Episode 28: After the Flood
2021 was a year of very ominous weather reports. What would it be like to try to build a life through the chaos? This is Rainbow’s story.
Image: A cargo barge washed ashore at Sunset Beach in Vancouver. Photo by Rainbow.
2021 was a year of very ominous weather reports. There were unprecedented heat emergencies, wildfires, and Biblical floods. Meanwhile COVID-19, income inequality, and the overdose crisis continued to become more and more grim.
What would it feel like to endure all of this as a young person? What would it be like to try to build a life through the chaos?
To find out, we asked Rainbow, a young woman in her 20s, to record big and small moments from her life for 40 days.
This is Rainbow’s story.
“Everyday’s a FLOOD” by Rainbow
Transcript
A full transcript is available here.
Policy Recommendations
We oppose approaches to preventing drug-related harms that are premised on abstinence.
Young people’s engagement with harm reduction programs and sites should be kept confidential.
We demand investment in low-barrier and youth-led harm reduction programs and spaces, including safer consumption sites.
Youth-oriented programs and spaces must account for the needs of polysubstance-using youth, BIPOC youth, gender diverse and queer youth, and self-identified young women.
Stop pathologizing young people who use drugs (YPWUD) and trying to “save” or “fix” us.
The services and systems that YPWUD traverse must be re-designed to foster youth’s self-determination in relation to their drug use, harm reduction, care, and families.
We add our voices to those demanding the decriminalization of drug use and an end to the war on drugs.
We add our voices to those demanding a safe supply of drugs via peer-led compassion clubs.
Youth voices should be better integrated into both bottom up, grassroots and top down, state-sponsored harm reduction movements.
YPWUD in the context of greater privilege and allies should focus energy on fostering and extending the activism of YPWUD in the context of street involvement.
—Adapted from Canêdo et al. (2022). Harm reduction calls to action from young people who use drugs on the streets of Vancouver and Lisbon. Harm Reduction Journal 19:43.
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 28 is especially useful for exploring the following themes:
Navigating systems of care as a young person in Canada
Supportive housing
Romantic relationships and structural vulnerability
Stimulant use and productivity
Safe supply prescribing
Suggested Additional Readings
For more discussion theorizing about romantic relationships and drug use, see:
Bourgois, Phillippe and Jeff Schonberg. Righteous Dopefiend. Berkeley: University of California Press, 2009.
Proudfoot, Jesse. “Drugs, Addiction, and the Social Bond.” Geography Compass 11, no. 7 (2017): 1-11.
Works Cited
CBC News. “2021 now deadliest year for illicit-drug overdoses in B.C.” CBC News. December 9, 2021.
CBC News. “B.C. Bracing for Increase in COVID Hospitalizations Amid 5th Wave.” December 29, 2021.
Fast, Danya. “Going Nowhere: Ambivalence about Drug Treatment during an Overdose Public Health Emergency in Vancouver.” Medical Anthropology Quarterly 35, no. 2 (2018): 209-225.
Fast, Danya. “‘We Don’t Belong There’: New Geographies of Homelessness, Addiction, and Social Control in Vancouver’s Inner City.” City and Society 30, no. 2 (2018): 237-262.
Fast, Danya, Thomas Kerr, Evan Wood, and Will Small. “The Multiple Truths about Crystal Meth among Young People Entrenched in an Urban Drug Scene: A Longitudinal Ethnographic Investigation.” Social Science and Medicine 110 (2014): 41-48.
McNeil, Ryan, Taylor Fleming, et al. “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.” Drug and Alcohol Dependence (2021).
Nosyk, Bohdan et al. “Evaluation of Risk Mitigation Measures for People with Substance Use Disorders to Address the Dual Public Health Crises of COVID-19 and Overdose in British Columbia: a Mixed-Method Study Protocol.” BMJ Open (2021): 1-15.
Stacey, Jocelyn. “The Year the Climate Emergency Came to British Columbia.” December 13, 2021.
Credits
Crackdown is produced on Musqueam, Squamish and Tsleil-Waututh territories.
If you like what we do, please consider donating to the show on Patreon.
Special thanks to Lee and Reith Charlesworth.
