Harm Reduction Is giving out needles to addicts really still "harm reduction" in this age of Fent and Nitazenes?

[Bleaney]

I know it's always been a controversial topic, but up until very recently I'd always understood the logic, that it helps prevent the risk of spreading infections / diseases, as being the main driver behind the schemes.

But I heard someone legitimately question the other day, how can it still be called "harm reduction", when facilititating easy access to injecting street drugs cut with things like fent and nitazenes? Injecting these things is going to kill a lot more people, a lot more quickly, than any infectious diseases!

He's not wrong!? I think he seriously has a very good point.

It might it be time to re-consider this policy, at least in areas where the prevalence of fent or nitazenes is known to be very high, and the area is seeing lots of fatalities. Mostly in certain areas of some of the big US cities, like San Fransiscos' Tenderloin, Philadelphias' Kensington, and Los Angeles' Skid Row, seeming to have the most catastrophically out of control problems.

Not sure if it's media bias on YouTube etc, but the political leaders of San Fransisco, mayor London Breed etc, are constantly getting a terrible reputation for being on the ridiculous side of "woke" with being far too soft on crime and other issues. But as far as I can tell it really does seem to be such woke policies that are at least playing a part in the problem.

 

[Shinji Ikari]

Is a lack of clean needles going to deter anyone from taking these drugs though? I'm guessing if someone's about to get sick then they're going to decide that a dirty needle is better than no needle.

Needle exchanges still deliver a form of harm reduction even if they can't make the drugs themselves any safer, but I do agree that's not enough to keep people safe. Never has been really it's not like nobody ever ODd before fent came along.

What we really need are places that can offer clean needles as well as supervised injection sites like they were doing in Scotland a while back with those vans. Rolling something like that out nationwide would save a great many lives.

 

[chippermonk]

I think another argument is that doing needle exchange gives health and social care workers an opportunity to interact with IV user and offer care and advice, maybe offer interventions, treatment etc.
And like Shinji says, lack of needle exchange isn't going to stop anyone from using. HIV, abscesses and other diseases are still a major health risk. If you can lower that risk than you are doing a good thing

 

[chippermonk]

...also, I would say that I think you can do needle exchanges without being soft on crime in general

 

[Bleaney]

Yeah, i didnt mean that the needle exchanges were the same thing as being soft on crime. But in places like San Fransisco it's essentially possible to shoplift items up to under $1000 without risk of arrest, charge, or prosecution. It seems that a mainly small and hardcore population is mainly resposible for majority of this form of crime, and they are doing this in order to pay for drugs.

SF also happens to be a place where there are needle exchanges. But I agree that it is possible to do needle exchanges without being soft on crime. Or at least not being so hard as to not provide amnesty from charges for any users seeking these services.

 

[Shinji Ikari]

It might be simpler if drugs weren't criminalised so we can just get on with treating it as a public health issue rather than conflating it with crimes of necessity. Shoplifting is a symptom. Address the cause.

$1000 without risk of arrest, charge, or prosecution

How does this actually work? Like can I just walk into any store nick $900 worth of gear and just keep repeating that on the daily? Seems to good to be true.

 

[50shadesofDave]

Only thing i can add is test strips given out with the pins, at least the dirty needle isn't an issue.

I'm speachless about the shop lifting in SF though, really, a country like the good old USA who declared 'war' on drugs now accept the M/O to buy drugs.

 

[neversickanymore]

It's going to be impossible to prevent an IV user from getting syringes to inject. Think about it, if you can't prevent the fentanyl etc, how do you think you can prevent a two cent syringe?

Removing access to clean injection supplies will likely just promote pathogen explosions and overall damage.

Given the current internet economy there is NO fucking way you could stop anyone from getting gear.

The needle exchanges do more then provide clean iv gear and remove used gear.. its a social life line to the most vulnerable. It's an undeniable evidence that someone gives a shit and still values and loves someone. It a clear and undeniable argument that they mean something, are important and someone is looking out for them. This is a big fucking deal in the whole picture.

 

[50shadesofDave]

Just as an aside to someone who's not in the H sphere.
Has the price of genuine H gone up? or is it ruined to the point of you get what you get?
I'm just thinking there must be DN vendors with the real deal, and i suspect this type of person would push up prices, maybe the cynic in me.

Thanks folks, take care.

