12/19/18 Ira Glasser

The Oregon Legislature's House Health Care Committee hears testimony regarding safe consumption spaces, and an interview with the DPA's Ira Glasser.

Program: 
Century of Lies
Date: 
Wednesday, December 19, 2018
Guest: 
Ira Glasser
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CENTURY OF LIES

DECEMBER 19, 2018

DEAN BECKER: The failure of drug war is glaringly obvious to judges, cops, wardens, prosecutors, and millions more now calling for decriminalization, legalization, the end of prohibition. Let us investigate the Century Of Lies.

DOUG MCVAY: Hello, and welcome to Century of Lies. I'm your host Doug McVay, editor of DrugWarFacts.org.

On December 12, the Oregon Legislature's House Interim Committee on Health Care held an informational hearing. One of the panels they heard from dealt with safe injection sites, these so-called supervised consumption facilities. We're going to hear from that hearing.

The speakers will be Haven Wheelock, she's a Risk Education Specialist at Outside In, which is a low threshold service providing agency in the city of Portland; Dan Epting, who's a peer mentor working in harm reduction; and Lydia Bartholow, who's Medical Director of Central City Concern. The Committee is chaired by Representative Mitch Greenlick.

OR STATE REP. MITCH GREENLICK: First, you need to introduce yourself.

HAVEN WHEELOCK: All right. I'm Haven Wheelock, and I've been working with people who -- to promote health with people who use drugs for over fifteen years. I'm also a Fellow at Johns Hopkins University, working on an MPH in overdose and addiction.

As you all are well aware, our nation and our state are in the middle of an addiction crisis. Addiction has lowered life expectancy three years in a row nationally and is costing roughly 500 lives here in Oregon every year.

This body has worked for many years to save lives by expanding access to naloxone and by making it easier for people to call 911 in the event of an overdose.

We're here today to talk about another harm reduction strategy that our state should consider to ease this crisis.

Overdose prevention sites, also known as safe injection facilities or safe drug consumption spaces are places where people can bring drugs that they've purchased in the community and use them in the presence of trained staff, who are able to intervene in the event of an overdose.

These spaces, which typically serve people who are living outside and at high risk for overdose, allows people to use in a safer way by bringing them out of public restrooms and doorways, and into a space that has safe tools to prevent the spread of HIV and hepatitis C, as well as leading them to other connections within the community for health care and drug treatment services.

These spaces have been shown to lower overdose death rates, HIV and hepatitis C infections, skin and soft tissue infections. They've also been shown to increase the likelihood that people will access drug and alcohol treatment, and do not negatively impact the greater communities where they're located.

Each day, I have clients who are using drugs in really unsafe ways coming in, and they're doing this because they are given two options: one, they use publicly where people can see them, which is not something people want to do, and so then they risk the scrutiny and shame of being seen while using; or they hide in places where if they were to have an overdose they are less likely to be found, and there's less likely to be intervention.

Just yesterday, I assisted in reversing an overdose on a freeway onramp, right outside my office. And this person was choosing to use there so that she wouldn't be viewed by people who are passing by and driving by, however when this overdose event happened, it was much harder for us to access her and had she not been with someone she would have been over there alone and no one would have known she was there.

Obviously this is not ideal conditions for folks. Currently there are over 120 overdose prevention sites in ten countries around the world. Cities including Seattle, San Francisco, New York, Philadelphia, and most recently Denver have all shown support for opening overdose prevention sites, and ten states across the nation have introduced legislation around this topic.

In addition to the health benefits associated with overdose prevention sites, a study out of San Francisco showed that one site could save an estimated three point five million dollars in health care costs annually by preventing HIV and hepatitis C transmission, hospitalizations for skin and soft tissue infections, and loss of life from overdose.

So far, Oregon has been fortunate that we have not seen the increase in fentanyl in our drug markets, as many parts of the country have seen. However we know that that's changing.

We've seen an increase in fentanyl related deaths in the last year, with 2017 numbers not yet released, and we have an opportunity to act now, and early, to prevent what's happening back east from happening in our communities here.

I'm very hopeful with all the work that the state has been doing to expand access to treatment. It's important, and we need to do it, but it takes time to build those systems, and people are dying today.

Overdose prevention sites are an important harm reduction tool that we should be using. They save lives, and they should be an important part of our continuum of care for people who are using drugs.

So thank you for your time, and I'm going to pass it off to Dan.

