10/24/18 Monique Tula

From New Orleans, Harm Reduction Conference with HRC Exec Dir Monique Tula, Gary Langis, John Koch & Denise Cullen from GRASP

Cultural Baggage Radio Show
Wednesday, October 24, 2018
Monique Tula
Harm Reduction Coalition



OCTOBER 24, 2018


DEAN BECKER: We open with the sound of the calliope on the steamship Natchez. This is Cultural Baggage, I am Dean Becker, and this week we go to New Orleans to attend the Twelfth National Harm Reduction Conference.

GARY LANGIS: I'm Gary Langis, I'm from Gloucester, Massachusetts.

DEAN BECKER: Okeh, now, Gary, we're here at this Harm Reduction Conference. There's apparently they said two thousand or so people showing up for this, from around the country, some from around the world. What's your first impression, what are you learning here?

GARY LANGIS: I knew there were a lot of folks going to be here this year, a lot of young folks that are, you know, just coming into, you know, the movement, and I saw it as an opportunity, really, to, you know, like, leave some kind of message for, you know, meet some of the new folks, meet them, let them, you know, understand where we really, you know, where we came from, and, with the syringe exchange, took a long, long time, it's still taking a long time because we have so much, you know, we have so much further to go.

With the naloxone, it worked a little faster, and I honestly, honestly believe that it's because of the population that's being impacted by a lot of the overdose, being white, suburban kids, you know. And now that you have, you know, parents and loved ones going to their legislators, demanding stuff, you know, we didn't have that -- that voice, you know, like, other than the voice of the drug user, who really didn't have a big say in how they're treated, how they're, you know, medically treated, how they're treated in society, how they've been demonized for friggin' eighty, a hundred years, since the 1870s, right?

And, so, we have -- we still have a long way to go, and I just want people to realize what the foundation is about, and what the foundation was built on by folks like, you know, Allan Clear and Edith Springer and Imani Wood, and, you know, Dan Bigg, and Dave Purchase, you know, like, those are folks that like, you know what, I mean, I still see Allan around, but for one reason or another, some of them can't be here, some of them are not with us any longer.

You know, there were so, so many, you know, like George Kenney, that we just, we don't have any longer, and it's, you know, this didn't happen overnight, it wasn't, it really wasn't an initiative pushed by public health officials, by law enforcement, by treatment providers, and as a matter of fact, it was like really hindered by that whole population, that whole crew of public health officials, treatment providers, and law enforcement, you know, those were the folks that fought harm reduction tooth and nail for years and years and years.

And now that we have, now, it's becoming recognized as, like, the, you know, an issue, the opioid crisis, overdose, losing so many people every year to fatal overdose. You know, we have programs starting around the country, and it sort of feels like harm reduction is being hijacked a little bit by some of these groups that have been, you know, that have really, you know, fought us through the year, like, treatment folks, that said, you know, like, that really, really, you know, talked down on us, for years, and decades.

And law enforcement, who used, like, who have arrested I don't know how many of us in here, that they've just, they've arrested like, you know, we've been put on trial and jury trial, and not only did it, like, it cost us time and effort and money, you know, it cost society money to prosecute us, but for what? For giving someone a clean, sterile syringe, so they wouldn't become infected?

And what I see going on around the country is a lot of these state coalitions being formed to combat this, the opioid crisis, or the overdose crisis, and our community folks are looking for the experts, and the experts are disguised as, like, law enforcement and treatment people who say we're the experts in harm reduction, when, like, you know, they're just coming on board, and why are they coming on board? Is it because of the, like, the hundreds of millions of dollars that, or the billions of dollars, that are being put toward, you know, put out there now?

That's the way it looks, you know, and the voice of harm reduction is, like, pushed away, not, they're not invited to the table. You know? I've heard so many times that, like, the experts in Narcan distribution and working with drug users is law enforcement. That's such bulls**t. All right?

Treatment providers that, like, you know what? They have their agenda, and that, and they continue to push their agenda in harm reduction.

Support the drug users' agenda, what, where they want to go, and how they want to get there, and be a voice in -- being a voice in what is out there for them. You know, there's no voice, there's no, a lot of the states are not inviting the real deal folks to the table, and to honest, like, we are the closest thing to the voice of the drug user, other than the drug users themselves, who should be sitting at the table, but that's not going to happen, it's just not going to happen right now.

