Morning Roundup: Oct. 25, 2019

New Sesame Street Muppet Can Be a Lifeline for Kids with Parents Trapped by Addiction [USA Today]Nearly 6 million young children have parents who are struggling with addiction, which is why Sesame Street's new Muppet, Karli, a foster kid whose mother is in recovery, is so important for kids to see. The Guardian View on Drug Policy: Rethink It Without Taboos [Guardian]"Much of the harm caused by illegal drugs is caused by their illegality." In this editorial, The Guardian newspaper argues against a policy of prohibition, but rather, a public health approach to the global drug problem. Some Hospitals Sue Opioid Makers for Costs of Treating Uninsured for Addiction [NPR]Hospitals across the country are hoping to recoup the costs of treating opioid-related ailments by joining the growing number of plaintiffs suing drug companies. ER overdose patients are just one part of the heavy cost of opioid abuse on hospitals. Courts Recognize Addiction As a Disease, Yet Some Judges Continue Punishing Relapse with Prison [Philadelphia Inquirer]A critique of the "probation trap" employed by the criminal justice system to ensnare people dealing with substance use disorder. Does it make sense to punish these people with more probation and jail time?  SF's Meth Epidemic: City Releases Plan for Tackling Skyrocketing Problem [San Francisco Chronicle]In San Francisco, methamphetamine has contributed to "violent encounters, property damage, thefts and hazardous waste," according to a new report. One possible solution: a meth sobering center.  Is It a Meth Case or Mental Illness? Police Who Need to Know Often Can't Tell. [NPR]Police are having trouble discerning between mental illness and methamphetamine. How can they respond effectively? However, substance use disorder and mental illness often go hand in hand.  Three Ways Childhood Trauma Affects Adulthood [Psychology Today]What is complex trauma? It is a more subtle childhood experience, more difficult to pinpoint than clear life-changing events, that has just as much of an impact. 'My Career Came Before My Family': Michael Douglas Blamed Himself for Son Cameron's Addiction [USA Today]Actor Michael Douglas admitted in a new interview that he put his career before his family. "We had reached a point where I thought I was going to lose [Cameron], based on everything I'd seen."

Safehouse Founders Talk Overdose Prevention Site's Recent Victory, Future Challenges

