09/23/16 Anna Marie D'angelo

Anna Marie D'angelo Dir of British Colombia safe injection rooms, Kris Nyrop of Seattle Law Enforcement Assisted Diversion, Shiloh Murphy Dir of Peoples Harm Reduction Alliance, Washington Representative Roger Goodman, Seattle Sheriff John Urquhart

Cultural Baggage Radio Show
Friday, September 23, 2016
Anna Marie D'angelo
Health Administration



SEPTEMBER 23, 2016


DEAN BECKER: Broadcasting on the Drug Truth Network, this is Cultural Baggage.

DR. G. ALAN ROBISON: It is not only inhumane, it is really fundamentally un-American.

CROWD: No more! Drug war! No More! Drug War! No More! Drug War!

DEAN BECKER: My name is Dean Becker. I don't condone or encourage the use of any drugs, legal or illegal. I report the unvarnished truth about the pharmaceutical, banking, prison, and judicial nightmare that feeds on eternal drug war.

Thank you for joining us on this edition of Cultural Baggage. I am Dean Becker, your host. Today, not too much talk about marijuana. We're going to talk about safe injection sites and free heroin for addicts. That kind of stuff.

ANNA MARIE D'ANGELO: My name is Anna Marie D'Angelo, I'm the senior media relations officer for Vancouver Coastal Health, which is the health authority in British Columbia, Canada.

DEAN BECKER: Yes, ma'am. I've had a chance to tour the Insite location, when I was in Vancouver several years back, and it seemed to be working quite well, and here we are I think 8 or 10 years later, Insite is still doing positives for your community. Right?

ANNA MARIE D'ANGELO: Yes. Since it's opened, and it opened in 2003, there's been over three million injections that have occurred in Insite under supervision of nurses. And there's never been one overdose death.

DEAN BECKER: Now, here in the United States, we are enduring, if you will, an avalanche of overdose deaths from portended legal drugs, which actually contain Fentanyl, to the heroin, which seems to be replacing the Oxys for many people. And the death toll is rising, but the city of Seattle is trying to do something about that. They are considering a safe injection site in their community. What's your thought in that regard, please?

ANNA MARIE D'ANGELO: Well, it's never -- it's not a safe injection site, because it's never safe to inject illicit drugs. It's supervised injection. For us, obviously, the benefits of Insite, the supervised injection site in Vancouver, have been proven over and over again. It does save lives. It connects clients to other services, such as detox, an abstinence program, and other healthcare. It is part of our addiction services that we have in our continuum, as an option for people that have -- that nothing else works for.

DEAN BECKER: Yes, ma'am, and I'm looking at your website here. One of your bulletins if you will talks about 86 percent of the drugs that have been inspected there at Insite contain this more powerful and deadly drug, Fentanyl. Would you talk about that situation, please?

ANNA MARIE D'ANGELO: Actually, earlier this year the provincial health officer in British Columbia declared a crisis in Fentanyl inclusion in illicit drugs. We're on track for having about 800 deaths this year from overdoses, mainly related to that. And we're not unique in British Columbia. You have the same problem in the United States, also across Canada. The antidote to that is obviously what they call Narcan, or naloxone, that that's administered immediately, and sometimes they have to do two and three, sometimes four injections, the Fentanyl's so strong. A person is revived and lives. So, we did do a survey of clients, if they would let us test their drugs, and we found out that most of them, close to almost 90 percent actually, had Fentanyl included. And we don't call it contamination, because illicit drugs are not, you know, standardized in any way. But the other thing, too, is somebody intentionally put that in those drugs, although they don't tell the person receiving it that that's what's in there.

DEAN BECKER: Right. And this is just an additional complication, if you will, to this prohibition scheme, that, you know, even heroin can't be trusted these days. I hear they're even using an even stronger component, elephant tranquilizer, which is several times stronger than Fentanyl. Have you seen that, there in British Columbia?

ANNA MARIE D'ANGELO: There -- it's been suspected a couple of times and no, there was another location in Canada that had confirmed that. Yeah, it was the tranquilizer, the horse tranquilizer drug. Yeah.

DEAN BECKER: Yes, ma'am. Well, if you could give some thoughts to the politicians in Seattle, heck, around the world, for that matter, in regards to their position, their draconian stance in regards to drugs, in particular heroin, there is a better way, I think, it's being proven there at Insite, is it not?

