The Drug Report
The Drug Report
Exclusive Harm Reduction Approaches to Drug Policy Aren't Working
Can a balanced approach to harm reduction and recovery really save lives? Join us in a thought-provoking conversation with Tom Wolf, a member of the Recovery community from San Francisco, offering a raw and unfiltered critique of today's drug policies. We scrutinize Vancouver's harm reduction model and its alarming overdose death rates, while Tom passionately argues for recovery-focused solutions in the face of new proposals advocating "safe" drug-use spaces and other radical drug provisions. This episode sheds light on the crucial need to integrate more sensible harm reduction interventions with prevention, treatment, and recovery initiatives for a more humane and effective drug policy.
Dive deep into the broader debate on drug policy strategies as we question advocates' desire to legalize all drugs, scrutinize the opioid crisis, and expose the cultural influence of big corporations on advocacy. With Tom's powerful insights, we explore how recovery voices must lead the way in policymaking. Listen as we highlight real-life advocacy successes from San Francisco and discuss the vital role of individuals in recovery in shaping policies that truly address addiction. This episode is a comprehensive examination of the pressing issues in drug policy, offering a blueprint for a balanced and recovery-centric approach.
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Yes or no? Do you believe nicotine is not addictive?
Speaker 2:I believe nicotine is not addictive. Yes, Congressman, cigarettes and nicotine clearly do not meet the classic definitions of addiction. I don't believe that nicotine for our products are addictive.
Speaker 1:I believe nicotine is not addictive. I believe that nicotine is not addictive. Hello everyone, this is Luke Neferatos. I'm your host of the Drug Report podcast. Thank you for joining us. Before we get started here with our special guest, I want to thank our two co-sponsoring organizations SAM, smart Approaches to Marijuana and the Foundation for Drug Policy Solutions. You can check out learnaboutsamorg and gooddrugpolicyorg, as well as our Drug Report website where you can sign up for our twice weekly newsletter, thedrugreportorg.
Speaker 1:So I've got Tom Wolfe back on the show with me today. For those of you who listened, about a month ago we had him on and had a great conversation. But I wanted to bring him in because there's been a lot of stuff happening in the harm reduction the extreme harm reduction space, and he's had a lot of thoughts on Twitter and X about this that are getting a lot of play. But I wanted to give him a chance to kind of expound on the podcast. So, tom, he's from our paper affiliate of the foundation and he lives in the San Francisco area. So, tom, thanks for joining us.
Speaker 2:Well, thanks, luke, it's good to be back and yeah, there's a lot of stuff that's been happening in the last few days in the harm reduction world where they've kind of exposed themselves to show us what their true intent is, and we're seeing some really disturbing trends around that and around things like the Denver City Council kind of following suit with some of the stuff, without actually talking to people in recovery like myself, without talking to people like you that offer a more nuanced and pragmatic perspective on drug policy.
Speaker 1:Yeah, I agree, and I want to get to the Denver Proclamation because that's close to home for me, but I think, conceptually I'd like to start actually with the news that more recently came out of this concept paper that was released on kind of the principles of harm reduction. Tell us who did this and what this was about.
Speaker 2:Well, I'm not 100%. So first of all, it came out as part of a report. It was a conceptual set of ideas on how we can support drug users. It came out of Vancouver, out of their harm reduction lobby up there, which is kind of dictating a lot of drug policy up and down the West Coast. Believe it or not, we've had numerous people from San Francisco, from politicians to nonprofit CEOs to people that run drug treatment programs go to Vancouver to learn their model, to try to emulate their model here in San Francisco, which is pretty crazy given that Vancouver has the worst overdose death rate in all of North America.
Speaker 1:They're failing worse than everyone on overdoses.
Speaker 2:That's right. Vancouver is unequivocally, unquestionably, the epicenter of the opioid and overdose crisis in North America, period end of story. And yet they employ the most permissive harm reduction measures and policies that you could possibly do with, everything from supervised consumption sites to safe supply programs of hydromorphone or Dilaudid for folks. And look, british Columbia, whether you like it or not, just broke all its records last year, all of its previous records last year, for drug overdose deaths, and they have 40 supervised consumption sites in their province. So you can't sit there and tell me that the policies that they're implementing, which completely turn away from recovery as a solution, from treatment as a solution, you can't tell me that their policies are working because the data just doesn't support it, or that anybody should be emulating them?
