Narcotica Podcast

In 2016, the Centers for Disease Control and Prevention laid out guidelines for primary care doctors prescribing opioids to treat chronic pain. Essentially, these guidelines stated that opioids should not be the first line treatment for pain, and that other methods should be tried first. Which is perfectly sensible.

But when it came to dosing and duration, these guidelines — not laws — guidelines, started to become widely misinterpreted. We don’t need to get in the weeds of morphine milligram equivalents here, but what wound up happening across the country is that doctors, medical boards, and even legislators took the guidelines as black letter law. And clearly mistook the intended audience for the guidelines: primary care providers. Not pain management specialists, primary care providers. The one you might go see for a wellness check up or if you have strep throat.

Why is all this important? Aren’t prescription opioids, after all, the very substance that ignited a massive wave of overdose deaths across the country? It’s not so simple. Well intended efforts to reduce everyday people’s exposure to high doses and long durations of opioids started to hit the wrong target: patients with chronic, intractable, debilitating pain.

And we have an excellent guest, civil rights attorney, writer, and advocate, Kate Nicholson. Kate has been a critical asset for the pain community, who has been speaking up about how policy intended to help is actually causing more harm. She has consulted on several Democratic presidential candidates, including Bernie Sanders, Julian Castro and even Joe Biden.

Follow Kate Nicholson on Twitter @speakingabtpain

Follow Narcotica on Facebook, Twitter and support us on Patreon. Your support is appreciated! We’re on Spotify, iTunes, YouTube, Stitcher and more. Tell your friends about us!

Producers: Christopher Moraff, Troy Farah, Zachary Siegel 
Co-producer: Garrett Farah
Music: Glass Boy / Garrett Farah / A A Aalto
Photo: U.S. Air Force photo illustration/Tech. Sgt. Mark R. W. Orders-Woempner // Edit Troy Farah

The post Episode 39: Pain Patients Are Still Fighting For Their Lives with Kate Nicholson appeared first on Narcotica.

Public officials have been yelling from the rooftops that there’s an opioid epidemic. Yes, an obscene number of people are dying from overdoses, many of which involve opioids. But they’re not quite right. Researchers who really get what’s going on describe what’s happening to the U.S. drug supply over the last few years as a mass poisoning. Were it not for potent fentanyl analogues being sold in heroin markets, many, many lives would be spared. 

That’s where the concept of a safe drug supply comes in. Troy and Zach speak with Dr. Mark Tyndall, a professor of medicine at the University of British Columbia, and the founder of My Safe Project, a vending machine that dispenses hydromorphone pills, otherwise known as dilaudid. Mark says this program is saving lives. We cut through some of the bullshit arguments about diversion, “enabling” drug use and other pearl-clutching fears, but also talk about safe supply for stimulants and benzos, and how this program is already changing lives.

Follow Dr. Mark Tyndall on Twitter @DrMtyndall

Follow Narcotica on Facebook, Twitter and support us on Patreon. Your support is appreciated! We’re on Spotify, iTunes, YouTube, Stitcher and more. Tell your friends about us!

Producers: Christopher Moraff, Troy Farah, Zachary Siegel 
Co-producer: Garrett Farah
Music: Glass Boy / Garrett Farah
Photo: PXFuel // Edit Troy Farah

The post Episode 38: Dead People Don’t Recover — The Importance of Safe Supply with Mark Tyndall appeared first on Narcotica.

It’s difficult to write about drugs without being steeped and schooled in the discourse. Cultural tropes and conventional wisdom dominates the space. Drugs are anthropomorphized as the enemy. People who use drugs are described as manipulative and selfish, unless, of course, they’re “clean.” Often there is little empirical research cited and the same old voices are quoted saying the same old thing. Writers may think they’re being empathetic when really they’re reinforcing stigma, criminalization, and the very narratives that propel dangerous policy in the first place. 

At Narcotica, we look out for people who do things differently and like to hear them out. For this episode, co-host Zachary Siegel sits down with culture writer and journalist Kate Knibbs, whose writing about drugs and harm reduction stands out as uniquely humanizing. Approaching drugs and harm reduction from culture angles, Kate’s work tells us about the way live now. Their conversation focuses on two stories Kate wrote while working at The Ringer. First, the bizarre story of a music blogger at Vice who was caught smuggling a lot of cocaine. Then, they shift gears and discuss a piece about supervised consumption sites. Kate and Zach both get deep, and talk about the aftermath of friends and loved ones who overdose, and the impulse to search for accountability and punish people.
Follow Kate Knibbs on Twitter and look out for her work at WIRED, where she’s now a staff writer. 

Follow Narcotica on Facebook, Twitter and support us on Patreon. Your support is appreciated! We’re on Spotify, iTunes, YouTube, Stitcher and more. Tell your friends about us!


Producers: Christopher Moraff, Troy Farah, Zachary Siegel 
Co-producer: Garrett Farah
Music: Glass Boy / Garrett Farah
Photo: Nick YoungsonCC BY-SA 3.0Alpha Stock Images Edit Troy Farah

The post Episode 37: Covering Culture and Drugs with Substance with Kate Knibbs appeared first on Narcotica.

