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Sheila Vakharia PhD MSW Profile picture
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10 Jun, 4 tweets, 3 min read
One of my final points at the #StigmaSummit was the need for us to include people who CURRENTLY use drugs in
➡️developing programmatic policies to address stigma and barriers,
➡️evaluating them, and
➡️ measuring them.

And that they need to be compensated for their time. (1/3)
And that researchers must include and PAY people who CURRENTLY use drugs in research abt them & their needs:
➡️Developing questions
➡️Gathering data
➡️Analyzing/interpreting data
➡️Writing and presenting on findings

#StigmaSummit drugpolicy.org/sites/default/… ImageImage
If you are a community org that has been contacted by a research team for data collection, YOU HAVE RIGHTS. Some tips:
➡️Form review committees to vet researchers (charge for the review process!)
➡️Create a detailed Memorandum of Agreement
#StigmaSummit drugpolicy.org/sites/default/… ImageImage
You can also check out the Research 101: A manifesto for Ethical Research in the DTES co-authored by amazing advocates who use drugs : open.library.ubc.ca/cIRcle/collect…

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More from @MyHarmReduction

Sheila Vakharia PhD MSW Profile picture
12 Jun
🧵A THREAD 🧵
1) I've been doing harm reduction work for 15 years and I've learned a few lessons about how to talk about it with people who aren't quite there yet.

I presented on this a few years ago and I'm going to share my slides and talking points here with you today -
2) First of all, it's important for US to reframe.

Rather than seeing non-harm reductionists as RESISTANT, I think it's more helpful to see them as RELUCTANT.

This helps us to approach conversations with more compassion and patience (altho not always easy!) Image
3) Then it's important to think about the types of reactions and responses you often hear from folks who may be reluctant about harm reduction.

Here are a few that I have heard over the years: "It's enabling bad beh...
Read 22 tweets
Sheila Vakharia PhD MSW Profile picture
6 Jun
Congratulations to advocates in Vermont, who successfully decriminalized the possession of small amounts of buprenorphine without a prescription!

Here's a thread on why this is great news and how it will save lives during the overdose crisis (1/x)

vtdigger.org/2021/06/03/ver…
Q: What is buprenorphine?

Buprenorphine (AKA Suboxone), is a lifesaving medication for Opioid Use Disorder. It helps people get off street opioids.

Check out my thread about how it reduces mortality
Q: Why should we decriminalize buprenorphine when people should just go to their doctor and get a legitimate prescription instead?

A1: Up until a few weeks ago, not all doctors or other providers with prescription privileges COULD prescribe this medication.
Read 22 tweets
Sheila Vakharia PhD MSW Profile picture
4 Jun
🧵🧵🧵
NEW STUDY:

The rate of all-cause mortality for people on Opioid Agonist Treatment (buprenorphine or methadone) was 53% LOWER than the rate when people were not on these medications. (1/x)

jamanetwork.com/journals/jamap…
“This association was consistent regardless of patient sex, age, geographic location, HIV status, and hepatitis C virus status and whether drugs were taken through injection."

AND

“Associations were not different for methadone vs buprenorphine” (2/x)
The researchers found there was:
➡️52% lower risk of suicide,
➡️28% lower risk of cancer,
➡️59% lower drug-related,
➡️41% lower alcohol-related , and
➡️ 31% lower cardiovascular-related mortality during treatment with buprenorphine or methadone. (3/x)
Read 11 tweets
Sheila Vakharia PhD MSW Profile picture
2 Jun
🧵🧵🧵

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)
Read 7 tweets
Sheila Vakharia PhD MSW Profile picture
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
Sheila Vakharia PhD MSW Profile picture
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

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