Last Day Revisited: The Opioid Crisis

7: 20,000 Fewer Funerals

Subscribe to Lemonada Premium for Bonus Content



[00:01] Hiawatha Collins: I hate to use this term. And I hate to say it but dead people don’t recover. And the thing is to just give people a second chance at recovery at life. That’s what it’s about. An overdose is preventable. We have naloxone Narcan, the medication that can reduce overdose but we have so many people dying. In New York and New York alone, someone is dying every six hours. Last year it was every seven hours. Are we going to wait before we do something to us every five hours every four hours that someone is dying from something that is preventable? I hope not. 


[00:37] Stephanie Wittels Wachs: I think a lot about how I got here. Doing a show about death, specifically by opioids? I mean, obviously it started with this guy:


[00:48] Harris Wittels:

I love chilli’s nachos chilli’s nachos are what I love 

To say no like an australian just say all the vowels, “noooo.” 

You should really dance like everybody’s watching cause then you’ll dance better.


[01:04] Stephanie Wittles Wachs: Would I be doing this podcast had I not lost this delightful weirdo? I think we all know that the answer to that. It’s No. Resolutely no. But listen, this is how life works. The things that impact us directly are the things that steer the ship. And so, I’m Stephanie Wittels Wachs. And this is Last Day. 


[01:37] Stephanie Wittles Wachs: Hiawatha Collins currently spends his days, nights, weekends, holidays, you get it, he’s committed, working as a Community Mobilization Coordinator with the Harm Reduction Coalition in the Bronx. And like many, he got into this work because he gets it. 


[01:54] Hiawatha Collings: I was on the other side of the fence. I was a person who used heroin. I kept it a secret or I thought I was keeping it a secret for a long time because of the shame the stigma. Everything that came along with it that I didn’t I didn’t know anything about. One day someone told me about a syringe exchange. And I was like Really? Someone gives you needles? A place where you can just go sit down and relax and get off the street for a minute. There’s really places like that. I didn’t believe it. It took me some time before I actually went into This Harm Reduction Agency but once I went in. I was treated well actually better than I thought. It didn’t matter that I was using at the time. The only thing that they told me that they wanted from me is that they wanted to make sure that I had a clean needle every time I used. They talked to me about being tested for HIV and AIDS. There was trainings going on. There were groups there. I wasn’t pushed into any groups. I was asked if I would like to join if I would like to be a part of. If I would like to be included. 


[03:03] Stephanie Wittles Wachs: What Hiawatha is describing is harm reduction. By now, you’ve heard lots of smart people on this show talking about “harm reduction” but this is what it feels like in action. And this experience made a HUGE impact. It changed the course of his entire life. 


[03:29] Hiawatha Collings: I ended up working for this Harm Reduction Agency. Still using, but in the process of using and being a part of this said agency, I learnt more and more about myself. I learnt more and more about drug use. I learned more about advocacy. I started taking classes and trainings and things like that and I started giving back to the community. In a process of giving back, or thinking I was giving back to the community at the time, I wanted them to know that they were worthy. That they were somebody. That they still had a voice. That even though they were using, they still mattered. And a lot of times when people use – because so many doors get closed in their face, because people treat them like outcasts and like they less than – they tend to go into a shell and withdraw. And go into a state of depression and anxiety and some other things. Because everything is closed off to them. But I wasn’t going through that anymore because I had an outlet. I had people in my corner that legitimately were concerned about my health and well-being. But they wasn’t making decisions for me. They was giving me information, educating me, and giving me suggestions on next steps. And they were allowing me to make those decisions for myself. 


[05:02] Stephanie Wittles Wachs: Harm reduction has become a buzzword in the recovery/treatment/addiction world, but the concept isn’t groundbreaking. In fact, it’s incredibly common in our everyday lives. 


[05:14] Hiawatha Collings: When a policeman goes to work what’s one of the things he does? He puts on a bulletproof vest. When you put on your shoes, if they have laces, what do you do? You tie them up so you don’t trip and fall. All of these things are reducing risk. And that’s what harm reduction is about. Reducing the risk of any types of behavior and everything like that.


[05:38] Stephanie Wittles Wachs: In terms of drug use, harm reduction accepts that, for better or worse, people are going to use, and since we know that saying “don’t do it” doesn’t work, let’s try to minimize, or reduce, potential harms. In other words, instead of telling people “you need to do x y and z or else,” we meet people where they’re at.