Speaker 2:No, no, not at all. I mean, we've done a lot of work in San Francisco to change the narrative here, to focus more on recovery. Here, to focus more on recovery. We even got our current mayor, who's running for reelection, talking more about abstinence-based treatment as a solution and how, that we want recovery solutions to go alongside some of the harm reduction measures that we're taking, and you have to understand that. Look, I'm not anti-harm reduction. Harm reduction is a tool. Yeah, it is a tool. It is a tool to help people with the and what used to be part of the philosophy of harm reduction. It would be a tool to help people stay alive in the hopes that they find the miracle of recovery. That last part has been taken out and now we're just stuck in this vicious cycle of just supporting quote unquote drug users.
Speaker 1:Yeah, and that being taken out, I think, is really personified by this concept paper. So here's a few things that are in this concept paper. I'm just going to read some of the headings Right drugs in the right dose for me. Being able to access safe, positive and welcoming spaces, ostensibly for drug use. Yeah, it says there should be physical spaces for smoking and injecting. Safe supply and other services are accessible to me. I can easily access my safer supply. That's pure drugs, crazy stuff. Talk to us about what's going on here, tom.
Speaker 2:Yeah. So look, it's packed with hypocrisy, and I understand that they're trying to help this subset of people that are struggling with addiction. But look, hey, I'm a formerly homeless drug user. I used to stick a needle in my neck, like everybody else, and shoot heroin and smoke fentanyl and all that. And so if you left it up to me in that situation as to you get to make the decision, tom, about what drugs are right for you, I'm going to want the strongest, largest batch of fentanyl that you can give me, because my goal in my addiction is to not only maintain my addiction, but it's to get as high as I can get.
Speaker 2:The nasty trick about addiction is that you get to a certain point when you're using drugs that the high is much, much harder to find, and it becomes more about just staying well is what they call it, not going into withdrawal or getting dope sick, and so that's the nasty kind of trick about addiction.
Speaker 2:And so, basically, what they're basically saying here is that we want the government to pay for drugs to give to these drug users just so they can stay well, and then, whenever they decide that they're ready for treatment, we'll be there and we can guide them in that direction. The problem is is that if you're struggling with fentanyl addiction and I said this today on X those moments, those aha moments, those moments of clarity where you're saying you're ready to access treatment, are few and far between, mostly because of the drug itself, because fentanyl metabolizes faster in your body, so you have to use it more often than you used to have to use heroin, so you have to use fentanyl every two hours now. So that window of opportunity to wake up one day and to say I am ready to go to treatment, those moments are fleeting at this point.
Speaker 1:Well, and you know that's also glaringly absent from this concept paper is the idea of them going to, ever going to recovery, never getting into treatment. Treatment is not mentioned here.
Speaker 2:This concept paper mentions the word treatment once and never mentions the word recovery at all, which also is very telling. And this is what I mean about. They're kind of like overplaying their hand now and showing themselves of what their true intent is, which is not recovery. Recovery is an afterthought. It's a bonus if you even make it there At this point. What they're focusing on is supporting drug users and destigmatizing their use and empowering drug users. And look, anyone in recovery from addiction will tell you that recovery 101, it's the first step in multiple 12-step programs is admitting that you have a problem and that you are powerless over your addiction. And so they're trying to take people that are powerless and empower them with more drugs. How does that solve the problem of addiction? It doesn't. And then there's a few other you know little hypocrisies within this concept paper when they talk about we need safe places for smoking drugs. Well, you know, in the United States we have something called the Clean Air Act.
Speaker 2:Right which we fought for decades to get Right. That's right. Where you know you can't smoke, you know no more smoking sections in restaurants. You can't smoke in the smoking section on an airplane anymore, like you used to. When I was a kid, I remembered the smoking section on airplanes. You can't have all that, but they want to make an exception for people to smoke their drugs, to be able to smoke inside in a ventilated area. Well, if they're doing that, how come I can't light up a cigarette. I can't even light up a of city property, of like city hall. I can't stand on the steps and light up a cigarette, but they want to make it so that it's okay for you to smoke meth or smoke fentanyl on a city funded site or a site that receives some kind of city funding in order for it to operate. It's a complete and utter hypocrisy, and if they're going to do that, then they've got to let people smoke cigarettes everywhere too. You can't have it that way and other substances.
Speaker 1:Yeah, that's right, and I see this as obviously counterproductive. And I think within our field there are a number of us that are somewhat educated on these policy nuances and these policy debates, but outside of our field, the average American out there, these ideas sound like complete, they sound like satire to probably, I would say, 90 percent of the American public, Like you're joking, right that we would do that. So question for you is you know where? I think for the average person that would listen to this podcast, where, where is this going? What? What are they trying to accomplish? Are they, are they saying that? You know, and I I have some ideas of the answer to this question, but I'd like you to answer this, just for kind of, the average person listening, who's saying you know, what on earth are we even talking about? Why are they pushing these forward?
