12/04/19 Howard Josepher

Cultural Baggage Radio Show
Howard Josepher
Drug Policy Alliance

Howard Josepher drug reform pioneer, Rafael Torruella Puerto Rico Harm Reductionist, tribute to passing of George McMahon Federal Marijuana patient + DTN editorial

Audio file



DECEMBER 4, 2019

DEAN BECKER: Hi, folks. This is Dean Becker the Reverend Most High, and you are listening to Cultural Baggage on Pacifica Radio and the Drug Truth Network. We’ve got some more segments to share with you from our trip to St. Louis and the big Drug Policy Alliance Reform ’19 Conference. We start with Mr. Howard Josepher.

HOWARD JOSEPHER: The work I have done for many years is to help inner city substance users including people coming out of prison, living with or at risk for HIV, and hardcore drug misusers.

DEAN BECKER: We area speaking with Mr. Howard Josepher who is a lifetime resident of New York City and has been involved up there for decades in helping to save lives, futures, and possibilities. Is that a good summation?

HOWARD JOSEPHER: Yes it is a good summation.

DEAN BECKER: Tell us a bit about some of the organizations and the processes that made that progress possible.

HOWARD JOSEPHER: I am a person that has a long memory and long experience in the substance misuse and drug treatment field. I overcame my own addiction to heroin 50 years ago by being forced/coerced in to going in to a newly formed program called Phoenix House, to do something about my drug habit. That turned out to be a great opportunity and it did turn my life around, I was about 30. Since then I have gone back to school to become a clinical social worker in New York State where I worked as a consultant in many drug programs and started my own private practice which I have been doing now for over 40 years. I took on a piece of consulting work in 1988 at the height of the AIDS epidemic when we were first becoming aware of what was happening in the drug injecting community. Until that point there was absolutely no attempt to engage them other than a few clandestine needle exchange programs. There was a research study that a group of researchers in New York obtained from the National Institute on Drug Abuse to create an experimental model and deliver it to the intended target which was people who were coming out of prison and injecting drugs; the vulnerable population. They wanted us to create this model, put however many people we could on the model within the three-year timeframe that the grant covered and see what happened with our ability to modify or change their behaviors. I put together the original curriculum and taught that curriculum which was started in a church basement. Seven guys just out of prison and we created a brief intervention. What I hoped for from people understanding from my own treatment process was that if there was any ability to get a commitment from a person to do something you have a chance at a good outcome.

DEAN BECKER: Good follow through.

HOWARD JOSEPHER: Yes. Exactly. I wanted to make it a brief program and what we created was something that looked like a three-credit college course. It met three times a week for eight weeks and they graduated, and they were allowed three cuts. It was a different form of engagement. We were not exactly treating as much as we were educating them in self-management and skills to handle the many, many challenges they had in their lives including stress reduction, meditation, and mindfulness. This was in 1988. Five guys graduated from that first group and we did another group with about 12 people who came and nine graduated.

DEAN BECKER: Good numbers.

HOWARD JOSEPHER: Right. The numbers went up exponentially and by the time the study needed to close down so the reports could be written on the outcome they told me and others who were with me at that time to shut it down.

DEAN BECKER: For what reason?

HOWARD JOSEPHER: The funding was given for a specific purpose which was to create an experimental model and then write a report. This is all that was funded even though the model was successful. There was great word of mouth out there and people kept coming so we decided to keep it going which we did.

DEAN BECKER: Seek more funding but keep it going?

HOWARD JOSEPHER: Right. At that point which was 1990, we incorporated in the State of New York as a nonprofit helping the population. We were somewhere in the middle between the traditional treatment people who looked at us as enablers and harm reduction people who looked at us more like treatment because they understood harm reduction as syringe exchange and treating people better but we were a program. We had something to deliver.

DEAN BECKER: Let me ask you a question, we have the modern concern now and needle exchange is becoming accepted in most states it is being implemented rather successfully but we now have these safe consumption facilities in Seattle, San Francisco, Ithaca, New York, and other cities are wanting to at least attempt that approach in order to save lives. Personally I think this is a wonderful thing and I hope it is successful in these cities and that others can then copy that progress.