It might happen, in small, like, little areas, little pockets, and that's what we try to do, is, like, get that voice to the table and get those folks that are being impacted, impacted by this, at the table, because they're the most important person to, like, address this issue. Like, they're the ones that are the first responders, you know, they're right on the front lines.

So, again, you know, I hate to see a movement watered down by a bunch of bureaucrats that, like, that have fought us for years and years and years, and now that there's money on the table, we want some of the money and that's why all of a sudden they're experts.

DEAN BECKER: You know, it's good that you're here, it's good that I'm here, to teach these young kids that it hasn't always been this good, not that it's perfect yet, mind you, but that it's taken a hell of a lot of work to get to this point, and as you say, we now have the treatment providers and law enforcement wanting to get in front of that new pile of cash they see on the horizon.

They want to take the forefront. They want to be the one who decide what is appropriate, mostly so they can get their share, the cut. Closing thoughts, there, Gary.

GARY LANGIS: I talked about the importance of coming down to, you know, to meet some of our new, brilliant, brilliant young folks. They're coming in with masses of, you know, public health, they're coming in with these degrees, they, you know, when we started this, we were a bunch of scruffy, you know, guys, that ran around.

You know what? I'm down here with my nineteen year old grandson, and I have other grandchildren, and I see -- and I work with a lot of young folks in this movement, and I learn more from them than I could ever teach. You know what I mean?


GARY LANGIS: And they can -- and they can refine it, and they can make it better. And that's it.

JOHN KOCH: My name is John Koch. K-O-C-H. And my title -- I work for an opiate treatment program called Community Medical Services, and my title is Director of Community Impact.

DEAN BECKER: Now, where are y'all based?

JOHN KOCH: We're based out of Phoenix, but we're in -- also in North Dakota, Montana, Alaska, Tucson, Arizona, and then we have recently acquired a couple of other companies that are in other states.

DEAN BECKER: Well, give us more of the nature of the work. What are some of the specifics, the -- what do you do for your clients?

JOHN KOCH: So, we provide MAT services, medication assisted treatment, along with counseling, peer support, nursing, I mean, the whole nine yards when it comes to an opiate treatment program.

Another thing we do is we provide every single one of our clients that walk through our doors with naloxone, so that they can help save a life, or have their lives saved if they need to, because we are very pro-harm reduction. We don't believe -- part of our mission statement is to reduce the consequences of drugs and alcohol for the person, so, with that, you know, meeting the person where they're at, helping them, allowing them to be able -- to feel safe, at the place they're going, and not like they're being judged.

DEAN BECKER: Yeah, that's very important, you're so right there. You know, I look at it that, over the decades, the perspectives have changed so much, haven't they? That, twenty years ago, there was not one law enforcement group, not one medical group, that approved much of the type of work you're doing. They thought it was enabling addiction. Talk to that change, if you will.

JOHN KOCH: Oh, well, we still deal with a huge amount of stigma, but I think what's coming is, and what's here is, that people are dying, and you have to understand that a lot of the -- that this is individualized treatment, and a lot of people, you know, are starting to realize that, hey, what we're doing is not working. We need to try some other stuff, or try this stuff that's proven to work instead of just, like, bringing our own opinions or beliefs into it.

Let's look at the science and the data behind it, just like with harm reduction. But we still receive a ton of stigma. But that's, like, my job, is to go into the community and break that stigma. Talk with the people. I'm a person in long term recovery myself, and you couldn't tell by talking to me that, you know, I was homeless, that I was in prison, and that's what we try to show people in the community, that there is no face to this.

There's no, like -- addiction and, you know, poverty doesn't look like one thing or the other. People need help, and we need to support them, and not judge them.

DEAN BECKER: Well, and that's -- that is the case. I mean, the number, 72,000 dead last year, right here in these United States. That is resonating, that is starting to ring the bell, so to speak, it is starting to help others realize there is a definite need for change. Would you agree?

JOHN KOCH: Yeah. I mean, if you look at it, so, 72,000 people, that's almost like a huge airliner going down every single day, and crashing, and everyone's dying, and if in this country that was to happen with anything else, that we would, I mean, we would be on the -- doing everything we can to change it.

But, due to, in the past, there was, with addiction and other things, and the stigma that relies upon it, they think people are making those choices just to harm themselves, when they're not. Everybody's a good person, and we need to try to help them, so I think it's bringing light and attention to it. It's just that we can't stop and even after a common opiates go out of the limelight, like, we still need to focus on helping people with that.