Our editorial board is: Samona Marsh, Shelda Kastor, Greg Fresz, Jeff Louden, Dean Wilson, Laura Shaver, Reija Jean. Rest in Peace Dave Murray and Chereece Keewatin.
This episode was conceptualized, written, and produced by Rainbow, Sam Fenn, Alexander Kim, Alex De Boer, Danya Fast, Ryan McNeil, Lisa Hale and Garth Mullins.
Sound design by Alexander Kim.
Original score was written and performed by James Ash, Sam Fenn, and Garth Mullins.
We produced this episode in Partnership with Professor Danya Fast. It was funded in part by Frayme and the Social Science and Humanities Research Council of Canada.
Episode 27: Cop Baked In
Can Crackdown’s editorial board member Reija Jean use Suboxone to kick dope? Who will win the battle for her opioid receptors?
Self-portrait by Reija Jean.
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?
“Beans” by Reija Jean. Note: Beans is healthy and happy. Don’t worry about Beans.
The phrase “cop baked in” was coined by Garth in a 2017 BCAPOM meeting.
Transcript
A complete transcript for this episode is available here.
Interviewees
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.
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 27 is especially useful for exploring the following themes:
Patient experiences with Suboxone (buprenorphine/naloxone) treatment
Complexities and stigmatization within the patient-prescriber relationship
“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.
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.
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, Alexander Kim, Alex de Boer, Danya Fast, Ryan McNeil, and Garth Mullins.
Original score was written and performed by Garth Mullins, James Ash, Sam Fenn, and Kai Paulson.
Episode 26: Artificial Energy
On episode 26 of Crackdown, we look at how crystal meth helps people keep up with an unrelenting world.
Image: Blurry night-time photo of a dumpster in a Vancouver alley. (Photo: Garth Mullins)
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 at how crystal meth helps people keep up with an unrelenting world.
Transcript
A complete transcript of this episode is in preparation and will be published here when ready.
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 Canadian 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.
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 26 is especially useful for exploring the following themes:
The social adaptation model of addiction
Stimulant use and productivity
Informal work and income generating strategies
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.
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.
Episode 25: The Lab
Garth interviews Rensselaer Polytechnic Institute Professor Nancy Campbell, about the so-called “Brain Disease Model of Addiction”. How did this idea rise in prominence and what does it misunderstand about the reasons why many people use drugs?
Image: In a laboratory at the Addiction Research Center in Lexington, Kentucky, a researcher in a white lab coat prepares a participant for an experiment. The participant is seated and the researcher stands over him. The laboratory is crowded with scientific machines. (Photo: Bill Eppridge/LIFE Magazine)
While overdoses in BC are climbing to unprecedented rates, some doctors still refuse to provide drug users with access to pharmaceutical versions of illicit drugs. Instead, many doctors view addiction as a chronic disease to be treated by limiting euphoria, prescribing “safer” analogues, or surveilling their patients.
On episode 25, Garth interviews Rensselaer Polytechnic Institute Professor, Nancy Campbell, about the so-called “Brain Disease Model of Addiction” (BDMA). How did this idea rise in prominence and what does it misunderstand about the reasons why many people use drugs?
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 25 is especially useful for exploring the following themes:
History of the development of the brain disease model of addiction
Ethics of research on incarcerated people
Works Cited
Campbell, Nancy. 2007. Discovering Addiction: The Science and Politics of Substance Abuse Research. Ann Arbor, MI: University of Michigan Press.
———. 2008. The Narcotic Farm: The Rise and Fall of America’s First Prison for Drug Addicts. New York: Abrams.
Fast, Danya. 2021. “Going Nowhere: Ambivalence about Drug Treatment during an Overdose Public Health Emergency in Vancouver.” Medical Anthropology Quarterly.
Fast, Danya, and David Cunningham. 2018. “‘We Don’t Belong There’: New Geographies of Homelessness, Addiction, and Social Control in Vancouver’s Inner City.” City & Society 30 (2): 237–62.
Harlow, Harry. 1959. “Mother Love.” Carousel Film & Video, CBS Television Network.
Olsen, J.P., and Luke Walden. 2008. “The Narcotic Farm.” ITVS.