Speaker 2:Yeah. So just to put it as plainly as possible for everyone out there, they want to legalize all drugs, which means they want you to be able to walk into Walgreens or your drugstore and purchase fentanyl patches next to the Tylenol and be able to administer that yourself.
Speaker 1:Under the idea of what? Preventing overdose? So basically someone can stay alive and that's basically the only metric. Is that?
Speaker 2:what it is. That's what they're proposing. But you have to look back into history. You have to look at the opioid crisis from the 1990s and the 2000s and how doctors and big pharma lied to the American public. They lied to the Food and Drug Administration and they over-prescribed opioids to the point that over 20 million people in the United States got addicted to those drugs and thousands of people died of drug overdose. So to suggest that giving out a legalized, pristine, safe supply is going to somehow reduce overdose deaths and addiction, I got news for you I got addicted to a legalized, pristine, safe supply of oxycodone through a prescription from my doctor after surgery. That's how I got addicted.
Speaker 1:Because drugs are addictive and drugs are the things causing harm, not the policies around the drugs.
Speaker 2:Well, I think it's both. I think you could say it's both. So, like you know, addiction doesn't discriminate, but our response to it can be discriminatory, but that cuts both ways. So you know, we talk about, oh, the war on drugs and we were too draconian in our enforcement efforts. Yeah, okay, that's fair. But you can also argue that this permissive kind of radicalized form of harm reduction, where we're just basically throwing in the towel, giving up on recovery and telling people that you can shoot all the dope that you want and in fact the government's going to pay for it and give it to you, is also equally harmful, but in a different way.
Speaker 1:Yeah Well, I think what's happened is it's been an overemphasis on yes, there have been harms from policy, but it's everyone's collectively forgotten in this, in this cohort of people that think this is a good idea, that the drugs are harmful too. There was a reason why these policy responses were put in place. Now we need to fix them and eliminate the draconian laws, but the drugs themselves are still a problem.
Speaker 2:Well, look back in the old West, in the 1870s, 1880s in the United States you could buy laudanum from a pharmacy and laudanum had morphine in it. And guess what happened? A bunch of people got addicted to it because it's addictive, so they banned it, right? You know? There's a reason. Like you have to like really think back through history and look at the North America's history, really the United States and Canada's history with drugs. You know we are a permissive drug culture here.
Speaker 2:It is in our culture to celebrate drug use. It's been in music since the 1960s about a variety of different drugs, and so our kids are growing up hearing that you know I'm smoking a blunt or I'm doing cocaine. You heard about it. I remember in the 80s they were talking about celebrating the use of cocaine in a lot of different songs, you know. But now we have something called illicit fentanyl that's out there on the streets and it's killing 108,000 Americans every single year.
Speaker 2:And if you look at the data again, in 2000, there were 17,000 overdose deaths in the United States. So we obviously have an epidemic in our country and we need to work towards changing the culture in our country around drugs, not to want a total prohibition, but to one that understands the health risks about using these drugs, not celebrating want a total prohibition, but one that understands the health risks about using these drugs, not celebrating the drug itself and trying to promote it and make it more easily accessible. And when you see these groups, these harm reduction groups, start to do that, like the Drug Policy Alliance, is a great example their ultimate goal is to legalize drugs, make no mistake about it.
Speaker 1:But when you look it's stated in their vision.
Speaker 2:That's right. And when you look deeper at that organization and you look at their funding sources, who's funding them? Big Tobacco, Big Pharma is funding them, the Soros Foundation. So you have to really look at who and what is behind the scenes. That's pouring all the money into organizations. To push a narrative like that.
Speaker 1:I couldn't agree more and speaking of pushing a narrative and the response to the overdose crisis. So we have overdose awareness day coming up and there's a whole week in honor of these victims, and we absolutely recognize and want to spread the awareness of this horrible tragedy, horrible crisis families destroyed, lives ended, people's potential gone. It is heartbreaking, it's horrible, it's something that we're all thinking about, we're all seeking solutions and so, you know, in the spirit of wanting to find real solutions, that's something we've been working on with Tom and others at the Foundation for Drug Policy Solutions, working on a blueprint for drug policy that we will be releasing, actually in September, with our comprehensive approach to start treating this crisis. So we're hard at work on that. And, to those of you who have lost a loved one, our prayers are with you, our hearts are with you.
