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Sheila Vakharia PhD MSW

4 Jan, 9 tweets, 3 min read

@nycHealthy

The NYC Dept of Health and Mental Hygiene (@nycHealthy) released some 2019 overdose death data and preliminary 2020 overdose death numbers for the first quarter of the year. It's not good news. A thread 🧵🧵🧵

1) Overdose deaths remained high in 2019; similar to 2018 rate of 21.2 per 100,000. Opioids involved in 83% over all overdose deaths, fentanyl most commonly involved drug in overdoses (in 68% of deaths). You can read more here:

www1.nyc.gov/assets/doh/dow…

2) You can see here that the overdose death rates in NYC increased in recent years. Not a coincidence that we saw this jump after fentanyl entered our heroin supply.

3) In 2018 and in 2019, Latinx NYCers had the highest overdose death rate in the city, particularly for middle-aged. Highest OD rates among Black older adults. In 2019, overdose death rates went up for both Black and Latinx NYCers while they decreased slightly for white NYCers.

4) Bronx had the highest overdose death rate in 2019, with biggest increases in South Bronx. Five neighborhoods across the city have had the highest rates of overdose in recent years.

5) This graph illustrates drug overdose death rates by drugs. Notice the light green line- that's cocaine. Cocaine was involved in 49% of opioid overdose deaths in NYC in 2019. Benzos not on graph, but involved in 30% of opioid overdose deaths. It's a polydrug overdose crisis.

6) Racial disparities in cocaine-involved overdose deaths, so rates highest among Black and Latinx NYCers. "Cocaine-involved overdoses among Black New Yorkers were less likely to involve an opioid (67%) compared with Latino/a (86%) and White (85%) New Yorkers"

7) Provisional 2020 NYC overdose death data available now, showing gradual increases every quarter in 2019 with jump up to 1st quarter of 2020. Largely driven by opioids and fentanyl. We will get more final coutns in coming months.

www1.nyc.gov/assets/doh/dow…

8) This data shows a troubling increasing trend that pre-dated COVID-19 and was likely exacerbated by COVID for the rest of the year. We have been in this overdose crisis for over a decade and it shows no signs of slowing down; only intensifying. It didn't have to be this way.

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More from @MyHarmReduction

Sheila Vakharia PhD MSW

@MyHarmReduction

7 Jan

Gonna switch gears for a second to tweet about the problem with Dryuary and other self-imposed periods of 100% abstinence since I’ve now read 5 different tweets about people “failing” their Dryuary goals bc 2021 is currently a dumpster fire and people want to drink. (1/?)

2. First of all, goals like Dryuary for a month free of alcohol are actually quite admirable and probably a good practice for most of us. A break never hurts. And they can be a chance to reboot and get perspective on our patterns of use, role of alcohol in our lives, etc.

3. BUT these kind of goals can also be a troubling set up for a lot of us because these kinds of efforts actually require a bit more conscious planning and preparation than most of us do in advance. And they require us to practice different strategies in the moment.

Read 15 tweets

Sheila Vakharia PhD MSW

@MyHarmReduction

8 Dec 20

A lot of really important and interesting myth-busting studies, articles, and papers have been released lately about people who sell drugs.

Here's a thread highlighting them and some key themes (1/?)

@Talkingdrugs

1) Just today, @Talkingdrugs ran a piece on a small study with 13 dark net drug sellers, which found many were motivated to keep customers safe and informed of drug risks, including harm reduction education talkingdrugs.org/consider-the-d…

@SessiBlanchard

2) A few days ago, @SessiBlanchard wrote a piece for @Filtermag_org based on leaked FBI documents showing they knew drug sellers were selling customers new syringes and fentanyl test strips, as well as testing their own meth supplies for fentanyl: filtermag.org/fbi-dealers-ha…

Read 18 tweets

Sheila Vakharia PhD MSW

@MyHarmReduction

11 Nov 20

Drug courts are not:
- an "alternative to incarceration;"
- a substitute for all drug decriminalization;
- a panacea; or
- a "public health" approach.

I was a drug court representative for years. I know.

A THREAD 🧵🧵🧵....

1. Drug courts cherry-pick their participants so few are eligible. Most have very strict criteria (first-timer, no mental illness, no felonies, no violent charges, etc.) so people with most severe problems who arguably have most to gain are usually INELIGIBLE for services.

2. Judges and non-clinical team members can weigh in on treatment decisions. Drug courts have a terrible track record when it comes to medications like methadone and buprenorphine. A judge can say you need a weekend in jail after your most recent relapse to "teach you a lesson."

Read 11 tweets

Sheila Vakharia PhD MSW

@MyHarmReduction

29 Sep 20

https://twitter.com/MyHarmReduction/status/1310595815476428800

Starting now - our September #DrugResearchersRT.

https://twitter.com/MyHarmReduction/status/1310595815476428800

@MayaSchenwar

.@MayaSchenwar opening by discussing the 'alternative to incarceration' that many talk about - electronic monitoring. "We shouldn't have to choose between prison and prison-lite." They "widen" the net. Same with probation- classist, ableist, and racist system. Set many up to fail

@MayaSchenwar

.@MayaSchenwar now referencing drug courts as a common alternative to incarceration and the current overdose crisis. "Giving people the choice between prison and treatment is...essentially, mandating it." And although these have gained bipartisan support, are deeply problematic.

Read 10 tweets

Sheila Vakharia PhD MSW

@MyHarmReduction

29 Sep 20

Really powerful piece in the New York Times today about the intersection of the overdose crisis and #COVID19. Some thoughts and observations in a thread below: nytimes.com/2020/09/29/hea…

1) I actually LOVED the title of the piece - "The Drug Became His Friend."

As a harm reductionist, I spend a lot of time talking abt the fact that drugs work. They WORK. They meet physical needs, emotional needs, spiritual needs, so many others. We need to be reminded of this.

2) Harm reductionists spend a lot of time trying to create space to talk about how and why drugs work for people. The role they play. The purpose. The meaning. "Don't take away what you can't replace" is a mantra we use a lot. And focusing on abstinence negates this process.

Read 15 tweets

Sheila Vakharia PhD MSW

@MyHarmReduction

25 Sep 20

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…

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.

Read 11 tweets

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