[06:01] Hiawatha Collings: Okay, meeting people where they at. And what that means is that we go out into the community. And we treat people with dignity and respect. You know, without judgment, without biases, without stigma. That is so important. We don’t condemn, endorse, or condone any type of behavior. People are already gonna and do what they do. But at the same time we want to keep people alive. The stigma behind drug use is what keep people behind the doors, keep people in the closet, keep people from reaching for help. Nobody in a second grade when I was growing up and the teacher asks, “What did you want to be when you grow up.” “Well I think that I want to be using drugs homeless and this this and that.” No one ever said anything like that. But real life happens. And in life we our society is one of the greatest societies in the world. You mean to tell me that we cannot do better by our people our community? I have nothing against pets and animals but if we can rescue dogs and cats and save them, we can save people too. 


[07:11] Stephanie Wittels Wachs: So that’s the idea: If people are going to use drugs, let’s make the drug-use less risky and hopefully less deadly – and while we’re at it, let’s stop using shame as our primary tool because – hi, I’m a broken record, nice to meet you – It. Does. Not. Help. But in addition to reducing stigma and providing information and treating people with respect and keeping people alive, harm reduction is also a movement for social justice. It’s about fighting for systemic changes that address unjust policies and drug laws.


[07:50] Mayor Myrick: And this sounds, you know, controversial. People still get upset. But if we stop arresting people for using drugs period. You know folks will often, when I say that sort of, hold their breath. It sounds so radical it sounds. It sounds crazy.  And if you told me that even me five years ago I would’ve said it sounded crazy.  


[08:11] Stephanie Wittels Wachs: This is the Mayor of Ithaca, Savante Myrick. And the idea of decriminalizing drug-use sounds crazy to most people, because man does our society love to punish the bad guys. Using drugs is bad, and if you use them, you are the bad guy. The end. But like everything we talk about on this show, it’s not as simple as that. To address such a crazy epidemic, maybe crazy thinking is warranted. For more on this, I sat down with the mayor himself, who was actually feeling a little under the weather when we spoke. 


[08:52] Mayor Myrick:I should I apologize, I’ve lost my voice. But that’s OK. I guess for this podcast this will be what I sound like. It’s sort of like a Christian Bale when he would put the Batman mask on. 


[09:03] Stephanie Wittels Wachs: I love that.


[09:04} Stephanie Wittels Wachs:Even though he was in Batman-mode for our interview, Mayor Myrick usually identifies with a different piece of pop culture, one that — if you’ve listened to episode 1 — you know is extremely near and dear to my heart. 


[09:18] Mayor Myrick: You know for those of us in local government Parks and Rec is like, you can’t understand. You should come tell US conference or something. I mean we’ll watch the show and wait for the funny part because it’s so spot on accurate. I know doctors who don’t watch E.R. because they’re like, “that’s not what it’s like.” And lawyers who won’t watch CSI because that’s not realistic. And I just watch Parks and Recreation and in my head it’s like yep that’s it exactly. And as somebody who as you know was elected to the city council when Iwas 20 and then I was like the mayor at 24. So when Ben Wyatt became famous, you know I can’t say how many people walk up to me and are like when’s Ice Town coming? When are we going to get our own ice town? 


[10:01] Stephanie Wittels Wachs: If you don’t get this reference, how dare you, but Ben Wyatt was a young lovable mayor on a fictional TV show and Ice Town was a huge political failure for him. He’s dead on with the lovable young mayor part, but he’s being a bit modest with Ice Town stuff, because Mayor Savante Myrick is ridiculously impressive. In case you just missed that – In 2012, he became a mayor at 24. Years of age. I’m pretty sure I was living at my parents’ house at 24. But in addition to being good at life and having great taste in television, Mayor Myrick has gained a reputation nationwide for his innovative policy initiatives around drug use. And you know what, he might as well be Batman because it is so rare to encounter a politician who sees a detrimental issue in his or her community and makes such radical strides to change it. But while Myrick thinks big, his work is often informed by small, everyday interactions with his constituents.


[11:08] Mayor Myrick: You know folks are a little bit more candid when, instead of coming into the public eye and coming to a city council meeting, you can get them at their doorstep. It’s just you and them and you ask them what’s going on. And often it would start slow. You know, somebody would say, “well you know there’s a lot of stuff in this town that nobody wants to talk about.” So yeah tell me about that. “Well you know I’m just worried about some of the kids.” I said, well what are you worried about. And eventually after 20 minutes, they would say, “well here’s the deal…” And that’s in part why I decided to come out of the closet so to speak. 