An opioid overdose can be a terrifying experience. When too much of a  drug like heroin or fentanyl floods the brain, it can cause your  breathing to stop. Sometimes you wake up, sometimes you don’t. But  there’s a miraculous drug called naloxone or brand name Narcan that can  reverse an opioid overdose and save your life.  

Today’s guest is Ryan Marino, an emergency room physician and medical  toxicologist at Cleveland University Hospitals. We discuss moral  hazards about naloxone, one of the most important drugs on the planet,  but also buprenorphine, competitive antagonists for benzos and  stimulants, and dispelling drug myths on social media. 

How to Get Naloxone by Zachary Siegel in VICE

Also visit: naloxoneforall.org

Follow Ryan on Twitter.

Follow Narcotica on Facebook, Twitter and support us on Patreon. Your support is appreciated! We’re on Spotify, iTunes, YouTube, Stitcher and more.
Tell your friends about us!


Producers: Christopher Moraff, Troy Farah, Zachary Siegel
Co-producer: Garrett Farah
Music: Glass Boy / Min Y Llan

Photo: Naloxone via Wikipedia / Edit Troy Farah  

The post Episode 36: Moral Hazards and Naloxone, A Toxicologist’s Perspective with Ryan Marino appeared first on Narcotica.

Magic mushrooms are having a bit of a moment. Some scientists are bending over backgrounds investing in psilocybin research, which is getting huge accolades from the FDA, while a decriminalization movement is slowly sweeping the nation. At least two towns have made psilocybin arrests the cops’ lowest priority.

But how do you prevent a mushroom trip from going sour? In this episode with author Michelle Janikian we enter the world of tripsitting, or watching over someone while they take powerful psychedelic drugs, in this case psilocybin mushrooms. Janikian is the author of the new book, “YOUR PSILOCYBIN MUSHROOM COMPANION: An Informative, Easy-to-Use Guide to Understanding Magic Mushrooms.”

**As with all our episodes, this is not medical or legal advice, it’s just a brief intro to the topic, please do your own homework and be safe.

Follow Michelle on Twitter: https://twitter.com/m00shian

Order “Your Psilocybin Companion” here: https://ulyssespress.com/books/your-psilocybin-mushroom-companion/

Some excerpts from the book:
https://doubleblindmag.com/how-to-trip-sit/

https://realitysandwich.com/325410/challenging-trips/

https://www.playboy.com/read/bliss-your-heart

Extra resources:
https://zendoproject.org/training/

https://www.decriminalizenature.org/

Follow Narcotica on Facebook, Twitter and support us on Patreon. Your support is appreciated! We’re on Spotify, iTunes, YouTube, Stitcher and more.
Tell your friends about us!


Producers: Christopher Moraff, Troy Farah, Zachary Siegel 

Music: Glass Boy / Min Y Llan

Photo: Psilocybe tampanensis via Wikipedia / Edit Troy Farah

The post Episode 35: Holding Space — The Values of Trip Sitting with Michelle Janikian appeared first on Narcotica.

President Richard Nixon ignited the War on Drugs in 1971 by declaring drugs “public enemy No. 1.” Over the ensuing decades, the U.S. has turned the Drug War into a vital feature of its vast empire, exporting a drug policy of militant enforcement and harsh criminalization in Mexico, Latin America, South America, and beyond. Exactly how this war plays out––its victims, villains, and profiteers––is the subject of journalist Antony Lowenstein’s vivid new book, “Pills, Powder, and Smoke: Inside the Bloody War on Drugs.” On Today’s episode, co-hosts Troy Farah and Zachary Siegel interview Lowenstein about what he saw on his journey chronicling the Drug War in countries like the Philippines, Australia, Honduras, and the U.S., among elsewhere.

You can follow Antony Lowenstein on Twitter and buy his book here.

Follow Narcotica on Facebook, Twitter and support us on Patreon. Your support is appreciated! We’re on Spotify, iTunes, YouTube, Stitcher and more. Tell your friends about us!
Producers: Christopher Moraff, Troy Farah, Zachary Siegel 
Co-Producer: Aaron Ferguson 
Music: Glass Boy / Monplaisir
Photo: Linnaea Mallette / Edit Troy Farah

The post Episode 34: “Inside the Bloody War on Drugs” with Antony Lowenstein appeared first on Narcotica.

Aphrodisiacs are powerfully attractive for a reason. Sex is, after all, crucial to the survival of our species and it feels fucking amazing, so using chemicals that can make sex last longer, feel better or otherwise enhance the act is going to be like candy to a bunch of horny primates.

But the term chemsex—using drugs, or chemical enhancement, to prolong or alter sexual experiences—is actually specific to the gay community, or men who have sex with men. Drugs used have included methamphetamine, Viagra or sildenafil, cocaine, the anesthetic GHB, mephedrone (also known as ‘bath salts,’ although that’s a broad term), ketamine, and amyl nitrates or “poppers.”

