Stigma Culture in the Overdose Crisis

As it trends today, the US is currently tracking approximately 130 opiate/opioid related deaths per day. Despite the staggering figure, the societal cry, once a piercing shrill, seems to be settling globally into the duller waters of an ever-more-painful and long-term form of simple acceptance. Darker, and a much more dangerous and depressing implication in that it suggests that there are simply just differences between you and me, right and wrong, good and bad. Even more disheartening is that it sort of implies that you (me) might in fact be, alone.

The debate about how to address the opiate epidemic is vast and varied and typically met first by responses that derive from fear, evidenced by enhanced law enforcement, more arrests and increased sentencing. Not far behind lies potential for the issue to be exploited in order to further serve other narratives like immigration, therefore creating a smoke-screen effect with ungaugable progress and a whole new eco-system of distractions. What’s left over is what existed from the beginning, the stigmatic attitude towards the sick, which alone perpetuates a cyclical divide.

I can’t help but notice that as a society, we tend to feel that people need to learn lessons, and hard ones goddamnit! And as spectators, the harder the better. Hell, we take great pleasure in consuming the pain you excrete while you learn your little lessons in life. And us? In those moments, we’ll simply block our own internal circuit boards that carry even the slightest bit of relatability to you, further impending your sense of isolation. Our lessons in life were hard learned and we’d feel deeply cheated if they weren’t for you too.

But as a society and a species, are we truly sadistic in nature, or is it that we simply just fear the unimaginable discomfort of self-reflecting, relating and connecting? Do we really insist that our fellow suffers in order to progress, or are we merely hyper-vigilant in protecting our own state of vulnerability? An objectionable notion, but possibly one that plays an influential role in the stigma of a drug user, or any unparalleled lifestyle that doesn’t make “sense”. Psychologically, it’s common to write-off a suspected user immediately. Age-old thinking can carve a neural algorithm that basically translates to a quick and common determination: “You’re not like me, and probably got what you deserved”. With that said, it’s no surprise to learn that the most effective asset in combating addiction, is another recovering addict. They understand firsthand what it’s like to have judged and to have been judged, and often times possess an intuitive duality of the two vastly different perceptions. An incredible gift to behold. Carl Jung dubbed this concept “The Wounded Healer”, where he implies that to effectively treat the sick, Jung had to be consciously aware of his own personal wounds. Another common judgement levied upon users are speculations as to why they use – usually summed up by simple pleasure-chasing and evading responsibility. Thankfully, this novel generalization isn’t holding up and as it slowly weakens, a little more light gets shed on the true origin of a user’s pain.

In some states like Arizona, efforts are in place to focus on the overdosing aspect of the opioid crisis. Non-profit groups such as Sonoran Prevention Works distribute lifesaving supplies to the public, such as Naloxone and clean syringes. Naloxone is an opiate/opioid antagonist that essentially acts as an antidote to lethal doses of heroin or opioids by restoring abnormal respiration. Shot In The Dark (SITD) is another non-profit organization that focuses on clean-needle exchange programs, giving users the opportunity to acquire clean syringes while safely and properly disposing of old hypodermics.

Organizations such as SPW and SITD are becoming lauded as the tip of the angel’s spear in combatting the opioid crisis. In addition to minimizing the spread of disease and reducing overdose related deaths, these programs communicate an even-more powerful message to the sick. It highlights that they are anything but alone. More importantly, they are accepted and within a short period of time, connected. They’ll take it from there and need not to be “fixed”, at least not by underdeveloped opinions that evolve throughout one’s lifetime, uninformed judgements, or any ideology. We sometimes think that we teach our children to physically speak during development, but they do that on their own. They’re human beings and the most intelligent organism we know of so far in the universe. Parents still play the most vital role however, and I’d argue that role is more along the lines of being an influential conduit for love and support, unconditionally. Perhaps our role in this existence is less defined by our external virtues and subsequent will to align with the like-minded and indoctrinate others, and better defined by our ability to first humble constantly through reflection, then influence with affection.

- Jay Dassele


Sonoran Prevention Works Surpasses 100,000 Naloxone Doses Distributed

For Immediate Release: August 15, 2018
Contact: Sarah Fynmore, (480) 532-8768, sfynmore@spwaz.org

Phoenix, AZ - Sonoran Prevention Works (SPW) is pleased to announce that it has distributed over 100,000 Naloxone doses since January 2017, with 4,553 reported lives saved.