 

[ShulginsReincarnation]

Is a lack of clean needles going to deter anyone from taking these drugs though? I'm guessing if someone's about to get sick then they're going to decide that a dirty needle is better than no needle.

Needle exchanges still deliver a form of harm reduction even if they can't make the drugs themselves any safer, but I do agree that's not enough to keep people safe. Never has been really it's not like nobody ever ODd before fent came along.

What we really need are places that can offer clean needles as well as supervised injection sites like they were doing in Scotland a while back with those vans. Rolling something like that out nationwide would save a great many lives.

The European Union Drugs Agency has recently talked about how the drug consumption rooms across the EU are saving lives, and it isn't strictly safe injection sites and needle exchanges that are responsible for the reduction in ODs and dangers. These drug consumption rooms also encompass drug testing as well. Being able to test for fentanyl/nitazenes, and even to help offer further treatment if desired is what harm reduction is really about. Not just offering a safe injection site in the more traditional sense. But, yes, they are all over the EU (not even sure exactly what Scotland had going on to be totally honest, but it sounds like they were at least doing something right.)




(Not seen this one yet, but will watch at some point in the future. Am a bit preoccupied with Dr. Gabor Mate interview right now haha )

 

[ShulginsReincarnation]

Just as an aside to someone who's not in the H sphere.
Has the price of genuine H gone up? or is it ruined to the point of you get what you get?
I'm just thinking there must be DN vendors with the real deal, and i suspect this type of person would push up prices, maybe the cynic in me.

Thanks folks, take care.

I haven't checked recently, but last I did which was not too long ago heroin was about the same price as its always been. The thing is that this means its still much less profitable than fentanyl. And, since fentanyl is becoming harder and harder to source due to decreases in production, the nitazenes are beginning to take place of fentanyl in some cases. In others, the fentanyl quality is just down and price is up. If someone really wants good heroin, its really not difficult to get... Most people just don't know how to go about how to do so or don't want to take the risk involved with doing such or whatever... Plus, if a heroin user did go through all that, wouldn't they want 5000 doses of fentanyl instead of like 100 doses of heroin? Its just basic economics is all...

 

[Bleaney]

How does this actually work? Like can I just walk into any store nick $900 worth of gear and just keep repeating that on the daily? Seems to good to be true.

Apparently so. I guess the individuals might rotate the stores they target, or leave it a couple of days.

If certain individuals kept on targetting the same store on a daily basis, even the store's staff and poilice which have effectively been made powerless and told not to intervene, they would be more likely to be take matters into their own hands in such cases.

I'm not making this up. There are countless videos on you tube about it. (Yeah I know about 'the algorithm'.) Check out the likes of Peter Santanello who has made several videos about San Fransisco since the Covid pandemic, for some higher quality content.

The downtown area has effectively been wiped out with so many stores closed down and empty as a result of all of this.

 

[Shinji Ikari]

I'm not making this up. There are countless videos on you tube about it. (Yeah I know about 'the algorithm'.) Check out the likes of Peter Santanello who has made several videos about San Fransisco since the Covid pandemic, for some higher quality content.

The downtown area has effectively been wiped out with so many stores closed down and empty as a result of all of this.

I'm not suggesting that you are. I'm halfway through his most recent video on SF and it seems like any other comparatively wealthy city with the usual problems and inequalities.

I can't speak much about the US on account of not living there or seen much of it, but a lot of cities including my home town in the UK have seen their downtown/high street areas take a massive hit since the pandemic but isn't it kind of an assumption to say that businesses closing down and stores being boarded up is a consequence of drug fueled crime? It makes more sense to me that those two things are correlated rather than one being a consequence of the other.

Physical retail stores were struggling before 2020 as shopping habits had already been moving away from brick and mortar stores and towards online shopping for several years, then all the lockdowns happened and many businesses weren't able to recover.

Then all of that is compounded by the consequences of wars in Europe and the middle east, rising energy costs and rents, massive inflation etc. The cost of living is through the roof and most parts of the UK are struggling with a housing shortage. I have spent a lot of time speaking to local business owners in my hometown at least and the broard consensus there seems to be that people shop less in person these days and business owners can't afford the rents.

The way I see it all of the above is likely to lead to a rise in poverty, homelessness and of course drug use and of course with all that more and more people are going to turn to petty crime as a way of getting by.

But anyway, weren't we talking about needle exchanges?