[11:43] Stephanie Wittels Wachs: Yep. Like me. Like Jess. Like Hiawatha. Mayor Myrick has a story, too.


[11:51] Mayor Myrick: You know my father suffered from substance abuse disorder. Well we don’t call it that the, you said he was an addict. And it was like our secret shame, you know? The whole town knew it and we knew it but nobody talked about it. And what we didn’t know is that everybody has somebody. Everybody has somebody in their family. Themselves, their father, their uncle, cousin, their daughter. You know many of my friends in college, many of my friends in high school, had no idea that the reason I grew up without my father and that from the age of 6 – my mother raised the four of us by herself – was because he was using crack cocaine. It was a secret. I guarded closely but when I found out that there were a whole lot of other people holding on to this pain is when I first said it publicly and invited a lot of people to come and join in this effort with me to address the crisis. 


[12:43] Stephanie Wittels Wachs: But more than the opioids themselves, he’s addressing how the inequities of our justice system disenfranchise people of color. Myrick thinks we can do better.


[12:53] Mayor Myrick: So there are new ideas, right? There are things we can do that will have different outcomes that aren’t as racially motivated. But what we can’t do is leave the current system in place and just try harder, right? We can’t leave the system of courts and cops and drug courts and prosecutors exactly the way that it is, but just scold them all. “Hey you know stop sending black folks to prison when you send white folks to treatment. Just just do better.” Because those implicit biases are so insidious. They live inside all of us. And what you have to do is design a system that’s actually bias proof. And that’s, you know, I think that’s possible to do. Look we’re not going to arrest our way out of this problem. There’s no police chief, no sheriff, no lieutenant, no sergeant, no officer who thinks we can arrest our way out of this problem. Because they see what happens when somebody gets arrested. Which is, whatever they had going on in their lives isn’t made better. It’s made worse. That if they were down on their luck before, you know a week in jail without a phone call to their employer if they had a job, to their children if they have children, doesn’t make them more likely to get their life together but less likely to get their life together. So we need to find a way in which we can stop arresting people for using drugs and instead try and funnel them into a caring center of treatment. But we can’t allow them to use drugs all over so that leads you to one solution which is let’s pick out certain spaces, certain zones, certain facilities, certain rooms that can be safe for consumption. And in that way we can invite people in. They know they won’t be arrested, they won’t be hassled if they get if they overdose, they’ll have their lives saved.  


[14:38] Stephanie Wittels Wachs: Alright. What he’s talking about are safe injection sites, or overdose prevention sites or supervised injection facilities or safe consumption sites there are a lot of names, but what it means is a safe, hygienic, often medically staffed location where people can use drugs without the fear of being arrested. These sites are controversial largely because communities fear that they will lead to people using drugs in their neighborhood – but here’s the thing – people are already using drugs in your neighborhood. Only right now it’s happening on playgrounds, in cars, inside public bathrooms. And what that means, is that the 17-yr-old who is taking drink orders at Starbucks is the one who may have to figure out what to do about the person who’s overdosing on their shift because currently, that’s one of safest places in our community, for someone to use. This issue is not uniquely American, and Myrick has gotten to witness how other countries are implementing solutions like safe injection sites to address it more proactively. 


[15:48] Mayor Myrick: The eastside of Vancouver is one of the most notoriously entrenched neighborhoods for heroin use and overdose deaths in the world. And it’s in part because it’s a huge port from Asia and in part because it’s like right on the border with America. And for 100 years this has been true. And about 20 years ago they opened their first supervised injection facility. And I went and toured it. I was touring it with with a sergeant from the Vancouver Police Department and we got up early and you know, walked through this neighborhood that really has just been gutted, really having a horrible time. And he walks us through this alley and there’s a group of five people sitting there shooting up and he nudges them with his foot. This one woman literally has a needle in her arm and looks up at us and she goes, “What?” And the uniformed officer says, “What are you doing. Insights just around the corner.” And she goes “Yeah it’s 8am, they don’t open yet.” And he said, “It’s summer hours. They open at 7:00 a.m..’ and she says, ‘Oh thank you I didn’t know that.’ And they all stood up and they took the needle and they walked around the corner and into the facility. 