Preminger, Otto. 1955. “The Man with the Golden Arm.” United Artists.
Rasmussen, Nicolas. 2010. “Maurice Seevers, the Stimulants and the Political Economy of Addiction in American Biomedicine.” BioSocieties 5 (1): 105–23..
Tatum, A. L., and M. H. Seevers. 1931. “Theories of Drug Addiction.” Physiological Reviews 11 (2): 107–21.
In Memoriam
On this week’s show, we remember our friend and comrade Hawkfeather Peterson’s son Edward Biggs, who died suddenly this month. Hawkfeather says, “He was only 22 years old. He hadn’t even begun to live life.” Rest in peace Edward.
Janis Warren was a harm reduction worker and the lead singer of the band Lashback. She died of a fatal overdose in May. Rest in peace Janis.
Gerrald Peachey–who most of us knew as Spike–was a drug user and a force within the movement. In 2018, he ran for city council with the campaign slogan “Put a Spike Through City Hall.” Rest in Peace Spike.
Credits
Crackdown is produced on the territories of the Musqueam, Squamish and Tsleil-Waututh Nations.
Thanks this week to Nancy Campbell and Steve Pierce for their help locating and digitizing the archival footage you heard on this month’s show. Thanks, as well, to Steve for recording our conversation with Professor Campbell.
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, Alexander Kim, Danya Fast, Ryan McNeil, and Garth Mullins.
Original score was written and performed by James Ash, Sam Fenn, Kai Paulson and Garth Mullins.
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)
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.
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.
Further Reading and Listening
Check out Desmond Cole’s book The Skin We’re In: A Year of Black Resistance and Power.
Desmond also discusses Robyn Maynard’s work in this episode. You can check out her book Policing Black Lives: State Violence in Canada from Slavery to the Present here.
You can hear Frontburner’s interview with investigative journalist Judy Trinh about the police killing of Anthony Aust here.
Also check out the CBC Database of use of Deadly Force in Canada 2007-2017.
Thanks to Allie Graham for recording Desmond Cole in Toronto. Allie works on the podcast We Are Not the Virus, which you can listen to here.
Today’s episode also included a clip from the YouTube interview show, Midas Letter. Midas Letter’s full interview with Julian Fantino is here.
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.
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
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
Further Reading
This blog post about Canada’s first drug arrest written by local historian Lani Russwurm.
Pivot Legal Society’s open letter on decriminalizing poverty in Vancouver.
Policing Black Lives by Robyn Maynard.
The Skin We’re In by Desmond Cole.
This blog post about the history of Anti-Asian racism in British Columbia by the historian Henry Yu.
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.
Episode 22: We’re Not Afraid of Needles Around Here
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.
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
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.
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.
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.
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.
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.
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.
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.
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.
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.
(Graph: BC Coroners Service)
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
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
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
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.
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 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.
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.
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.
(Art by Garth Mullins)
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.
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: 604-587-3755Rapid 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 2019CBC 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.
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)
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?
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
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.
Credits
Crackdown is produced on the territories of the Musqueam, Squamish and Tsleil-Waututh Nations.
You can support us at Patreon.com/crackdownpod.
Thanks to Louise Vincent, Urban Survivors Union, North Carolina, housing activist Wendy Pedersen, and OPS Vancouver manager Trey Helton.
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 Alexander Kim, Lisa Hale and Alex De Boer.
Our science advisor is Ryan McNeil. Assistant Professor & Director of Harm Reduction Research in 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, Kai Paulson and me. 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.
Follow us on twitter @crackdownpod. Our patreon is here.
Episode 13: Someone Else’s Problem
Conservatives say we need recovery not harm reduction. In some places, the right is fighting to stop safe injection sites from opening – or trying to close down existing ones. But what do they really mean by recovery? We followed one woman’s journey through four recovery homes.
Image: Tanis Rose overlooking the Port of Vancouver. (Photo: Alexander Kim)
Conservatives say we need recovery not harm reduction. In some places, the right is fighting to stop safe injection sites from opening – or trying to close down existing ones. But what do they really mean by recovery? We followed one woman’s journey through four recovery homes. She had lots of family support. And these places were not the worst, most notorious ones. Still, all we found was a bureaucratic, broken patchwork of a system.