Our guest today is David Stuart, who has spent decades as a fixture in London’s gay community. Stuart is an independent social worker and activist who actually coined the term ‘chemsex’ in the 1990’s. Stuart has witnessed the fundamental changes in the gay community as homosexuality has become more acceptable, but fleeting internet-based hook ups became increasingly ubiquitous, and in some cases fraught with potential medical and mental health risks.

You can follow David Stuart on Twitter and learn more about him at https://www.davidstuart.org/

Follow Narcotica on Facebook, Twitter and support us on Patreon. Your support is appreciated! We’re on Spotify, iTunes, YouTube, Stitcher and more. Tell your friends about us!
Producers: Christopher Moraff, Troy Farah, Zachary Siegel 
Co-Producer: Aaron Ferguson 
Music: Glass Boy / Monplaisir
Photo: Linnaea Mallette / Edit Troy Farah

The post Episode 33: Party and Play—An Intro to Chemsex with David Stuart appeared first on Narcotica.

The single biggest driver of the overdose crisis today is not oxycodone or heroin: It’s fentanyl. Drug trends around the world are always in flux, and a wide-range of nebulous supply-and-demand factors are always in play. But according to “Fentanyl, Inc.,” a sprawling investigation into the global supply of illicit fentanyl by journalist Ben Westhoff, the advent of fentanyl is not driven by user-demand.

Rather, the prevalence of illicit fentanyl, largely produced in China, is part of a larger material history involving free trade, technology, and a web of complex geopolitics. On today’s show, co-host Zachary Siegel interviews Westhoff about his new book, diving into thorny topics that went unmentioned with his interview on NPR’s Fresh Air. They discuss how Westhoff gained access to a clandestine lab in China, the prominent role that America’s War on Drugs has played in producing deadlier, more potent drugs that no user actually really wants, and finally, that in order to save the lives of people using drugs, the US must adopt innovative harm reduction strategies that have been tested around the world, like supervised injection sites and drug checking.
Follow Narcotica on Facebook, Twitter and support us on Patreon. Your support is appreciated! We’re on Spotify, iTunes, YouTube, Stitcher and more. Tell your friends about us!

You can buy Fentanyl, Inc. here.
Producers: Christopher Moraff, Troy Farah, Zachary Siegel
Co-Producer: Aaron Ferguson
Music: Glass Boy, Chad Crouch
Photo: Pixabay / edit Troy Farah

The post Episode 32: How Synthetic Drugs Conquered the Globe with Ben Westoff appeared first on Narcotica.

Safehouse is safe, for now. On Wednesday Oct. 2, a federal judge in Philadelphia ruled that a supervised injection site proposed by the nonprofit Safehouse would not violate a provision of the Controlled Substances Act, known as the “Crack House” statute, authored by none other than Democratic presidential frontrunner, Joe Biden. On today’s episode, hosts Troy, Chris, and Zach are joined by Philadelphia Inquirer’s Abraham Gutman. Gutman has been cranking out fiery editorials in support of harm reduction, criminal justice reform, and tons of other topics for Philly’s biggest newspaper. He breaks down the complicated legal, political, and social implications of the Safehouse ruling and what comes next. 

You can follow Gutman on Twitter and read his work here. 

Follow Narcotica on Facebook, Twitter and support us on Patreon. Your support is appreciated! We’re on Spotify, iTunes, YouTube, Stitcher and more. Tell your friends about us! Producers: Christopher Moraff, Troy Farah, Zachary Siegel 

Co-Producer: Aaron Ferguson 

Music: Glass Boy 

Photo: Holden Blanco 

The post Episode 31: Supervised Consumption: Narcotica Breaks Down Safehouse Ruling with Av Gutman appeared first on Narcotica.

Doctors are often blamed for prescribing America into the opioid crisis. Their reckless actions, relying on opioids to relieve just about every morsel of pain, ignited the deadliest overdose crisis in history, so we’re told. Of course, the narrative around doctors is much more complex than that.

But one truth is inescapable: Without doctors prescribing methadone and buprenorphine, and taking care of some of the most marginalized people in the health care system, like incarcerated women, there is no end to the crisis in sight. Meet Dr. Kimberly Sue, the medical director of the Harm Reduction Coalition, and a leader in addiction medicine. Dr. Sue wrote a new book, Getting Wrecked: Women, Incarceration, and the American Opioid Crisis. In this episode, co-host Zachary Siegel interviews Dr. Sue, and they talk about women’s self-determination, the brutality of incarceration, and they imagine a world where women are treated humanely, not criminalized. 

Buy Dr. Sue’s book: https://www.ucpress.edu/book/9780520293212/getting-wrecked
Follow Dr. Sue on Twitter: https://twitter.com/DrKimSue

Follow Narcotica on Facebook, Twitter and support us on Patreon. Your support is appreciated! We’re on Spotify, iTunes, YouTube, Stitcher and more. Tell your friends about us!
Producers: Christopher Moraff, Troy Farah, Zachary Siegel
Co-Producer: Aaron Ferguson
Music: Glass Boy, Pictures of the Floating World

The post Episode 30: Getting Wrecked with Dr. Kim Sue appeared first on Narcotica.