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Sheila Vakharia PhD MSW Profile picture
@MyHarmReduction
Apr 21, 2020 β€’ 5 tweets β€’ 1 min read β€’ Read on X
THREAD: For those of us who are partaking in some herbal refreshment in light of #420day , how are you practicing harm reduction?

πŸ’š Acquired from a trusted source
πŸ’š Known dose
πŸ’š Considering "set"/frame of mind
πŸ’š In a safe setting
πŸ’š Considered safest mode of consumption
πŸ’š Made a back-up plan for caretaking responsibilities
πŸ’š Planned to have enough time for come-down
πŸ’š Staying hydrated
πŸ’š Using the buddy system (IRL or virtual)
πŸ’š Set limits
πŸ’š Turned on your favorite music/show/movie
πŸ’š Took out your creative outlet (paints, instrument, etc)
πŸ’š Avoid mixing w other drugs if never mixed before or had a bad time
πŸ’š Wait before using more
πŸ’š Write down your thoughts and wait to send texts/tweets/posts until tomorrow
πŸ’š Start only after you've taken care of today's responsibilities
πŸ’š Stay home and/or on your own property
πŸ’š Remember- if you feel bad, it will pass. And I love you.

β€’ β€’ β€’

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More from @MyHarmReduction

Sheila Vakharia PhD MSW Profile picture
Sep 21, 2023
Thrilled to be here at the @MethadoneLib conference!

Great turnout in the room and I’m sure we have plenty folks logged in remotely representing so many diverse groups and regions!

We all share a commitment to #FreeMethadone!
Image
Image
We are listening to an infuriating clip from @National_usu β€˜s podcast Naturally Noncompliant to hear from people about their experiences and why we need to #FreeMethadone.

Follow and tune in podcasts.apple.com/us/podcast/nat…
@National_usu Moving onto our first panel with a fantastic lineup of speakers- @suenlw @DrChinazoOASAS Paul Joudrey @highway_dave and Kelly Knight!

#FreeMethadone Image
Read 6 tweets
Sheila Vakharia PhD MSW Profile picture
May 10, 2023
People often ask, "What about treatment?" "Why aren't they in treatment?" when talking people with addictions or other mental health diagnoses.

We talk about treatment as some magical black box- people walk in sick and then walk out "better," improved, stabilized, asymptomatic.
But the reality is that treatment is slow and time-consuming.

Change does not happen overnight; it may not look how you expect.

The first days, weeks can be challenging. You settle in. You meet the counselors- some are great, some are terrible. You may not speak right away
Sure, there are lovely, warm. caring counselors. But there are shaming, blaming, harmful counselors too.

They may recognize you from the last time- some will welcome you back. Others will tell you, "I told you so."

There may be familiar faces in group therapy too. Good and bad.
Read 12 tweets
Sheila Vakharia PhD MSW Profile picture
May 3, 2023
New CDC report on OD trends in US 2016 to 2021 🧡

- The US fentanyl-involved OD death rate is 21.6 per 100,000, a rate that more than TRIPLED in just 5 yrs
- Methamphetamine-involved OD death rate more than quadrupled,
- Cocaine rate more than doubled

πŸ”—cdc.gov/nchs/data/vsrr… Image
- Meanwhile the rate of heroin-involved OD remained relatively stable during the 5 year period,
- Oxycodone-involved OD rate decreased by 20+%

**At this point, any talk of the overdose crisis without acknowledging prevalent stimulant use misses the mark
Gender disparities in overdose deaths remain so that men have significantly higher rates of overdose for all drugs compared to women.

Meanwhile middle-aged adults (aged 25-44) have incredibly high overdose death rates involving fentanyl Image
Read 8 tweets
Sheila Vakharia PhD MSW Profile picture
Mar 8, 2023
Watching @CNN and @andersoncooper talking about the overdose crisis. They are talking about two tragic cases of young people who died of overdose with their grieving family members.

Both overdoses were with counterfeit pills. (1/?)
In first story, the young person thought it was a Percocet. When he was overdosing, a friend was deterred from calling 911 for fear of law enforcement.

In second story, the young man ODd while talking to his girlfriend on the phone but she didn’t know signs of him overdosing.
While they are talking about the need for more awareness of fentanyl adulteration, recognizing overdose, and naloxone accessβ€”tougher laws and prosecutions are also being proposed by family. They worry that felony charges for the dealer and 4 years in prison are not enough.
Read 28 tweets
Sheila Vakharia PhD MSW Profile picture
Feb 25, 2023
Many people do not realize the difference between these terms and that they actually mean different things:

Decriminalization =/= Legalization =/= Regulation

These are three different things.

And only 1 of them ensures a known, tested, and monitored drug supply for all users.
1) Decriminalization simply means that possession is no longer a criminal offense.

You cannot get arrested, booked, finger printed.

No potential jail time.

Nothing on your record when you get a background check.

You may owe a fine. You may be diverted to a case worker.
+ You may be able to waive that fine if you complete a health assessment or see a dissuasion panel.

However, your drugs may be seized.

And, if they aren't seized, your drugs could still be adulterated or unsafe.

You may not know exactly what is in them.
Read 9 tweets
Sheila Vakharia PhD MSW Profile picture
Nov 22, 2022
Learning from Dr. Joseph D'Orazio that xylazine is being detected in over 90% of tested heroin and fentanyl samples in Philadelphia.

Screenshot below shows that it's also prevalent in overdose victims - xylazine + fentanyl positive in 100% of those who died in 2020.
Also, Philadelphia seeing a notable trend of decreased benzodiazepine-involved overdose deaths while xylazine-involved overdose deaths are rising.
This slide shows that xylazine overdose response must prioritize airway management so they can breathe and keep in the recovery position.

Administering naloxone still important since opioids often still on board, yet may appear as a "narcan resistant OD" due to xylazine
Read 7 tweets

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