This episode discusses suicide and self harm. If you are struggling with thoughts of suicide or know someone who is, you can reach out for help at crisisservicescanada.ca
Transcript
Screenshot from Westminster House self-referral form
Screenshot from Westminster House website
Screenshot from Westminster House Primary Care Guidelines
Screenshot from Westminster House Primary Care Guidelines
Recommended Reading
BCCSU Safety Bulletin. “Avoid the use of withdrawal management as a standalone treatment for opioid use disorder”
Ferri M, Amato L, Davoli M. “Alcoholics Anonymous and other 12‐step programmes for alcohol dependence.” Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD005032.
MacArthur GJ, Minozzi S, Martin N, et al. “Opiate substitution treatment and HIV transmission in people who inject drugs: systematic review and meta-analysis.” BMJ 2012;345:e5945.
Medola A, Gibson R. “Addiction, 12-Step Programs, and Evidentiary Standards for Ethically and Clinically Sound Treatment Recommendations: What Should Clinicians Do?” AMA J Ethics. 2016;18(6):646-655.
Strang J, McCambridge J, Best D, et al. “Loss of tolerance and overdose mortality after inpatient opiate detoxification: follow up study.” BMJ 2003;326:959-60
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 Fess, Jeff Louden, Dean Wilson, Dave Murray, Al Fowler, and Laura Shaver.
Rest in Peace Chereece Keewatin. It’s been just over a year since we lost you.
Crackdown’s senior producer is Sam Fenn. Our producers are Lisa Hale and Alexander Kim. This month we had production help from Alex de Boer and 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 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
Episode 12: Love in a State of Emergency
You can’t understand Canada’s overdose crisis without knowing the truth about this country – and that’s the story of colonization: a centuries-long effort to steal land and erase Indigenous peoples.
Image: WAHRS treasurer Linda Steinhauer stands by a mural painted by Trey Helten and Sean “Heph” Hefele in the alley outside OPS on the Downtown Eastside. (Photo: Alexander Kim)
You can’t understand Canada’s overdose crisis without knowing the truth about this country – and that’s the story of colonization: a centuries-long effort to steal land and erase Indigenous peoples.
In April 2019, Garth and Thunder Bay podcast creator Ryan McMahon were chatting on the phone. Ryan said that some Indigenous communities are reticent about harm reduction and that Crackdown should look at that.
Transcript
Image: Garth Mullins interviews Ryan McMahon. (Photo: Lisa Hale)
We’ve been talking about making this episode since our first editorial board meeting in 2018, when Chereece Keewatin, Shelda Kastor and Jeff Louden talked about how the overdose crisis affects them as Indigenous people. Since then Chereece died – and we blame racist drug war policies for that.
Shelda guided the work on this episode, mapping the connections between abstinence programs, the Red Road and Indigenous approaches harm reduction.
WAHRS treasurer Linda Steinhauer. (Photo: Alexander Kim)
The names of loved ones who have died in this crisis on Trey and Sean’s mural, “For the Loved Ones We Have Lost”. Joseph Steinhauer was Linda’s son. He worked at this OPS before he died, and was recognized for his work there by the Nurses and Nurse Practitioners of BC Awards. (Photo: Alexander Kim)
KEY FINDINGS from the work of our editorial board member Shelda Castor and our science advisor, Ryan McNeil.
Canada’s drug overdose crisis disproportionately affects Indigenous Peoples differently owing to a legacy of colonialism, racism and intergenerational trauma.
Disaggregated data on Indigenous people are needed to understand more clearly how Indigenous Peoples are affected by drug overdoses.
Indigenizing harm reduction and addiction treatment must involve integrating cultural and traditional Indigenous values that align with the principles of harm reduction.
Reconciliation with Indigenous Peoples must include ending the war on drugs to address underlying structural conditions that produce drug-related harms, including overdose.
