Sheila Vakharia PhD MSW Profile picture
Sep 25, 2020 11 tweets 6 min read Read on X
Tuned in to #PharmFest panel right now, "Decolonizing Drugs from the South."

First presenter: Thembisa Waetjen, : “Apartheid’s War on Cannabis.”

You can join us here: uwmadison.webex.com/uwmadison/j.ph… Image
Interesting parallels between marijuana prohibition and demonization in Apartheid SA and US - painting its use as something that would radicalize young white users ( who should support the military) and make their brains "spongey."
Marijuana policing increased dramatically after apartheid implementation and election of their party. It was clearly a prioritized domain of policing and social control. Despite crackdowns, people continued to use and engage with markets. Image
Here you can see the comments of Indigenous South Africans referencing their own cultural use of the plant being colonized and policed by white elites. Similar comments are being made today as many call to decolonize drug policy and allow access to marijuana.
#PharmFest Image
Now up- Athos Vieira, “Cocaine and the Night: The Social Life of a Drug in Rio de Janeiro during Brazil’s First Republic, 1885–1920.”

You can tune in to #PharmFest here: uwmadison.webex.com/uwmadison/j.ph… Image
You can see here cocaine advertisements at the turn of the 20th century that look quite similar to those here in the US around the same time. Similar ads for morphine and other drugs were prominent as well. #PharmFest Image
Increased reports emerged of more prevalent use, particularly in cases of suicide. Newspaper coverage began to make it appear to be dangerous. #PharmFest Image
Next up #PharmFest: María-Clara Torres, Stony Brook University: “The Twilight and Revival of Coca: Northern Cauca, Colombia, 1950s–1980s”

Tune in here: uwmadison.webex.com/uwmadison/j.ph… Image
The case of Cauca is distinct from other Amazonian regions where mestizos are associated with what many of us think of as the coca "agrarian frontier." This is partially due to the high % of Indigenous communities and their cohesion in Cauca compared to others #PharmFest
The Nasa (Cauca's Indigenous community) was galvanized and radicalized by oppressive land policies that violated their rates and did not entitle them to enough land rights. They took on agrarian forms on their own terms as a result. #PharmFest Image
Follow along with #PharmFest for the next few days and check out their excellent programming: aihp.org/new-social-his…

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More from @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!
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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 Image
Read 6 tweets
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
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… 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
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 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
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
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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