No Pleasure: Addiction, Poverty, and the Everyday Lives of Drug Users | Roberto Abadie | CAS Inquire

CAS MarComm Author

01/27/2022 Added

10 Plays

Description

"No Pleasure: Addiction, Poverty, and the Everyday Lives of Drug Users" by Roberto Abadie for CAS Inquire on January 25, 2022.

Searchable Transcript

Search:

[00:00:06.360]Good evening, I am Dr Taylor Livingston.
[00:00:08.840]I'm the director of the College of Arts and Sciences Inquire Program.
[00:00:12.720]Thank you all for coming tonight.
[00:00:14.200]For those of you in attendance for braving the cold in the surge and
[00:00:19.000]for those via Zoom, thanks for joining us from the comfort of your home.
[00:00:24.840]This is the first installment of the Spring Semesters
[00:00:28.440]Inquire lecture series on pleasure and pain.
[00:00:32.320]Although the topic for the series was chosen prior to the COVID 19 global
[00:00:36.560]pandemic, it seems particularly apt given our current cultural moment.
[00:00:41.760]The Inquire program is structured around these lectures,
[00:00:45.360]allowing students, faculty, staff and the wider public
[00:00:49.240]to investigate how we, as individuals
[00:00:51.960]and a society understand the concepts of pain and pleasure
[00:00:57.400]and how their perceptions shape and are reflected by human behavior.
[00:01:02.600]Additionally, it creates an opportunity to learn about the fascinating research
[00:01:07.520]of our faculty members in the College of Arts and Sciences
[00:01:11.240]and enable students to see how various disciplinary approaches
[00:01:14.560]to the study of a topic, as well as the necessity of multi trans
[00:01:19.720]and interdisciplinary insights, are truly enable human actions.
[00:01:25.240]Tonight's lecture by my colleague and fellow medical anthropologist Dr.
[00:01:30.280]Roberto Abadie, assistant professor of anthropology
[00:01:33.800]in the School of Global Integrative Studies, explores
[00:01:36.880]the tenuous line between pain and pleasure among people who inject drugs.
[00:01:42.720]Dr. Abadie is the author of the award-winning book
[00:01:45.360]The Professional Guinea Pig, Big Pharma and the Risky World of Human Subjects,
[00:01:49.960]and is currently working on a book based on this research
[00:01:53.200]about people who inject drugs and their experience
[00:01:56.200]after Hurricane Maria struck the island of Puerto Rico.
[00:02:00.760]After his talk, Dr.
[00:02:01.840]Abadie will take questions from the audience.
[00:02:04.360]So if you are joining us in person,
[00:02:07.000]if you just want to make your way up to the microphone here to ask a question.
[00:02:11.000]It's great if you're joining us
[00:02:13.000]and hope if you just want to put your question in the tap.
[00:02:16.120]I will ask it on your behalf.
[00:02:19.600]Please join me in welcoming Dr.
[00:02:23.760]Abadie. Hi, everybody.
[00:02:26.880]and thinking about pleasure,
[00:02:28.920]Abadie. Hi, everybody.
[00:02:29.480]Thanks for coming.
[00:02:31.480]And thank you for your introduction and thank you to us inquiry for
[00:02:37.600]inviting me to talk about my research, but more than anything else,
[00:02:41.240]thank you CAS Inquire for coming with this brilliant idea about talking about
[00:02:47.440]pain and pleasure. We are.
[00:02:51.120]We are in pain as a society.
[00:02:54.840]The world is in the middle of a pandemic, and I think it's very important
[00:02:58.360]to understand what the pain is coming
[00:02:59.960]from, what's producing the pain and how we're dealing with the pain.
[00:03:03.720]I don't see a lot of pleasure, but both.
[00:03:06.480]And I think that's the inside of anthropology and the social sciences.
[00:03:09.480]Both pain and pleasure have a social basis,
[00:03:12.600]are felt individually, but are shaped by culture and society.
[00:03:16.800]So when I want to explore today, is there ways in which
[00:03:21.240]addiction, poverty and the everyday lives of users really shapes
[00:03:25.520]the experiences of people using drugs in Puerto Rico?
[00:03:29.360]And are those based on more than five years of this presentation
[00:03:33.200]is based on more than five years of study in Puerto Rico.