HOWARD JOSEPHER: That is exactly my hope because I see that we came across an effective way to engage people and transmit very useful information with a classroom setting. It is a whole different way to engage drug users. I see it as another form of treatment but it is harm reduction practices and principals as well as what it takes to create an experience that could be of benefit and make a big impact on their lives. From that program, my agency grew from traditional drug treatment, Suboxone treatment, which is a licensed component of our operation in New York. We are also licensed by New York State to provide training for people to become certified alcohol and substance abuse counselors (CASACs) as well as peer support systems. We are providing a lot and it is an opportunity for a better life. It is our job to provide the opportunity – our job meaning society. It is their job to take advantage of the opportunity and if they don’t they are going to get kicked in the head until maybe they wake up.

DEAN BECKER: The experience and knowledge I have gained over the years tells me that a lot of these addictive behaviors began at an early age and by the time people get in to the mid to late 20s, they’ve got a wife, kids, obligations and many begin to walk away. This is not true of everybody but it holds true that if we can get folks through those years they stand a better chance of living a longer life. Your thought on that?

HOWARD JOSEPHER: I bet if they did a study they would find a lot of people made their turnaround in their early 30s. For me it was in the 29th year that I went in to treatment and completed it when I was 30 I think. I wasn’t really young when I started using drugs. I was a college graduate the first time I tried it.

What we also have to do is really understand how good an opiate can feel.

DEAN BECKER: I have heard it is something like being held by Jesus or something like that.

HOWARD JOSEPHER: Right. It is uplifting. When I was younger I was so insecure and going in to a club or something like that was awkward for me but if I was high I did not feel in the least insecure.

DEAN BECKER: Howard, we are here at the Drug Policy Alliance Reform ’19 Conference and you are one of the pioneers who took this on and showed us some examples and got us started in the right direction. What is your thought on these young kids who are mostly marijuana-centric and don’t have a lot of toward harder drugs or the complications that go along with it but there is a bigger drug war to be fought, am I right?

HOWARD JOSEPHER: Sure. It is interesting what you are saying because you do see at this conference a representation of what I would consider young kids with the saying ‘where there is weed, there’s need’. It is all about need though, isn’t it? For some marijuana is enough, it is all they need. They don’t need to go in to other stuff but that is probably all related to the pain the individual feels. The more the pain the more the need to self-medicate and the more at risk they become.

DEAN BECKER: I have heard that a lot of the people that are in to the opiates have had some abuse in their life – something that has driven them in that direction. You would know this better than anybody.

HOWARD JOSEPHER: A lot of people have brought attention to the idea of trauma and what that causes. Freud certainly did that. It is that something went wrong in their youth and it creates something. The way that I experienced it was that something was missing. Use of the words avoid, emptiness is the feeling of depression and nothing does it like an opiate for most people.

DEAN BECKER: I guess I could say that I was lucky in the sense that I tried heroin with some friends a few times and it just wasn’t for me. I was a speed freak for years but heroin just had no appeal to me. I guess to each his own, right?

HOWARD JOSEPHER: Yeah. I don’t get speed. I don’t get it, man. I do get the madness though.

DEAN BECKER: Well Howard, we are gonna wrap it up but I want to thank you for taking time to speak with us here and I want to thank you for blazing some trails, showing us there is a better way, and saving lots of lives along the way.

HOWARD JOSEPHER: Moving forward with the lives we would like to be able to save now the medications are very helpful but we also need to find a way to ignite hope in people and to inspire them to be more at peace and hold more esteem for oneself in order to become a real human being.

DEAN BECKER: Is there a website you want to recommend?

HOWARD JOSEPHER: Certainly. The organization that I have been with for many years is Exponents and that website is:

It’s time to play Name That Drug By its Side Effects. Hives, fainting, pain, swelling, tiredness, headache, fever, nausea, dizziness, vomiting, itching, bruising, stomach ache, shortness of breath, chest pain, swollen glands, weakness, tiredness, seizure, blood clots, and death. Times Up! The answer: from Merck and Co., Gardasil which may help prevent cervical cancer in your teenage daughter.