ANNA MARIE D'ANGELO: Well, we look at it, we're a health authority, so we look through a healthcare lens. A lot of people look at it through a police lens. If you look at it through a healthcare lens, addiction is an illness that you need to treat, that's our view of it. It's -- some people think it's kind of a pragmatic approach, in that, you know, it's really a black and white issue, and it's not right what we're doing, but actually, it's medically researched and supported, that, you know, harm reduction let's you reduce the harm you do to yourself and you connect people to care. Our goal always is health and healthcare, it's abstinence, because it's not a good idea to be doing illicit drugs, taking illicit drugs, any time.

So, for, like, say, for some people, it's a black and white issue, it's just not right. But if you look at, say, the patch, the cigarette patch, that's a harm reduction model. You're getting the nicotine, the addictive substance, but you're not harming yourself with the smoke. You look at say an alcoholic, that's drinking, you know, 15 glasses of alcohol a day, if you reduce that to 5 glasses a day, nobody has a problem with that. But as soon as you go into the illicit drug area, people, the only option for a lot of people is abstinence, just got to say no, that's wrong what you're doing. But it doesn't work. One size doesn't fit all when you do addiction treatment and you have to give people those options.

Certainly, and you have to do something, that's the other thing too that we found out with Insite, because there are -- there is a cost if you don't do anything, because of all the tragedy, all the people that die, the huge draw on your first responders, that have to respond to these overdose deaths. Your draws on your healthcare system, like an emergency with people unconscious and dying of overdoses, you know, you really need to have other things in your bag of tricks to deal with this.

DEAN BECKER: All right. Well, once again, we've been speaking with Anna Marie D'Angelo, she's senior media relations officer at Vancouver Coastal Health.

KRYS NYROP: So, my name is Krys Nyrop, and I am the LEAD National Support Director, and what that means is that it's my job to assist, providing technical support and assistance to jurisdictions around the United States and even in other countries that are interested in implementing LEAD projects.

DEAN BECKER: And now, let's talk about LEAD projects. I am trying to work with some local community folks to bring forward that idea for the city of Houston. How would one begin that process?

KRYS NYROP: Yeah, and actually you and I should talk offline at some point, because there's been interest in Houston before. But typically the way that a jurisdiction expresses interest in doing LEAD is either community groups or police, or prosecutors, or business groups, or some combination thereof, comes together and decides that LEAD is something that they're interested in looking at and perhaps pursuing. And then reaches out to those of us who are already working on LEAD programs here in Seattle or Santa Fe, or now Albany, New York, and that sort of begins the process of dialogue.

DEAN BECKER: Just last week I was talking to a gentleman in Fayetteville, Arkansas, who are trying to formulate a plan, trying to put their LEAD project in effect for their city. It's an idea that has proven itself to be of great benefit, am I right?

KRYS NYROP: You are correct, and the Seattle project was rigorously evaluated by an independent team of evaluators that were funded independently by a foundation that had nothing to do with LEAD, so neither for foundation nor the evaluators had any skin in the game. And they looked at three things, one of which was recidivism, the second of which was cost, and the third of which was individual outcomes, and on the recidivism, people who were diverted into LEAD were 58 percent less likely to be rearrested than individuals who were diverted through the criminal justice system as normal, and that unsurprisingly LEAD is significantly cheaper than the criminal justice system.

DEAN BECKER: Give us some of the component parts, how this LEAD effort functions, please.

KRYS NYROP: So, the frontline part of it is obviously is the law enforcement officers themselves. They are the individuals that are out on the street, that are coming into contact with people who are engaged in either drug activity, as in purchasing or using drugs, or activity that they may be engaging in to support a drug habit, such as prostitution, perhaps, you know, car prowls or shoplifting, things like that. So the officers are the ones that are encountering these individuals, and they are the ones that have been empowered under LEAD to offer them a diversion immediately to a case manager. So this isn't giving someone a business card and saying follow up next Tuesday. This is the officers making a phone call to a case manager and there is an actual direct hand off.

And at that point, the individual is in a harm reduction based case management program that focuses on all of what their needs might be. So it does not just focus on their drug use, it looks at their general health, their mental health, their housing status, their employment, you know, all of the things that go into making an individual an individual.

DEAN BECKER: Now, this is, you mentioned, you know, the other crimes that are committed, you know, shoplifting, prostitution, and car burglary, et cetera. And this is often a result of just being caught up in this addiction, this need to hunt down money and hunt down drugs, which deprives them of the ability to actually educate themselves or go to work, or lead a more productive life. Your thought in that regard, please.

