148: Are Fentanyl Dispensaries a Good Idea? (Sort Of)


Ever heard of a fentanyl dispensary? In Vancouver, Canada, they now have a maintenance program that dispenses fentanyl instead of alternative medications. There are a lot of feelings about this, positive and negative. We talk about whether this is a good idea, if the implementation seems to be ina  useful way, and how this could impact the struggle with opioid use disorder. We also mention how many people are confused by the idea that this is a treatment for “addiction,” which it is not. Further, we address some of the concerns around giving people drugs, taxpayer costs, etc. Listen in as we explore ideas around harm reduction by talking about a pilot program that gives people fentanyl. Listen in and share your thoughts with us. 

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Email: RecoverySortOf@gmail.com

Episodes mentioned:

Compassion

Moms in Recovery

Marriage

Spiritual Bypassing

Big Book Update

Voices of the Abstinence Movement

Alcoholism vs Addiction

Chronic Pain

Article used for this episode: New York Times

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Transcript:

recovery sort of is a podcast where we discuss recovery topics from the perspective of people living in long-term recovery this podcast does not intend to represent the views of any particular group organization or fellowship the attitudes expressed are solely the opinion of its contributors be advised there may be strong language or topics of an adult nature

welcome back it’s recovery sort of i am jason a guy who believes in free drugs for everyone and i’m billy i’m a person in long-term recovery and i’m jenny and i’m a person in long-term recovery too and we are going to be talking about an article uh that comes from our media but that is about a new program of harm reduction methods in vancouver and we will get around to that just shortly but we do have some recap to go through so we got some feedback somebody said we should do an episode this was holly actually on being sick in recovery not necessarily long-term illness but rather the average colds etc that you get she’s ill with a cold at the moment and the symptoms mimic withdrawal and it is a mind [  ] i struggle with that a lot in my recovery like probably the first eight ten years i don’t know like but yeah i always every time i was sick that was like the most pressing time in my mind where i thought drugs would fix this because it did it felt just like being you know having that that kind of dope sick ill feeling i’m wondering i guess that doesn’t apply to alcohol did you get sick feeling when you didn’t have alcohol not like you guys did so maybe that’s like a heroin specific problem i don’t ever hear about people like smoking weed and getting sick and i’ve never had i mean when i’m sick i’ve always felt like i’m sick i’ve been through heroin withdrawal but i just didn’t make that correlation like maybe it’s like an inability to tolerate that that illness feeling or that i don’t know huh that could be interesting i i honestly ever since she said it like i i feel like it’s super valid but i never feel like i figured out any way to make it better like no good information to give on it i have no clue what we’d talk about but maybe maybe that’s where my lack of compassion comes in because i went through it’s like well just suck it the [  ] up get through it you need that couple of days ain’t gonna kill you uh another person so this is on spotify i guess we get to put up the question what topic would you like to hear more about and they can answer um so somebody used that method to reach us and answer but it wasn’t about a topic and they are apparently their name is music dreams which is kind of cool uh i will say again i love your podcast very helpful and i laugh throughout these thanks again so thank you music dreams

laugh at each other yeah that’s for sure another piece of feedback we got from stephanie who did an episode with us at one point a long time ago you were here i think is she the mom yes okay that’s what the episode was i just re-listened to that did you okay well stephanie reached out after listening to the married and recovering episode uh she says number one jen’s voice is like a warm hug i know it’s so [  ] hard to argue with her um and two when stephen is about stephanie when my husband and i met we were at different stages of recovery but we had the same values and goals i had negative one day and he had over a year lol but we both had the same goals so it was easy to stay on the same page most of the time and when we went through tough times it wasn’t the end of the world and we made it back without burning it all down she said it was awesome to hear the different perspectives and once again she was wrong about a few things and that’s great thanks to you guys um you know when she was sharing that with me it brought up an interesting piece for me like we are always talking about and i guess i thought this was what was going to come out in that marriage episode like these rules like you have different home groups and keep your recovery separate and you know 13th stepping is a terrible thing and i think that is a thing we think generally 137 is terrible and then jen came on that episode and was sharing all these couples she knows that you know if we wanted to technically apply the 13th step took place in those relationships and they’ve worked out great and so i started wondering like okay is it possible sure people are out there taking advantage of newcomers and you know preying on them or however we like to frame it yes that is absolutely possible that that’s happening but if you really think about it if i came into recovery and i have no idea how to live in the world and i’m like coming from a dangerous survival place if i was to you know quote unquote shack up with somebody who had a life based in recovery i’m kind of putting myself in an extremely safe environment for my first couple of months in recovery you know what i mean like maybe that’s like the most ideal place a newcomer could be is in an environment that’s kind of already established to be a safe environment right a home that doesn’t have drugs and alcohol laying around with a person who goes to meetings every night with a person who’s got all friends who don’t use substance like that seems like a really healthy place to be so i was like i don’t know man maybe not that the 13th step is a good idea but i’m like maybe there’s positive stuff right and it’s more the behavior not necessarily the overarching you shouldn’t get in relationships thing because if you’re out preying on people that are new that’s very different than trying to enter into a relationship with someone that doesn’t have a lot of time like those two things are different it’s danger i mean it’s definitely difficult to be in a relationship early in recovery no matter what because the tendency is to put that relationship ahead of your recovery and then you know you don’t stick around it’s hard enough for new people to stick around but and i’m sure you’ve seen it i’ve seen it over the years that happens with people with time i mean people get four or five years of time and hook up with someone else with time and then they get married and have kids and they stop [  ] coming around like the same exact thing happens but we don’t call it 13 stepping you know 14 seven right it’s something else i always thought people got in relationships like 13 step relationship it’s because they’re not they should be spending the time looking into themselves and yet they’re exploring this other person so that’s why i thought yeah and like in our case so that’s jen and i were i had a couple months clean when her and i got together and she had 12 years but the point that i tried to stress there for me was i didn’t put that relationship ahead of my recovery like i still went to meetings all the time i still worked on myself i did all the things i would do if i wasn’t in that relationship i just added a relationship into my recovery program i didn’t supplement my recovery program with that relationship and that’s why you’re a winner yeah that’s why it worked um i don’t know i guess this could be a whole other side conversation right which maybe we do need an episode on the 13th step you know but this idea of like we say people are preying on newcomers and when you say that you’re picturing this like i don’t know maybe you’re not picturing this this is what i’m picturing i’m picturing this like older guy he sits in his basement and like he’s got these pictures on his wall like plotting out like oh yeah she came in this day she’s got six days that’s that’s probably a good target next right you know what i mean like it seems so so convoluted when we talk about it like praying on people and like really in my understanding what’s going on more than that is that you have an individual that really struggles to tolerate life and feelings and their nervous system and they go with what works for them whatever coping method has ever brought relief and that happens to be new relationships or sex and so they run through new relationships and sex trying to keep recreating that relieving feeling so it’s not like this terrible monster out here plotting to steal our little girls right it’s more just somebody who’s trying to they are there that’s the scary part i don’t know does that even exist or 100 i don’t know i could well we talk off air i tell you a few of them i mean there’s you know those people exist too and unfortunately we’re in a fellowship with a lot of mentally not well people and people that are emotionally not well so they make some really predatory type decisions like those i guess my take on is just looking at it from the outside what looks like a predator and prey situation is probably a lot more just this person doesn’t know how to handle their life and this brings them a sense of relief like that’s why we do things we do them because they feel good i don’t think i don’t think it looks in that person’s brain and body the way we’re picturing it looking from outside of the view that’s i guess my take on it but i don’t want to get too lost in that yeah well somebody with 10 years you know like sobriety or clean time you know that doesn’t make them sane they could still be very deep in their sickness you know just because they’re abstinent from substances right so that happens but i think the idea is more of a you should know better kind of thing like if you’re that person you know you could go to prostitutes or somewhere else why are you going to pray on young new vulnerable people that are coming into our fellowship like it’s not the idea isn’t that you have a sexual issue so that makes you a horrible person it’s that you’re and it goes back to the compassion thing like this is our tribe this is our group and we’re supposed to be protecting and loving each other because we’re all the same and yet you’re a person that’s going to come in here and take advantage of you know that’s funny because not weaker but you know that sounds like oh we got to take care of our own but those sex workers that haven’t made it in here yet go ahead and use that i guess the thing that’s interesting is you talked about we think people should know better and yet one of the pieces of literature that always stuck out to me and i i want to say it’s in the step working guide maybe not but it says are you plagued by the idea that you should know better and what i’ve always taken out of that is that no and better has never been our [  ] answer we knew better before we got into drugs i knew heroin and cocaine and shooting it into my veins was a terrible idea but knowing better never fixed me so it’s interesting that we say once we get to recovery oh well no and better now should have fixed you you should have stopped doing that i don’t know that we say it should have fixed you but it there’s you just there’s certain behaviors like you don’t just be like well you’re sick so that’s fine you know what i mean like if you’re stealing the home group money we don’t just go oh well you’re fine you can keep being the treasurer just keep stealing the money that’s fine like you say no you have some issues there you need to address you know what i mean we’re gonna try to protect ourselves from you because you do this we should try to do it without judgment and like hey that’s what we do we [  ] steal money you know we can do it with empathy and love but you don’t [ __ ] hand them the keys in the bag of money again and go we’ll do better next time you know no bad people just bad actions right well i want to move on to this next comment because it’s good for me so so dave who’s joined us for a couple of conversations one of them uh the most recently the spiritual bypassing topic which was a really good episode uh he commented on our youtube a couple weeks ago and said nice guns jason thank you dave i appreciate someone noticing dave’s like hugging a rock too so it feels even better coming from him i’m not gonna lie he’s a solid dude uh so now the the really interesting one that i i am curious of your guys takes on it so so disappointed in your episode on the a.a big book especially the two wives i found your comments based on ignorance being a wife and a long-term al-anon member this chapter while it does use old-fashioned language is solid advice for partners or wives of alcoholics often an alcoholic will use their partner in numerous ways to keep the illness strong and continue to drink so the advice given is helping partners to avoid being part of that i nagged scolded threatened left him came back begged a huge range of strategies and nothing worked to get him sober because his drinking wasn’t about me or within my control i couldn’t love him sober or hate him sober what i didn’t realize was that i was part of the cycle there’s an interesting pamphlet maybe you should read to help you make more informed statements a merry-go-round called denial the wives or partners of alcoholics are often quite sick too and often addicted to their partners in the drama and misery that surrounds them so this advice is the