MALE VOICE: My name is Rafael Torruella, and the work that I do is a broad and interesting question. I guess the best way to say it is that we are a harm reduction organization. That means that harm reduction is not just a way to do services that reduce HIV and Hepatitis C, it is more of a way to conceptualize the problem. So we do service from a harm reduction perspective; we do policy from a harm reduction perspective; we do advocacy from a harm reduction perspective. We also do technical networking from a harm reduction perspective in order to have other organizations understand what harm reduction is and from there they can provide services such as overdose prevention, syringe, exchange, and thinking about next steps to make service delivery better as well as how to push government to think more openly and more humane toward people while having less of a stigma. So the thinking that we need to just catch people and then prison will give them better services is just not true. Putting a drug user in prison is not the right approach. So we approach the things that we do from a harm reduction angle.
DEAN BECKER: I want to underscore what you are saying in that there is a diverse set of processes and applications that you try to do to make that harm reduction work. I would like to submit that harm reduction is growing; it seems to be finding new avenues of approach or new means to accomplish those goals, am I right?
RAFAEL TORRUELLA: Yes and at the same time it is being used in wrong ways and some call harm reduction something that is not actually harm reduction. So there is more growth and diversity and there are also people saying that they do harm reduction but they don’t. Some say that they work in Public Health and that this is a public health measure and the first part of it is to roll out the cops and criminalize people which is not public health.
RAFAEL TORRUELLA: That is actually criminalization which is the wrong way to go; we have done it and it doesn’t work. Harm reductionists are saying the same thing and now it is now in vogue to be harm reductionists in a way because there is this whole opiate overdose crisis. We should come back and talk a bit more smartly about it because it is not just an opiate overdose crisis because it is contained to the United States and Canada mostly so it is more of a policy thing. If it were a global thing, it would be everywhere but it is not. It is a policy problem, a lack of access problem, a criminalization problem, a stigmatization problem of a drug user and that is the wrong approach and something that has created the symptom or the outcome of an opiate overdose crisis.
RAFAEL TORRUELLA: Harm reduction can be used in incorrect ways; for example, just doing overdose prevention with cops when cops and drug users don’t get along so why throw the money at cops to do overdose prevention when people who are drug users don’t call cops when there is an overdose. I am not saying that cops shouldn’t do it but a first line should be redefining that first responder as a drug user and that is where the main response is because we’re all hiding in order to use drugs because we are being persecuted and criminalized. Who can help me if I am overdosing? My buddy, my friend, my family member that knows that I use – but not the cops. Let’s start with what we know works.
A wrong way to do harm reduction would be if you have ten dollars for opiate overdose prevention and you gave that ten dollars to the cops and not to a community based organizations and harm reduction organizations that are already in contact with active drug users because mostly active drug users will die of using. Giving that money to the cops may look like harm reduction from far away but when you get down to it is not policy based on evidence and focused where the need is and what harm reduction should be.
DEAN BECKER: Okay folks, we have been speaking with Rafael Torruella and we have kind of overlooked the elephant in the room. Where are you doing your work, Sir?
RAFAEL TORRUELLA: I am doing my work in Puerto Rico. I was born and raised in Puerto Rico but received my education in the United States where I did overdose prevention, harm reduction, and syringe exchange and now I have this beautiful chance of being a part of an awesome team in Puerto Rico, so I have gone back to my home and I work from there at a harm reduction organization providing services including syringe exchange and with the behavioral side as well as a biopsychosocial harm reduction outreach model for people who use drugs including sex workers and homeless individuals, advocacy and policy change, and technical (UNINTELLIGIBLE) on the island and in the Caribbean and in Latin America when I get a chance.
DEAN BECKER: I mentioned earlier that perspectives are changing here. Are perspectives changing there on your island with regard to the cops and the top dogs?
RAFAEL TORRUELLA: Sadly not as much as we need in order to create sustained change. There is this new consciousness that is out there but what do you do with consciousness once it is there? You have to give it shape, form, teeth, background, and policy as we as ideas. It is not just this consciousness that we should be better to drug users and that the war on drugs doesn’t work. What are we going to do with the knowledge that we have? We specifically have policy that includes basic stuff. Don’t put drug users in prison or jail. The criminal justice system is not the intervention these people need. Additionally, everybody deserves access to healthcare including drug users.
DEAN BECKER: Appropriate medicine when required.
RAFAEL TORRUELLA: Yes. Also this should be approached from a civil and human rights angle. The black, brown, and poor communities need to stop being criminalized. The war on drugs has created a massive human and civil rights problem mainly in the United States. We also need to regulate the markets and use the best of science to lead the way and we need to create a plan. Most of the United States doesn’t have a plan.
We have strategies, techniques, and things we know we want to do in place of the failed drug war. Some people are listening. After Hurricane Maria some people have been listening, but the top dogs are still too invested and I think there is enough corruption with the war on drugs that lubricates the system that doesn’t work.
DEAN BECKER: One last thought, you mentioned the hurricane. Are funds less available because of that?
RAFAEL TORRUELLA: The hurricane only took the lid off the mess that the relationship between Puerto Rico and the United States has. A lot of people are asking if they need a passport to go to Puerto Rico and I explain that they don’t because it is a Colony of the United States, and yet we can’t vote for a President. Trump is our President but we can’t vote for him because we don’t have the right to vote. You gave us this messy President to begin with so –
DEAN BECKER: Not me! Well, Rafael, I want to thank you for your insight and your effort because we all do what we can and I thank you. Is there a website you might want to share with the listeners?