Soon after a judge ruled in their favor, the organization set to open the first-ever overdose prevention sites in the United States reflected on their recent victory in an op-ed.This month, a federal judge ruled that Safehouse may go ahead with efforts to open two sites (also known as harm reduction sites or supervised injection facilities) in Philadelphia. The ruling was a clear victory over the federal government, which argued in court that the proposed facilities violated a provision of the Controlled Substances Act.“Opioid users would be free to come to the sites and inject their products with clean needles, and health workers would be on hand to make sure no one overdoses. At no point would we distribute or even touch controlled substances; the user would bring them to our facility. This isn’t a substitution of treatment, but it is safer than having people use drugs alone or on the streets,” wrote the three founders of Safehouse, the organization that proposed to open the sites, in a Washington Post opinion piece.They would be the first such (legal) facilities in the United States."We Could No Longer Wait As The Death Toll Continued To Rise"Ed Rendell, a former governor of Pennsylvania, Jose A. Benitez, executive director of Prevention Point Philly and Ronda B. Goldfein, executive director of the AIDS Law Project of Pennsylvania founded Safehouse because “we could no longer wait as the death toll continued to rise almost unabated,” they wrote.The face of Philadelphia’s drug crisis is Kensington, a neighborhood so notorious for its drug problem that The New York Times called it “the Walmart of Heroin” in a feature last year. Rendell, Benitez and Goldfein noted that 1,217 people in Philadelphia died of opioid overdoses in 2017. “The problem was, of course, that most people who overdose do so alone, and even if naloxone was on the table next to them, they couldn’t administer it because an overdose renders a person unconscious,” they wrote.Safehouse’s mission is to save lives, which overdose prevention sites have proven to do in Canada and about 120 other such sites around the world.“It is important to note that we, like other harm reduction advocates, do not believe supervised injection sites are the answer to the opioid crisis… but we do know that supervised injection sites will save lives,” they wrote.With the momentum from their recent victory in court, the founders say, “We hope it will be one of many across the country.”Suits Followed By CountersuitsThis month, US District Judge Gerald A McHugh ruled that the facilities were not in violation of federal law, as the federal government tried to argue in court.Pennsylvania prosecutors and the Department of Justice filed a civil lawsuit against Safehouse in February, trying to stop the organization from moving forward with opening the facilities, which had the endorsement of local officials including Mayor Jim Kenney.In suing Safehouse, the government argued that the facilities would violate the “crack house” statute under the Controlled Substances Act, which made it a crime to “knowingly open, lease, rent, use, or maintain any place, whether permanently or temporarily… for the purpose of unlawfully manufacturing, storing, distributing, or using a controlled substance.”Safehouse countersued in federal court, which concluded with the judge’s recent ruling.McHugh said in his decision that it was clear that overdose prevention sites were not intended targets of the Congress in 1986 when they created the “crack house” statute.“There is no support for the view that Congress meant to criminalize projects such as that proposed by Safehouse,” McHugh wrote. “Safe injection sites were not considered by Congress and could not have been, because their use as a possible harm reduction strategy among opioid users had not yet entered public discourse.”McHugh determined that Safehouse’s mission did not clash with the law. “The ultimate goal of Safehouse’s proposed operation is to reduce drug use, not facilitate it, and accordingly, [the “crack house” statute] does not prohibit Safehouse’s proposed conduct.”Despite their victory, the founders—Rendell, Benitez, and Goldfein—acknowledged in the Washington Post op-ed that the fight is far from over.“While we may have won that first legal battle, we still have hurdles to clear,” they wrote.“We hope that our victory emboldens other cities to venture into setting up their own harm reduction sites. While our federal ruling is not binding on other jurisdictions, we believe its logic and reasoned interpretation will help proposed facilities in places such as New York, San Francisco, Boston, Seattle and Denver when and if they face court challenges,” they wrote.

Drug Policy Alliance Creates Harm Reduction-Based Guide For Drug Education

Teachers now have access to a harm reduction-based guide to teaching kids about drugs.The Drug Policy Alliance created a new drug education curriculum for high school teachers—available online for free download—that doesn’t rely on demonizing drugs and alcohol. Instead, the curriculum is based on harm reduction principles—an alternative to abstinence-only drug education programs like the original version of D.A.R.E.The DPA, a non-profit organization that promotes drug policy reform, explained the difference: “For example, abstinence-only education may tell young people that they should refrain from using drugs because they could overdose. Harm reduction drug education explains how to recognize the signs of drug overdose, how to respond and how to get help if they fear that a friend is overdosing.”Safety First: Real Drug Education For TeensThe package of 15 lesson plans (PowerPoint slides included)—titled Safety First: Real Drug Education for Teens—goes over material that is familiar to traditional drug education curricula like Alcohol & Other Depressants, Vaping & E-Cigarettes and Cannabis.But other lessons, like Mental Health and Coping and Health & Policy, feel new to generations who were raised on D.A.R.E.Sasha Simon, Safety First program manager for the DPA, told Benzinga that the organization saw the need for a comprehensive, alternative drug education program.“Safety First was created in response to a lack of accurate, science-based and compassionate drug resources in schools,” she said. “With nearly 70,000 people dying of accidental overdose last year alone, it is essential that our young people develop the necessary skills to navigate their risks. Not only will it protect them while in school, but will serve as a foundation for them to foster healthy attitudes and habits around drugs that they will carry with them throughout their lives.”Testing the Curriculum on StudentsThe Safety First curriculum was piloted in New York City and San Francisco, and produced positive results, DPA said.They observed in the much larger San Francisco trial, where over 600 students were taught the curriculum, that students demonstrated increased knowledge of harm reduction, drugs and alcohol, and how to detect and respond to a drug-related overdose.