DAN EPTING: Oh boy. Good afternoon, Chair Greenlick and Committee Members. My name is Dan Epting. I am a state certified recovery mentor, and Oregon Health Authority certified peer support specialist and traditional health worker.

I identify as a man in recovery. I recently celebrated ten years clean from all chemicals. My preference was opioids.

OR STATE REP. MITCH GREENLICK: Congratulations.

DAN EPTING: Thank you. Thanks very much.

My last use of heroin was in a Nordstrom's bathroom on Broadway in downtown Portland. I frequently used drugs in public restrooms, because that was the driest, safest place. And frequently people walked in.

Syringes were left behind. I can't tell you how many hospitalizations, or how many times I had an abscess, where I just had to play surgeon at home and take care of them.

I've been stopped on the streets, arrested for possession of drugs, and the one thing that I really want to say is that addiction, as we are seeing more and more, can happen to anybody, and it is -- it is not a moral failing. It is a disease, and until everybody starts to think that way, we're going to be stuck.

I was fond of saying that I thought I would die on a Starbuck's toilet. I used dope in bathrooms, cars, alleyways, and I still see the same things going on today, in fact even more.

I worked at a residential treatment center in downtown Portland for four years, and frequently on my way to and from the method of public transportation that I took, I would see people actively injecting drugs in the open. It's dangerous. It's unsightly. You know, it's shameful to the addicts who are using.

There are syringes that end up left in public places, where they have no business being, and drug paraphernalia and remnants.

You know, the idea of a safe place, where you're monitored, to prevent you from overdosing, and prevent the spread of disease, is definitely revolutionary, and with that being said, I think as time moves forward it's something that will become accepted, just the way that suboxone and methadone treatment are accepted today, whereas they once were frowned upon.

You know, the amount of money that we're spending on emergency room visits, ambulance response, police response to public overdoses, I don't have numbers, but I know it's got to be immense.

You know, so, yeah, I'm here as an advocate. Additionally, when I got clean, I believed there was one way to do it, and over the course of the last ten years, being a person with the ability to have linear thought, I'm realizing that recovery is an evolving process, just as anything is.

And what worked fifty to sixty years ago, when Bob and Bill, or longer than that, sat down and came up with the big books of Alcoholics Anonymous, has changed significantly since that time. And as a society, we need to evolve with the new things that are coming forward.

Thanks very much for your time, and the opportunity to speak here today.

OR STATE REP. MITCH GREENLICK: Thank you for your time and your good works in this area.

LYDIA BARTHOLOW, PhD: Thanks, Dan, and thank you Chair Greenlick and members of the Committee for having us here today.

My name is Lydia Bartholow. I'm a registered nurse, a psychiatric nurse practitioner, I have a doctorate in nursing practice, in health leadership, and I'm dually credentialed in addiction medicine.

So, I want to speak first as a clinician. My spiritual work is to help the most vulnerable among us, and to ensure that they're safe. Overdose prevention spaces ensures this, regardless of the stage of the disease that my patients are in. It says we don't care where you are in your disease, we will provide for you. We will care for you.

So, I wanted to open with that, but what I'd really like to elevate is not so much the personal relationship with my clients, I really want to focus on community safety, because I have a doctorate in health care, which really focuses on translating evidence into action, and because I'm a medical director at a well known nonprofit in Portland that focuses on addiction, I want to talk about this as a systems issue, and again a keeping communities safer issue.

What we know is that overdose prevention spaces are evidence based. The evidence is overwhelming in favor of overdose prevention spaces. What prevents this evidence from being enacted is stigma.

And so I want us to focus on the science, and I ask you all to focus on the science and the data and the numbers here, and question some of the stigma that surrounds this.

We know that overdose prevention spaces decrease the spread of infectious diseases, keep people alive by preventing overdoses, and keeps the entire community safer by keeping used needles, used dirty needles, out of community spaces.

So, I'll leave you on that note, and I'll open us up for questions.

OR STATE REP. MITCH GREENLICK: Do we have safe sites in Portland?

LYDIA BARTHOLOW, PHD: Do we have safer consumption sites in Portland? We do not.

HAVEN WHEELOCK: So, currently, there are no legal sanctioned safe consumption spaces in the United States. Seattle, San Francisco, Philadelphia, New York, and Denver are all working to open them in their cities currently, but there are none legally operating.

There is an underground site that has been written up in the literature somewhere in the United States that's been operating for over three years with no problems, and having overdoses reversed, but currently there are none in the United States.