[00:03:36.760]I think some of the elements of the conversation
[00:03:39.760]might be extrapolated to other realities of people
[00:03:44.520]who use drugs and drugs in other parts of the US and elsewhere as well.
[00:03:49.120]So let me just start
[00:03:51.840]by showing you a quick here.
[00:03:57.680]It's not working.
[00:04:03.640]We're supposed to go like this.
[00:04:05.280]A quick outline, I'll do an introduction, I'll tell you
[00:04:08.920]a little bit about the research sites and the background of the study.
[00:04:12.000]The study faces the methods, the findings and the conclusions.
[00:04:16.800]I think all these songs very boring, so I've got to move straight
[00:04:20.800]to one of my observations in this field really to you.
[00:04:25.360]This is an observation I did.
[00:04:29.640]When I was sitting in my office in Theodore,
[00:04:32.000]in rural Puerto Rico, I could see what's going on
[00:04:34.760]through the glass window and this is what I observe.
[00:04:37.520]I suddenly recall him getting me by because he kept saying
[00:04:42.720]Fight fight, which is that that everybody who says that, that
[00:04:46.000]that's his nickname in the street or history name is like Dunning me by.
[00:04:49.920]He was going through an awful episode of heroin withdrawal,
[00:04:52.960]and I could see everything through my window.
[00:04:56.240]So this is what I describe
[00:04:58.440]feeling the pain in his bones, shivering, sweating and extremely weak.
[00:05:03.040]He stopped working. Finally, now share it.
[00:05:06.400]You think anything solid would make him throw up immediately curbing pain?
[00:05:10.800]He vomited on the sidewalk, burning a young man in his mid-thirties
[00:05:15.920]was undergoing through all the symptoms of heroin withdrawal,
[00:05:19.520]in his own words. He was sick.
[00:05:22.800]The only cure was another heroin shot.
[00:05:32.240]Anthropologists have been thinking
[00:05:34.480]about pain and pleasure for decades.
[00:05:37.920]And one of the things that anthropologists understand
[00:05:41.640]is that pain and pleasure are individually perceived.
[00:05:45.040]You feel you feel it
[00:05:47.920]and experience, but that pain and pleasure cannot be shifted from culture.
[00:05:53.040]Culture this takes the ways in which pain
[00:05:57.040]and pleasure is experienced by individuals the way they talk about it.
[00:06:01.600]They will go through it and also who gets to experience pain
[00:06:05.840]and pleasure on which kind of pain and which kind of pleasure every society
[00:06:09.720]or culture selects or defines what is pleasurable, who can experience it
[00:06:13.600]for access to it and who cannot.
[00:06:15.800]And in turn, each society produces their own forms of pleasure.
[00:06:19.720]This might sound very theoretical, but just to think about America
[00:06:27.600]consumerism, going shopping, that's what we that's what we do.
[00:06:31.760]You know, when I was in New York City in 2000, one after
[00:06:38.280]the the World Trade Center was stuck and
[00:06:41.720]we were all in pain. The nation was in mourning.
[00:06:44.080]The city was in pain.
[00:06:45.480]And President Bush said when the economy sunk.
[00:06:48.680]Go on, go shopping.
[00:06:50.320]I think that's how we cope with our pain
[00:06:52.160]and that's also our place of shopping, but also gambling.
[00:06:55.640]There are many addictions.
[00:06:56.840]We are addicted to the likes on Facebook
[00:06:59.440]and we screen Twitter and social media develops
[00:07:03.920]some certain kind of addiction on us and thus pollution as well.
[00:07:08.400]But of course, that's our society, other societies of all sides of
[00:07:13.000]pleasure, us as well.
[00:07:14.840]And with the pain, likewise based pain is also socially produced.
[00:07:19.000]Some individuals or some group are disproportionally exposed to pain
[00:07:22.640]or what anthropologists call social suffering.
[00:07:26.640]And I know you are totally tired of listening
[00:07:29.400]and hearing and going through COVID, but if you're thinking about COVID,
[00:07:33.560]they are very important, especially these people most affected,
[00:07:37.040]of course, the old, because that's the way the virus work.
[00:07:40.160]But people most affected are people from marginalized
[00:07:44.520]backgrounds and poor people that are forced to serve people like me
[00:07:49.760]that can go to our store and then walk out or us
[00:07:54.240]order food from the front of my house or work from home.