KRYS NYROP: Absolutely. You are correct. I mean, it is one of the uncomfortable truths of this, is that some of the most profound harm associated with drug use in this country and in others has to do with the drug's legal status, and because drugs are illegal, they are horrifically expensive and they're hard to come by, so that sometimes a person's entire life gets wrapped up in that, which is not something you see with say people who smoke tobacco or use alcohol in a non-problematic way.

DEAN BECKER: Right. And I want to thank you, Krys, for taking time to visit with us, and again, what we have to do is forget the hysteria of the past, a lot of folks latched onto it, made it part of their life credo, when the truth be told, much of that hysteria just has no basis in reality. Your thought there, please.

KRYS NYROP: Exactly. It is not evidence based at all, it is based on a lot of mythology and a lot of, unfortunately, media in many case have generated and propagated, in some cases they just repeat what they're told by people who have a vested interest in the drug war paradigm that we've been locked into now since the early 1970s.

DEAN BECKER: Folks, once again we've been speaking with Mister Krys Nyrop, he's director of Law Enforcement Assisted Diversion Pre-Booking Division for the city of Seattle. Krys, is there a website, closing thoughts you'd like to share?

KRYS NYROP: Absolutely. So, folks can learn more about us, they can go to one of our websites, it is LEADKINGCOUNTY.org, that's LEADKingCounty.org. And if they're interested in bringing LEAD to their area, we have another website, it's called LEADBureau.org, where they can find out information on how to go about bringing LEAD to their place.

DEAN BECKER: It's time to play Name That Drug By Its Side Effects!

ALEX TREBECK: a 2009 study recommended treating heroin addicts with Diacetyl Morphine, the active ingredient in this.

DEAN BECKER: The time's up, the answer, from a recent edition of Jeopardy!


KAREN: What is heroin?


SHILOH MURPHY: So, my name is Shiloh Murphy. I am the executive director of the People's Harm Reduction Alliance, which is a drug user run direct service program serving smokers and injectors to reduce harm and to stop the spread of disease.

DEAN BECKER: And, Shiloh, you're based in the city of Seattle, Washington?

SHILOH MURPHY: So, I am based in the city of Seattle, but our program goes all the way from Portland to Everett, to Bremerton, which are obviously city names that your listeners may or may not know. But we do a big geographical area, so, but I particularly am based in Seattle.

DEAN BECKER: You know, Shiloh, I had a chance to speak with Anna Marie D'Angelo, up in British Columbia, about their Insite, their, she said not to use the term safe injection, but their injection site, nonetheless. And, Seattle has a very similar idea in mind, right?

SHILOH MURPHY: Yes. So, we are going to do something a little differently, is, we are going to include all drug users. And so, I say that because they, their task was, they did a safer injection facility, which means they only worked with injectors. And our goal is to work with snorters, smokers, injectors, to first and foremost kind of get them off the streets, and also to reduce any harm related to that. So, with opiates, obviously, that's going to be overdose. And able to also link them to services, like, you know, testing, vein care, access to treatment, and other services, you know, to kind of create a place that can be linked to a large group of folks.

Because, like, needle exchanges in our state and our area are really effective with working with injectors, but there's not a lot of groups that work with smokers. And what we don't want to do is, we don't want to send this message of saying, you have to inject in order to have a safe space. Because if I'm a smoker, there's a chance that I might convert to injecting in order to have that safe space, and that seems ineffectual in trying to do disease prevention.

DEAN BECKER: Yeah, counterproductive indeed. Folks, we're speaking with Mister Shiloh Murphy of the People's Harm Reduction Alliance up there in Washington area, I'll just put it that way. Now, Shiloh, what you've put forward there about, you know, allowing people who smoke, inject, or otherwise ingest their drugs, having a safe space, because that's, and you know, I've seen stories of people using ditch water or alley water to mix with their heroin, because of the circumstances they're under. And that's, that's just way counterproductive to the health of that individual, and to those that they may be around, because it's just, what am I saying here, it's just another means by which they can contract diseases, right?