Speaker 1:Now, unfortunately, in the context of this conversation we're having today, tom, the city of Denver in their attempt to recognize this day of awareness, they declared a proclamation formally recognizing Overdose Grief Day, and that proclamation was, regrettably, unfortunately, a reflection of everything that you just talked about, which is this idea that we are just going to focus all in on harm reduction and enabling drug use prevention, no mention of recovery. In essence, it feels like this movement has. All you know, there's a race to hoist the white flag on addiction and overdose, and they're doing it on a day where we should be talking about solutions to the overdose crisis, not talking about ways to give up on the overdose crisis. But that seems to be what was happening with this Denver City Council proclamation. I'd love to hear your thoughts on it.
Speaker 2:Yeah, I was very surprised to see that proclamation come out of the Denver City Council. I understand, you know politically where they sit and I understand where the current mayor of Denver politically sits. But at the same time, recovery is not a partisan issue. It's not a Republican thing or a Democrat thing, but permissive harm reduction policies is and has become a partisan issue. And so to hear the Denver City Council issue a proclamation that basically supports safe injection sites, safe supply programs for people and continuing to support drug users in perpetuity, without acknowledging the need for recovery, for drug treatment, to be funded at scale, or to acknowledge the fact that many of these decisions that they put into that proclamation around overdose prevention centers and safe supply have not actually reduced drug overdoses.
Speaker 2:And again, look to Vancouver for your data. You know people like to point to other countries in the world where they have safe injection sites, like Australia et cetera, and say, look, their overdose deaths are really low. Yeah, but guess what? They don't have fentanyl. Fentanyl has not arrived to their shores.
Speaker 2:And if you're in Europe right now and you hear this podcast, you need to buckle up because it's coming to you and when it does get there, everything that you thought you knew around. Harm reduction is going to get thrown out the window, and that's what we're seeing happening in Canada right now, and so much so that it's going to affect the political outcome of their elections later on this year in regards to who's going to be the new prime minister and all that. Harm reduction is one of the top primary issues up there. So to hear the Denver City Council issue this proclamation without doing any kind of research from anyone else except the harm reduction lobby, I mean it's clear who was in their ear talking to them about it, because if they had taken five minutes to talk to you or me, they might have inserted a sentence or two even that talks about the need for recovery and treatment.
Speaker 1:And think about how much better that proclamation would have been if they'd done that.
Speaker 2:I mean think about it.
Speaker 1:Yes, these are extreme policies that are failed. But if they at least said, look, we want a safer supply, we want injection sites, etc. But all in the spirit of recovery. And they had another one to two sentences saying all of these services should be geared toward getting people in recovery, helping them with their path to treatment, think about how much more inspiring that document could have been.
Speaker 2:Well, yeah, and it look it comes off as biased, right, so it's biased. That's not the only drug policy that's out there. Harm reduction is not the only drug policy that's out there. I mean, obviously, abstinence-based treatment is evidence-based. 12-step programs are evidence-based.
Speaker 2:Yet there was no mention or acknowledgement of the need for any of those things as part of the overall solution to the drug crisis. So again, it really makes me question who they were talking to and whether or not they've lost their objectivity on this issue. On the city council there in Denver and I have reached out to the mayor, mayor Johnson, on numerous occasions to come out to Denver and try to sit down and speak with him Governor Polis as well so that we can kind of try to move forward and find kind of a pragmatic, middle-of-the-road approach to the drug crisis that's really having an outsized effect in Denver. I mean, last year there were over 500 drug overdose deaths there and the number is not going to go down, no matter how many people that you house, unless you do something about the drugs and encourage people to access treatment. That's the bottom line.
Speaker 1:Yeah, and I agree with you completely and I think we just need a more optimistic and hopeful approach from policymakers on this issue. You know we can't just throw in the towel on, like you said, these evidence-based programs that are working. You know the 12-step programs. You have treatment programs, you have other recovery programs and there's a lot of paths to recovery. Recovery looks different from person to person, but just policies geared towards getting people towards some sort of recovery, however you define it, that at least is hopeful, versus saying well, you know, we are only going to like this proclamation says and like what the DPA and the Harm Reduction Action Coalition want us to do is only focus on harm reduction. That's all we're going to do. We're going to reduce the harm of drug use. That is such a disappointing and short-sighted narrative. We just cannot give up on people. We cannot give up on them. We have to give people hope.