[16:59] Stephanie Wittels Wachs: Wow. 


[17:00] Mayor Myrick: And I asked him I said ‘You didn’t want to arrest them? You don’t want t…” And he goes “No. We want them to get inside and we want them to get out.” He goes, “We’ve tried arresting them. It doesn’t doesn’t fix anything. We want to clean this problem up by actually cleaning the people up not just by moving them around.” I thought that that was so profound. And I should say too that safe consumption sites, supervised injection facilities, whatever you call it – is not a cure all. You know, it won’t work for everybody. It actually works best for the very poor and the homeless. People who tend to use by themselves on the street. We would love if it turned out that people who were using in their homes and you know, the wealthy, the famous would also use facilities. But that hasn’t proven out in other countries, so this really is about saving the lives of the poorest folk. Here’s what happened when they’ve tried that in other places. Switzerland is the first place they tried it. They found that they’ve reduced overdoses by two thirds. 


[17:55] Stephanie Wittels Wachs: That’s incredible.       


[17:56] Mayor Myrick: I mean if it would mean in America that would mean 20,000 fewer funerals every year. Every year. Just right away. Two thirds. And it turns out that people use the facilities are 35% more likely to successfully complete rehab and stay clean. Because unlike somebody who’s just using on the street, the folks who are using in one of these rooms is coming into contact everyday with a medical professional who cares about their health. And doesn’t even say when they come in, they don’t even tell them, “Hey we want you to get clean.” They just say “Hi how are you. You can sit there. How’s everything else with you? Do you have a toothache? We can connect you with a dentist. We noticed you have what looks like an infection, we can maybe clean that up.” And they come in the second day and the third day and the fourth day. Some people come in – I don’t want to sugarcoat it – some people come in for three years straight and they’ll never get clean. 


But some people come in and after, you know, two months of using and they got the tooth fixed and that’s not hurting them anymore, and they’ve got that infection cleaned up and that’s not ailing them anymore, and they can look around and they say, ‘You know what? The only thing that’s bothering me in my life is my drug problem. It’s the last problem I need to solve.’ And when that happens, unlike using with your friends or using on the street where nobody around you is motivated to help you get clean, right? If you tell your dealer, ‘I don’t want to do this anymore,’ your dealer’s not going to say, ‘OK well help in the car hop in the car we’ll go to the detox.’ Right? Your dealer is going to say ‘Sure sure. Come back and see me again tomorrow.’ We can build a better system but it requires that kind of creative thinking that takes us away from the status quo and actually takes bold chances. 


[19:38] Stephanie Wittels Wachs: Yes, it’s bold. But remember when Dr. Harrison talked about support and community being a critical component of recovery? This is what that is. These facilities give marginalized people a place to go, where they feel like they belong, where people are looking out for them, maybe for the first time in their lives. 


And if that doesn’t do it for you, let me reiterate that the data suggests it would reduce overdose rates by two thirds AND that people who use these facilities are 35% more likely to stay in remission. 


But –– and I know this will be shocking since no one ever disagrees about anything in America –– not everyone is on board with this plan. 


[20:24] Mayor Myrick: Oh yeah. Oh boy. Well we were the first in the country so we got all of it. 


[20:31] Stephanie Wittels Wachs: And by “all of it” – he means ALL the opinions from every corner of the internet. Doesn’t that sound fun??? I love the internet! 

More on that, when we come back. 




[22:53] Stephanie Wittels Wachs: We’re back.  So when Mayor Myrick proposed this radical (and by radical I mean proven effective by data) idea to open a safe consumption site in Ithaca, people had feelings. 


[23:08] Mayor Myrick: I’ve never received more emails that went around the country and then around the world like wildfire. People calling me a crazy socialist. Other people were calling me a crazy libertarian. Other people were saying I was a wonderful socialist. Other people saying I was an amazing libertarian. You know Fox News really didn’t know what to do with this because I think their producers are more sort of business friendly libertarian. And they recognize this as a smart, data centered approach to us use less government resources, right? Like instead of imprisoning people, which is very expensive, you could lower taxes and get better outcomes. This is smart. And so they put me on the air several times where their viewers exploded at me. I mean that the hate mail I would get into the station would get – because I think all of their viewers are more not fiscal business centered conservatives but sort of cultural conservatives that believe that drugs are bad and bad people should be punished and punishment should take the form of jail and prison. 