b-i-g-n-o-r maybe that’s supposed to be a big book this advice in the big book is given to the recovering drinker and it’s about navigating this new family situation it’s of its time but i was able to relate to it this time to this time to my life my relationship and my family and it worked for us and many others this fellowship has given many addicts and alcoholics their lives back interesting that they say addicts has given many alcoholics and addicts their lives back and also their families get a chance to recover from the trauma please consider your words carefully if your words had influenced my recovering alcoholic partner then my family would not have the peace and love it’s had for the last 10 years please be careful and do your research you seem like an intelligent enough person thank you so much i mean i i what i do appreciate is that this is more of a thoughtful comment instead of just saying that was a dumb episode that was stupid the big book is great like there’s actual thought yeah no so i appreciate that and you know even though it seems slightly backhanded the you seem like an intelligent enough person was nice but i i yeah i don’t know i guess so can i say i i would need to re-listen to the episode i mean for me it was the issues were around the old timey language and this sort of sexist idea that the alcoholic was always the male and that the stay-at-home person was always the female like to me that was kind of what i thought we were laughing at most it wasn’t necessarily specifically the information in how to handle it if they updated it with partner or spouse or whatever and took out some of the gender specific roles and gender specific stuff and updated some of the you know or some of the words that were i can’t remember some of the funny old-timey words that they use at the moment yeah it was like a sock hopper totaling and you know these weirdos