Some of the CALLS TO ACTION from the Truth and Reconciliation Commission:
18. We call upon the federal, provincial, territorial, and Aboriginal governments to acknowledge that the current state of Aboriginal health in Canada is a direct result of previous Canadian government policies, including residential schools, and to recognize and implement the health-care rights of Aboriginal people as identified in international law, constitutional law, and under the Treaties.
19. We call upon the federal government, in consultation with Aboriginal peoples, to establish measurable goals to identify and close the gaps in health outcomes between Aboriginal and non-Aboriginal communities, and to publish annual progress reports and assess long- term trends. Such efforts would focus on indicators such as: infant mortality, maternal health, suicide, mental health, addictions, life expectancy, birth rates, infant and child health issues, chronic diseases, illness and injury incidence, and the availability of appropriate health services.
21. We call upon the federal government to provide sustainable funding for existing and new Aboriginal healing centres to address the physical, mental, emotional, and spiritual harms caused by residential schools, and to ensure that the funding of healing centres in Nunavut and the Northwest Territories is a priority.
Recommended Reading
We recommend Bob Joseph’s book “21 Things You May Not Know About the Indian Act.”
The Truth and Reconciliation Commission’s final report and the 94 Calls to Action should be read by everyone.
Chelsea Vowel’s book Indigenous Writes: A Guide to First Nations, Métis & Inuit Issues in Canada is essential reading.
We recommend listening to all of Ryan’s CANADALAND’s podcast THUNDER BAY. Ryan also produces Red Man Laughing and Stories From The Land.
(Graphic: First Nations Health Authority)
Works Cited
An Act Further to Amend “The Indian Act,” Chapter Forty-Three of the Revised Statues. 1888.
Ben, Leon W. 1991. “Wellness Circles: The Alkali Lake Model in Community Recovery Processes.” A Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Education, Northern Arizona University.
Cariou, C. 1986. “Native Alcohol Workers See No End to the Problem.” Kainai News, April 25, 1986.
FNHA. 2019 “First Nations Opioid Overdose Deaths Rise in 2018.”
Giovannetti, Justin. 2016. “Alberta Reserves Struggle to Access Fentanyl Antidote.” The Globe and Mail. March 2016.
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, no. 178 (April): 87–94.
Government of Canada. 1876. The Indian Act.
Joseph, Bob. 2018. “A Look at First Nations Prohibition of Alcohol.” ictinc.ca.
Joseph, Bob. 2018. 21 Things You May Not Know About the Indian Act. Indigenous Relations Press.
Kelly, Doug. 2017. “The Hidden Complexities in Substance Abuse.” The Globe and Mail. August 25, 2017.
Lavalley, Jennifer, Shelda Kastor, Jenna Valleriani, and Ryan McNeil. “Reconciliation and Canada’s Overdose Crisis: Responding to the Needs of Indigenous Peoples.” CMAJ. December 17, 2018.
Lucas, Phil, dir. 1986. The Honour of All. Film. UCLA Film & Television Archive.
Mail, Patricia D., and Linda J. Wright. 1989. “Point of View: Indian Sobriety Must Come from Indian Solutions.” Health Education 20 (5): 19–22.
McMahon, Ryan. 2018. “Thunder Bay.” Podcast. Edited by Jesse Brown. CANADALAND.
Narcotics Anonymous. 1996. “Bulletin #29: Regarding Methadone and Other Drug Replacement Programs.” na.org. 1996.
Truth and Reconciliation Commission of Canada. 2015. “Truth and Reconciliation Commission of Canada: Calls to Action.”
Willie, Elvin. 1989. “The Story of Alkali Lake.” Alcoholism Treatment Quarterly 6 (3–4): 167–74.
Western Aboriginal Harm Reduction Society. Talking Circle Series: The healthcare experiences of aboriginal peoples living in the downtown eastside; National Collaborating Centre for Aboriginal Health. (2009).
Credits
Crackdown is produced on the territories of the Musqueam, Squamish and Tsleil-Waututh Nations.
You can support us at Patreon.com/crackdownpod.
This month, editorial board member Shelda Kastor provided invaluable advice and direction to me and the production team. Thank you Shelda.
We’d also like to thank Esk’etemc for letting us use clips of their film and Trey Helten and Shawn “Heph” Hefele, whose mural is in the art for this month’s show.