And I think that’s actually that sums up the opposition, right? Things that are bad should be illegal. Things that are illegal should be punished. If people are punished they won’t do bad things. That’s like a logical chain that we’re very familiar with here in America. But we’ve spent 50 years with this war on drugs. Pretty good estimate I think is about two trillion dollars locking up people. We’ve locked up more of our population than any nation on earth and our drug usage rate has only gone up. So following this logic chain that says ‘you have to punish people for doing bad things’ just doesn’t work. But that’s that’s the largest response I got. Then I would say there was another camp. We know they are we know that they’re using. Why not just bring them into a space where we can supervise them from the jump. The folks who really knew about this who had experience with it…it didn’t sound crazy, it didn’t seem crazy, they were all for it. And especially the first responders who are like, ‘look I’ve revived the same person in that subway bathroom nine times. I’m terrified I’m going to get there too late.  Nurses who were maybe the leading advocate for this approach. Then there were the people in the middle who didn’t know. But you know they were just horrified by the way things were going. And then the Crime and Punishment folks continue to not be my biggest fans. 


[25:28] Stephanie Wittels Wachs: Ah, the crime and punishment folks. Not sure if you know this, listeners, but um, crime and punishment related to drug use (and everything else) is not doled out equally in America. 


[25:45] Hiawatha Collins: This pandemic has been going on for a long long time. And it is most unfortunate that now, that it has become a white issue, only now is it being really talked about. And not only being talked about but things being implemented to really make a difference and a change. And I’m only bringing this up to basically say this: It doesn’t matter black or white, your color, where you come from, this is affecting all of us.


[26:22] Stephanie Wittels Wachs: Right like Hiawatha says, people are suddenly super committed to fighting this epidemic because now it’s affecting “all of us.” But, the way we deal with it is still very uneven and that has to do with the historic face of addiction. 


[26:40] Mayor Myrick: In the 60s and 70s in the first heroin epidemic that swept the nation, the face of your average user was a teenager or somebody in their 20s who was black, usually black men. But not exclusively. And that was the public visible face of that epidemic. And I think that informed the public’s response which was, ‘Geez we need to build more prisons.’ Even liberal politicians. Because it was assumed that ‘Well these folks are scary. They’re out of control they’re super predators. The only way that we are going to survive their addiction is if we separate them from ourselves.’ And you know that had a lasting impact on all of us who are young black kids. You know I was born in 87. All of us who were born in that era when our fathers, our uncles, our mothers, were both suffering from addiction, getting no help for their addiction and going to prison. That really scared a lot of us and made a lasting impact that kept us away from what you might call hard drugs: powders and I.V. drugs. So, cocaine and crack and heroin is actually quite unpopular with kids of color. Now white kids it’s a little different. You know we see now young white folks don’t have that ingrained fear and are using at a higher rate than kids of color. You see the kids of color mostly sticking to weed. But, even that’s a little simplistic. And I think there’s another over simplification where we are always looking for the…You know when you have you ever watch this documentary on PBS or when you see that you know your local news is going to spotlight the new face of addiction. You always know it’s going to be the accidental addict, right? The worthy the addict, right? The person who this person was a star quarterback. They weren’t intending to be an addict. They were a star quarterback. They had their life together until they had a shoulder injury and then they had surgery and then they got Oxycontin and it turned out the OxyContin really interacted with their brain in a way that it doesn’t with most people. And they were off to the races. And that’s really convenient because that allows us to imagine that there are people who aren’t accidental addicts but are instead intentional addicts. That the kid who is 16 who is dealing with not a separated shoulder but wounds that we can’t see, right? The wounds that come from maybe being assaulted as a child or bullied in class right? Or just feeling isolated and feeling like they’d never fit in, they never belong, they never quite feel right in their own skin. Until somebody hands them at a party a pill suddenly makes them all go numb. They don’t feel anxious anymore. They don’t feel alone anymore. They don’t feel separate. And suddenly they’re off to the races too. That person, I believe is just as big an accidental addict as a high school quarterback. But we don’t really frame it in the same way. We keep seeking out people who we feel are blameless in order to allow us to still blame the folks who whose stories aren’t quite as visible. 


[27:47] Stephanie Wittels Wachs: Yeah there’s an empathy hierarchy for sure. 