Chemical Warfare Tool Provides Lifesaving Info About What’s In Your Drugs

A machine intended for use by military and emergency personnel who handle hazardous material has become a lifesaving tool amid the fentanyl epidemic.The MX908 mass spectrometer was first marketed as a tool for “elite responders conducting chemical, explosive, priority drug and HazMat operations around the world.” But in places like Boston and Chicago, the machine is a harm reduction tool.The MX908 can detect 70 types of fentanyl as well as more than 2,000 yet-unidentified fentanyl analogs.WBUR witnessed the machine in action as Sarah Mackin of the Boston Public Health Commission tested a swab sample from the inside of a baggie “that was sold as heroin.”“So, there’s multiple kinds of opioid analgesics and multiple kinds of synthetic fentanyls in this sample that was sold as heroin,” she said. “It’s kind of an example of what the drug landscape looks like here.”Testing Fentanyl This summer, Massachusetts health officials reported that the presence of fentanyl in the state had reached “an all-time high” despite a decrease in overall opioid-related deaths in 2019.One woman named “Bri” who tested drug residue using the machine in July suspected that carfentanil was present in her personal stash and triggered a previous overdose. “Now I’m going to be honest. If I was sick and I had one bag of dope on me and you told me there’s carfentanil in there, I’m not going to lie and say I wouldn’t use it. But I would know not to put the entire thing in,” she told WBUR.Proponents of the MX908 say that by having access to clear information about their drugs, people like Bri are empowered, in a way, to mitigate their risk and avoid overdose.The Chicago Recovery Alliance invested in two MX908s as part of its new drug-checking program that launched in March.Pricey & Legal-ishHowever, those seeking to make the machine available to more people are hindered by the “legal gray area” of drug checking and its hefty price tag. One machine costs $65,000.A trial of the MX908 in Boston is currently on hold while they determine if the practice is legal.As WBUR notes, fentanyl test strips are a much more cost-effective method of detecting fentanyl, at $1 per strip.

Sacklers Pulled $13B From Purdue Prompting States To Push Back On Settlement

The Sackler family reaped up to $13 billion in profits from Purdue Pharma, money that some states say the family is trying to protect from going to settlements in the opioid lawsuits. Now, states are trying to stop the family from getting a nine-month stay to protect them from opioid-related lawsuits, The Washington Post reports. The Sacklers are asking for the stay as part of the Purdue bankruptcy case. However, the states say that the bankruptcy can move forward without protecting the family. “The Sacklers used the profits from their illegal scheme to become one of the richest families in the world—far wealthier than the company they ran," twenty-four states argued in court documents. “Now, the Sacklers seek to leverage Purdue’s corporate bankruptcy to avoid their own individual accountability.’’"They’ve extracted nearly all the money out of Purdue and pushed the carcass of the company into bankruptcy."The settlement agreement with Purdue includes $3 billion in funds from the Sackler family, but states say that’s not enough when the family pulled more than four times that amount in profits. Massachusetts attorney general Maura Healey, who has been one of the most outspoken critics of the family, said, “The Sacklers want the bankruptcy court to stop our lawsuits so they can keep the billions of dollars they pocketed from OxyContin and walk away without ever being held accountable. That’s unacceptable.”North Carolina Attorney General Josh Stein echoed that sentiment, “The Sackler family is trying to take advantage of the fact that they’ve extracted nearly all the money out of Purdue and pushed the carcass of the company into bankruptcy. That’s unacceptable. Multibillionaires are the opposite of bankrupt.’’Some States Feel Short-Changed By Settlement OfferTwenty-four states have agreed to the settlement, and an equal number—plus Washington, D.C.—are filing legal steps to oppose it. While some states are desperate for resources, others feel short-changed by the agreement.Daniel S. Connolly, an attorney for part of the Sackler family, insisted that the agreement was fair, and the family should be protected from further lawsuits. “The Sacklers have agreed to relinquish their equity in Purdue and to contribute at least an additional $3 billion to the fight against the opioid crisis,” he said. “The stay, if granted, will allow parties to focus their efforts on this goal rather than on litigation that will waste resources and delay the deployment of solutions to communities in need.”He said that talking about $13 billion is unrealistic. “The distribution numbers do not reflect the fact that many billions of dollars from that amount were paid in taxes and reinvested in businesses that will be sold as part of the proposed settlement,” he said. 