but yeah so i don’t i mean there’s a lot of great information in the big book well and and you know coming from that standpoint of what you’re saying like this is great that it helped a wife of someone in aaa right there her situation kind of matches what i guess it would have looked like in 1939 but how many husbands are saying oh yeah man i read the two live section and it totally felt relatable to me too and it helped our marriage my alcoholic wife i’m an ally you know what i mean like they would probably say this if anything made me feel more pushed away from the program so it’s great that it fit for your particular situation it’s almost like you know uh me coming in here and saying you know i did some i don’t know just some off-the-wall stuff man like i i go outside and bury my head in the dirt every night for five minutes and like that has just created such great change in my life maybe it did but that doesn’t necessarily mean it’s a practice that we all want to go out and do right or maybe it was just some me setting a routine and a goal and then i did it and that’s the part of it that actually mattered and it wasn’t actually having my head in the dirt that made any difference at all you know what i mean like it’s just claiming that something worked because it worked for one person or it worked for me or worked for a million people that’s great but what if it didn’t work for 30 million at the same time we don’t i feel like we forget to look at the other aspect like hey this worked for millions but what about the countless millions that didn’t work for because it’s the way it is right i mean and again i thought when we kind of joked about it it was about maybe updating it or or changing it in a way that was more inclusive and more helpful for more people like it doesn’t mean that information’s bad it’s just maybe limited or presented in a way that there was some information that was bad though yeah yeah i remember like they were more familiar um but like i think jason pointed out like there was one tip in there that was like you know don’t leave your husband yes exactly like and like you know back in those days like if if your husband hit you it’s because you know you you were sass mouthing whatever you know like right you know and so that doesn’t fly today you don’t sad no no i i’m totally on board with jenny like i think a lot of it was the fact that it’s not inclusive for sure the wording but there was also the aspect of like i seriously as a therapist questioned some of the [  ] guidance in there i was like this is setting people up to get hurt because i read it before we did that i’d have to go back and read it again yeah i don’t remember the specifics either and that’s where i think i would challenge this individual personally like okay fine you don’t think the language needs to be updated that’s fine i think that hinders people from getting the information in 2022. maybe you don’t that’s okay we disagree but i would definitely challenge them that some of that information really seems dangerous in the light of the world we live in today and that’s where i’m like i just can’t get on board with saying two wives is a positive section the way it’s written if they rewrote it if it was two partners if it had you know hey make sure you protect yourself first before you worry about your [  ] alcoholic partner then maybe i’m on board but the way it’s written yeah so i appreciate your comment i love the comment i love like i i enjoy this kind of conversation so right and and you know i mean there’s a couple little jabs in there but i i don’t think i’m giving bad information but i appreciate the check right gave me time to rethink about it so thank you guys as always for the the feedback we love it it helps us understand what we’re doing and you know tackle these subjects for maybe places we didn’t think about so all right on to the topic of the day vancouver canada forefront of like at least in our western environment doing what we would consider wild crazy new ideas to see what can help the opioid epidemic right they’re they’re tired of seeing people die from overdoses and i guess it seems at least in that region of canada if not in canada in general maybe there’s not as much pressure because they’re not the you know they’re not the number one country in the world they don’t have to be like the world’s leaders or anything so they can just kind of play around with [ __ ] and see if it works i feel like better than the us can like we feel like we have to hold on to this moral standpoint or something like are we the moral police of the world uh we try to be yes i mean we dictate to other countries drug policies and stuff based off money and financing to them for you know i i believe there’s some or there used to be some things in place to where if your country ever decriminalized drugs or legalized drugs you know we would reduce funding or say we wouldn’t support you and not give financial so yes there’s some of that that goes on too the difference in canada too is the socialized medicine so the the government is more in charge of how it’s spending that there’s like they have more money to play with right to decide so who wants to describe the the fentanyl dispensary well can i also just mention briefly too if that book in the realm of hungry ghosts that’s actually written from a doctor that worked in that whole area of vancouver and it gave a pretty interesting to me an interesting insight from an i’m going to say an outsider pointer he’s not an outsider but he’s not an addict either it wasn’t an addict who’s giving you their representation of something this is a medical doctor who worked in that environment and his experience and it isn’t specifically about this topic but it gives you some insight into what’s going on in that part of the country and their country and it’s interesting as a guy who’s not a drug addict he does identify so much with the process of obsession and compulsion in his life in different ways his it’s like classical music and he kind of jokes throughout the thing of like you know how can this be as bad and yet he has all these similar feelings and ways of acting and sneaking and like hiding his cd purchases of classical music from his wife some of the criticisms of the book where he tried to relate in that way and that people found that offensive because if you’re a heroin addict who’s like spending all your money that that which i found funny because i didn’t take it offensive at all as an addict i thought like it’s a person trying to relate trying to connect see i felt like it was even more than that because and and the guy the author’s name is gabor mate for anybody’s interested in reading any of his work he’s got a pretty good book on adhd as well uh and another book that he just wrote that i haven’t read yet um but he it feels like that was part of his process of coming to this place of compassion was identifying in right was being able to realize that like every human if they look hard enough has this behavior mechanism it’s just that some of us i guess don’t need the escape in this drastic of form maybe and i feel like that’s what led him to see like we need to address this differently because we’re all kind of like this so anyway not to get too far off but that’s a good book to give you some point of reference for what’s some pretty major harm reduction strategies that they’re trying in canada well and the the people we talked to uh were from that general vicinity i don’t know they were directly in vancouver um on that episode that we did what what was that even about i don’t know it’s about harm reduction methods and how they feel like the abstinence voice doesn’t have enough voice in this area so who wants to describe the program i mean is that oh you guys are looking at me jenny’s gonna have a nice voice thank you i hope i do a good job i wasn’t prepared for this part but so we’ll uh we’ll mansplain anywhere we’ll fix it appreciate that guys um so the city of vancouver has a space like an indoor space and people uh i’m not sure how they qualify for the program can come in and get fentanyl dose four times a day to maintain their with you know just prevent withdrawal and it’s a clean environment and i think they have to so the drug dose is measured i’m not sure how they test to see how much you need but i remember it’s it’s near the end of the article i think they talk about they start you at a pretty low one but then they monitor you over time and like they bump it up to where it prevents the withdrawal symptoms from happening okay yeah i think that’s similar to what they do with methadone as well you go in and you figure out what your dose is and it’s individualized right i was shocked how much this many

yeah i was looking at my notes to see if i had that sample okay so here it is he receives 30 000 micrograms of fentanyl that dispensary each day that is vastly more than would kill a non-user a doctor would typically prescribe about 50 micrograms 50 micrograms versus 30 000 micrograms so this was a multiple decade user and that was featured in this article i don’t remember if they operate 24 7 but if you can come in four times a day i guess you know at least 6 a.m to 9 at night or something right and um that’s that you want to mansplain the rest yeah well more or less they’re giving out medical grade fentanyl yeah it’s free i forgot that yeah but that’s but it’s all it’s not free they have to pay for it it’s ten dollars a hit yeah just like it is what it would be but they do say that they’re funded to cover anybody who doesn’t have it but like what they’re hoping to see and what i think they’ve seen in a couple of cases and because this isn’t technically the first place that’s doing it but they’re very limited um and hopefully the idea is once you are stabilized enough that you don’t have this daily battle of like how am i going to get more money how am i going to get the next hit how am i going to do this that you can go and work a job and then you can pay for your hits at ten dollars a piece yeah and the idea was that if it’s cheap enough or at least matched what the cost was on the street that you wouldn’t turn to street drugs like if you know obviously for most addicts money’s an issue you know coming up with money to support your habit is hard so if you can keep it cheap as it would cost you on the street you’re more likely to go to the program and i guess the biggest issue too is it’s regulated so you know what you’re getting every time it’s not like tainted with other things because that’s what kills a lot of people and then so by managing this program you are needing ambulances less police less and reducing crime in the area though reading through the comments people who live there say not so much but we’ll get into that i guess in the show um but the point is is redirecting the funds from emergency like too little too late into hey let’s prevent this death or crime and that’s what i got out of it right the the idea is number one save lives people are dying because they don’t know what the [  ] they’re doing right and when i say don’t know what they’re doing they don’t know what they’re purchasing on the street they have no idea the concentration of fentanyl in it fentanyl has you know exacerbated the opioid crisis by leaps and bounds because people don’t know how much they’re getting and if you get a little too much it’s it’s the end of your life and so step one save lives these peop the the theory is people are not going to stop using until they’re ready whatever that means you know we say that a lot i don’t even know what the [  ] it means but they’re not no matter what you do we can beat people we can moralize with them we can lock them in a basement like they’re generally just not they’re going to find ways to use so let’s prevent death and then the secondary you know thing is it stabilizes their life so maybe they can actually live and function in society and then i think you know from the compassionate standpoint the third thing but maybe this is the seller to the taxpayers is that it costs way less because it costs less to treat it up front than it does to overburden your health care system down the line you know when your grandmother’s having a heart attack there’s an actual ambulance that is available to come get her because they’re not taking care of the 48 people who are overdosing at the same time in your town yeah and to me it i mean when i read it i it didn’t seem like a huge deal like i’m like yeah it’s another uh like a maintenance medicated assisted treatment program like to me what’s the difference between what drug we give them i mean when you’re a hardcore heroin user you know or now fentanyl user i guess that’s the thing now like that’s what you want so why you know if you’re just going to tell them well we won’t give you that but we’ll give you something else well [  ] that i can go get fentanyl on the street like that’s what i’m going to go get because that’s the best you know and and it didn’t seem like anything overly shocking to me i was actually kind of taken aback when you shared that with me the other day i was because i didn’t think of it that way i was like this is a big deal we’re giving out drugs to people right but like we’ve already been giving out drugs to people we give them methadone we give them suboxone we give and abuse like we always we’ve been giving people stuff forever like why is it different depending on what drug i don’t know it feels different we moralize the dr again it gets right back to what you know we always do we moralize like the drug is the problem you know and like an alcoholic is somehow different than a you know weed smoker is somehow different than a heroin user is different you know it’s like no the underlying symptoms of a person in chronic use disorder are the same and the symptoms are a lot the same and the consequences are a lot the same the treatment is a lot the same you should have been there for that alcoholism versus drug addiction episode because yes the the only difference we came up with was that society looks at them different that was it that is why the person who needs another glass of alcohol isn’t out there sleeping with somebody to pay for it because it’s legal and cheaper and yeah now one of my concerns with this particular program and i’ve heard this in other medicaid assisted treatment programs is that by the government or the states providing substances to people you actually drive the street costs down making it cheaper and more affordable which theoretically opens the market up to people that otherwise wouldn’t be in the market i mean i don’t know how realistic that is but the idea is that by you know putting cheaper more affordable drugs out there that drives the street price down that sounds like the most ridiculous bunch of [  ] can you imagine that you’re sitting at home and you’re like oh my god honey drugs just went down to five dollars a poppy we can afford them now let’s go get high well i don’t know that that’s going to encourage new users but it’s going to make this bigger supply more you know i follow yeah if if you could pay so you’re saying the street drugs are going to be cheaper than the government funded drugs yeah because if if i’m a drug dealer and i know you can go to the state and get medical grade safe you don’t know what i just cut the [  ] out of my stuff with right stuff why would you want to come to me like oh they’re charging you 10 well i’ll give you mine for five you know like and they’ll deliver yeah and you don’t have to be on a program or nothing you can just call me whenever like that’s the idea now and i don’t know that making them expensive is the answer because that’s kind of stupid then people will just go to the street guy anyway but that was you know that was one of the concerns that i read and i just i thought it was interesting i was like yeah i can i mean i can see where they’re coming from i just don’t know that that’s means you shouldn’t do it i think the hope from the government by free drugs was to put um like crime dealers out of business but it sounds like you know that’s going to come first the phase you’re talking about would come first before you put them out of business yeah the problem is that those programs aren’t implemented near to the level of demand that we have for the street drugs these this state runner federally run programs aren’t near enough to meet the need well um i have a question you know alcoholic here non non-hard drug user would you guys want to do this program if you were still using it again would you want to go like shoot up in a mcdonald’s i never wanted to do any of the maintenance programs but only because i was like i want to get high when the [  ] i want to get high i don’t want to have to be somewhere at a certain time and report into a place that was just me i mean i had friends that did it but i would sleep in their [  ] alley i would love this well that’s one of their problems i guess and it sounds like that’s what’s happening that is exactly what’s happening that doesn’t take away from your high like being watched and monitored and like sitting i okay don’t know never been there yeah see and it did for me like that’s like i like using it in a like partying type environment i just i like using around other people i typically i wasn’t a person that like went and hold up in a cd motel and use by myself like that’s just not the way that i used i use way more in social environments social settings billy’s not a real addict wasn’t hardcore i was like medium core media core heroin user i love it um i don’t know i’m picturing like if if i knew if say the food industry was not regulated and mcdonald’s had burgers for five dollars but you weren’t really sure what the [  ] they were making them out of or you know for all we know it’s soil and green like ah who knows and then you know the government steps in and they’re like man there’s a lot of unsafe burger eating going on people are [  ] dying we’re going to create u.s burgers that’s the new fast food joint and our burgers are ten dollars but it’s definitely safe i’m probably going for the safe burgers as long as i can afford it like marine i’m not choosing i’m like i don’t know about that five dollar burger the [  ] am i getting but what if the mcdonald’s had a fun land but there’s no fun lane at the government i mean does mcdonald’s ice cream machine work because then maybe i’m going maybe i’m getting that shake that i don’t know what’s actually in it who knows or just you know again without knowing the specifics in this case like can i just go there whenever i need to or want to like or or are there limited times and hours and again they are saying you get four four doses a day right what if i won five well if i want to smoke weed or do some other drugs this episode has been brought to you in part by voices of hope inc a non-profit recovery organization made up of people in recovery family members and allies together members strive to protect the dignity of those that use drugs and those in recovery by advocating for treatment harm reduction and support resources and mentoring please visit us at www.voicesofhopemaryland.org