I mean, I would love to, in two years, not have a job for what I'm doing because everybody's doing better, but it's -- that's not the fact of it. It's just not going to happen like that. But, keep doing what we're doing.

DEAN BECKER: There's going to be new generations that are going to think they know it all, and will start down that long, dark path, without knowing the repercussion. Right?


DEAN BECKER: John, I really appreciate you taking the time. Is there a website, some closing thoughts you'd like to share?

JOHN KOCH: Yeah, I mean, you can look us up on CommunityMedicalServices.org, and reach out through there. And it just -- if you know somebody that needs some help, look, find the resources, and also look into those resources, because not every resource is a great one, and a lot of people are taking advantage of this epidemic to also become rich, which is not exactly -- it's not the right thing to do, but look into what you're referring people to, and, you know, don't judge the person, and support them in what they're going through, no matter what it takes.

DEAN BECKER: Ladies and gentlemen, Mister Cheech Marin.

CHEECH MARIN: This is America. You get to criticize the government in this country. You get to say, I think these guys are ridiculous. It's guaranteed in the very First Amendment to the Constitution. It's what this country was founded on. You get to do that by being an American.

DEAN BECKER: It's time to play Name That Drug By Its Side Effects! Yellow eyes, vomiting, black tarry stools, cloudy urine, fever with chills, sores, ulcers, or white spots on lips and mouth, unusual bleeding. Time's up! The answer: another FDA approved product: acetaminophen.

DENISE CULLEN: Denise Cullen.

DEAN BECKER: What is your organization, please?

DENISE CULLEN: Broken No More, and GRASP: Grief Recovery After a Substance Passing.

DEAN BECKER: Now, we're here at the this harm reduction conference in New Orleans. I missed the first day or two. What's your take? What are we learning here?

DENISE CULLEN: Well, there's a lot of new people here, that's a good thing. There's many, many more people that I don't know and haven't ever met than there are people that are the regulars and the oldtimers.

DEAN BECKER: Well, I think that's indicative that this issue's not dying, this need for human rights, this need for respect, this need for change, is gaining strength, is it not?

DENISE CULLEN: It definitely is, because this problem, and in particular the opioid epidemic, or crisis, or whatever you choose to call it, is just getting much, much worse every day.

DEAN BECKER: Well, and that's very much in the -- in the ball park, or the bailiwick of what you guys are all about, that you have been about, overdose epidemics that have taken so many of us, that have taken our youngsters, right?

DENISE CULLEN: Exactly. And we're talking much more these days about appropriate and science based treatment for people who are addicted to opioids, and that will obviously cut down on the death rates, and getting people help when they need it and want it.

DEAN BECKER: Well, you know, I often talk lately about, they've got these new drugs that are, you know, symbiotic [sic: synthetic] or whatever you want to call it, heroin, carfentanyl, five thousand times stronger than heroin. Nobody knows what's in that bag and it's killing our kids, is it not?

DENISE CULLEN: You've been saying that since I met you, as long as there's prohibition, you don't know what's in that bag, so be careful out there.


DENISE CULLEN: And it's more true today than it ever was.

DEAN BECKER: Yeah. Yeah. I put a meme up on Facebook, a little one packet -- one gram sugar packet worth of carfentanyl equals five kilograms of heroin. Fifty thousand doses can be in that one gram bag. It is so dangerous now.

DENISE CULLEN: Right. It really is, and when you don't know what you're taking, I mean, they cracked down on the pills and so what are people supposed to do? Go, oh, okeh, I guess I won't use anymore? No, they're going to get what they can get, and what they're getting, they don't know what it is.

And so people are dying left and right, at such a high rate, and we have to do something about it, and there's a lot of talk, and little action, and not a lot of money going towards it. And that's what's wrong.

DEAN BECKER: Well, I know your organization's not exactly, you know, replete with cash. You have a lot of interested and concerned members and supporters of the work you do. Tell us the, I don't want to say average, or typical, but, who gets involved with your work?

DENISE CULLEN: Well, with GRASP, it's always somebody that knows somebody who's died from either drug use or overdose, typically overdose, and their families, and, but with Broken No More, it's the wider community of people that just care, like people that are here, it's not just overdose that they're interested in, it's changing drug policy and improving what we're doing.

And still after, you know, it seems like forever, but it's been nine years I've been doing this, and we're still having to address the stigma, and language, and how people, you know, appreciate this problem, because it, if you don't know somebody, there's still a lot of ignorance out there.