Morning Roundup: Oct. 10, 2019

Thai Court Sentences Taiwanese to Life for Smuggling Heroin [Washington Post]Chen Kuan Lin, 38, evaded the death penalty after confessing to smuggling heroin from Thailand to Taiwan. Because of his confession, the punishment was commuted to a life sentence. Lawsuit to Allege Fortnite as Addictive as Drugs [Reuters]A forthcoming class action lawsuit will try to argue that the popular game Fortnite triggers the same chemical "pleasure hormone, dopamine" in players as habit-forming drugs. Federal Agents Raid 4 Southern California Addiction Treatment Centers [OC Register]Authorities raided four treatment facilities in southern California seeking evidence in a criminal investigation. An FBI spokesperson could not comment further. A Lost Decade and $200,000: One Dad's Crusade to Save His Daughters from Addiction [Vox]Michel Cote drained his family's savings to fund his daughters' substance use disorder treatment—totaling $200,000 over a decade. Plenty of time and money were wasted, he said, from sending them to facilities that did not offer evidence-based treatment.Bronx Teenager's Death Is the Youngest Vaping Fatality in U.S. [NY Times]New York's first vaping related death, and the 23rd nationwide, was a 17-year-old boy from the Bronx. "You are playing with your life when you play with this stuff." Opioid Treatment Scam, Quashed in Florida, Spreading to Other States [Florida Phoenix]Patient brokering is coming to Maryland, and the state is trying to get ahead of the corruption that plagued Florida's recovery industry. Donna Johnson, a mother who had it happen to her 21-year-old son, is leading the charge.Marblehead Play Focuses on Mothers and Their Addicted Children [WBUR]From the stage, Recovery tells the story of three young women as they enter treatment for substance use disorder. The play is based on playwright Anne Lucas' personal experience watching her daughter battle heroin.Wisconsin Woman and Her Sons Charged with Running Illegal Vaping Operation [NPR]With more than 1,000 vaping related lung injuries and 23 deaths reported across the country, a Wisconsin family operation busted for producing and selling counterfeit vapes has shed light on the potential cause of the emerging public health crisis.

Morning Roundup: Oct. 8, 2019

Uncomfortably Numb: Inside Gaza's Opioid Addiction Crisis [Al Jazeera]Prescription opioid abuse is a coping mechanism for young Palestinians on the Gaza Strip, fueled by the daily struggle of surviving the Israeli occupation. "Those who are supposed to build our future are the most affected."Comedian Artie Lange Podcasting After Rehab with 'Halfway House' [NJ.com]Artie Lange has a new podcast coming out next month: Artie Lange's Halfway House. Since he left rehab, the now sober comedian has returned to the stage to perform stand-up.Opinion: Addicted to Screens? That's Really a You Problem. [NY Times]The author of Hooked: How to Build Habit-Forming Products has a new book on how to control technology "addiction." "These are things we can do something about, but we love to think the technology is doing it to us."Student's Perspective: Give Students Struggling with Addiction Accessible Options [Daily Pennsylvanian]A student columnist examines the lack of "accessible, clear and destigmatized" recovery pathways offered to University of Pennsylvania students seeking help. "A student should be able to easily find and understand their options."Young People Are Poisoning Themselves at Alarming Rates with OTC Drugs [Vox]Tylenol, Advil and other over-the-counter medication are often used in poisoning attempts by young women and girls. While just a small percentage of OTC poisonings are fatal, many can lead to "serious outcomes." Indiana's Only Addiction Recovery High School Plans Relocation [WBAA]Hope Academy, one of just a handful of public recovery high schools in the U.S., is hoping to move closer to downtown Indianapolis. A more central location would make the school more accessible to underserved families, they say. Kenya Struggles to Cope with Growing Number of Heroin Users [Reuters]The number of Kenyans who inject drugs, mostly heroin, increased by more than 50% in nearly a decade. The problem affects young people across all backgrounds. "They are the most productive members of our society."Syracuse Narcan Trainer Dies of Apparent Overdose: 'The Stigma Is So Bad' [WRVO]Kevin Donavan, a harm reduction worker from Syracuse, New York, has died from an apparent overdose. He is remembered for educating thousands on overdose prevention.

