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Sheila Vakharia PhD MSW

@MyHarmReduction

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!

We are listening to an infuriating clip from @National_usu ‘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

Read 6 tweets

Sheila Vakharia PhD MSW

@MyHarmReduction

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

@MyHarmReduction

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

🔗cdc.gov/nchs/data/vsrr…

- 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

Read 8 tweets

Sheila Vakharia PhD MSW

@MyHarmReduction

Mar 8, 2023

@CNN

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 access—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

@MyHarmReduction

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

@MyHarmReduction

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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