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one of the things that stands out to me about this program that i guess contradicts my my old theory of like we need to just have big warehouse environments where there’s beds and you just give out whatever drugs people want all the time but you can’t take them off premises i like that idea but this this idea they’re going for the idea that once we stabilize people’s lives they can rejoin society right and then maybe that rejoining society that connection helps them want to do something else besides the drug right and my version doesn’t have that and so i wonder how much my version actually perpetuates addiction because everybody’s still isolated in this warehouse or whatever and not part of society again and i believe it was uh chasing the scream uh the guy gives the history of cameron’s name at the moment but he gives a history of you know the war on drugs and leading up to the war on drugs and he actually talks about that like we used to have it where you could go get drugs from a doctor and that’s what people would do you would go see a doctor you get i think it was morphine back then or medical or whatever the drug was and you would just go get morphine from the doctor but you were expected to still like be a functioning person in the world to have a job to take care of yourself and all that stuff and it just was looked at differently before the war on drugs came about and moralized it the way that we do now so we just need to give everybody a card for everything you got your medical methamphetamine card your your medical mushrooms card whatever you need well and just some things i thought about i don’t know like i guess because it’s the biggest overdose risk but we tend to talk about like maintenance programs or like this type of program to keep people from overdosing from fentanyl but they really seem to only address opiate specific disorders they don’t address other forms of addiction as much you know and so when we look at maintenance programs or any mats or whatever i don’t know that they’re a solution to addiction in general they’re more of a limiter on opiate overdoses like unless i think wording that’s important because addiction still happens in all these other ways whether it’s sex or alcohol or you know cocaine or now it’s adderall and a lot of those kind of drugs you know those people are still dying and suffering as well you know maybe not as fast or as noticeably as opiate addicts but these maintenance programs aren’t a solution to addiction i i think that is a good point i was trying to think through it when you were saying that i’m like well alcohol doesn’t need it because it’s already monitored by the government and available for purchase so i feel like that doesn’t need a replacement therapy because it’s already legal marijuana i’m just trying to picture marijuana maintenance programs right i’m like marijuana’s not harmful you don’t need to [ __ ] worry about that one that is like how would you have like a cocaine or methane like i’m picturing uppers because that’s the ones who like have a strong addictive quality to the nature of how they operate in the body and yet don’t tend to have like that physical withdrawal worry about you know your medical health you know what i mean like you can come off of cocaine you’re not you’re probably not you’re not gonna die like that’s not what happens in cocaine withdrawal but they don’t die coming off of opiates either you die using them i thought you could possibly have seizures or something coming off opiates and that’s why the detox had to be so monitored could be but that’s not most majority of the death i mean you could technically can die overdosing from anything because your heart could stop but you know it’s just not what’s common is this an issue too like um one of the comments kind of alluded to this like from the article was that this is how we treat the poor people we give them maintenance programs like if if it was a cocaine user that you know that’s more like an addiction for people who have money and they would go to like a rehab and get help that way and this is just kind of like this is one of the comments was like this is how we treat our poor people instead of giving them real recovery help so this becomes one of my criticisms and i am a huge supporter of uh harm reduction and harm reduction strategies and techniques it actually the idea kind of first came up on our uh interview that we did with the people from canada and it’s that just providing harm reduction with no sort of recovery involved is not helpful like that’s actually you know to use the word enabling which i kind of hate that word but to you know you’re just enabling someone or just allowing someone to use freely until they die and like i never looked at my drug dealer who was providing me with drugs and maybe needles or whatever else i needed to get high and thought they have compassion for me because they’re giving me drugs you know so if we just have these programs that are like hey here’s some needles here’s some drugs have at it you know have fun i don’t know that that’s can i i mean i get where the the idea is right you know the idea is we want to save people’s lives but if you’re not trying to lift them up out of that or provide some sort of recovery supports whether that’s i mean maybe your recovery supports aren’t abstinence-based maybe your recovery supports are hey we think you need to talk to just this guy a therapy you know him call him a therapist whatever you need to check in with joe once a week so that joe can just talk to you see how you’re doing make sure you’re healthy make sure you don’t have any wounds you know just whatever there are different little interventions you could do with that but i don’t think just handing people drugs and saying hey here you go you know use that’s good like i think that’s not enough and then you’re like joe who joe mama