Our Editorial Board is: Samona Marsh, Shelda Kastor, Greg Fess, 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 Alexander Kim and Lisa Hale.
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 me. 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.
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.”
Image: Samona Marsh and her dog Ollie ride a mobility scooter outside VANDU’s Downtown Eastside storefront. (Photo: Alexander Kim)
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.
This episode discusses suicide. If you are struggling with thoughts of suicide or know someone who is, you can reach out for help here.
Transcript
Image: Jeff Louden’s arm, covered in Tagaderm. (Photo by Garth Mullins)
Sam Fenn interviews Samona Marsh and Kevin Yake upstairs at the Vancouver Area Network of Drug Users. (Photo by Alexander Kim)
Image: Garth Mullins sits with Ollie. (Photo by Dexter McMillan)
Reading List
Bardwell, Geoff, 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 96 (1): 12–20.
Bardwell, Geoff, Thomas Kerr, Jade Boyd, and Ryan McNeil. 2018. “Characterizing Peer Roles in an Overdose Crisis: Preferences for Peer Workers in Overdose Response Programs in Emergency Shelters.” Drug and Alcohol Dependence 190 (September): 6–8.
Bardwell, Geoff, Evan Wood, and Rupinder Brar. 2019. “Fentanyl Assisted Treatment: A Possible Role in the Opioid Overdose Epidemic?” Substance Abuse Treatment, Prevention, and Policy 14 (1).
Bula, Frances. 2019. “B.C. Municipalities Pass Bylaws Targeting Homeless.” The Globe and Mail. The Globe and Mail. November 15, 2019.
Government of Canada. 2014. “Evidence – SECU (41-2) – No. 36 – House of Commons of Canada.” Ourcommons.Ca. Government of Canada. November 4, 2014.
Government of Canada. 2019. “Opioid-Related Harms in Canada – Public Health Infobase | Public Health Agency of Canada.” Canada.Ca. Government of Canada. 2019.
Johnston, Jesse. 2019. “Meet the B.C. Man Who Has Reversed More than 190 Overdoses.” CBC. April 15, 2019.
Kennedy, MC, Jade Boyd, Samara Mayer, Alexandra Collins, Thomas Kerr, and Ryan McNeil. 2019. “Peer Worker Involvement in Low-Threshold Supervised Consumption Facilities in the Context of an Overdose Epidemic in Vancouver, Canada.” Social Science & Medicine 225 (March): 60–68.
Kennedy, MC, David C. Klassen, Huiru Dong, M-J S. Milloy, Kanna Hayashi, and Thomas H. Kerr. 2019. “Supervised Injection Facility Utilization Patterns: A Prospective Cohort Study in Vancouver, Canada.” American Journal of Preventive Medicine 57 (3): 330–37.
Kerr, Thomas, Sanjana Mitra, Mary Clare Kennedy, and Ryan McNeil. 2017. “Supervised Injection Facilities in Canada: Past, Present, and Future.” Harm Reduction Journal 14 (1).
Mayer, S., Boyd, J., Collins, A., Kennedy, M. C., Fairbairn, N., & McNeil, R. (2018). Characterizing fentanyl-related overdoses and implications for overdose response: Findings from a rapid ethnographic study in Vancouver, Canada. Drug and alcohol dependence 193, 69-74.
Luymes, Glenda. Vancouver. 2017. “‘I’m Going to Allow These Things to Drive Me Forward … :’ Maple Ridge Mayor on Threats to Her Safety.” Vancouver Sun. Vancouver Sun. July 7, 2017.
McNeil, Ryan, Thomas Kerr, Hugh Lampkin, and Will Small. 2015. “‘We Need Somewhere to Smoke Crack’: An Ethnographic Study of an Unsanctioned Safer Smoking Room in Vancouver, Canada.” International Journal of Drug Policy 26 (7): 645–52.
McNeil, Ryan, Will Small, Hugh Lampkin, Kate Shannon, and Thomas Kerr. 2013. “‘People Knew They Could Come Here to Get Help’: An Ethnographic Study of Assisted Injection Practices at a Peer-Run ‘Unsanctioned’ Supervised Drug Consumption Room in a Canadian Setting.” AIDS and Behavior 18 (3): 473–85.