[27:52] Stephanie Wittels Wachs: Oof, the empathy hierarchy. I not only understand this in theory, I feel like maybe I even helped to perpetuate it. My brother’s initial back pain is a piece of the story that makes him more sympathetic. Like, this wasn’t his fault. It was the Oxy! It was the doctor! It was Purdue Pharma! But let’s go ahead and spell something out that actually does not go without saying – my brother, and Jess’s brother are two white men from privileged backgrounds. And while, I do think we’ve been pretty open about the fact that neither of our brothers were perfect angels – that their disease led them to act in ways that were often baffling and frustrating – ultimately their actions were met with support in the form of treatment, interventions, therapy, more treatment. For way too many Americans who don’t look like them, those same actions lead to incarceration. 


[28:58] Hiawatha Collins: That is one of the hardest parts. And the other part is this is not, this is no way shape or form a knock on our police nationally. But sometimes the police tend to get in the way of the work that we are doing. And the reason why I want to say it’s not a knock on the police, because I know they have a hard job to do, I know that they do the best that they can at their job. But sometimes when it comes to something that is a public health issue – think about what I just said: a public health issue – why are police needed in that? When we’re talking about saving lives and changing lives it shouldn’t be about lock them up lock them up lock them up. When we think about the definition of community or what makes up community, we talk about homeless people, we talk about drug users, we talk about the schools, we talk about the churches. But guess what? All of these dynamics makes up community. Its takes a village, a community to make it work. Every time we try to move people or relocate people will push them out, push them out. They go to another what? Another community. And then that issue still circumvents and comes right back to where we pushed them out from. So if we really want to work on the issue it won’t be about locking people up and moving them or relocating them. It would really be about resources and helping people to make systemic changes. And then we can really take care of the problem.The problem is not just one sole issue. It’s all these things intertwined together and we need to take this approach holistically. It becomes a human rights issue. If you really want, if you we really want to talk about it, that’s what it is. It’s a human rights issue.


[31:51] Stephanie Wittels Wachs: I was nodding my head so hard during this part of his interview, I nearly broke my neck. Hiawatha is right. In order to change and save all lives, not just some, we have to make major systemic changes. Which is why it’s so important to have people like Mayor Myrick in positions of power who are promoting data-driven policy initiatives rooted in empathy and compassion for ALL.


[33:22] Mayor Myrick: When I proposed supervised injection facilities it was at the end of this long two year long community planning process. It was 100 pages long and there were 25 recommendations in it. And I think the seriousness of the plan is what caught people’s attention because this wasn’t just some mayor tweeting ‘you know what I think would be a good idea…’  And I think these politicians, I think they’re feeling like I’m feeling. Which is that every funeral you show up to, and people look to you and say ‘How are you going to stop this?’ And they’re just sick and tired of having no answers. They’re sick and tired of doing what should be the preacher’s job which is talking about how horrible it is and how sad it is and how tragic it is. And then sitting back down without ever saying what we as a society and in particular what we as a government could do to stop it. 


[34:13] Stephanie Wittels Wachs: So I read an article in the Cornell Daily Sun. It said that the state health department said it would review New York City’s request for a supervised injection facility. And I’m wondering if there has been any progress on that front. 


[34:28] Mayor Myrick: Sadly no. We remember that Mario Cuomo, in the 80s, when the legislature was saying hell no to syringe exchanges. Gov. Cuomo went around them and with an executive order through the Department of Health, created a state of emergency that allowed syringe exchanges to operate. And we’re hoping that we could do the same thing here. So we joined forces. with New York City where they want to open five centers and here in Ithaca where we want to open one. And we’re still waiting to hear back as they’re reviewing the data. I think that the bureaucrats think this is a good idea. You know, that they, they just look at where it’s working and they go ‘Wow. It’s just actually getting results.’ And bureaucrats are about data and results. And I think that they’re a little afraid of the politics. They need the politicians to come out and stand in front of them and take the arrows. And so we’re we’re very hopeful that our governor will do that. 


[35:19] Stephanie Wittels Wachs: I’m wondering are there any safe use injections sites in America currently?  


Mayor Myrick: Yes, but though none legal. 


Stephanie Wittels Wachs: Mmmm.


Mayor Myrick: Yeah. 


Stephanie Wittels Wachs: They’re like underground super supervised injection sites? 


Mayor Myrick: Yes exactly. 


Stephanie Wittels Wachs: Wow. 