These days, it seems like almost everybody knows somebody.


DENISE CULLEN: So that's changing, but we just have to keep being loud, and louder, and keep talking, and we're now fighting against this -- this group of families that, I was told when I started this I had the moral authority because I was the mother of a child who died. Well now we have lots and lots of mothers out there who want to put people in prison for the rest of their life because they happened to be with their child or their loved one when they took that last dose of something they didn't know they were taking.

You know, the dealer issue, and that, that's something that we, at Broken No More, fight very hard against and have been for years. And so, it's -- that problem's getting worse, with the introduction of a lot of drug induced homicide laws and prosecutions.

So we have to be even louder than the families that are new coming into this, because they haven't -- they're newly bereaved, and they're angry, and trying to find blame. So we have to just push back on that even harder than we did before.

DEAN BECKER: You know, to me, it really boils down to the ignorance that's been kind of ingrained into people, that's been force fed over the decades. It's really hard to remove, it's like plaque or something that you've got to clear out to get a free flow of new and useful information. Your thought there.

DENISE CULLEN: Yeah, I feel like that too. And, every single day, you see another, you know, Vice show or HBO show or some kind of, what you would think is credible news, about the opioid epidemic and the drug policies, and the sentencing laws, and how we need to get harder on it. It's like we're taking, you know, two steps forward and ten back. That's how it feels to me. It's discouraging, but we have to keep having hope.

DEAN BECKER: No, too much television is just -- just still spouting propaganda, still recycling the old, in essence, reefer madness. Reefer madness is attached to every drug, as far as I'm concerned. It has leached over over the decades.

DENISE CULLEN: Yeah. I can't watch those shows, because they're just -- even when they try to do their best, there's still misinformation and stigmatization and that. And every time you talk to a reporter these days, someone wants to interview you about the issue because you're involved in it, you have to be extra careful now, because they, you know how some reporters are, they twist what you say and -- to fit with what they want it to fit with.

And so, it's -- we just had our fourth biennial conference, I don't know if you know that.

DEAN BECKER: I was aware.

DENISE CULLEN: And, we had Tony Newman from Drug Policy Alliance come to teach new people about dealing with the media, and how to get what you want, and acknowledge that they want what they want, and try to, you know, accomplish what you're doing, and not make the problem worse.


DENISE CULLEN: Especially with the grieving part of the work that I do, because those people are vulnerable, and they're a lot of times new to this, and it can go -- it can go sideways real easy.

So, we try, at our conference we try to educate, not just about how to cope with the loss of someone you loved, you know, sometimes more than anyone in the whole world, and, but how to get involved in doing this work to make change, to make that person's death mean something.

Their life did mean something, we know that, but their death has to mean something. And so getting involved in any way, and teaching reality based education in schools is a good way, if you want to just do something more neutral and less scary, or getting involved in syringe exchange, or testifying for your legislature to get bills passed for safe injection facilities.

And people are hungry for that. Not everybody, but a lot of people are. They need a goal, and it can be a healing mechanism to get involved.

DEAN BECKER: Well, if folks would like to get involved with the work you do, please point them to your website, how they can reach your organization.

DENISE CULLEN: Okeh. For, we have two. GRASP is GRASPHELP.org, GRASPHELP.org, and then for the advocacy and policy and harm reduction portion of what we do, it's Broken-No-More.org.

MONIQUE TULA: Monique Tula, Executive Director of the Harm Reduction Coalition.

DEAN BECKER: Monique, I want to commend you. This is an amazing event. The diversity, the enthusiasm, the people. It's really something. Thank you for this.

MONIQUE TULA: Oh, you're welcome. You know, we've got two thousand people here this weekend. It's the largest event that we've ever had, and in fact it's the largest harm reduction conference in the world.

DEAN BECKER: No, I've been to many of them, and this one is something else. I tell you what, the courage, the knowledge, that the people I've been interviewing, is really amazing. It's -- it's grown over the years. People are not afraid to do more, to speak out, to challenge the old ways.

MONIQUE TULA: Yeah, indeed, you know, and I think, you know, there's a double edged sword to this growing movement. Right? We've got more and more people who are embracing this philosophy, this very humane approach to working with people who use drugs, people who have been affected by the war on drugs.

