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  1. 5-HT2A
    As President Trump calls the opioid crisis an emergency, it's emerged that a US social services agency has secretly run supervised drug injections at an undisclosed location. We speak to Maia Szalavitz, author of "Unbroken Brain: A Revolutionary New Way of Understanding Addiction."



    AARON MATE: It's The Real News. I'm Aaron Mate. President Trump says he will declare a national emergency over the opioid epidemic.

    President Trump: We're going to draw it up and we're going to make it a national emergency. It is a serious problem the likes of which we have never had. When I was growing up they had the LSD and they had certain generations of drugs. There's never been anything like what's happened to this country over the last four or five years.

    AARON MATE: Drug overdoses are the leading killer of Americans under 50, about two-thirds of them from opioids. A national emergency declaration would marshal federal resources to address it. But this comes amid news some are taking bold action on their own. According the American Journal of Preventive Medicine, a US social services agency is secretly running a supervised injection site at an undisclosed location. The underground facility has over seen more than 2,500 injections by around 100 people.

    Joining me is Maia Szalavitz, author of Unbroken Brain: A Revolutionary New Way of Understanding Addiction. Her new piece for VICE is called "There's been a secret safe injection site in the US for three years." Maia, welcome.

    MAIA SZALAVITZ: Hi. Thank you so much for having me.

    AARON MATE: Let's talk first about this site that you've written about. Shocking news that somebody here in the US, we don't know where, has been running a safe injection site on their own.

    MAIA SZALAVITZ: Yeah, I mean I think there's probably more than one. There certainly was a bathroom in the Bronx that was sort of unofficially serving as such a place. When people see people at risk, they have to, people feel moved to do something to help.

    AARON MATE: What is going on at this facility?

    MAIA SZALAVITZ: Basically what happens is people who inject drugs can go there. They have clean equipment, a nice mellow place to just do their thing. They don't have to rush. They can properly find a vein and not just sort of stab at themselves. That allows people to practice safe injection technique and be safer about what they do.

    AARON MATE: This is a practice that is legal in many other countries. Can you talk a bit about what happens there and what the research has shown about its efficacy?

    MAIA SZALAVITZ: Sure. There about 66 such facilities in at least nine countries. The most important statistic is that there has never been an overdose death, even though they have had thousands of injections and at least hundreds, perhaps thousands of people through these places.

    AARON MATE: Looking at this news now of this secret site in the context of Trump appearing to be poised to declare the opioid crisis a national emergency, your thoughts on the conversation around addiction right now and this potential federal response to it.

    MAIA SZALAVITZ: Well there's a good thing that could happen from declaring an emergency and there's bad things that could happen. The good thing would be that when you have a state of emergency for health, you can cut through a lot of red tape. One of the things that has really been hampering the response to this epidemic is we have two treatments that we know of that cut the death rate 50% or more. We are not, only about 10% of treatment programs offer these treatments and we create all these barriers because we have just too much regulation on this.

    Ironically, the sort of Republican let's cut red tape and let's get rid of bureaucracy and let's stop overregulation, that is a really important aspect of this because basically methadone and buprenorphine, we know that if you use them long term, they cut the death rate 50% or more. Yet we have limited access to those substances only to people who are willing to show up at a certain time and go through counseling and get urine tested and all these kinds of things, when really we should be giving those substances to anybody who wants a dose as long as we know that they haven't gotten another dose from another site the same day.

    Because even if they're going to use illegal drugs on top, if they maintain their tolerance and at least have some access to something of known dose and purity, they will be at far less risk of dying. The research shows that if you, regardless of whether you provide counseling or other things, these medications save lives.

    AARON MATE: I'm sure you've gotten this question though before. How can you give people a dose of something that is bad for their health?

    MAIA SZALAVITZ: Well it's not necessarily bad for their health and if the alternative is taking poison, it certainly is appropriate to do. I think what we have to do is we have to think about drug related harm, not about is somebody taking a substance I believe to be immoral or the law has decided is immoral? We have laws that were made because of racism. Our drug laws, nobody sat down and said, "Yeah tobacco and alcohol should be legal and marijuana and all these other substances shouldn't be legal based on clear science."

    The way we got our drug laws was a series of racist panics. If we're going to be rational about substance use, what we need to realize particularly about opioids is that most of the danger associated with them is associated with illicit use. This is not to say that you can't overdose on pain pills. It's more to say if you want to avoid overdose, and you know the dose and purity of something, you are much more likely to be able to do so than if you are taking something that you have no idea what it is.

    AARON MATE: What do you make right now of the efforts to hold big pharmaceutical companies accountable. There have been lawsuits against some ...

    MAIA SZALAVITZ: I think that actually, I think ... The drug companies did serious wrong here. They should be fined. They did terrible marketing things, but the crime here is what's legal for them to do. It's not that ... I mean they, like I said, I'm not justifying anything they did, but one cannot become a person with addiction without taking drugs not as prescribed. You have to repeatedly use drugs despite negative consequences in order to meet criteria for addiction.

    You can become physically dependent on a substance if you just take it every day, but that's not addiction. Addiction is compulsive behavior despite negative consequences. If the consequences of taking a substance every day are I get out of bed and function really well, I'm not addicted to that substance.