Nicotine and Self-Recrimination: Kicking My Last Addiction

According to the QuitNow! app glowing from the glossy face of my phone, I’ve been smoke-free for 294 days. I have saved almost $3,000 and “won” back three weeks that otherwise would have been squandered away standing in the rain sucking on a Basic Menthol Light. This almost unthinkable achievement, this formerly unattainable goal, is a boast I have bellowed to and fro for the last eight months to anyone who does or doesn’t give a shit. In support groups with quitters swimming in self-pity and weakness, I have proclaimed myself the victor over nicotine and tobacco; an easy battle because I am committed. Though 42 years of smoking may have damaged my body in ways yet to be revealed, I have managed to silence the relentless chatter of the irrational addict and return logic to the part of my brain that runs every other program of my life.That is, until a month ago.During my four tours in rehab, counselors and addicts alike proposed the theory that the last substance an addict quits will be the most difficult. I have 16 years clean and sober from drugs and alcohol but it was not without many slips along the way. Whatever made me think I could quit smoking and get it right on the first try? The hubris of the addict.Using the NicoDerm patch system, the first few months of my quit were reminiscent of my first stay in rehab at age 26. The pink cloud, as it’s called, evidently happens no matter what drug you kick and it buoyed me through those initial weeks of cigarette cravings. I lived and breathed the Facebook quit smoking groups (there are dozens!) where I could experience all the regret, heartache, and depression of relapsing by reading of others’ failures while still remaining smoke-free.I weathered internet and cable outages and the subsequent maddening phone calls to Comcast that I thought I couldn’t endure, and I considered lighting up and smoking my Williams Sonoma Wintergreen candles to deal with the stress. I survived a devastating family fight that left me bent in half on the couch for a week, my tears spilling onto the floor until they crested over the cushions. I couldn’t write because I didn’t smoke and those two activities were knit together like a friendship bracelet. But I persevered. I went on walks, something I hadn’t done for, well, ever. With my grandchildren, the nucleus of my motivation, I trotted along as they biked or scootered; again, unprecedented. “Gwammy, you’re going to walk us to school?!” they would squeal, their incredulity expressing a maturity unheard of for a seven- and five-year-old.“Why yes, my darlings,” I would declare with the wisdom and assurance of Yoda. “Gwammy can walk now!”I had spent so many years anticipating the sudden fatal heart attack that would befall me should I exert myself even a wee bit, and now I felt a freedom I had not known since my teenage years, when I first started smoking but thought myself immortal. And I gloated. I admit it. I went to the groups and while they whined and cried about gaining weight, I lectured about exercise and eating right and how it’s all about choices. Eat fruit and popcorn, like me! Drink lots of water, like me! Walk to the store, like me!I had not had a problem with my weight for, well, ever. At five feet and 105 pounds, I felt very positive about how I looked – in clothes. I was hypervigilant about maintaining my weight because at my height, even a few extra pounds could mean an unwelcome eight-hour shopping excursion to Nordstrom Rack for a wardrobe in the next size up. That’s not happy shopping. I had four months smoke free under my still loosely fitting belt and had been patchless for over 30 days. Hours passed without any thought of a cigarette and most of the habitual smoking associations like driving, talking on the phone, writing, eating, cooking, breathing, living, had