that’s who you gotta talk to boy get your [ __ ] together but i think that’s the danger of you know if we just say yeah here’s some people just give them some drugs they’ll be okay like no we need to provide treatment services no matter if they are poor people or obviously if you have money typically more resources are available and are we providing those same resources to the people that are on these types of programs so that they can get the same kind of you know mental health or whatever is their other holdups maybe it’s financial stuff maybe it’s housing is vancouver doing that is it so i i mean i hope that bank this place in vancouver is also offering alternatives to the way out one of the big arguments against this article when we were reading the comments was who’s going to hire these people if they’re using drugs four times a day you know they want to help them get on their own feet by getting work but who’s going to hire somebody who’s high you know what kind of work could they really do and i’m just playing definitely i see a lot of high people working at jobs i mean they could do our podcast

they’d be great and i’m just playing devil’s advocate because you know i’m pro harm reduction right but um but seriously like the one dude in the article um using 30 000 micrograms a day what kind of work could he really do i mean i know you have to start somewhere but we really need a total package like this is nice but how do we it’s got to fit into a bigger puzzle when they talk about these programs the idea is that you’re not supposed to be like he shouldn’t be nodding out high when he walks out of the door like the and it’s the same with methadone or whatever at least the way that they’re presented is that the right word like the the way that they’re presented is we just want to get you stable like the idea isn’t to get you so [  ] high that you can’t move you know okay so you stabilize and that way you’re able to function because when you’re in a severe withdrawal like you don’t even want to get the [  ] out of bed like you hurt you’re sore you’re you know unable to do much so i’m kind of dumb because i didn’t actually know that like we’re just getting like not having use like opiates myself like i didn’t know that we’re just getting to like a place of stability you know like so i think with me as an example educating the public is part of this we need to do part of that solution like tell the employers like they can you know they can work you know if they got in a partnership with you know certain like warehouse jobs or whatever like they can work we’re just getting them high enough to like is that even the right word high enough we’re just getting them stable so they’re not in dopesick withdrawal and someone coming in new who’s coming off the streets who has no coping skills who is in a severe place of trauma and stuff like they might need to be high as [  ] like that might be what they need for hopefully temporarily like you know but again there should be some goal of like stabilization reintegration into society how can we sort of help navigate those things what are your needs um and when those pieces aren’t there that’s to me where harm reduction can get a little muddy because there are places the more i’m gonna say radical harm reduction places are just like no you just [  ] give them like whatever they need to use with no judgment no criticism no strings attached no nothing you just here this is for you go live how you want to live i i guess i don’t know and maybe this is my tainted view or maybe i haven’t even thought through it enough but just when you were talking about that idea of like we’re just giving them drugs and there’s nothing else to help them recover or whatever i’m like but isn’t that kind of the first step on the road like just to get them stabilized like maybe you know you introduce it you’re like hey look we’ve got these modes of recovery right there’s total abstinence over there we have 12-step programs or smart or you know recovery dharma that can help you achieve those and some of those could also help if you’re just interested in a more moderation attempt like possibly smart recovery or recovery dharma could assist you with that like maybe they’re okay with that and they don’t have specific rules about abstinence or clean time and but then there’s these other methods like where we provide you know uh maintenance medications and maybe just stabilizing someone is enough like maybe once i don’t know i’m picturing and it god forbid i cannot for the life of me picture what it would have been like if somebody was just giving me what i needed drug wise