OR STATE REP. MITCH GREENLICK: Is there organizational desire to have one in Portland? Does Inside Out [sic: Outside In] want to do one, or?

HAVEN WHEELOCK: I think there is a lot of support, and a lot of people really interested in looking at this crisis that we're currently dealing with, and how to be innovative and do things to save people's lives before we see fentanyl really hitting our drug market.

OR STATE REP. MITCH GREENLICK: Vice Chair Nosse?

OR STATE REP. ROB NOSSE: Thank you, Mister Chair. Do any of you on the panel have an analysis or an understanding that you can share with us about whether or not, as a state, we're permitted to basically legislate the thing that you're seeking? Or is it federally controlled and we're sort of hamstrung in our ability as a state to do something like you're suggesting?

HAVEN WHEELOCK: So, it is still federally illegal, much like marijuana, which is currently also federally illegal, and we've been able to work to allow for the consumption of marijuana throughout our state, and sales as well.

But we -- there would be federal risk involved with that.

OR STATE REP. MITCH GREENLICK: Representative Vial?

OR STATE REP. A. RICHARD VIAL: Yeah, mine was essentially the same question. Is that really the only impediment to moving forward on this is the federal regulation of the controlled substances?

HAVEN WHEELOCK: I would say that stigma is probably the biggest barrier to doing this. People who use drugs are not well represented in general, and aren't treated very well, and so it makes people cautious about opening these spaces.

I think that the greater policy support for these programs helps move that stigma, and allows space for that. Federally, there are laws, crack house laws in particular, that would be -- could be a barrier.

OR STATE REP. A. RICHARD VIAL: Follow up, Mister Chair? So, what have you heard from these other jurisdictions that are trying to do something, like Seattle or San Francisco, in terms of political opposition. Help prepare us a little bit for what we might run into here.

HAVEN WHEELOCK: So, Seattle's been working on this the longest at this point. They, two years ago, they said that they were planning to start to open, and have put a million plus dollars in their budget to open a space. Their biggest barriers have been neighborhood associations who are nervous about having these facilities in their jurisdictions.

That's been their biggest pushback, so again, stigma.

OR STATE REP. A. RICHARD VIAL: It's a land use issue, more than it is -- okeh.

OR STATE REP. MITCH GREENLICK: Location.

HAVEN WHEELOCK: Yeah, it's about siting location, is the biggest one.

OR STATE REP. MITCH GREENLICK: I think this is going to be on our agenda. We'll be hearing from the Governor's Task Force, right behind you, see what they think about it. Thank you very much for presenting to us. Certainly have to be thinking of these kinds of options, to deal with the problem we have.

HAVEN WHEELOCK: Thank you.

OR STATE REP. MITCH GREENLICK: We appreciate you very much.

LYDIA BARTHOLOW, PHD: Thank you for your time.

DOUG MCVAY: All right, that was a presentation to the Oregon Legislature's House Interim Committee on Health Care December 12. They were talking about supervised consumption facilities, or safe injection sites.

Speakers were Haven Wheelock, a Risk Education Specialist with Outside In, a low threshold service providing agency in the city of Portland; Dan Epting, who's a peer mentor working in harm reduction; and Lydia Bartholow, who's medical director of Central City Concern.

You're listening to Century of Lies. I'm your host Doug McVay.

It's the end of the year, you know, so I'm looking through the crates and checking out some of the work that I've done in the past, and I found a few things that I've never actually broadcast. So, I thought that this week we would get a chance to listen to one of those interviews.

Back in 2013, I had the good fortune to be able to go to Denver to attend the Drug Policy Alliance's International Reform Conference. While there, I had the incredible good fortune of being able to sit down for a few minutes with Ira Glasser, former [sic] board chairman and one of the co-founders of the Drug Policy Alliance. Here's that interview.

Testing testing. Yeah, my level's perfect. It always is perfect. This is a great recording device.

And so, yeah. Tell me your name, sir, and who you're with.

IRA GLASSER: Ira Glasser. I'm the retired former executive director of the American Civil Liberties Union, and I'm the chairman of the board of the Drug Policy Alliance, which Ethan Nadelmann directs.

DOUG MCVAY: Ira, you do tremendous work. Congratulations. This organization is incredible, and this conference has been just off the hook. Tell me about some of the things you're doing, and -- talk to me for a minute.