Notta, Dania, Brian Black, TianXin Chu, Ronald Joe, and Mark Lysyshyn. 2019. “Changing Risk and Presentation of Overdose Associated with Consumption of Street Drugs at a Supervised Injection Site in Vancouver, Canada.” Drug and Alcohol Dependence 196 (March): 46–50.
Shearer, Daniel, Taylor Fleming, Al Fowler, Jade Boyd, and Ryan McNeil. 2019. “Naloxone Distribution, Trauma, and Supporting Community-Based Overdose Responders.” International Journal of Drug Policy 74 (December): 255–56.
Wallace, Bruce, Katrina Barber, and Bernadette (Bernie) Pauly. 2018a. “Sheltering Risks: Implementation of Harm Reduction in Homeless Shelters during an Overdose Emergency.” International Journal of Drug Policy 53 (March): 83–89.
Woo, Andrea. 2019. “Unsanctioned Overdose-Prevention Site Opens in Maple Ridge, Renewing Debate over Drug Use and Homelessness.” The Globe and Mail. The Globe and Mail. June 6, 2019.
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.
Today’s episode also featured the song “Fuck You Pigs” by Trey Helton’s band The Fuck You Pigs.
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 yet taken over the U.K.’s drug supply. In episode 10, Crackdown crosses the Atlantic to try to figure out what’s going on.
In 2018, Scotland had a higher rate of drug-related deaths than Canada or the U.S. — even though fentanyl hasn’t yet taken over the U.K.’s drug supply. In episode 10, Crackdown crosses the Atlantic to try to figure out what’s going on.
Transcript
Sources: Scotland and Glasgow; Canada; B.C and Vancouver; US
Reading List
U.K. House of Parliament. Scottish Affairs Committee. “Problem drug use in Scotland.” 2019
National Health Service Scotland, “Measuring Health Inequalities”. NHS Scotland. (retrieved Nov 25, 2019)
Izundu, Chi Chi. “Fake Xanax: Anxiety drug deaths an ‘escalating crisis.” BBC Six and Ten O’clock News. February 4, 2019
The Scottish Government, Population Health Directorate. “Road to Recovery Strategy: A new approach to tackling Scotland’s drug problem”. ISBN: 978075595657. May 29, 2008
C. Matheson, D. Liddell, E. Hamilton and J. Wallace. “Older People with Drug Problems in Scotland: A Mixed Methods Study Exploring Health and Social Support Needs. Report to the Scottish Government.” Scottish Drugs Forum. June 2017
Scottish Drugs Forum. “HIV in Glasgow: Responding to an Outbreak.” 2018
Scottish Drugs Forum. “A Drugs Strategy For Scotland: Response to the Scottish Government proposal to refresh Scotland’s existing strategy”. 2018
Scotland Drug Strategy Delivery Commission. B. Kidd, C. Lind, K. Roberts. “Independent Expert Review: Opioid Replacement Therapies in Scotland”. 2013
The Scottish Government, Population Health Directorate. Ministry of Public Health. “Rights, Respect and Recovery; Scotland’s strategy to improve health by preventing and reducing alcohol and drug use, harm and related deaths.” ISBN: 9781787810747 . November 28, 2018
The Scottish Government, Scottish Drugs Forum and Hepatitis Scotland. “Staying Alive in Scotland: Strategies to combat drug related deaths”. June 2016
National Records of Scotland. “Drug Related Deaths in Scotland in 2018” 2019
Ewan Angus. “The Scheme”. 2010. Kilmarnock . BBC One Scotland. Television series
Mornings, With Kaye Adams. BBC Radio Scotland. Glasgow. Radio Interview. Aug 28, 2019
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.
Episode 9: Change Intolerance Part 2
Crackdown investigates the relationship between the BC government and Mallinckrodt Pharmaceuticals. Many people on methadone complain that Methadose® “doesn’t have legs.” Why hasn’t the government provided them with a more effective option?