well i can’t picture what it would have been like but i feel like my entire day was centered around how do i get more and if it didn’t have to be there’s a [  ] ton of room in there for like well what else do i want to do and i guess to me that’s like well okay maybe that is step one and they they heard you talk about the other things right maybe they get there and they want that eventually but just getting them to feel like they can get through a day and they don’t have to have the total 24-hour focus on how to get more of this to get through the day i feel like that opens up a lot of space to be a first step in recovery oh 100 yeah and i guess maybe i didn’t say that well but that’s exactly what i mean with the guy that’s on the 30 000 whatever’s a day like maybe that’s where he needs to be to stabilize for now but i would think the hope would be that one like he’s still functional at that level i i don’t i’m not sure i don’t know the effects of what levels but let’s all do 30 000 milligrams and see what happens he’s not like that’s okay we’re not trying to tell him he can’t have that whatever it takes to get him stable but hopefully in six months a year two years whatever he stays on the program he gets that level to a place where he is functional and stable and whatever he needs to get him there whether it’s like say crisis intervention mental health financial assistance housing whatever you ever been getting ready to do a chore around your house like the dishes or something and you’re like even walking towards the sink and then somebody’s like oh hey can you do those dishes for me or kind of points out something about it now you don’t want to do it anymore it’s that same idea right as humans we have a thing called counter will it’s the best name we’ve come up for it but it makes sense when somebody wants to put what they want onto you there’s a desire not to anymore and so i feel like if we can eliminate that counter will right because that’s what we have we keep telling all these drug addicts or people with substance abuse or disordered use of drugs it’s like you need to get your [  ] together you need to get a job you need to do this and like counter will instantly kicks in whereas if you have the whole day free from figuring out how to get the next one and you don’t have this pressure of counter will of society happening in your body it’s like oh no it’s fine go ahead do what you need to do and then hopefully you can figure that out i feel like that gives you more room to figure out either a that you want to do something different or that b maybe you really don’t like the way drugs affect your life like i don’t have the space to even evaluate if this drug is good for my life or not if i’m constantly battling against everyone telling me it’s bad for me and that’s the instant thing that happens in a human when somebody when the whole world’s like oh no what you’re doing is bad what you’re doing is bad you lose the space to discover that for yourself you’re just constantly fighting no it’s fine it’s good it’s what i need and i believe that some of the uh ideas behind the more person-centered care like you talk to the individual and say well what do you want like what are your goals where are you trying to be maybe you’re going the next year to get your [  ] driver’s license that’s it okay let’s move towards that how do we help you get there maybe we just get you a driver’s license in the next year you know you let them pick what their goals are i mean and unfortunately i’m just a person that believes like there’s going to be some people that just want to be high as [  ] all the time and don’t want to participate in society can we just do that and there well we have that i mean don’t say we have that now but that’s i’ll talk to people like at my job about some of this because we currently have some homeless people kind of living in the woods behind my work is very recent and we’re on the end of this industrial park and this lady who looks like a mom or somebody comes and [  ] drops them off all the time and brings stuff out to them and it’s and they’re fairly young looking people and so we’ll get into conversations about some of that and the people at work they want to call the [  ] cops and all this stuff and i’m just like can we just leave them alone it’s not even our property they aren’t hurting anybody they aren’t bothering anything we have cameras up here if they come steal anything or do anything we’ll have it on camera like why the [  ] like it’s terrible like that’s a tragedy to me it’s sorry you know the people at work want to like moralize them and [  ] kick them out of the woods i gotta go somewhere else like we’re at the end of a [  ] industrial park there’s nothing back here there’s swamp back there they’re back living in a [  ] swamp but i try to express to them like they have just like they’re like why don’t they go to a program or a homeless shelter all those things come with rules and check-in times and you’re in the room maybe with 30 or 40 or 50 other people and you don’t have any privacy or any space you know they’re going to search through your [  ] when you come in every day like some people just don’t want to go through all that like it’s a hassle like they’d rather go live in the [  ] woods and be left alone and i mean to me it seems kind of sad i’m sure that’s not their ideal situation but if that’s where they are do we really have to punish them more like that seems so wrong well there you go you can tell your boss that uh in his efforts to make the world a better place which he believes in he needs some compassion training yeah we’re gonna go buy one of them tiny houses and [  ] drag it out there for him like here at least be in this game there you go compassion is contagious so you’ll be spreading it oh they would [  ] burn my car i would get in trouble they’re trying to get them out oh they’re sure they’re gonna come steal all our [  ] and they’re sure they’re from the methadone place down the street and all these judgments compassion training um i i guess you know where we were talking about with that like reading somebody’s comments it’s troubling to see health care workers and a government facilitate addiction like this you know preventing overdoses is important but it cannot be the sole objective in the larger battle against addiction the goal should be to lead these people back to healthy productive and happy lives giving away free fentanyl does nothing to really help them that’s where like i kind of disagree with that comment because i think it can be the stepping stone right do we want places along the way where they’re interacting with people and where people are being kind to them and where treatment is being mentioned here and there is an option yes but why are we trying to force that you need to get back to this healthy productive and happy life like why is productivity number one in all our well capitalism that’s why but yeah it’s like why do we even have to be productive why can’t we just live and be happy and why do we get to choose what happiness is right and you do see i mean i’m going to say a little more of that with the idea nowadays that’s you know become trendy and popular of like living off the grid and being out you know in nature and not being dependent on you know credit and the energy source and the food system like we are starting to get some hints that like hey maybe this machine that we’ve created isn’t the only way to do things right like maybe there are some alternatives and maybe that’s what some of these people wanted like they don’t want to be a part of our society or what we’re doing here and can’t that be okay why don’t we have like alternative societies available you know what i mean like oh hey you guys just want to live off the grid we totally got a estate for that like just drive out to [  ] wherever pre-loaders we got a state where people who just want to live off the land paying their fair share what words you want to hear the productivity thing stuck out to me too when i was reading through the comments so many comments were like productive members of society you know you kind of i wasn’t sure how i felt about that but um i think like in canada because of the socialized medicine if they’re going to take from the health resources such as um fentanyl or ambulances then they should be giving back so i get that there’s a trade you know like a trade there but i mean yeah if you want to be a hermit and live in the woods you should by all means be free to do that but an ambulance can’t come get you you know i’m not sure so i’m still trying to figure out how i feel about this but i understand what people are grumbling about in the comments i just don’t know how much emphasis i put on like the value of a human is how productive they are well and i think one of the comments you’re talking about it’s like it’s usually something like when you’re ready to make the change okay how long are the rest of us going to have to wait and do it and pay for it and what about our quality of life and that’s like that sticks out to me because i’m like one you’re already paying for it and you’re paying 10 times the cost because we’re not doing it in upfront right right you’re paying for all the back end health care costs so to question whether you should pay for it you already are [  ] the difference right you’re actually paying less now that’s that’s what we’re trying to tell you and the whole what about our quality of life like my quality of life doesn’t go down because someone else is using necessarily i mean if it’s a family member it sucks ass if it’s a close friend it [  ] hurts but my quality of life doesn’t go down because people choose they want to do drugs somewhere else like right i don’t know that that one really bothers me some of the testimonial in the comments was like how dreary the blocks around this um dispensary have become like people on the streets uh like nodding out it’s just become like a hub for drug use maybe it already was yeah okay rowdy was yeah that’s why vancouver’s so drastic is because it already was a [  ] difference yeah i guess there’s like crime and you know like people sleeping on the street and going the bathroom on the street and like it already was but there’s the whole you know which came first the chicken or the egg because they have you know the housing programs and things that they have there they have a housing program that was basically set up to be like look if you’re homeless just come and we’ll just put you up in one of these rooms and it costs you nothing and you do nothing in the portland portland hotel society um and so they you know have different what we would call more radical programs but on top of that now there’s like a huge open-air drug market because you know typically people that are homeless or that need a lot of those services are suffering with addiction and mental health issues so it’s like when you build it that’s who comes you know so then that’s a centralized location it’s similar to what’s happening in skid row in la is the same way what la decided a bunch of years back is hey we’ll centralize all these services that we need for homeless and social security and all this different you know veterans benefits like we’ll put all that stuff into one area of the city well that’s where all the people that need those services come so now you have a huge tent city that’s blocks long because they don’t have the resources to travel 10 15 20 miles you know what i mean they need to be where the services are so if you were a person that had property in that area you’re now dealing with that yeah there’s there’s not besides the you know my version of the warehouse off in the distance that nobody ever has to be bothered with but you know that has its own drawbacks there there is a consequence to that but i i guess what these people are seeing and there was a comment about how while the person’s area that they’ve been living in for a long time didn’t look any different there was less crime and that’s what i thought was the fascinating when they’re like yeah it still looks pretty rough you know when you come into my part of town but there is way less crime because of all the not just from this particular intervention but all the interventions right the place to live and you don’t have to be you know quote unquote clean to live there like you can just live there for no good reason and use and do whatever you want lifestyle like those kind of things have created this environment that people don’t need to be participating in as much criminal activity to get what they’re looking to get out of their life and so i mean i i think there is that portion of it like crime does if you give everybody the drugs they need there’s no crime there’s really like literally almost no crime because that’s what crime is around it’s around getting money for more or selling it or getting it or possessing it or that’s what everybody’s locked up for yeah and there’s a something to be