Naloxone, also known as Narcan, is an emergency response medication that is used to reverse an opioid overdose and was approved for layperson distribution in 2016. Sonoran Prevention Works has reached this benchmark in ensuring access to Naloxone through partnerships with AHCCCS, public health providers, community organizations, families, and individuals.

Not all reversals are reported, thus the reported amount of lives saved is conservative. Since June of 2017, the Arizona Department of Health Services reports that there have been 1,613 suspected opioid deaths, without Naloxone, this number could be incredibly higher. It is crucial to continue efforts to get this live saving medication out to those who need it.

The SPW team is thrilled to continue distributing naloxone across the state. Turiya Coll, SPW’s Northern Arizona Overdose Coordinator says, “It is refreshing to see us hit this landmark number, and at the same time I truly believe that until we have naloxone in the first aid kit of every home in AZ, in every person who uses drugs hands, we will continue to see overdose and death. Rural AZ is where my heart lies, and I will continue to advocate and educate and empower up here until we have ended overdose death!”

SPW operates the state’s largest free naloxone distribution and overdose prevention program offering education and resources to behavioral health agencies, hospitals, law enforcement, family members, and people who are at risk for overdose. Any organizations or individuals wishing to have naloxone on hand, please contact Sonoran Prevention Works today.


The Intersection of Drug Policy and Immigration Justice

The battles faced by advocates for immigration justice and drug policy reform have many overlapping and intersecting elements. What has been thought-provoking is how the prioritization of the opioid crisis in the current political agenda has played out in dialogues over immigration control enforcement and border security. Below I will detail a couple recent events that exemplify the intersection of drugs and immigration policy, the underlying theme of culpability, and how advocates must work together to reduce the harms of oppressive policies.

At the National Level

Administrations tie the narrative of drug supply with immigrants smuggling from Mexico, giving ground to enforcement agencies to act on racial biases and further prey upon people of color. In February a congressional hearing was held to discuss how sanctuary cities impede efforts to combat the opioid epidemic because of ordinances that keeps police forces and ICE from sharing information. The purpose of sanctuary city ordinances to limit cooperation with federal immigration forces is to build and maintain trust between local law enforcement and the communities they serve.

During the hearing, titled “The Effect of Sanctuary City Policies on the Ability to Combat the Opioid Epidemic”, questioning by Representative Raul Labrador (R-ID) made it clear that he is of the belief that if we further embolden ICE and law enforcement agents in their capabilities to deport migrants, it would decrease the amount of drugs in the US.

While it is evidenced that heroin and other drugs do make their way north from Mexico and other southern countries, as former white house drug policy advisor and professor Keith Humphreys stated during this hearing, “Few people spontaneously decide to use heroin, and even less so heroin laced with fentanyl. But many people get pushed to that point after first becoming addicted to prescription opioids… Arresting heroin dealers from other nations will thus never eliminate the root of our problem.”

While Arizona does not have any sanctuary cities, this hearing is an important recent example of the ways in which politicians and decision makers attempt to focus the narrative on how drugs come into our country, to tie blame to immigrant communities rather than consider how addiction and dependence on illicit drugs like heroin, for many began through use of prescription opioids.

In Our State

Last month, Donald Trump got angry after a news story about a group of Central American immigrants traveling North to seek asylum reminded him how his wall isn’t happening. This resulted in the Dept of Homeland Security approving funding for up to 4,000 national guardsmen to be sent to the border. Governor Doug Ducey got on board and sent 338 state national guard forces.

It was a highly political spectacle with discussion over militarization of the border, asylum seekers fleeing violence but what was clear was that in the motivation for all of this were the words, “immigrants” “drugs” “crime”. The way that these words are constantly tied together demonstrates the narrative formation that melds immigration and drug policy.

While Trumps focus was on stemming movement of people across the border, Governor Ducey honed in on drug control. An Arizona Capitol Times piece spoke with Ducey’s spokesman Daniel Scarpinato, who “downplayed an immigration crackdown, instead focusing on drug smuggling, pointing to ongoing efforts by a state police task force to help the Border Patrol catch drug smugglers.”

Governor Ducey reinforced that in an article he penned for USA Today where he said “The majority of illegal drugs in this country come through our southern border. If you know someone impacted by drug addiction, there’s a good chance their last ‘hit’ came from drugs that flowed through Arizona.”