RAFAEL TORRUELLA: Our websites are:, and, and thank you for your work and all that you do.
DEAN BECKER: Thank you, Sir.
Conscientious objectors to drug war I submit my objection to the injustice of our nation’s drug policy, especially the incarceration of nonviolent drug offenders. I state that my belief and actions henceforth in regards to the control of supposedly controlled substances will align with common sense, modern science, truth, and reality itself via modern science and reporting. It is now easy to discern that the war on drugs is a failure of immense proportion and a century of horrible lies with misfiring propaganda. The majority of the harms ascribed to drug war are actually caused and exacerbated by the mechanism of the drug war itself. In recognizing the truth of this matter, I seek to be recognized as embracing rationality and common sense. I therefore state that my conscience compels me to commit to ending the war on drugs. As a conscientious objector to drug war I am logically compelled to reach out to others, to humanity to join in this conscientious objection to this irrational war on plants and plant products via an embrace of one or more of the following reasons to end this eternal assault on human dignity and life.
The following comes to us courtesy of celeb stoner and medical marijuana pioneer, George McMahon who passed away in Algona, Iowa on November 30. He was 69 years old. McMahon was one of a handful of federal patients who received 300 joints a month from the government’s secret Compassionate Investigational New Drug Program. He had been receiving that marijuana since 1990. He was hospitalized in 1988 when he was 38 years old and he was offered a joint by an orderly there at the hospital where he “noticed that when I did smoke marijuana I didn’t get sick”. But McMahon said the government weed was “not very good, and not very potent”. He stopped receiving the federal stash in 2013 when his doctor retired. McMahon who ran for Vice President as a grassroots party candidate in 1996 and 2012. He wrote a book in 2003 called Prescription Pot: A Leading Advocates Heroic Battle to Legalize Medical Marijuana. He is survived by his wife Margaret and their three children.
I was able to dig out a 2002 interview I did with George. It is very rough, but he makes a very valid point. Please listen.
GEORGE MCMAHON: I know that there are things out there that are much more effective for me. I can smoke much less. I would like to do that. I am one of the people that you’ll meet that would only want to smoke less. I smoke a lot every day, seven days a week. I just don’t like to do it as it is just too much. If I could do it less I would be happy.
DEAN BECKER: In this day and age when even Willie Nelson is cutting back, if not quitting his smoking of marijuana George makes a strong point that we need to make this stuff stronger and purer and easier to use. We need to stop making people smoke bullshift.
Again, I remind you that because of prohibition, you don’t know what’s in that bag. Please be careful!

Cultural Baggage is a production of the Pacifica Radio Network, archives are currently stored at the James A. Baker III Institute for Public Policy, and we are all still tap dancing on the edge of an abyss.