SHILOH MURPHY: Well, yes, I also feel like an important thing that is not mentioned in a lot of these stories is, if you are a every day drug user living in the streets, and really poor conditions, you have been given negative reinforcement about yourself and your self image for months to years. And so, one of the things we do that is really important is to tell people we love them, tell people that we care for them, because that can build their self image, and if you believe that you're going to die tomorrow and you're worthless, you're going to make very different decisions than if you believe you are somebody that can fulfill their dreams, and is a human with -- that has love, that has a community. Because two different people are going to make two different decisions. Right? And we want people to think past tomorrow, we want people to think that they -- want people to not share syringes. So all these things can happen, too.

And also, we're not going to have anyone rushed, and so if you're in an alley and you are going to smoke or inject, you have to do it very quickly because the police can catch you. Right? And they, so, you can do damage to your body just to get the drugs in as fast as possible, and or have an overdose in a rush to get high, where if you come to a place where it's safe and secure, everything there is clean, everything there, you know, there's protocols for where there's an overdose, where there's any incident, and then you go there and you start ingesting. You can take your time, you don't have to make mistakes, you suddenly -- you don't have to use old stuff, everything can be new for hep C infections reduced. So the whole community wins.

DEAN BECKER: Right. Restoring a little dignity to that life is very important, I would agree, Mister Murphy. Well, once again we've been speaking with Mister Shiloh Murphy of the People's Harm Reduction Alliance, up there in the Seattle are. Shiloh, is there a website, some closing thoughts you'd like to share?

SHILOH MURPHY: Yes. First, you can always go to our website, PeoplesHarmReductionAlliance.org, and two, if you live in Seattle and you're listening to this, please, or in King County, please call your elected officials and tell them that you want the heroin task force, all of its recommendations, implemented as fast as possible.

DEAN BECKER: One of the problems I have as a radio reporter is making contact with high elected officials. The other is in screwing up my recording levels. We have a combination of the two, which leads me to use the following, because I can't reach him right now.

You know, it seems with every passing day, more and more politicians, more and more officials, are starting to recognize the futility of this drug war, in regards to marijuana and safe injection sites, and now in regards to the use of heroin for those who cannot seem to escape their addiction through the use of methadone or other drugs. Here to talk about it is one such official who saw the light many years ago, and now is a state representative in Washington, my good friend, Roger Goodman. Hello, sir.

ROGER GOODMAN: Hi Dean, it's good to talk with you again.

DEAN BECKER: Roger, I nailed it pretty good, didn't I? More and more politicians are beginning to realize the futility of continuing down this same drug war path.

ROGER GOODMAN: Yeah, I mean, a dozen years ago, I ran for office, for the first time, and trying to end the war on drugs, and I was a radical. But you know what? I got elected by a large margin, because the public is always ahead of the politicians. But today, I can't imagine a politician arguing to ramp up the drug war, and winning an election. So we really have come a long way.

DEAN BECKER: And, the situation in Seattle is flexible at the moment, people are talking about your state allowing for the use of actual heroin, correct?

ROGER GOODMAN: Yeah, the city of Seattle appointed a task force. Seattle has been a locus of heroin use, both because of people falling into addiction, you know, pain pills, turning to the street and so forth. And also culturally, as well, for a long time. But we do nationally, as you know, have a problem now with heroin addiction. People who are, they don't to be using it, they're caught in a cycle of addiction. And the drug war has certainly made it worse, and in other countries, they have tried the idea of maintenance, or what we're going to be doing here, of safe consumption spaces.

We don't say injection, because, I don't know, needles I guess scare people away, and frankly I wouldn't put a needle in my arm, but we call them safe consumption space or safe consumption room. A place where people who are, they're down and out, these are socially dislocated people who are coming into a safe place, and they're able to administer heroin with a clean, clean apparatus. There's also a gateway to treatment, you know, it's sort of the first time anyone's ever cared for them, maybe, and it is the, a gateway to recovery for many of them.

DEAN BECKER: And, this is following on the heels, I think it's Switzerland, Germany, to some degree Great Britain, and other countries who have done this, to great success. Am I right?

ROGER GOODMAN: Yes, and right across the border, we're in the northwest corner of the United States, and British Columbia, in Vancouver, they've had a safe consumption space for a number of years. Very controversial, but the data, the peer reviewed research, is very clear, it reduces addiction, it reduces public disorder, it reduces the spread of disease. Law enforcement loves it, and anyone who says it fosters more drug abuse or it's, you know, bad for the public spaces, they're absolutely wrong. These safe consumption spaces are a good step in the right direction for people who are in trouble.