Image: Garth’s collection of “old school” methadone bottles. (Photo: Garth Mullins)
Crackdown investigates the relationship between the BC government and Mallinckrodt Pharmaceuticals. Many people on methadone complain that Methadose® “doesn’t have legs.” Why hasn’t the government provided them with a more effective option?
This episode follows Episode 2: Change Intolerance.
Transcript
A full transcript of this episode is available here.
Crackdown and BCAPOM Demands
We demand access to the old methadone formulation immediately. Give us medication that works for us, whether that is methadone, Metadol-D, Suboxone, slow release oral morphine, injectable Dilaudid, or prescription heroin.
We demand to have a say in policy decisions about our lives. Nothing about us without us.
We demand an apology from Mallinckrodt, the BC Ministry of Health, and the BC College of Pharmacists.
We demand a formal investigation to determine why Methadose® failed.
Works Cited
Gourevitch, Marc, Diana Hartel, Peter Tenore, Katherine Freeman, Ira Marion, Joe Hecht, Joyce Lowinson. “Three Oral Formulations of Methadone: A Clinical and Pharmacodynamic Comparison.” Journal of Substance Abuse Treatment 17:3 (1999): 237-241.
Greer, Alison. Sherry Hu, Ashraf Amlani, Sarah Moreheart, Olivia Sampson, and Jane Buxton, “Patient Perspectives of Methadone Formulation Change in British Columbia Canada: Outcomes of a Provincial Survey.” Substance Abuse Treatment, Prevention, and Policy 11:3 (2016): 1-8.
McNeil, Ryan, Thomas Kerr, Solanna Anderson, Lisa Maher, Chereece Keewatin, M.J. Milloy, Evan Wood, Will Small. “Negotiating Structural Vulnerability Following Regulatory Changes to a Provincial Methadone Program in Vancouver, Canada: A Qualitative Study.” Social Science and Medicine 133 (2015): 168-176.
Mullins, Garth. “New Methadose is Failing the People it’s Designed to Assist, Says Local Researcher.” Megahopne, June 15, 2015.
Silver, Junell, Howard Shaffer. “Change Intolerance to Shifts in Methadone Formulation: A Preliminary Investigation.” Journal of Substance Abuse Treatment 13:4 (1992): 331-39.
Socias, Eugenia, Evan Wood, Ryan McNeil , Thomas Kerr, Huiru Dong, Jean Shoveller, Julio Montaner, M.J. Milloy. “Unintended Impacts of Regulatory Changes to British Columbia Methadone Maintenance Program on Addiction and HIV-related Outcomes: An Interrupted Time Series Analysis.” International Journal of Drug Policy 45 (2017): 1-8.
Steels, M.D., M. Hamilton, and P.C. McLean. “The Consequence of a Change in Formulation of Methadone Prescribed in a Drug Clinic.” British Journal of Addiction 87 (1992): 1549-54.
Additional Reading
Moreheart, Sarah. “BC’s Change in Methadone Formulation: A Metanarrative Review of the Literature.” 2016.
Soyka, Michael and Christina Zingg. “Feasibility and safety of transfer from racemic methadone to (R)-methadone in primary care: Clinical Results from an Open Study.” The World Journal of Biological Psychiatry 10:3 (2009): 217-224.
Credits
Crackdown is produced on the territories of the Musqueam, Squamish, and Tseil-Waututh Nations.
Special shout out this month to Zoe Dodd for showing us all how to most effectively interrupt a minister while they’re giving a speech.
Crackdown’s Editorial Board is: Samona Marsh, Shelda Kastor, Greg Fess, Jeff Louden, Dean Wilson, Dave Murray, Al Fowler, Laura Shaver, and Chereece Keewatin. RIP Chereece.
Crackdown is produced by Sam Fenn, Lisa Hale, and Alexander Kim.
Our science advisor is Ryan McNeil.
I’m Garth Mullins, host, writer and executive producer.
You can follow me on twitter @garthmullins.
Original score written and performed by Sam Fenn, Jay Heen, Kai Paulson, James Ash and me. Our theme song was written by me and Sam with accompaniment from Dave Gens and Ben Appenheimer.
We get funds from the Canadian Institutes of Health Research and the Social Sciences and Humanities Research Council of Canada.