[00:07:59.520]So COVID disproportionately targets a certain kind of people and inflicts
[00:08:03.920]pain and death on certain groups and not others. Right.
[00:08:07.240]So you can see how both pain of pleasure and socially produce
[00:08:13.840]entrepreneurship.
[00:08:14.440]She has also made
[00:08:15.800]a significant contribution to the understanding of people who
[00:08:18.640]inject drugs basically after the emergence
[00:08:22.120]of HIV in the early eighties. The really
[00:08:26.760]large reduction in our interest on people who inject drugs as a discipline.
[00:08:31.480]What we did is instead of focusing like epidemiological public publishers
[00:08:35.200]has done and continue to do on individual behaviors, we focus instead on practices
[00:08:40.480]what people do, providing what preferreds calls a deep description
[00:08:45.120]of the context in which individuals live and make decisions about risk.
[00:08:50.600]Finally, the show that the particular ways in which sharing
[00:08:53.200]syringes and injecting equipment contributed to the epidemic, contributing
[00:08:58.040]to shape harm reduction programs, the epidemiology Sunday.
[00:09:02.800]The public health practitioners knew, of course, that the HIV virus
[00:09:06.960]was contained in the blood, and they theorized
[00:09:10.680]that the syringes would be a vector for HIV infection.
[00:09:14.000]But they didn't think about the cougar, the core of the worker on the water.
[00:09:19.080]The works that the injectors use to ensure
[00:09:22.200]you're not not only to use the syringe, but also you have to dilute the what
[00:09:25.760]the drug and water and the anthropologist through
[00:09:30.680]observation understood and documented the ways in which users
[00:09:37.120]could trust me, not just
[00:09:38.560]by sharing the syringe, but also sharing the other elements the quicker
[00:09:41.560]the water and the cotton and under help sustain important harm reduction programs.
[00:09:47.320]This approach contributed to destigmatize the population of users moving
[00:09:52.040]from the initial category of risk group
[00:09:55.800]to these practices and more recently, at risk environments.
[00:09:59.280]And finally, I argue that more attention should be paid
[00:10:02.320]to the experiences of people.
[00:10:03.640]When should drugs as they face a double whammy?
[00:10:06.880]We have a fentanyl overdose death epidemics
[00:10:10.360]epidemic this year, 100,000 this past year, 100,000 people who use drugs died
[00:10:16.320]in America due to overdose, basically and mainly caused by fentanyl
[00:10:22.240]and also people controlled drugs also have to face the effects of COVID 19.
[00:10:28.000]COVID 19 affects everybody, but as I argue at the beginning,
[00:10:31.840]it affects more or disproportionately people that are more
[00:10:34.880]vulnerable or marginalized.
[00:10:37.720]Drug use is a social event.
[00:10:40.120]You have to buy the drug from somebody and then you have what you can use the drug
[00:10:43.720]with somebody else.
[00:10:44.640]So with COVID, you are forced to,
[00:10:48.080]you know, you cannot do social distancing with your dealer
[00:10:51.600]and you are not going to do social distance with the people who
[00:10:54.480]you are going to use.
[00:10:55.560]So that in turn, exposes people who use drugs to a disproportional risk
[00:11:00.200]for COVID 19 in the middle of a fentanyl epidemic epidemic.
[00:11:04.560]So I'm arguing that we have to pay more attention to that.
[00:11:11.080]This is somewhat political point, very,
[00:11:14.320]very also shaped by the theories of embodiments
[00:11:18.680]developed by medical anthropologists like sodas, but many take it, so go.
[00:11:22.240]So my argument here is that the pain and suffering of addiction
[00:11:25.920]cannot be understood without examining colonial conditions in the island
[00:11:30.520]as a system of power, colonialism permeates really every aspect of life
[00:11:34.800]in Puerto Rico and particularly among people who inject drugs.
[00:11:39.640]So they are exposed to the effects of the war on drugs,
[00:11:43.640]lack of treatment for dependance and also poverty, homelessness and migration.
[00:11:51.320]Now this these circumstances
[00:11:53.680]actually leave scars on the bodies of the people who had drugs,
[00:11:58.200]and this is not just a theoretical or metaphorical point.
[00:12:03.120]These cars are there after years of infection.
[00:12:06.560]They get ulcers. They are.
[00:12:09.560]No, it's very hard to to explain, but they have middle marks.
[00:12:13.040]They have ulcers, they have MS.