    With opioids what we have done is basically chased people from having a supply that they know the dose of and they know the purity of, to fentanyl which is thousands of times stronger often, depending on the variant, and it's, what we have done is simply increased harm.

    AARON MATE: Finally Maia, if you were on the president's commission, what would have been your top recommendations for how we should address the epidemic on a federal level?

    MAIA SZALAVITZ: Sure, so I mean immediately lift all the regulations that prevent prescribing of buprenorphine and methadone to whoever wants it in a controlled fashion. Do not say that you may only get methadone for addiction in X clinic. Allow all doctors who want to prescribe to prescribe and the only requirement for participation in maintenance programs should simply be we know your name. You show up. You get your dose. You can do your thing.

    Now there are certainly people who want to stabilize their lives and want to move on and who could benefit from counseling and psychiatric care and all kinds of other good services that we can give them. We should triage those services to people who actually want them rather than forcing people into them who don't want them.

    If we do this, we will get access to a far greater number of people and we know that if people have access to these drugs, people who stay on them have a 50% less risk of dying or overdose. If we get this to as many people as possible, we can cut this thing in half.

    AARON MATE: Maia Szalavitz, author of Unbroken Brain: A Revolutionary New Way of Understanding Addiction. Her new piece for VICE is called, "There's Been a Secret Safe Injection Site in the US for Three Years." Maia, thank you.

    MAIA SZALAVITZ: Ah, thanks so much for having me.

    AARON MATE: And thank you for joining us on The Real News.

    Original Source

    Aug 13, 2017, Secret Safe Injection Site Responds to US Drug Crisis, The Real News

Recent User Reviews

  1. KevinNikDee
    "Fantastic initiative !"
    5/5, 5 out of 5, reviewed Aug 28, 2017
    We need more folk to start thinking out the box. After years of this so called war on drugs its benefitted no one really. So thanks for looking out for us IV users in the best sense possible, given the circumstances. Much respect! ;) wish my country wld follow suite of Portugal where all drugs have been decriminalised! Peace out :)

Comments

  1. aemetha
    Ugh, this is entirely disgusting. Approval ratings go down, say something positive to the poor to boost them without actually making any personal commitment to fixing things. If Trump were serious about dealing with the opioid epidemic he would deal with big pharma. Despite promises Trump has done absolutely nothing to restrain the profiteering of big pharma. In fact, he has advocated for tax cuts for the wealthy that benefits big pharma and disadvantages the poor who are most affected by the opioid epidemic.

    America, your President is lying to you. He tells you tax cuts for the rich benefit the poor. Your attorney general tells you this is a moral issue when it is a health issue. It's a lie. Call a spade a spade, the evidence is clean, tax cuts for the rich result in the rich hording wealth... look it up. Tax cuts for the poor result in more government spending which benefits the majority, not the 1%. What has Trump actually done that he promised? Do the poor earn more? No. Do coal miners have a future? No, don't be silly, you can mine as much coal as you like, nobody wants to buy it. Has Trump boosted education to give you other employment opportunities? Nope, coal miners still mine coal in a dying industry. You want a new job, vote for someone who will train you in a new job. You want to die, keep breathing coal dust and voting trump. He'll get richer and live forever on life support, you'll die in a few weeks because you can't afford any longer than that.

    He doesn't represent you.
    1. WoWlifer
      NOT protecting *or* bashing anyone, but the "War on Opiods" began with Obama and medical reform. Opana was being forced to withdraw their time-release pxs well before the change to Trump. Though i would Like to blame him for everything, sadly much IS on Obama.
      As for keeping people on methadone as some of my friends, now at 35 yrs. plus, and Wayyyy harder to withdraw from than a week kicking dope, i personally think it's a terrible idea. *because people will linger for decades and never face their addiction or Need to change.
      Is your president/Prime Minister honest with you? (Please don't slaughter me!) Just asking.
      detoxin momma likes this.
  2. WoWlifer
    1. aemetha
      I don't disagree. What bugs me is the blatantly cynical approach by Trump. He cared not a whit about the opioid epidemic and did everything he could to try to defund opioid treatment funding. Then as soon as his approval started dropping he decides to throw the masses a bone. He should do it because it needs doing when it needed doing.
  3. WoWlifer
    welp, No president/prime minister/leader should have the power to revoke prescriptions written by a dr. with a long-worked for degree in just that specialty... to treat pain, anxiety, whatever. Lumping heroin o.d.'s and deaths - as well as non-prescribed users, even suicides by people with these problems that can no longer Get the meds they need - into "opiate deaths" is a dangerous and misleading stat to throw around. That's been going on for many years now too - almost longer than Korea has had a nuke :O (2013, he's a crazy fucker)
    Would sure be nice if they all legalised or 'decriminalised' weed on a federal level though.
    it's really is Bad. <sigh>
      detoxin momma likes this.
  4. detoxin momma
    welp, i think you are right.....how many years of schooling for peoples individual needs did these politicians take, none...

    Even still, i do feel opioids are way over prescribed, of course they are, its a trillion dollar industry... truth be told, alot of those people could be saving themselves alot of hassle by simply using something like acetominophen.
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