Thread by @MyHarmReduction

Starting now @BrookingsInst webinar, "The Opioid Crisis in America – Prevention, Treatment, and Regulation"
brookings.edu/events/webinar…

Cringe - while talking about treatment access, Rep David Trone also speaking about the need for more supply-side efforts internationally and domestically to address synthetic opioids in drug supply. Who's going to tell him fent enforcement has motivated creation of new analogs?

Check out our @DrugPolicyOrg report, entitled "Criminal Justice Reform in the Fentanyl Era: One Step Forward, Two Steps Back" which problematizes the user/seller dichotomy, and racial disparities in enforcement: drugpolicy.org/resource/crimi…

Most fentanyl and other illicit drugs come in through legal ports of entry. And efforts to target specific countries contribute to spillover/balloon effects to shift supply elsewhere, rather than eliminating it. As long as US demand remains, ppl will try to meet it.

We can talk about expanding Medicaid/Medicare in prisons/jails, but they already have ADA responsibility to provide care. It's clear they don't WANT to. (Even Rep Trone saying this) Maybe we should talk about letting ppl out and getting them community services.

We need to ask WHY so many people with mental health dx and substance use disorders are criminalized and incarcerated to begin with. Although Rep Trone says treatment can prevent recidivism, we can also say that criminalizing drugs and other behaviors is a CHOICE.

Oh wow! Vanda Felbob-Brown suggesting Safer Consumption Spaces as part of solution. Rep Trone heartily agrees! "Harm reduction is the overall key." And he supports naloxone access, especially among family/lay community! Also supports MOUD. #YesToSCS

They are announcing a series of papers that have been released in this series: brookings.edu/multi-chapter-…

Who is going to acknowledge that most people who misused Rx opioids weren't the patient who is was prescribed for??

When are we going to talk about X the X waiver? Since the waiver itself limits access and deters many potential providers for taking on patients.

Naltrexone shots after release from incarceration cannot be equated with warm handoffs to methadone or bupe care. And the overdose prevention effects are not the same.

If you support value-based reimbursement that incentivizes doctors to provide better care to people who use drugs, then you cannot fight contingency management as a treatment approach.

If you're going to pay docs more to DO THEIR JOB, then why not patients???

Woohoo! @BeauKilmer talking about #SafeSupply and Heroin-Assisted Treatment. He's highlighting the fact that the US can do more to use treatments proven to work in other countries.

Now sharing the evidence on Safer Consumption Spaces and that they are an important component to overdose prevention. He's saying Fed Govt doesn't need to get involved in several ways.

Caulkins using Vancouver as example of treatment/harm reduction/universal healthcare not being enough in the OD crisis, NOT a fair comparison. They didn't have enough SCS or safe supply, criminalization was ramping up due to gentrification, more inequality, #OpioidCrisis

Glad audience is asking about the "overreaction" policy response that the overdose crisis has not led to undertreatment for patients who need the care. Also that we haven't started covering other good treatments for pain means ppl need something to help.

I'm also going to say again that patients weren't the ones largely misusing prescriptions. But also- let's acknowledge this is a polysubstance overdose crisis. The HT of this event as #OpioidCrisis affirms this false narrative.