[00:12:14.640]Kids really embodies all this.
[00:12:17.320]I argue that these marks embody the effects of colonialism,
[00:12:21.360]austerity, privatization of health care services
[00:12:24.760]and the effects of a system of colonial system.
[00:12:27.440]But this humanizes an invisible system as well.
[00:12:32.800]The questions I had going into
[00:12:34.720]this project, this is a five year project that started in 2015, funded by the NIH
[00:12:41.720]on social networks and on HIV and IBS-C risk.
[00:12:45.600]The questions they had was how is partners safe
[00:12:48.760]shape risk practice among rural people going to drugs?
[00:12:52.480]What are the differences between people which are drugs in rural Puerto Rico
[00:12:55.440]compared with the European counterparts?
[00:12:58.680]How is the live experience of addiction among rural people? The drugs?
[00:13:02.080]You know what it means to be an addict,
[00:13:05.160]somebody that initiate drugs and what it means, you know how
[00:13:07.840]it is their life and how it's shaped by these different arrangements?
[00:13:11.640]I was talking about,
[00:13:13.400]you know, particularly how colonialism, dispossession and poverty
[00:13:16.920]shape their practices, but also their ability to seek
[00:13:19.640]or affect change in their lives as well.
[00:13:24.880]This is this is not my field site.
[00:13:27.400]It's kind of tricky.
[00:13:28.600]This is Culebra.
[00:13:31.040]I did my research in rural Puerto Rico, but I think it's a beautiful picture
[00:13:35.480]and also illustrates this.
[00:13:37.120]A thunk illustrates the military presence of us in the island.
[00:13:43.240]So initially, Puerto Rico was a position of Spain
[00:13:47.080]until 1898 and has become a territory of the US since then.
[00:13:52.320]They became the Puerto Ricans, became citizens in 1917,
[00:13:55.440]and they were enrolled to fight in the first World War right away.
[00:13:58.280]That's how they that's
[00:13:59.360]why the US made them citizens so they could enroll them to fight.
[00:14:02.400]And then they also for the second World War, the Vietnam War and many other wars in
[00:14:07.240]Iraq and Afghanistan.
[00:14:09.120]As a testament of the military
[00:14:11.720]and colonial presence, there was a military base Navy
[00:14:14.920]Navy base in Vegas until 2003, where they were ousted by Popular Mobilization.
[00:14:21.040]They left all that unexploded bombs and the radiation on the salt.
[00:14:26.200]Half of the population is poor.
[00:14:28.000]That's the poverty line line. But that's what it means.
[00:14:31.160]And the per capita household income of less than $20,000, it's half of what it is
[00:14:36.160]in poor and the poorest states like Mississippi and West Virginia.
[00:14:43.000]Puerto Rico is not a very big island,
[00:14:45.320]100 miles long and 35 miles wide.
[00:14:50.360]Someone in the north is the capital where two thirds of the population
[00:14:53.920]live around 2 million people.
[00:14:56.040]And this is my that was my research area
[00:14:59.400]I conducted research in.
[00:15:00.480]I was going to see on that score, Mario.
[00:15:03.720]It's so small it doesn't show up in the map.
[00:15:06.080]It really is a particular challenge.
[00:15:08.600]Just the idea we have about somebody that instructs dogs
[00:15:12.440]because it's rural and it looks like so beautiful.
[00:15:16.160]But yeah, there's
[00:15:18.240]people who inject drugs there like it is like it is also in rural
[00:15:22.880]Kentucky or rural Appalachia.
[00:15:26.000]Not that they are the same thing, but I'm just mentioning it.
[00:15:30.920]The background of the study is that Puerto Rico had the highest rates
[00:15:34.520]of HIV in the country among people who had drugs.
[00:15:37.880]As I mentioned, people continue to face HIV and hep-C risk because they believe
[00:15:43.720]not containing the syringes and also in the U.S. equipment.
[00:15:47.840]This was the first study looking at social networks
[00:15:50.680]and risk in rural Puerto Rico, and the idea of this social narco
[00:15:55.760]study was the HIV at risk are not at risk, but embedded in social networks.
[00:16:00.600]You cannot pass HIV on ABC to somebody else if you don't have it,
[00:16:05.560]but if you are not interacting with anybody else.
[00:16:07.920]So the goal of this study was understand how HIV anybody
[00:16:11.200]would travel within a population of people can check the drugs.