 

[ShulginsReincarnation]

I'm not suggesting that you are. I'm halfway through his most recent video on SF and it seems like any other comparatively wealthy city with the usual problems and inequalities.

I can't speak much about the US on account of not living there or seen much of it, but a lot of cities including my home town in the UK have seen their downtown/high street areas take a massive hit since the pandemic but isn't it kind of an assumption to say that businesses closing down and stores being boarded up is a consequence of drug fueled crime? It makes more sense to me that those two things are correlated rather than one being a consequence of the other.

Physical retail stores were struggling before 2020 as shopping habits had already been moving away from brick and mortar stores and towards online shopping for several years, then all the lockdowns happened and many businesses weren't able to recover.

Then all of that is compounded by the consequences of wars in Europe and the middle east, rising energy costs and rents, massive inflation etc. The cost of living is through the roof and most parts of the UK are struggling with a housing shortage. I have spent a lot of time speaking to local business owners in my hometown at least and the broard consensus there seems to be that people shop less in person these days and business owners can't afford the rents.

The way I see it all of the above is likely to lead to a rise in poverty, homelessness and of course drug use and of course with all that more and more people are going to turn to petty crime as a way of getting by.

But anyway, weren't we talking about needle exchanges?

Yes, we were talking about needle exchanges not all the things I warned would happen if lockdowns were permitted during the pandemic. How the various world governments that are now largely controlled by corporations and criminal enterprises has destroyed civilization as we knew it is another story entirely. I could write an entire book on that subject haha

 

[ChemicallyEnhanced]

I know it's always been a controversial topic, but up until very recently I'd always understood the logic, that it helps prevent the risk of spreading infections / diseases, as being the main driver behind the schemes.

But I heard someone legitimately question the other day, how can it still be called "harm reduction", when facilititating easy access to injecting street drugs cut with things like fent and nitazenes? Injecting these things is going to kill a lot more people, a lot more quickly, than any infectious diseases!

He's not wrong!? I think he seriously has a very good point.

It might it be time to re-consider this policy, at least in areas where the prevalence of fent or nitazenes is known to be very high, and the area is seeing lots of fatalities. Mostly in the big US cities, like San Fransisco, Philadelphia and Los Angeles seeming to have the most catastrophically out of control problems.

Not sure if it's media bias on YouTube etc, but the political leaders of San Fransisco, mayor London Breed etc, are constantly getting a terrible reputation for being on the ridiculous side of "woke" with being far too soft on crime and other issues. But as far as I can tell it really does seem to be such woke policies that are at least playing a part in the problem.

Yes, probably, as it's not like people will be like "oh, I guess I won't shoot up then", rather they would keep re-using needles or share needles with others, which obviously is worse.

I actually (due to temporary inability to access clean needles) maybe contracted Hep C from sharing needles*

*they could only estimate - at time of diagnosis - that I had had it for "12 to 18 months, probably closer to 18" so I COULD have gotten it from also raw-dogging multiple people

 

[Mana0909]

I know it's always been a controversial topic, but up until very recently I'd always understood the logic, that it helps prevent the risk of spreading infections / diseases, as being the main driver behind the schemes.

But I heard someone legitimately question the other day, how can it still be called "harm reduction", when facilititating easy access to injecting street drugs cut with things like fent and nitazenes? Injecting these things is going to kill a lot more people, a lot more quickly, than any infectious diseases!

He's not wrong!? I think he seriously has a very good point.

It might it be time to re-consider this policy, at least in areas where the prevalence of fent or nitazenes is known to be very high, and the area is seeing lots of fatalities. Mostly in the big US cities, like San Fransisco, Philadelphia and Los Angeles seeming to have the most catastrophically out of control problems.

Not sure if it's media bias on YouTube etc, but the political leaders of San Fransisco, mayor London Breed etc, are constantly getting a terrible reputation for being on the ridiculous side of "woke" with being far too soft on crime and other issues. But as far as I can tell it really does seem to be such woke policies that are at least playing a part in the problem.

This is a very deep and controversial topic.