[33:34] Mayor Myrick: All over the country. And I think the way that you’ll be able to spot them is if, you know, five years from now you look back on the data on where people are living and where people are dying. You’ll be able to see where the underground sites are. I won’t get more specific than that because I want to get anybody in trouble. But is very similar to you know syringe exchanges, which also people thought was just a nutty idea 30 years ago. And the communities that held out the longest, including in Indiana were Governor Mike Pence closed down syringe exchanges that were already up and running, you saw skyrocketed incidences of HIV and hepatitis. So bad, in fact, that Indiana had to go back on itself and re-open these facilities. But the syringe exchanges, they didn’t wait for legal permission either. They were operating in the basements of churches and people’s apartment complexes, out of the back of some health clinics. You know people put together syringe exchanges wherever they could and then they went and asked for permission later. So you have folks all over the country are actually already doing this. 


[35:39] Stephanie Wittels Wachs: So, actually, in the time between our recording this interview this summer and the release of this episode it looked like Philadelphia was slated to open its first legal safe injection site. Yay! But it looks like the justice department is determined to shut it down. Boo. But in the meantime, people still need these services. So where do they find them if they’re not, like, openly listed on the internet. 


[35:07] Mayor Myrick: Well I don’t know how to answer without getting people in trouble. 


Stephanie Wittels Wachs: Well I don’t want you to do that but I think it is really fascinating the idea that, you know, in times of turmoil the human race will find ways to survive. And to progress. Yes, you can see it again and again. Right.


Mayor Myrick: Like the Underground Railroad, right?


Stephanie Wittels Wachs: That’s exactly what I thought when you when you were talking about it. 


Mayor Myrick: Yeah. Who know they’ll be in trouble for doing what they’re doing and have just decided you know we’re not going to wait for those politicians to get it right. We’re not going to wait. And they’re not going to go to any anymore funerals. I can say that you should go to you know find your Harm Reduction Agency in town. For a lot of us that’ll be the local syringe exchange, and they can point you in the right direction. 


[37:58] Stephanie Wittels Wachs: We plan to do just that, when we come back.




[40:09] Stephanie Wittels Wachs: We’re back. So what happens at your local Harm Reduction Agency? What does a typical work day look like?


[40:19] Hiawatha Collins: We’re out providing individuals with sandwiches. We’re providing people with harm reduction supplies, which consist of needles, water, cookers, cotton… that type of stuff. Condoms. Narcan trainings on site. We’re providing people with hygiene kits. We have detox available on site if anybody wants to go to detox. If somebody has some issues and they want – they have an abscess or something like, that we have medical on site. One stop shop. I call it the no judgment zone. And I call it the no judgment zone because a lot of times people come in and they they are ashamed, they’re shy, and and they want to get what they want to get and just go. Now we have people that come to us on a regular basis. They hold conversations with us they let us know what they’ve gone through. Last year around the holidays one of the young ladies who was out on the site, boots on the ground, gave every participant they came up a holiday card. A gentleman instantly broke down crying. Because he stated that he hadn’t gotten a card – a birthday card, a holiday card, I love you, I thank you – in over four years. 


[41:36] Stephanie Wittels Wachs: Hiawatha and his team are providing services and supplies that are saving lives, and rebuilding broken spirits in the process. Which is important because many of the drug users he helps will end up saving lives themselves. Literally saving lives.


[41:54] Hiawatha Collins: So when when they call for EMS or call for help when someone overdoses, the people that’s usually around someone is another drug user. So that means that that other drug user is the first responder. That means that that individual is the first person on the scene. That person can have, will have the opportunity to use the in the naloxone and reverse that overdose. 


I’m a certified naloxone trainer. I do many other things, but right now there’s a lot of people in New York at at all the syringe exchanges. Most everybody is trained on how to use naloxone. We train people in the community how to use naloxone. EMS has it, Police have it. Right now, the thing is trying to get it into the hands of the lay person and in the hands of business people. The reason why we want it in the hands of business people is because, say for instance -McDonald’s, Starbucks – if someone is in their said facility using the bathroom, and they overdose. If they have a Narcan kit on site, that three to seven minutes is precious. Because all overdose is is a lack of oxygen to the brain. So in either using the Naloxone kit and bring them out of the overdose or simply doing rescue breathing, they can sustain a person till EMS gets there.