said for you know there are consequences to having a huge society that has a lot of needs and resources you know like when we talk about gas prices right now that are super high everybody [  ] and complains about gas prices but yet we haven’t built a refinery in this country since the 1970s they can’t really build one because we’ve set the regulations to be so difficult and every single person’s like yeah well i don’t [  ] want one in my neighborhood like i’d love cheap gas but you can’t build a [  ] refinery two miles from me [  ] that i’m gonna fight you every step of the way and unfortunately you know when we have these big societies with lots of people like mental health substance use you know traumatic experiences ptsd like all that comes with it and to just say well that’s fine but it needs to go somewhere else like you know that seems to be the attitude like we can be compassionate over there it’s not my backyard right i want to read this comment um vancouver did the math this was a comment on the new york times article vancouver did the math cheaper to provide addicts drugs and set up de facto government zone ghettos and provide the support the addicts need and possibly raise taxes so some of the observations i read in the comments for that well one this is just like a small band-aid on the problem because you need the whole system to support someone in recovery and the other part was that politicians are saying yes to dispensaries because people like it it’s you know like uh people are like oh good you’re trying but it’s actually not solving the problem like it’s it’s a it’s a political thing and it’s setting up these this person called government zone ghettos wow solving the problem to me is interesting because that’s part of the reason i brought up the different types of addiction um not everyone that’s a heroin addict wants to be on a maintenance program some people do and that’s fine i don’t i’m not trying to judge them but some people do want to be the [  ] off and they want to be abstinent and that’s fine too like none of these is a one-size-fits-all gonna fix the [  ] opiate problem that’s so true we have this conversation we should stop calling it addiction this is just like right this is okay this is a treatment for opiate use disorder you know is what this is that’s all that it is it’s not you know now again if there is a recovery program attached to it in some way shape or form then you might be able to call it recovery but this is treatment you know we get these words all intertwined but this is treatment for opiate use disorder like a medical treatment for an opiate use disorder recovery can mean a whole lot of things and typically encompasses a lot of the services that that comment made and i think the two of those things together are the best situation you know one without the other is sort of pointless well and i do think we as a society especially people maybe not as in the mix as people like us you know they’re just your average everyday guy out there or gal normies yeah there is not going to be this thing that comes along that solves or fixes addiction it’s just not going to happen there’s not going to be a pill there’s not going to be a practice you’re not going to it’s not going to be prisons it’s not going to be free drugs none of this is going to solve the problem of addiction that is like a whole other if there is a quote-unquote solution for this it’s going to be in like changing the way we are as a society fundamentally on a level over like 100 years that’s going to be the solution so i’m hoping for aliens what i feel like i mean me personally i feel similarly about crime crime isn’t about bad people it’s about typically poor people that are desperate to try to survive and so they’re doing what they got to do and there are some other types of crime you know that are different but right the large part of people that are in these types of situations committing crimes are just desperate well i guess i just think maybe if we can move away from this idea that we’re going to solve right the problem right maybe we can attack some of the separate little problems like hey first let’s just stop people from dying because right that’s a great [  ] priority right and then from there let’s think about other things that can possibly shift to make an environment where these people might want to stop right let’s make them maybe let’s motivate them to want to be part of it you know if you talk about systems theory and family therapy we always have the the scapegoat right one of the children in that family dynamic is the scapegoat they’re the ones who are causing all the problems according to everyone else in the family but the therapy world views that as they are the person who can’t tolerate the dysfunction in the family system as a whole and is going to speak up for everybody about it like other people can ignore it they can just you know well i’m just going to work you know i’ll leave that family dysfunction at home whatever they have their escapes but this one individual is like no i’m just not going to tolerate this and i’m going to say what nobody else is saying even though it doesn’t look like that it just looks like they’re causing problems and so to me that’s exactly what’s happening with this like a lot of us in society are willing to overlook the ways that we don’t act very family oriented or or very nicely towards others right we ignore [  ] homeless people we ignore all the problems in the world we don’t help our struggle and neighbors whatever it is and these people are like those scapegoat children who are you know screaming in a way there’s a [  ] problem in the way we live and the rest of us are just kind of ignoring it and i think you know it was that idea was kind of proposed in the realm of hungry ghosts right they’re like the people who are unwilling to tolerate this way we live and most of us go along with so the burdens on all of us is what i’m trying to get at right you don’t fix that family system by helping that scapegoat child get better you fix the whole system everybody’s got a part to play and acting differently that creates things and i mean i have watched this in my house my daughter was obviously the scapegoat right running away doing all kind of crazy behaviors and we have had a family [  ] shift all of us and she’s now back home with us and things are going well and it’s like damn was it all her all along right it sure seemed like it was going on but maybe it was all of us and we all had to change a little to make it work and i guess i just view this problem the same way these aren’t terrible people these are people screaming that there is something [  ] wrong with the way we live yeah and i guess this goes more towards the compassion like at what level do we all feel a responsibility to help make our communities better you know i i don’t know there’s not an easy that’s an individualized answer and for some people it’s [  ] nothing i don’t owe anyone anything they need to pull themselves up by their bootstraps i would argue that that’s i think what we’ve been trying for a while and that doesn’t [  ] work you know or at least overall it’s not worked or maybe it’s not and again i maybe i’m wrong it’s worked for some people there are a few people that come out of those situations they find they get empowered for whatever reason pull themselves up by their bootstraps go on to college but that works for a very small percentage of people so that’s okay for some people some people are going to need a maintenance program some people are going to need an abstinence program some people just need some mental health addressed and then they’ll be okay and some people are just going to use till they [  ] die like that’s just it’s a broad problem that comes from a lot of places and there’s going to be a lot of solutions yeah this idea that we look at this is better or that’s better or that doesn’t work or this works you know they can all work if they’re done right and and here’s what you need to know in that people you can either spend 10 times the amount of money trying to pay taxes that supports your your local hospital situation and jails and all these things and also have some of these people who are just going to use forever coming and stealing off your [  ] front lawn right and you’ll feel morally right yeah or you can pay a tenth of that price and just give them drugs they don’t steal your [  ] i don’t know like why do we have such strong opinions about what other people need to do out of fear um yes beer so do you think that what’s going on in vancouver is this still an experiment or is this like fact you know this this scene so it’s hard to say because maintenance programs are so i’m gonna say dependent but they’re they’re the evidence is so dependent on the program itself like what is what is the program set up to do and how do we measure successes you know what is a success what is a failure because i know like around here on some maintenance programs you can be on a maintenance program and you can still come in and test dirty for other drugs and continue on that maintenance program so you know i does that just mean okay you’re better because you’re doing less street heroin but you’re still doing street heroin so your risk of death is still very high you know what i mean so is that a success or not and i don’t know i’m not saying it is or isn’t i’m just saying it gets complicated on what are we saying as a success or are they a success just because they’ve been on a maintenance program for a year you know i don’t yeah it’s tricky you know it’s it’s tricky but i think any of these programs that are supplemented with some sort of care and compassionate interventions for recovery are gonna benefit i think there’s evidence to that and if you’re looking at just research i mean they’ve done some of these pilot programs this is again another pilot program it’s only like there’s a hundred yeah it’s like 100 people it can hold so there there is evidence that these types of programs have shown in you know these uh trials to at least if nothing else lessen overdose deaths yeah right so that’s why they keep implementing them and keep trying them and keep grabbing the research but i feel like even to call them a success like some of the comments say like you know oh the idea of success that’s laid out in this article is addicts who’ve been using for decades and still have no jobs and aren’t doing anything and they’re like well that’s not success well and it’s like what are we measuring is it just the fact that we’re keeping people alive because i there’s definitely people in the comments who and i’m not saying that they’re shitty people from this perspective but they’re like why people should suffer from their own consequences that’s what works well in fairness i wonder that sometimes too i mean i can’t parse out how much of the legal consequences or you know that stuff moral failures that i felt whatever i hate to say it that way but the shame and guilt that i felt from you know being moralized like i don’t know how much that contributed to my desire to change my life you know i i can’t honestly say and i i don’t know that moralizing and shaming people is right i don’t think that’s right yeah but it’s like that that pain does motivate some kind of change it does but i i feel like every time and i’m with you i can’t go back in my life and do something different so i can’t know for sure but when i look back at when consequences have helped me change it’s when the consequence felt bad for me not when other people said this is bad here you’re going to be punished for it right like nothing i did as a child that i got punished for that i thought was fine because i was just having a good time never did i think oh i’ve learned my lesson from that i learned i don’t want to get caught next time right right it’s only when i encountered that thing of like oh this doesn’t feel good for me that’s when i’ve changed and that’s why i feel like this whole idea of consequences falls short like somebody else putting me in prison for something i didn’t think there was a problem with that never that didn’t make me think i needed to be different made me think i didn’t like prison but and for myself a large part of like i knew or you know unquote new what i was doing was wrong and it didn’t feel good and it didn’t feel like the way that i wanted to live but nobody was proposing things that felt helpful or no one was asking me hey what are you trying to do here like all it felt like people were saying was like look just stop doing these drugs and go get a [  ] job and you know and it was okay go to treatment for 30 days and when you get out don’t get high anymore and you’ll be fine and it’s like well duh thanks that way of living [  ] hurts like that sucks i feel like i’m in pain and i don’t want to feel like this and when i take this substance i feel better and if your only solution is stop taking the [  ] substance ah i’ll take the consequence