Speaker 2:Yeah, not only that, it's not reducing the harm Like again, look at the data. It's not reducing the. I can't stress that enough. It is not reducing the harm. People are still dying in record numbers from drug overdose, despite the hundreds of millions of dollars that have been spent on harm reduction programs throughout the United States. I'm in San Francisco. Last year alone we spent well over $100 million on harm reduction programs syringe access programs, harm reduction-based evidence-based treatment. They even had a linkage center here open a couple of years ago. That was a supervised consumption site. And did the overdose numbers go down? No, the only time the overdose numbers went down have been the last two months here in San Francisco, and that's because we ramped up our enforcement and brought in the federal government and the Department of Justice to crack down on organized drug dealing. So that's the data. Those are the facts, right.
Speaker 2:And so, again, it's very disappointing that the Denver City Council obviously didn't consider all the facts before they issued that proclamation. I think they just did a nod more politically to the groups that were lobbying them. But at the same time, that's a warning or a message to people like you and me that you need to start showing up to people like you and me that you need to start showing up to city council meetings. You need to start speaking out publicly about your views on drug addiction If you're in recovery. There's more and more of us in the recovery community that have decided to toss out our anonymity and step forward and say, yes, I'm in recovery from addiction and this is what I think. I love people like that because, while I respect people's anonymity, it's also important that people that have made it to the other side have an opportunity to speak out and tell their story and have our elected leaders making policy listen, listen to our stories so that they can have a more balanced perspective.
Speaker 2:Because right now, all these policies, in that proclamation that they made, are all driven by academics. They're all driven by activists and many of them have had themselves. And doctors and many of them themselves have never used drugs to the point where it is developed into an addiction. So you know, I get a little sharper on social media and I suggest to these doctors and policymakers that you know what. You go out to the street and live on the street for a week, stick a needle in your neck every two hours to shoot fentanyl and then come back after a week and tell me what you think at that point, and of course they won't do that. But I'm just trying to drive the point home that lived experience matters and lived experience of people in recovery is what really matters, because when you ask a drug user what they think, of course they're going to tell you give me more drugs. The brain is hijacked.
Speaker 2:I mean it's nuts to me that they actually use data that they obtain from drug users. And then we found at the Yale School of Medicine that one of their researchers, dr McNeil, who got in big trouble a couple of weeks ago, was actually paying drug users for their interviews to get the data that he actually wanted. Giving money to a drug, to someone who's struggling with addiction for them to tell you that yeah, I need these drugs, or yes, your policy is good, is like it's nuts to me, like it's actually insane that you would actually give money to a drug addict so they can go out and purchase more drugs, just so you can obtain the data that you want to retrieve. That's what we're up against, that's what we're dealing with and that needs to change.
Speaker 1:Yeah, it's terrible. And so, to kind of bring this full circle, I love the optimistic, forward-looking message you have of getting people in recovery more involved. And I would take that a step further and say, for those in recovery that are listening to this podcast, you know now is the time to go to your lawmakers, your city councils all across the country and ask for proclamations for recovery, for treatment, for prevention that's what these proclamations so you know, two can play at this game. It can't just be the extreme harm reductionists out there going to every city council and getting proclamations done. We need to amplify our narrative of recovery, of a comprehensive approach, not throwing the baby out with the bathwater. On harm reduction, there are harm reduction interventions that need to be a part of this absolutely, but has to be a comprehensive approach, comprehensive message that's out there and you all can do that, and the people who are listening to this can do that by approaching their lawmakers and their city councils all across this country. So I think that's a really strong takeaway.
Speaker 2:Yep, I mean, look, I live in the belly of the beast in San Francisco and we were able to do that twice at our board of supervisors, our city council, and get proclamations celebrating recovery. We had a recovery summit earlier this year in San Francisco that had over 400 people attend, including the mayor of San Francisco. We do an annual recovery day now in San Francisco where we're celebrating recovery. So again, it is possible. We just need to get people that are willing to come together and stand up and say we're tired. We're tired of the overdose deaths, we're tired of the money being wasted on the wrong things and we're tired of these finger wagging activists telling those of us that used to use drugs what is best for people that use drugs. You don't know. Because we use drugs, we know we should be the ones that you're listening to.
Speaker 1:It's good stuff. Tom, Thank you for joining us on the show. I'm definitely gonna be having you back as we have more of these interesting news items pop up. But have a wonderful rest of your day and to our listeners, thank you for listening. Please leave us a review of five stars would be much appreciated.