been broken effectively enough for me to feel like an actual non-smoker. I steered clear of the last few friendly smoking circles I’d once been a part of (people, places, and things) and reveled in my success. I felt confident. I didn’t need support.And then one morning, I stepped on the scale. And it was different. VERY different. I had read accounts of ex-smokers who claimed to gain ten pounds overnight. I thought them daft. I accused them of looking for excuses to smoke. I showed them no mercy.And the scale continued to climb. Suddenly everything that seemed manageable fell into chaos. Work became untenable. I seethed with HATRED for my boss, who had the unmitigated gall to ask me to do things. I purple-screamed in traffic at other drivers. I muttered in the grocery store like a sociopath when the deli clerk sliced honey ham instead of Black Forest. I stopped eating plain, dry, Styrofoam-like popcorn at night because clearly that was the culprit behind the weight gain. I cried on the kitchen floor because I could no longer have popcorn. I cried because I grew a muffin top overnight. I cried because I hate fruit and now it was my only treat. I cried because my thighs were about to…touch.The chatter returned. Quiet, reluctant, and shy at first, it built up steam quickly, as I fought with all the strength I could muster to shut it down.“Fatty. Fatso. FAT GIRL. You’re going to get so fat, it won’t matter if you live longer because you’re going to hate yourself.”“Shut it.”“Look how depressed you are! Is that how you want to feel the rest of your life? Don’t you know you could feel BETTER, happier, skinnier, right now?”“Feel better momentarily and then feel horrible because I failed? No thanks.”“Who says you’ll feel bad? All those other fat people? Who cares! You’re the one alone, depressed and getting larger with every clean, deep breath you take. And there’s nothing you can do about it. Walk, cut back on popcorn – it’s inevitable. Your metabolism is in a coma.”“That’s rubbish. Leave me alone. I don’t want to die.”“Drama queen.”I’d quiet myself down, still the noise with an audiobook or some raucous comedy on Spotify. But always waiting in the silence: the nicotine Night King, ready to strike...and I felt ill-equipped for the battle.“Hey, you know it took you four tries to kick drugs and alcohol.”“That’s true.”“Theoretically, you’ve got a few more years of smoking to go before you really quit.”“As illogical as that is, I’m listening.”And so it goes.I bought a pack of fake, herbal smokes made of marshmallows, rose petals, and the flatulence of unicorns. And I told EVERYONE. I brought the unopened pack to my therapist’s office and slammed them down on the couch. “Let’s talk about these fake cigarettes,” I stated.And we did, but I still wanted to smoke them. I told my older sisters, my greatest champions in this quit, and they both implored me to refrain from lighting them. I told my son, who shrugged and mumbled “slippery slope.”I’ve smoked a few a day for about a week. The menthol flavor is not terrible, as the reviews on Amazon claimed. They help when a strong craving steers my car into the 7-11 with only one objective that has nothing to do with Slurpees. Already, my lungs feel uncomfortably full and I’m concerned about the long term effects of marshmallow leaf and unicorn farts.But for now, I’m still nicotine and tobacco free. I can’t say smoke-free anymore because that’s dishonest. I hope I don’t go back. It would be miserable AF to have to start a quit again. I hope I don’t gain any more weight. I’ve already dropped a grand at Nordstrom’s for a wardrobe to fit my new bountiful 115 pound frame. But mostly, I hope that whatever happens, I can cut out the self-recrimination as successfully as I cut out the popcorn. That, I suspect, is the deadliest extra weight I now carry.