DEAN BECKER: Now, this brings to mind, you know, it is the failures of the drug war that are often used as justification for more drug war. And that is, that equation is beginning to lose its connection, it's not working anymore, is it?

ROGER GOODMAN: Yeah, I guess I'd have to say that, you know, the millennials, we keep hearing about the millennials these days, they're pretty wise. They get it. They see through these cognitive distortions, these incoherent messages. With social media and with, you know, people getting educated, that makes sense these days. And so the drug war doesn't make sense, and so it's winding down, I'm very pleased to see.

DEAN BECKER: Once again, we're speaking with Washington State Representative Roger Goodman. We're talking about the potential legalization of heroin in his city of Seattle. And, Roger, I want to bring this forward. We have the escalation if you will of the heroin addiction, of the horrors of the heroin addiction. We've got the Fentanyl on the market, and now, they're increasing it a hundred times even more dangerously with this elephant tranquilizer, put on counterfeit pills. It needs addressed so badly, does it not?

ROGER GOODMAN: It does. I do have to distinguish these strong opiates from marijuana, for instance. These are medically useful, in some circumstances. Heroin, as you probably know, but most don't, was synthesized by Bayer Pharmaceutical in 1898 as a cough suppressant. Heroin comes from the word "heroisch," in German, meaning feeling strong. And was a wonder drug in the first part of the 20th century. So heroin's been around, it's a pharmaceutical, it's not some, you know, dangerous thing out there, it's being misused, but I say, and we have to be very careful about our words, rather than legalization, I say "re-medicalization." That's too many syllables, but I think we need to re-medicalize heroin, so that it is administered under medical supervision, and properly used, and so there's definitely a use for it, but as long as it's prohibited, there's going to be a black market that pops up and criminals are going to get into that space, and then they're going to peddle even stronger drugs, and that's what's happening with Fentanyl and these other opiates that are literally killing people within minutes of their using them.

DEAN BECKER: Now, one thing I'm working on here is to put together a coalition, if you will, you know, the DA, the police chief, some churches, and others, to, I'm hoping to put together a LEAD effort here in Houston. Seattle has done that, Fayetteville, Arkansas just started their effort recently. It's of benefit to the city to at least consider, is it not?

ROGER GOODMAN: Yes. We pioneered it here in Seattle. Very controversial in the beginning, but it's shown great results. Basically, young people who are in trouble or about to be in trouble, in the community, in public spaces, are identified by their peers, who work closely with law enforcement, to intervene before arrest. This is basically pre-arrest diversion. You know, we hear about diversion programs, most of the diversion programs are after you've been arrested or after you've been in jail, maybe even after you've been convicted. We want to push it further up the chain, and say even before you've been arrested, let's identify you and direct you to some therapeutic alternative or to some educational opportunity, or something that will stabilize your life. And it's working very successfully here in Seattle.

DEAN BECKER: All right, folks, there you have it. My good friend, Washington State Representative Roger Goodman.

The following was recorded at a press conference in Seattle last week. The speaker is the sheriff of Seattle King County, John Urquhart.

JOHN URQUHART: I'm here to tell you, the war on drugs hasn't worked. I was a foot soldier in it, so I have a little bit of experience, but I know that it has been a failure. It's been an abject failure, actually, so we have to try something different.

Recently I was in Washington, DC, at a task force convened by the drug czar, Michael Botticelli. And it's really reassuring to see that King County is so far ahead of many communities, who are still debating whether they should have needle exchanges or not. And some of them that do have needle exchanges are prohibited by law to call them needle exchanges.

Finally, what is so reassuring is, when you talk about heroin in particular, is we've gone from a bunch of cops sitting around the table, fighting heroin, to a group like this, who includes a cop or two, but most of the people here have either MD or PhD, or ACLU, after their name, because it's not a problem that I can solve, or my deputies can solve, or any police officer can solve. It's a community problem that has to be solved by everybody. And I'm very happy that that's what we're trying to do right now.

DEAN BECKER: All right, that's it for the week. I hope this show awakens you to the need for change to our drug laws, and it awakens you to the need for you to help make those changes. Reminding you again, because of prohibition you don't know what's in that bag. Please be careful.

To the Drug Truth Network listeners around the world, this is Dean Becker for Cultural Baggage and the unvarnished truth. Cultural Baggage is a production of the Pacifica Radio Network, archives are permanently stored at the James A. Baker III Institute for Public Policy. And we are all still tap dancing on the edge of an abyss.