But the other side of this, we're growing because we have so many deaths related to opioid fatalities, you know, and so we've got communities that are sort of filling the ranks of the harm reduction -- harm reduction community, you know, friends and family members who are joining us because they've lost people.

DEAN BECKER: And that tends to give people courage, enables them to speak a little louder, a little more boldly.

MONIQUE TULA: Yeah, absolutely. We've got at least two, maybe three different what I would call mothers groups who are here, GRASP and Broken No More, who have found their voices and use this conference as an opportunity to share their experience, to prevent more children from overdosing from opioids.

DEAN BECKER: It comes back to the futility of the drug war, the inability of it to ever accomplish any of its stated goals. We, for decades, turned it over to law enforcement to fix this medical problem, and it did not pan out.

MONIQUE TULA: No, it absolutely did not, instead we filled up our jails and prisons with people, we have commodified black and brown families, families have been broken apart, and, you know, we are not seeing a decreased incidence of drug use, in fact we're seeing more drug use than ever before.

DEAN BECKER: Yeah. I think the economy has something to do with that, but the economy of a drug user is many times in a spiral downwards because of the complications in life, the arrests and then the inability to get a job, and so on, and so forth, leads to, now we have record numbers of people that are homeless here in America, and a large part of that has to do with that spiral I'm speaking of, does it not?

MONIQUE TULA: Yeah, indeed, you know, there were some researchers that figured out, they were looking at the decline of American life expectancy, and found correlates between what they're calling sort of deaths of despair, or diseases of despair, so they were looking at rates of suicide and overdose -- overdose and overdose, fatal overdoses, and, you know, they were really indicators that people, because of stressors, are really acting in ways that quite frankly are, you know, out of desperation, because we don't know -- we haven't been given the tools to manage this increasingly complicated world that we're living in.



DEAN BECKER: In some ways we have become more callous, and in other ways we've become more compassionate. It kind of depends on which side of this coin you were on in the beginning, to bring us to this point. What am I trying to say -- I'm trying not to talk about Republicans, but --

MONIQUE TULA: We talked about being grouchy before, we talked about the fact that there are two thousand people here who would probably agree that we're all feeling pretty grouchy, pretty raw, like almost in a place of desperation when we look at our administration.


MONIQUE TULA: Right? If there's nothing else that binds this community, it's that. We're incredibly disappointed, and in fact, even Harm Reduction Coalition, we have done a lot of federal advocacy and federal policy making, but quite frankly, we're reinvesting at the state level. We're turning our attention to the state level because we think that that's where we're going to get the most traction in the next, certainly in the next two years, and potentially the next six years, which is a really scary thing.

And I just want to say one more thing. So we're here in New Orleans, and we received word earlier this morning that the Proud Boys are here, which is a white pride, alt-right group, and we are, you know, we're really concerned. They're here in New Orleans. We're really concerned about our people, you know, and so when we -- when I think about how far we've come as a community, that we're seeing the rehumanization of people who use drugs, that it's going to be -- you know, if we get there, then we've got this whole other contention, you know contingent to deal with.

We've got a lot further to go, and what's right outside the hotel door is a clear -- is a prime example of that. They literally drove by in a truck that said Trump Unity.

DEAN BECKER: Y'all's website.


DEAN BECKER: The following is a Drug Truth Network editorial.

As Monique and I were discussing, there's a lot of tension, hatred, building up on the left leaning side here. I've been trying to discern what the right's love of Trump is all about. And I've figured it's just greed, a lot of forgiveness of greed. His lies don't register with his minions because they give him all the slack he needs, figuring he's a billionaire, a tv star, a huge success, because he is an ass-hat, a manipulator, a winner.

So you've got to forgive rich fatcats for being massive sinners, deviants, liars, thieves, because that's what made them a success and some of that luck may rub off on his minions, and on the US, so forgiveness abounds.

Besides, they already made their bones when they voted for this ass-hat, and cannot now back down without admitting they are a herd of doofi, the multiple of doofus, and that's a hell of a lot like being a lifelong supporter of drug war, where you cannot now admit that the death, disease, empowering of terrorist cartels and gangs, along with fifty million arrests and squandering of trillions of dollars, could have ever been avoided.

Well, that's going to wrap it up for this week, and once again I want to remind you that because of prohibition you do not know what's in that bag. Please, be careful.

Drug Truth Network transcripts are stored at the James A. Baker III Institute, more than seven thousand radio programs are at DrugTruth.net, and we are all still tap dancing on the edge of an abyss.