And they did something absolutely unforgivable that will cost people their lives and freedom: They proposed extending the class-wide scheduling of fentanyls.
1) Currently, fentanyl is a scheduled substance. Some analogues with proven high potency have been scheduled as Schedule 1.
Class-wide scheduling means that EVERY FENTANYL ANALOGUE EVER SEIZED IN THE FUTURE will be treated as a Schedule 1 drug with harsh penalties. Huge problem.
2) Schedule 1 status means a drug has "high abuse potential" and "no medical use." It also means harsh penalties.
But not all fentanyl analogues are psychoactive or are potent. Some have no effects or milder effects than fentanyl. This incorrectly presumes analogue = dangerous.
3) Before 2018, if a fentanyl analogue was seized, the burden would be placed upon the prosecution/State to prove that this analogue was highly potent or dangerous.
Then governments could use the EXISTING "Analogue Act" to prosecute people for it.
4) In some ways, the class-wide scheduling of fentanyl analogues is Drug War Theater- it makes it look like we're "doing something" about fentanyl. Even while there's already laws on the books at their disposal.
They just don't want to have to work to prove their cases.
5) Also- we've temporarily had fentanyl class-wide scheduling since 2018. It's not working.
The brown line in the image below is "synthetic opioid" involved overdose deaths (including fentanyl and analogues). It has only increased. Nearly 2/3 of all deaths in 2020 had them.
6) Check out US Sentencing Commission's own report about fentanyl analogue prosecutions.
(not sure why stock image is medicinal fentanyl while ODs are for illicitly manufactured fentanyls) ussc.gov/research/resea…
7) Longer sentences, predominantly minority defendants, many did not know they had fentanyl/analogues, most were low level sellers.
Also- "any detectable amount" could trigger charges. If granules in a bag of heroin, you get penalties based on the full quantity of the heroin.
8) This also places the burden on Health and Human Services to prove any fentanyl analogues are not potent/psychoactive so they can be removed from scheduling. And THEN they can go back and retroactively reduce expunge records of wrongfully convicted 🤬
9) This also has a negative impact on researchers who want to understand and study analogues. Scheduled drugs are hard to get approval to study. We could be missing out on the next MAT for OUD or pain treatment medication.
10) To learn more about each of these, you can tune into this conference we co-hosted back in March with expert panels discussing all of these challenges.
2) Although the sample size is small, based in Dayton OH, their findings are aligned with several other recent studies highlighting similar motivations for use.
Here's a part of their descriptive table showing how many used it to manage opioid withdrawal and for other reasons:
3) The study used the Drug, Set, and Setting model to really synthesize and tie together the numerous factors that contribute to increased use.
Setting: Increased availability of meth
Set: Expectancies and beliefs about how it could work
Drug: Meth characteristics being helpful
✅Illicit drug use occurs in every zip code but drug arrests don't.
✅A drug arrest record (even without a conviction or incarceration) can mess up your life.
✅The drug war has made social workers, doctors, teachers, etc. into frontline enforcers like cops.
✅Drug use disorders are the only health condition where being actively 'symptomatic' makes you a 'criminal' too.
✅The drug war and criminalization makes recovery harder to achieve.
✅The drug war incentivizes unsafe drug use and behaviors to avoid law enforcement detection.
✅You're still a drug warrior if you only want to free your drug of choice (looking at you, plant activists)
✅You're still a drug warrior if you see drug users as 'victims' who need saving
✅You're still a drug warrior if you only want decrim, but not a safe supply
🧵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!)
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.
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
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 #StigmaSummitdrugpolicy.org/sites/default/…
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)
“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)