Morning Roundup: Oct. 1, 2019

Half a Million Doses in 2 Years: Opioid Prescriber Faces Life in Prison [Las Vegas Review-Journal]Dr. Joel Smithers faces sentencing this Wednesday for operating his medical practice as a pill mill, exacerbating the opioid abuse epidemic in West Virginia, Kentucky, Ohio, Tennessee and Virginia. He could possibly get life in prison.'Wild West of the Drug Industry': John Oliver Takes on Compounding Pharmacies [Guardian]Compounding pharmacies are not inherently evil, but the lack of oversight has bred fraud and corruption. Last Week Tonight explored the issue in this week's episode. In 26 Hours, 10 People Fatally Overdosed in Ohio [CNN]On Sunday, Franklin County, Ohio reported 10 fatal overdoses in a span of 26 hours. Officials urged residents to "make sure you are armed with naloxone" and "fentanyl testing strips." No One Knows What Vape Juice Actually Is [Vice]Lab testing has revealed that vape cartridges contain some disturbing ingredients. Despite state and federal investigators searching for the cause(s) behind the vaping public health crisis, we are still far from getting answers. School Taps Eastern Kentucky's Rich Music Tradition as Part of Opioid Crisis Solution [WVPB]Paul Williams is teaching people in Eastern Kentucky how to build stringed instruments (guitars, mandolins and more) hoping to empower them with the skill and help them find a job.Dallas Chefs Rally for Recovery at Foodie Fundraiser [Dallas Observer]Money raised at the AllStar Chef Classic (Oct. 13) will go toward funding sober transitional housing for men and women in Dallas who are seeking recovery. Some of Dallas' top chefs will serve up bites at the event. 'You're Not Going to Arrest Your Way Out of Addiction': Jail Program Emphasizes Recovery [WUSF]A recovery program in the Sarasota County Jail provides 12-step meetings, skill-building and peer support. "Are we doing the best that we can do to help people reintegrate?"Anti-Prescription Drug Campaign on LA's Billboards Funded by Prominent Scientologist [BuzzFeed News]Nancy Cartwright, the voice of Bart Simpson, is behind the billboard campaign in Los Angeles, "Know More About Drugs." Cartwright, a Scientologist, said she spearheaded the initiative because she is passionate about drug abuse prevention.

