. If you inject something that could kill you several times each day for several years, a virus can seem less immediate. Government has been undermining faith in health programs and emergency responses for years. It is hard to expect everyone to suddenly take those same authorities seriously. It is also hard to ask people to take action on something when the material circumstances to do so have been denied them.

But the virus is holding a mirror up to capitalism. And we all see a system that has always left so many of us vulnerable. Things that seemed impossible last week are here now. And that means the solutions that we’re proposing could well be on the table too.

COVID-19 guidance for people who use substances

(https://yale.app.box.com/v/COVID19HarmReductionGuidance)

BE AWARE that some early symptoms of withdrawal and COVID-19 infection are similar. These include fever and muscle soreness. If symptoms include a persistent cough, it could be COVID-19.

YOU ARE AT AN INCREASED RISK OF BECOMING SERIOUSLY ILL OR DYING because

COVID-19 infection will worsen breathing impacts of opioids, benzos, and alcohol
Opioid withdrawal may worsen breathing difficulties
Smoking, including drugs like crack or meth, makes breathing problems worse