🧵🧵🧵

The drug war and criminalization are the unmeasured confounding variables that impact ALL other variables and outcomes in drug and drug policy research.

We don't even know the full extent of how they impact everything we THINK we know about drugs.

FULL STOP.
(1/x)
Some examples:

➡️Any study about the supposed effects of an illicit drug on emotional, mental, physical health and well-being of users.

As long as the participants used the unmonitored and unregulated illicit supply, you never really know what you're measuring. (2/x)
➡️Any study abt the association btwn illicit drug use & outcomes like risk behaviors, treatment engagement, 'recidivism,' housing, employment, etc.

If ppl fear arrest, incarceration, or having a criminal record bars you from accessing these services, we can't pin it on use (3/x)
➡️Any study abt the impact of health policies on health outcomes among people who use illicit drugs

Health-promoting policies can do a lot, but their impact on health outcomes among a group that is criminalized and subject to policing is often unmeasured (4/x)
➡️Any study that aims to identify racial or ethnic disparities in drug-related outcomes

These often fail to recognize that systemic racism in healthcare, the racist war on drugs, racist policing, deportation fears, etc can drive or create these disparities
➡️Any study on stigma towards or against people who use illicit drugs

Criminalization is the formalization and institutionalization of moralism. As long as drugs remain criminalized, you can't really measure or reduce stigma. Medicalizing it won't save us. (6/x)
I think you get my point. Of course, we can find various associations between these variables.

Yet we cannot confidently make a lot of claims without acknowledging that criminalization is the air we breathe.

It's invisible, it's everywhere, and we forget it's even there. FIN

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More from @MyHarmReduction

16 Apr
On May 6th, the class-wide scheduling of fentanyl analogues expires. We should let it.

Hear me and @grantwilder3 explain why this policy is old fashioned drug hysteria + racism that will only increase criminalization and overdose.

fb.watch/4UDbnv6Lbs/
This is a bit of a tricky issue to explain, but basically - the DEA wants to preemptively schedule every fentanyl analogue in existence and that will ever exist as a Schedule 1 drug with 'high abuse potential and no medical use.' BUT THIS IS A TERRIBLE IDEA...
1) Not every fentanyl analogue is necessarily even psychoactive, let alone MORE potent than fentanyl.

With class-wide scheduling, someone could get a harsh sentence for trace detectable amounts of a non-psychoactive or less potent fentanyl analogue.
Read 13 tweets
3 Apr
A thread 🧵

On Monday, JAMA Pediatrics published a new study about the time from drug use initiation to substance use disorder among young people 12-17 and 18-25 for different drugs.

Some politicized it's findings. But they're complicated.

jamanetwork.com/journals/jamap…
It's tricky to design a study that looks at someone's drug use independent of all their life circumstances and to draw a straight line from that use to the development of a substance use disorder.

Drug use doesn't occur in a bubble.
Though they controlled for some variables like gender, race, family income, ever having a depressive episode, and other substance use disorders, that may not capture other pre-existing personal, social, familial, and environmental factors that may surround a person's drug use.
Read 19 tweets
25 Mar
All the good tweets condemning the fatphobic and moralistic tone have been written. (She's clearly been ratio'd)

I'd like to zoom out to look at what this post says about our puritanical culture how we think about *pleasure* and *treats* and DRUGS.
1) There is clearly this belief that because they are available for free, that somehow every vaccinated person will show up every day for their daily free donut.

They won't. Some might. But that's not how most people work. Most people moderate pleasure.
2) It's also clearly *RICH* to individualize something as policy-driven as sugar consumption, weight, and obesity. An innocent campaign for a free donut isn't going to undo systemic policy choices. (Not my wheelhouse, so I defer to the other tweets on this)
Read 12 tweets
23 Mar
Two projects I collaborated on with colleagues have been released TODAY and they're both on ✨STIMULANTS ✨

A mini-thread, I promise...
1) ✏️We filled a gap in the policy space by developing a resource on policy responses to stimulants since everything is opioid-focused these days.

"Policy Proposals to Reduce Stimulant-related Harm: How to Address the Fourth Wave of the Overdose Crisis"

drugpolicy.org/sites/default/… Image
2) Just in time for #NDAFW (National Drug and Alcohol Facts Week) which ends up being a week about fear and stigma, we have released our "10 facts about methamphetamine" page and fact sheet!

drugpolicy.org/drug-facts/met…
Read 4 tweets
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
4 Jan
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. Image
Read 9 tweets

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