We Need Harm Reduction for All Drugs, Not Just Opioids

A quick glance at the news reveals the catastrophic effects of opioids across the nation: around 120 people a day die from opioid-related overdoses. It’s so devastating that the nation is calling it an opioid epidemic. Yet even as we watch this tragedy unfold, we’re missing the point.By focusing exclusively on opioids, we’re overlooking the harm caused by other deadly drugs. How can we highlight harm reduction resources if we only focus our efforts on people who use one class of drug?The Problem with the Opioid “Epidemic”According to the Centers for Disease Control and Prevention, more than 700,000 people died from a drug overdose between 1999 and 2017. Sixty-eight percent of those deaths in 2017 involved an opioid — approximately 70,200. However, that’s not the 100 percent that the “epidemic” coverage would have us believe.While I’m not arguing that the opioid-related deaths shouldn’t be covered — they should! — I am saying the problem with zeroing in on the opioid epidemic is that we are focusing too narrowly on the harms caused by one drug and are blinding ourselves to the impact of other deadly drugs. We should be reporting on those, too.A more accurate picture of drug-related deaths in 2017, according to the CDC, looks like this:Alcohol was responsible for the deaths of 88,000 peopleCocaine misuse killed 13,942 peopleBenzodiazepine misuse was responsible for 11,537 deathsPsychostimulant misuse, including methamphetamines, was responsible for 10,333 deaths.Those aren’t insignificant numbers, so why are they being overlooked? I asked recovery activist Brooke Feldman for her perspective."The sensationalized and narrow focus on opioids fails to account for the fact that people who develop an opioid use disorder typically used other drugs before and alongside opioids,” Feldman said. “So, we really have a polysubstance use situation, not merely an opioid use situation.”She continues, “Focusing on opioids only had led to the erection of an opioid-only infrastructure that will be useless for the next great drug binge and is barely relevant to address the deadliest drug used, which is alcohol.”The Deadliest Drug: AlcoholAlcohol is responsible for more deaths than any other drug. But we overlook it for two reasons: because it’s legal, and because it’s a socially acceptable drug. Not only that, but advertising actively promotes its use — you only have to look on Instagram or Etsy to see how widely excessive use of alcohol is normalized — especially among mothers and millennials. These advertisers have been smart to market alcohol as a means of self-care — encouraging drinking to help unwind from the stresses of the week — and as a means of coping with motherhood. Social media reinforces the message that alcohol is a tool to cope with stress and something that should be paired with our favorite stress-relieving activities, like yoga. Captions on Instagram read like “Vino and vinyasa,” “Mommy’s medicine,” “Mommy juice,” “It’s wine o’clock,” “Surviving motherhood one bottle at a time,” and “When being an adult starts to get you down, just remember that now you can buy wine whenever you want.”Perhaps what is most insidious about alcohol is that it heavily impacts marginalized and oppressed communities. For example, Black women over 45 are the fastest-growing population with alcohol use disorder. And the LGBTQ+ community is 18 percent more likely to have alcohol use disorder than the general population.Alcohol aside, looking at the harm done by other drugs, we can see that opioids are no longer the leading cause of drug-related death in some states. In Oregon, statistics show, deaths related to meth outnumber those that involve one of the most common opioids, heroin. In fact, there has been a threefold increase in meth-related deaths over the last ten years, despite the restriction on pseudoephedrine products, which now require a prescription. Similarly, in Missouri, which was ground zero for home-based meth labs 20 years ago, the recent spotlight on opioids has overshadowed an influx of a stronger, purer kind of methamphetamine. Deaths related to the new and improved drug are on the rise.Oregon’s state medical examiner Karen Gunson speaks to this disparity of focusing on opioids over other deaths and the damage that those other drugs cause. "Opioids are pretty lethal and can cause death by themselves, but meth is insidious. It kills you in stages and it affects the fabric of society more than opioids. It just doesn't kill people. It is chaos itself."Abstinence Is Not Attainable for EveryoneOur approach to recovery has been too one-dimensional, stating that complete abstinence is the goal. But this perspective is outdated. Abstinence isn’t attainable for everyone. If it were, then more people would be in recovery. However, harm reduction is attainable. It reduces deaths, treats medical conditions related to drug use, reduces the transmission of diseases, and provides options for treatment services. In fact, people who use safe injection sites are four times more likely to access treatment.“Whether it is with problematic use of alcohol, tobacco, cocaine, methamphetamine, etc. use, centering harm-reduction principles and practices would likely engage more people than an abysmal 1 out of 10 people who could use but do not receive SUD (Substance Use Disorder) treatment,” Feldman explains. “Requiring immediate and total abstinence rather than seeking to address overall well-being and quality of life concerns is a barrier to engagement — and sadly, it is placing the focus more on symptom reduction than it is on what is causing the symptom of chaotic drug use in the first place.”Harm Reduction for All Drugs Means Fewer DeathsOur focus on the opioid crisis has helped improve harm reduction resources — like the increased availability of naloxone to reverse overdoses, and the more accepted use of pharmacotherapy and medication-assisted treatment (which has now been endorsed as a primary treatment by the Substance Abuse and Mental Health Services Administration), and some safe injection sites — but it has also meant we aren’t concentrating as much on research, funding, and education devoted to harm reduction practices for other harmful drugs. The result is that we have fewer resources and less awareness when it comes to keeping people who use non-opioid drugs safe.We need to look at reducing harm across the spectrum of drug use to reduce all deaths. More safe usage sites, clean tools, safe disposal bins, medical assistance, education, referral to other support services, and access to pharmacotherapy (including drugs to treat or mitigate harms of alcohol use disorder and the development of new medications for help with other substances). Specialized treatment other than abstinence should be accessible for people who use all drugs — not just opioids.