IRA GLASSER: Well, you know, the central task of the Drug Policy Alliance is to build the movement that is capable of changing and repealing, if not reforming, the disastrous policies that flow from the war on drugs.

And building a movement is primarily what you have to do, because, you know, three people, five people, eight people, ten people, in an organization, no matter how talented and energetic they are, cannot create those changes.

They have to come from below, they have to come from the varieties of people who are not all the same, except in one respect, which is that they are all suffering from some consequence of the misbegotten war on drugs, and the dreadful, the tragic mistake of trying to regulate or trying to control the problem by making it criminally prohibited.

You know, you think we would have learned that lesson from alcohol prohibition, but we didn't, and exactly the same kind of thing is happening. So, you have among the eleven or twelve hundred people who are at this conference, a kind of a rainbow of different interests and different people, who are all united by their singular opposition to the use of the criminal law to deal with this problem.

So, you know, you have black folks and white folks and Latino folks of all colors that have former -- formerly incarcerated people, you have women who -- for whom pregnancy is often an excuse for government oppression, and, you know, you have people from Europe and people from South America and people from North America.

You have harm reduction people, you have recovery people, you have people who are trying to assist heroin addicts by treating them with heroin, you have cops who are not here to arrest us but to help change the laws, which they understand almost better than anybody how crazy they are. You have judges, and you have some elected officials.

You have people who have been barred from voting because of nonviolent drug convictions. So what you have here is a collection of very different people, who might not be in the same place together, except for this one reason. You have libertarians, you have social justice activists, and so what happens is, is that this movement has been building for twenty-five years.

Ethan and I first started going to these kind of conferences back in 1988, 1989, for the -- run by the predecessor organization to Drug Policy Alliance, which is called the Drug Policy Foundation. And there were maybe 300 people in the room in those days.

And they were all white, and they were all people who were there because they just believed that -- in personal sovereignty over your own body, but the major victims of the war on drugs were not in the room, and the issues involving incarceration, involving voting barriers, involving pregnant women who are tyrannized by drug laws. That was not in the room, and it was not part of the discussion.

And the result of which is that it had a very limited capacity, not just because of the numbers, but because of how the numbers were composed, to produce the sorts of changes that we're now beginning to see.

This room, this year, has eleven, twelve hundred people in it, but it's not so much that it's four times as large, it's really the variety of interests, and the different sorts of victims who are here, that has created a real movement for justice in this area, and has begun to bear fruit.

You know, we have the laws passed here in Colorado and in the state of Washington. We're about to have a similar law passed in Uruguay, which I think will happen within the next couple of weeks, it will be the first country in the world to basically regulate marijuana like alcohol.

But, you know, it's one country out of two hundred, and the two states that have done it here are two states out of fifty. So it's a nice beginning, and it's an encouraging beginning, and it proves that we're making progress and that we can prevail, but there's, you know, just like the beginnings of all the other social justice movements in the country, it's a first step, and there's a lot of steps ahead.

And there will be defeats along the way, there always are. You know, when Rosa Parks sat down on that bus in Montgomery, Alabama in 1955, on a seat that was reserved for whites, and a then-unknown Baptist minister named Martin Luther King, Junior, stood up and organized a boycott of the buses in her behalf, and actually changed the policy, it was reasoned to be terrifically happy about that, and encouraged, but it was hardly the end of the struggle for racial justice in this country.

That struggle isn't over even now, you know, almost six decades later, but it was the beginning of the end of that system of oppression, and that's where we think we are now.

DOUG MCVAY: That's fantastic. I've got more than enough, this is audio gold, and, my first Drug Policy Foundation conference was also 1988. I was just a kid from Iowa, came out to work at NORML, and my friends back home thought that's really radical, and, you know, and then I go into this thing and I'm meeting all these people in the needle exchange, and Merseyside folks, I mean, it's just ...

Okeh, so, I still have friends back in Iowa, and all this stuff ... yeah, like I say, they may still consider marijuana legalization radical, and they may be, you know, ... yeah. And socioeconomically, they're not exactly on top, and it can be a little depressing. Any advice for those folks who are -- yeah. Any advice for those folks.

IRA GLASSER: Well, you know, I would just remind people like that that it isn't about whether or not you would smoke marijuana yourself, or want your kids to smoke it, and it isn't about how do you control it so that it doesn't become a problem.

You really have to think about, people have to think about the problems caused by alcohol. I mean, there are more alcoholics in this country than there are people who are addicted to all other drugs combined. Alcohol is a drug that produces violent behavior, which certainly marijuana does not.