In my country, we have "consumption rooms," where you can consume whatever you want (heroin, cocaine, pills, etc.), as well as areas where you can get tools for injections and insufflated consumption for free. Back in 2022, my fiancé and I passed by such a consumption place (they can be outside or inside; in this case, it was outside), and it was full of people who seemed destroyed. I don't want to use the word "junkie" because calling a person "junk/trash" is, in my opinion, insanely hurtful. It dehumanizes them and makes them seem beneath you. However, almost everyone there was unpleasant. We only passed by, meaning we could inspect that place for about 10 seconds, but we heard a very broken, stinky, and dirty woman begging someone (a male) to give her a "plump of cocaine."

For those who don't know, there are €10, €15, and €20 cocaine "plumps." The €10 option contains 0.077g (77mg) of cocaine, which is incredibly rare because it's too little. The €15 option contains 0.1g (100mg) of cocaine, which is also practically non-existent. She wanted a €20 plump, which included 0.144g (144mg) of cocaine, a middle dosage by our street quality standards. You know how short-acting cocaine is!

He then said, and I quote, "only when you give me a blowjob" (translated from my language). My husband saw her nod, meaning she agreed. That's how broken those people were. It wasn't really a consumption place; it was a marketplace. That makes sense, of course! When there isn't a team of people controlling those places to prevent abuse, you essentially create a new local marketplace for drugs.

In my opinion, these places and rooms should be way more controlled. When you give them clean tools for free, you should have someone watch over them to ensure they only consume and then leave.

 

[ShulginsReincarnation]

This is a very deep and controversial topic.

In my country, we have "consumption rooms," where you can consume whatever you want (heroin, cocaine, pills, etc.), as well as areas where you can get tools for injections and insufflated consumption for free. Back in 2022, my fiancé and I passed by such a consumption place (they can be outside or inside; in this case, it was outside), and it was full of people who seemed destroyed. I don't want to use the word "junkie" because calling a person "junk/trash" is, in my opinion, insanely hurtful. It dehumanizes them and makes them seem beneath you. However, almost everyone there was unpleasant. We only passed by, meaning we could inspect that place for about 10 seconds, but we heard a very broken, stinky, and dirty woman begging someone (a male) to give her a "plump of cocaine."

For those who don't know, there are €10, €15, and €20 cocaine "plumps." The €10 option contains 0.077g (77mg) of cocaine, which is incredibly rare because it's too little. The €15 option contains 0.1g (100mg) of cocaine, which is also practically non-existent. She wanted a €20 plump, which included 0.144g (144mg) of cocaine, a middle dosage by our street quality standards. You know how short-acting cocaine is!

He then said, and I quote, "only when you give me a blowjob" (translated from my language). My husband saw her nod, meaning she agreed. That's how broken those people were. It wasn't really a consumption place; it was a marketplace. That makes sense, of course! When there isn't a team of people controlling those places to prevent abuse, you essentially create a new local marketplace for drugs.

In my opinion, these places and rooms should be way more controlled. When you give them clean tools for free, you should have someone watch over them to ensure they only consume and then leave.

The way you describe how the DCR should be monitored for such activity is exactly how EUDA expects them to be run from my understanding. The DCRs are not supposed to allow the behavior you described. However, I have heard of some DCRs looking past small drug transactions as you mentioned because they figure this will just happen elsewhere if the do not allow it, and if it happens elsewhere then worse things may happen because it isn't in plain sight of people who are willing to help if something bad happens like say a rape or robbery or something.

I like the DCR model that does not allow the drug sales, but I also think drugs should be legal and regulated so as to avoid the complications resulting from unregulated markets. Hopefully one day this will happen, and there are even politicians that support this such as Alex Vanopslagh. I think in the long term this will eventually have to happen, but it will take a lot of work to get us there and the less liberal/libertarian oriented governments/political parties will of course push back extremely harshly in most cases unless they see the opportunity to profit. Just my take on the situation, but everyone's belief on the matter may be different of course.

 

[Mana0909]

I totally understand and get your point.

The thing is, with very controlled legalization, we could stop the very dangerous RC market. Yes, many substances are safe or even pro-drugs of already existing ones, but most people don't inform themselves. They see a printed big zip bag on a website with "Flash Turbo" and a price tag of €29.99 per gram and buy it. Most of those legal high sites aren't really "RC" sites, where they just tell you the chemical name of the drug. They mostly sell it in neutral zip bags with a print on it, showing the substance's name and the chemical formula, or sell it in already pressed pellets, etc.

"But those websites don't look fancy, and the product names aren't anything special. It looks like they are made by amateurs," casual users might think.