After an address to national guard troops, Ducey stated in an interview, “The people that are suffering the drug overdoses, often times these products are coming over the border and through our state.”

This example is noteworthy because it demonstrates the ease in shifting dialogue to place blame on immigrants for presence of drugs in our communities. Politicians appear to believe that stopping immigrants and stopping drugs can be one in the same. But they aren’t.

Scapegoating

It is truly remarkable how carefully yet callously politicians and decision makers connect the topic of drug control to the anecdotes used for anti-immigration agendas.

There are plenty of examples of ignorant leaders legitimizing their claims based on stereotypes that dehumanize individuals and disregard context. As Laura Pegram of the Drug Policy Alliance so eloquently explains, “Racial and cultural stereotyping aims to create and permeate repressive immigration strategies using inaccurate and conflated drug war rhetoric.  In the end, this is an attempt to justify the use of racial profiling when it is used in relation to drug issues and scapegoats immigrant communities as somehow responsible for the presence and use of drugs within America – a stereotype that is blatantly false.”

The dialogue regarding how the war on drugs disproportionately targets communities of color is acutely nuanced and well evidenced. Kevin Johnson is the Dean of UC Davis College of Law and in his astute article, “It’s the Economy, Stupid: The Hijacking of the Debate Over Immigration Reform by Monsters, Ghosts, and Goblins (or the War on Drugs, War on Terror, Narcoterrorists, Etc.)” he describes how in the US, immigrants of all backgrounds have received blame for effectively every social, economic, and political issue across the spectrum throughout our nation’s history. Johnson writes of how racial profiling becomes a tool when police develop drug courier and gang member profiles that target young African American and Latino Men.

This takes on a deeper meaning for immigrant communities, due to risk of deportation.
According to Drug Policy Alliance’s fact sheet “The Drug War and Mas Deportation”:
- For noncitizens, including legal permanent residents, any drug law violation (except first-time possession of less than 30 grams of marijuana) can trigger automatic detention and deportation
- A 2015 report by Human Rights Watch found that deportations for drug possession offenses increased by 43 percent from 2007 to 2012.
- “barred from reentry, often for life – no matter if they have family members who are U.S. citizens or decades-long ties to their communities of residence in the United States.”

Opportunities for Intersectional Action

Typically the main focus in harm reduction communities is in decreasing the public health impacts of drugs, which are crucial endeavors that need all the support possible. But what if we take the core idea of harm reduction, accepting that people will use drugs and minimizing the negative consequences, and think about the harms felt by immigrant communities in the criminalization of drugs. What if we find ways to emphasize the intersectionality of our issues to collaborate and be stronger in the face of backwards and oppressive politics?

Some efforts of this nature are already being made. The Drug Policy Alliance assisted the Immigrant Legal Resource Center in their detailed report analyzing the impact of California’s Prop 64’s decriminalization of marijuana on immigrants. Prop 64 reduced the harms faced by immigrants through the protection decriminalization provided for individuals who previously would have faced severe consequences like deportation for minor marijuana possession offenses. It is a great example how immigration justice advocates and harm reductionists can collaborate to shine light on the nuances of drug policy as it relates to the immigrant experience.

There have also been efforts to apply harm reduction frameworks to immigration and drug trafficking issues. No More Deaths has distributed their own take on Harm Reduction kits of humanitarian aid to migrants found in the desert. Ronn Pineo of the Council on Hemispheric Affairs has expound on what a harm reduction approach to dealing with cartels in Mexico would look like. Both examples are based on the premise of working outside the system, accepting that migration and trafficking occur, to lower fatalities and violence.

In terms of supporting advocacy efforts, the Harm Reduction Coalition put out a blog post on how members can support Dreamers with resources for information and links of organizations to send donations. We need more supportive undertakings like this. For example, when events occur where politicians try to tie anti-immigrant rhetoric with drug policy, harm reductionists must raise their voice with the evidence based research that shows that the solution they are looking for lies in services and treatment, not criminalization and law enforcement.

These issues overlap with one another and advocates of immigration justice and drug policy reform can and should be allies. We are fighting many of the same fights, the more that we can collaborate the stronger our defenses will be.

 


Sarah Fynmore
SPW Member
fynmoresarah@gmail