[43:22] Stephanie Wittels Wachs: One of the best parts of making this show is realizing that I am not in this thing alone – I’m part of a way bigger community that includes people like Hiawatha and Mayor Myrick. Like many of the guests I’ve interviewed, I asked the mayor what he would do if I gave him a magic wand to fix any part of this mess, and being a man of many metaphors, he described trying to save a person from falling off a waterfall. Tarzan was involved, too. 


[43:54] Mayor Myrick: You see someone going over the edge and you swing like Tarzan on bamboo vine and grab them bring them to the other edge. And you look back and somebody else was going over the waterfall. And you keep swinging back and forth. Finally you go, ‘Why are all these people going over the waterfall?’ So you go upstream a little bit and you see that they’re in the river. So you try and pull them out of the river one by one. No matter who you pull out, people keep coming down the river. So you want to go further up the river. And you see that what it is is that there is a, you know, a blind turn that people keep tripping over. And they keep tumbling down the hill and into the river. And that’s why they go over the waterfalls. So if you can put guardrails up and stop people from falling into the river at all, you can save everyone’s life. But I I want to caution against magic wand thinking for public policymakers because sometimes people will only want to do one part of the river. They will say, ‘Look people who are using they’re already in the river.’ Or, ‘People who are living on the street and already using they’re already going over the waterfall anyway. We don’t have time to save them. We’ve got to focus upstream.’ Well, we had to do the whole thing because I don’t care who you are, if you’ve already gone over the waterfall I want to save you too. And I think we are a country that’s big enough we’re smart enough we’re rich enough. We can save everybody and everybody deserves to be saved. 


[44:19] Mayor Myrick: Gosh. I love this work because I have so many feelings of my own. I mean I’m sure you can relate of like, you know like, how do I translate what I’m feeling into something useful? And I don’t even know, and honestly I don’t even know if that’s healthy, if that’s the healthiest coping mechanism. But it’s the one I got, right? You know I’ve got survivor’s remorse as well as like feelings of shame and, how can I make myself useful? And politics is very good for that. 


Stephanie Wittels Wachs: Well it’s turning it’s turning your story into action is what it’s doing. 


Mayor Myrick: Right. Yes.


[44:56] Stephanie Wittels Wachs: Turning your story into action. That’s what we do as humans, right? Through boots on the ground, through a podcast, maybe like the one you’re listening to right now. 


Next week, we meet a congressional giant and a congressional  hopeful, each with strong personal stories that inform their work in this space on the national level. 


[44:20] Sarah Gad: We really need to take a good, hard look at our current drug policies and be able to concede that we made a mistake, our policies have failed, and it’s time to take a new approach that will actually have the capacity to treat this disease, reduce the impact of this crisis and I mean, they say insanity is doing the same thing over and over and expecting different results. And I think that by this point it’s fair to say that America is insane.


[46:55] Stephanie Wittels Wachs: This insanity is precisely WHY we are doing this show. Because you know what my grandma used to say, if you always do what you’ve always done, you’ll always get what you’ve always gotten. And we can’t keep getting what we’ve always gotten because it’s sad and fucked up and soon, there won’t be any people left.  


[47:20] Stephanie Wittels Wachs: This show is about looking for hope and progress. When we thought about what we wanted it to be, we wanted to talk to experts and thought leaders. We wanted to figure out what, if anything, we could have done differently. And we wanted to talk to you. Your stories are such an important part of this show. After the holidays, we’ll dive into the second part of Season One, going into local communities, doing town halls, and featuring more last day stories. We’ve dug into what led to our brothers’ last day, and now we want to hear from you. So, we’re asking you, our listeners, to reach out and tell us about yourself and the people in your life who have been affected by the opioid crisis. You can email us at or leave a voicemail at ‪(651) 764-8383. That’s ‪(651) 764-8383.


Last Day is a production of Lemonada Media. Jessica Cordova Kramer is our Executive Producer. Jackie Danziger is our consulting producer. Our technical director is Kegan Zema. Nathalie Boyd helped to edit this episode and our music is by Hannis Brown. Special thanks to Westwood One, our ad sales and distribution partner.


You can find us online @lemonadamedia. That’s Lemonada like L E M O N A D A. If you liked what you heard today, tell your family and friends to listen and subscribe, rate and review us on Apple, Spotify, or wherever you get your podcasts. And check out our show notes for a deeper dive into what you’ve heard today and how to connect with the Last Day Community. 


I’m Stephanie Wittels Wachs.  See you next week.


Spoil Your Inbox

Pods, news, special deals… oh my.