yeah some opponents to this program say that normalizing drug use um ends the stigma and shame of addiction and there’s like you know there’s big movements to end the stigma chain of addiction but they think that that will keep people in addiction and i don’t i don’t know that that’s true but by like a certain amount of stigma or shame should be attached to addiction that motivate people to get out and i don’t i don’t know how i think i’m sorry enough to cut you off but i think people confuse uh addiction and drug use you know what i mean like they’re to me there isn’t necessarily anything wrong with people that can use drugs and function in society like that should be okay i don’t know why that but i think we tend to think oh if you do cocaine you’re a [  ] addict who has a problem like people i’d argue the heroin thing people say there’s recreational heroin users i’m not saying they don’t exist i’ll report back i don’t know that you know i’m just saying i never met juan or saw one i know people that recreationally drank or recreationally smoke weed or whatever those are a little easier to pick out but just because someone does illegal drugs doesn’t make them an addict i want to walk you guys down this kind of thought experiment thing that happened to me and see if we can wrap it around to change our view on this or maybe change somebody else’s view okay so i i read this article headline a couple months ago and it said something about like research has found that most suicides aren’t attributed to mental health and i thought it sounded absurd i was like who the [  ] takes their life and in their right mind right who would not see that like this feeling won’t last or it’ll get better or life is worth living whatever i’m like you would have to be suffering from a mental health crisis to want to end your life right so i was like really fascinated so i i asked my coworkers in our little online chat i was like what do you all think about this we talked it through a little bit and we kind of came up with this example of like okay so who could take their life and everybody in the u.s would kind of think oh i i get it that makes sense to me right when could we ever have that instance and we thought of like a prisoner of war okay you’re a prisoner of war you’re getting brutally and viciously tortured every day for a year and you decide you just you’d rather not be here and you end your life and we felt like pretty much everybody in the u.s is going to agree with that like oh i get that right you’re getting brutally tortured of course yeah with no hope of it ending totally understand why you would take your life that’s sane it’s a sane decision now why do we think that anybody that takes their own life isn’t also being tortured brutally every day and in that level of pain so now every suicide becomes a sane event because obviously if they’re feeling that same internal feeling that the person who’s a prisoner of war who’s getting brutally tortured having their teeth pulled out their fingernails rip right so everybody that commits suicide must be doing a sane thing and i felt like that shift in that was like oh [  ] and i feel like that kind of applies to this like we have this moralistic view that suicide is wrong right but it’s because we can’t see the unspeakable pain that people are in even though we understand it when it’s given an external situation and from that lens i’m like why can’t we just give people [  ] drugs if they’re in that much pain without them we can’t see it we wouldn’t hesitate if we saw their [  ] leg broken and mangled to give them you know painkillers we’d be like oh my god they need that so why can’t we just understand that that’s exactly where these [  ] people are or they wouldn’t need it right i i mean i think the debate would be your argument could be that there are other ways to deal with that pain that are better you know like the prisoner of war taking their life is a way of coping with that but maybe you know i don’t know escaping is a better option or having hope yeah i’m just saying and i’m not saying i agree i’m just saying there are people that would say giving them drugs is not helping it’s actually making it worse and that what they need there are other interventions that might be better than that so would we do that if we saw somebody in a in a terrible car crash who was like clinging to life and obviously very much in pain because maybe some of their [  ] organs are hanging out from the accident would we ever say would we ever say well maybe there’s some other interventions besides pain medication that we should give them well what i mean is like let’s pray over them no yeah well what else means like with with like there are other forms of pain management than just giving opiates like that’s not the only form of pain management available there are other things people can do for pain well that’s definitely what we do when people are in crucial pain and arrive at the hospital so if we’ve got better methods why aren’t we using them that’s a good question a lot of people will ask why don’t pharmaceutical companies invest more money into alternative medications there are out there there’s research that shows that they are out there but that’s not where the money’s invested the money’s invested in the development of pharmaceuticals opiate specific pharmaceuticals and now fentanyl whether you’re on the conspiracy thing because it’s cheaper easier whether somebody just flip the coin one day and decided that’s the road they were going on and now that’s hard to say but there are other medications out there that are not opiate-based and there are other pain management programs that aren’t based on giving out opinions do they all work in the moment same way opiates do like i could understand i mean we had the guy on for chronic pain pete and talking about like what he could do over a long period of time to alleviate his pain but there wasn’t anything on day one like he had to be well in pain that i’m just making some stuff up now this isn’t based but there are some i’m sure like pain coping strategies like hey maybe you need to be a little bit uncomfortable like that’s alleviating all your pain might not be what’s best for you even though that feels the best that might not be what’s best for you well i guess what i what i hope with that thought experiment is if we can understand any situation where this action might be necessary why can’t we work back from that and understand that maybe it’s necessary way more often and we just can’t see the internal situation that we said externally would absolutely justify us doing this like if we can see in a situation where we’re like oh yeah you should definitely give that person drugs they’re in [  ] pain i can see i can see the external situation and why if we can believe that why can’t we also think [  ] maybe that exists inside people and i’m just not aware of it and maybe they need that same help yeah we don’t make that connection and i guess that was kind of groundbreaking for my mind when i thought about the suicide in that version i was like all suicides are crazy and then there’s one situation where they’re they’re not that’s the same decision and then i’m like well [  ] doesn’t that make all of them sane if people are feeling that i can’t imagine being sane when you’re getting viciously tortured daily but i still i’m i still get your example like um but i would say if somebody living with like in like a prisoner of war living with no hope i don’t think you can be sane in that situation and that’s the situation i would say everyone that is using drugs in a way that is unmanageable and and bad for their life that’s exactly what they’re feeling inside they are a prisoner of war in their own body right and i i agree with that i’m just saying the solution to that may not be just give drugs to all of them no it’s suicide obviously no well i mean

about that right yeah i don’t i don’t know i think to me it just it it’s a different way to think about it yeah we can all think about it that way uh any any final thoughts i’m all for it i mean i think the more programs we have out to help treat addiction the better you know it’s it’s not like the problem is getting any better we saw with covet addiction overdose deaths are up right another issue we’re not going to talk about it too much here but fentanyl is also in [ __ ] everything now they’re fine in adderall pills and all these other things so you know how that’s affecting overdose deaths is crazy potato chips this type of program won’t really fix that unless you want to tell someone who’s addicted to adderall that now they need to go get on a fentanyl program i mean you know there’s some hairy stuff there that i’m like i don’t know if that feels so good but you know this is just another potential solution to a huge problem that needs more solutions okay oh i’m all for this like progressive stuff i bring up the devil’s advocate stuff just so we can discuss it but i mean i mean i still think this isn’t an experimental face but i’m all for it let’s find out how this goes because this is like the best thing we got going okay there you go uh if you got any thoughts or feelings about the fentanyl distribution program up there in vancouver feel free to reach out we’d love to hear your opinions too and we will see you soon

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