Nobody's ever died from marijuana overdose, there's almost no such thing, but aside from the fact that it's a more benign drug than alcohol, if you want to control the problems that flow from using marijuana, the worst way to do it is criminal prohibition. That's what we learned from the experiment with alcohol prohibition.

What did the alcohol prohibition do? It didn't control people's drinking, which went on. Everybody knew where to get alcohol, and they did it, the same way now that any kid in America can tell you where to get marijuana.

Fact is, teenagers have more trouble getting alcohol now than they do marijuana, because the alcohol market is regulated. You know, you can lose your license if you sell to a minor, so it's harder for a kid to get a beer unless he gets it from his own house, and -- but marijuana is not regulated.

You know, the people selling marijuana are already subject to criminal penalties, so they're not afraid of losing their license, so they sell to kids, and kids have more access to marijuana this way than they would under an alcohol regulatory system. Alcohol prohibition didn't stop alcohol consumption, it didn't stop alcoholism, it didn't stop any of the problems it was supposed to stop, and it created a whole other problem: it created a criminal industry.

It created Al Capone. It created violence and murders and shootings in the street, because people who were competitors or wanted to collect their bills from people that they sold alcohol to couldn't do it by going into court, because the whole enterprise is illegal, so what you got is you settled these disputes with guns, which is going on now with marijuana in Mexico, and, you know, hundreds of thousands of people are being killed.

It's the same thing that happened, and Al Capone didn't shoot people because he was drunk. He shot people because prohibition created a criminal industry. And that's what drug prohibition has done.

So, it's not a question of whether you like people to drink alcohol, or whether or not you have to have treatment programs for people who drink alcohol problematically. The same thing is true of marijuana prohibition.

Prohibition doesn't work. It doesn't solve the problem. It doesn't control the use. It doesn't keep kids from smoking. And it creates a whole other set of problems that didn't exist before, namely the criminal market and the violence and the crime that goes with it, and the enormous amount of money that criminals get from a market where the prices are inflated by the fact that it's a criminal enterprise.

And so, you know, it's not a question of convincing people to think that marijuana is a good thing. It's a question of saying that if you want to control the problems that flow from marijuana use, the same way that if you want to control the problems that sometimes flow from alcohol use, you can't do it through criminal prohibition.

And the sooner everyone understands that, the sooner we'll get rid of the problems that are caused by the law, and focus on the problems that are caused by the drug. You know, people can drink a glass of wine with dinner, nobody thinks that's a problem.

What they think is that if you, you know, get up every morning and have a bottle of vodka, that's a problem. But putting you in jail and arresting you for it, or arresting the person who has a glass of wine every night with dinner, which is what we do with marijuana, doesn't make any sense. It doesn't solve the problem, and it creates other problems.

So you don't have to like marijuana, and you don't have to -- have to forget about dealing with problematic use. You've got to do it in a way that's effective, and doesn't tear apart the country in other ways, and that's why you've got to get rid of marijuana prohibition and go back to dealing with it the way we deal with alcohol.

DOUG MCVAY: That was my interview with Ira Glasser. Ira was executive director of the National ACLU for several years, then moved on to be the board chairman and co-founder of the Drug Policy Alliance. I met up with him in 2013 in Denver, Colorado, at the Drug Policy Alliance's International Reform Conference.

And well, that's it for this week. I want to thank you for joining us. You have been listening to Century of Lies. We're a production of the Drug Truth Network for the Pacifica Foundation Radio Network, on the web at DrugTruth.net. I’m your host Doug McVay, editor of DrugWarFacts.org.

The executive producer of the Drug Truth Network is Dean Becker. Drug Truth Network programs are available by podcast, the URLs to subscribe are on the network home page at DrugTruth.net.

The Drug Truth Network has a Facebook page, please give it a like. Drug War Facts is on Facebook too, give its page a like and share it with friends. Remember: Knowledge is power.

You can follow me on Twitter, I'm @DougMcVay and of course also @DrugPolicyFacts.

We'll be back in a week with thirty more minutes of news and information about drug policy reform and the failed war on drugs. For now, for the Drug Truth Network, this is Doug McVay saying so long. So long!

For the Drug Truth Network, this is Doug McVay asking you to examine our policy of drug prohibition: the century of lies. Drug Truth Network programs archived at the James A. Baker III Institute for Public Policy.