Those shady legal high sites don't tell you what's in their products. They just have different fancy names for stimulants with race cars, explosions, or destroyed cities—just such edgy and corny "prints" on the baggies, which mostly contain very cheap cannabinoids or cathinone analogues that nobody knows a thing about.

The second problem is that many die from dirty substances. The heroin on the street has a purity of 5-8%, sometimes even just 1-3%, but the addicts don't care. They need to fix their withdrawal symptoms, and sadly, many countries like the U.S. have a very bad healthcare system. I'm happy because my country is ranked number 2 or 3 in the entire world in terms of healthcare. Everyone here can go freely to doctors or to the hospital. Everyone here has standard health insurance, but this doesn't exist in 80% of the entire world. Many don't have the cash to get methadone treatment, which is sadly an entire hellish cycle.

We have to find a middle way, you know what I mean? I think the key to this problem lies in the middle.

 

[matt<3ketamine]

Only thing i can add is test strips given out with the pins, at least the dirty needle isn't an issue.

I'm speachless about the shop lifting in SF though, really, a country like the good old USA who declared 'war' on drugs now accept the M/O to buy drugs.

i literally just went in and picked up about 30-40 nitazene tests from my local exchange, if they added a fent one - this would NOT be a problem for IV users. cook your stuff, add an extra .2 of water to the tray, dip and stir twice with strip, then 5 mins and you've your answer if its 'clean' or not of the killers-kit/nitazenes BUT i fully understand the ol' feeling of getting it straight from the tray and getting a nice hot barrel of gear just 'warms' up your veins n MMMMMM but alot of that could be psychosomatic and/or of the drugs effects.
But i know for myself that: attempting to have told me back then, in peak WD, to test my stuff (and this fent n nitazenes everywhere), as im shaking like a leaf, i may just skip that 5 min wait to see and get this sickness gone!

I think they should be putting a nitazene test in with every pack now, shouldn't have to ask nn be 'in the know about them' and show the street addicts: look, you can keep yourself even safer from dying now.
i mean you could even do your test before cooking but i don't know about nitazene water solubility - if you could, then you could just throw your gear in a tray with water n see if it is and doesn't need cooked in but i'd imagine they pick up even traces of it so, this imo should be implemented now and educate anyone who gets a needle pack or 'one shot kit', instead of them being needing asked for and known about before

 

[ShulginsReincarnation]

i literally just went in and picked up about 30-40 nitazene tests from my local exchange, if they added a fent one - this would NOT be a problem for IV users. cook your stuff, add an extra .2 of water to the tray, dip and stir twice with strip, then 5 mins and you've your answer if its 'clean' or not of the killers-kit/nitazenes BUT i fully understand the ol' feeling of getting it straight from the tray and getting a nice hot barrel of gear just 'warms' up your veins n MMMMMM but alot of that could be psychosomatic and/or of the drugs effects.
But i know for myself that: attempting to have told me back then, in peak WD, to test my stuff (and this fent n nitazenes everywhere), as im shaking like a leaf, i may just skip that 5 min wait to see and get this sickness gone!

I think they should be putting a nitazene test in with every pack now, shouldn't have to ask nn be 'in the know about them' and show the street addicts: look, you can keep yourself even safer from dying now.
i mean you could even do your test before cooking but i don't know about nitazene water solubility - if you could, then you could just throw your gear in a tray with water n see if it is and doesn't need cooked in but i'd imagine they pick up even traces of it so, this imo should be implemented now and educate anyone who gets a needle pack or 'one shot kit', instead of them being needing asked for and known about before

I am working on making this happen, but the process is tedious and there is no guarantee this will be widely adopted as best practice due to the fact that nitazenes are still seen as relatively uncommon. The thing is that they may be more common than we realize as of now because most places (in the US especially) aren't even checking for the presence of nitazenes in overdose victims. So, we really have no clue how prevalent they actually are right now. All we know is that they are out there, and that they are dangerous. We do seem to see more and more cases wherein they are tested for and identified though, so either their presence is increasing or surveillance of the problem is becoming greater.

Either way, I am working on getting a campaign going to raise awareness of the situation as best I can with the resources I have available. I already have nitazene test strips at one treatment facility as well as a flyer about the situation and information on how to obtain test strips. Slow progress is better than no progress I guess, but I just hope to beat the dealers to the finish line here in making people aware of the current threat.