[00:16:17.920]Very briefly, this study had four faces.
[00:16:21.880]We recruited hundreds of participants, we tested them for HIV and ibs-c.
[00:16:25.720]We collected demographic data and data about infection practices.
[00:16:31.480]But the main the research presented today is focus on
[00:16:35.440]or based on our second portion of the study, which is an infographic
[00:16:39.560]or observation of 33 participants and the people
[00:16:44.120]that were associated with them.
[00:16:47.280]We also asked them questions about risk behaviors and HIV and hep-C.
[00:16:53.160]And we tested them.
[00:16:54.240]But the main point was to observe
[00:16:57.280]who were they using with, and that was the main thing,
[00:17:01.000]but also wanted to go and do a study of, you know,
[00:17:06.000]how their life, you know, how it is to be uninfected in rural Puerto Rico.
[00:17:11.360]So we followed them.
[00:17:13.200]We showed them them for up to two weeks.
[00:17:16.560]We map their network, but also on the strength of this
[00:17:19.760]and who they were using with or how often or how much they were spending.
[00:17:24.600]We went to shooting galleries where they used drugs.
[00:17:29.400]And we also went to other venues.
[00:17:32.160]We followed them as they hustled to make money,
[00:17:34.800]and we also gave them rides to methadone and Suboxone treatments.
[00:17:40.360]We took them to the hospital.
[00:17:42.520]We did a lot of things that gave us the opportunity
[00:17:46.280]to understand, you know, how do they live
[00:17:49.800]and how their poverty and disposition and the addiction really shaped
[00:17:55.600]the way they live in Puerto Rico.
[00:17:59.080]This is very briefly demographic data about.
[00:18:04.400]The population overwhelmingly male around 40 years of age,
[00:18:09.520]not a lot of money, as you can see, mostly unemployed,
[00:18:13.280]one in six homeless, half finished high school and half note
[00:18:16.880]and one fifth have been married or living as married.
[00:18:21.760]Almost four in ten infected four or more times.
[00:18:25.080]Are they now the findings?
[00:18:28.360]They no pleasure.
[00:18:30.240]And I think maybe they surprise you the idea that people who inject drugs
[00:18:35.080]get no pleasure from injecting drugs?
[00:18:37.880]Are you tell me when when we have this section about questions,
[00:18:41.120]but I think it's not intuitive to think that somebody that inject drugs
[00:18:45.600]don't does not get any pleasure from injecting drugs.
[00:18:49.520]The, you know, the dominant idea is that drugs are fun
[00:18:54.040]and people have been using drugs for millennia.
[00:18:57.000]It's part of the human condition and we want to explore.
[00:18:59.440]We want to know what this limits and different level
[00:19:04.400]drugs allows people to escape a reality
[00:19:07.840]to escape the present state, to escape the stressors of everyday life
[00:19:12.400]and to, you know, do not have to think about
[00:19:15.200]how to prevent them from thinking about what's going on.
[00:19:18.400]So it's a form of scoping as well.
[00:19:20.520]It might be fun. It's maybe a form of social.
[00:19:22.520]I mean, the social socialization, a form of interaction.
[00:19:26.920]So the idea is that
[00:19:29.360]drugs are fun and thus and preferable, and that's why people do it.
[00:19:33.000]And that's what people have been doing it.
[00:19:34.280]So the idea that people can do dogs find no pleasure in instructing dogs
[00:19:40.640]challenge this vision.
[00:19:42.040]And also you might be wondering if they don't find pleasure in it.
[00:19:46.560]Why do they do it then?
[00:19:48.200]So let me tell you about this.
[00:19:50.920]When I asked them about drug use and how they felt about it, they say
[00:19:54.800]they feel everything and everything translates as fill up and Thayer.
[00:19:59.560]And that's how they talk about their situation.
[00:20:02.440]They feel they enter a pact with the devil and heroin.
[00:20:06.800]Once you tasted, by the way, it's very hard to quit.
[00:20:09.560]They feel they're slaves to the drug that controls them,
[00:20:13.400]you know, and the drug that became their master.
[00:20:16.440]They said, I've been working to enrich my, my dealer or the betrothed.
[00:20:22.400]That's the way they talk about the big shots.
[00:20:24.800]The the owner of the Punto, where the drugs are being sold,
[00:20:27.600]so they feel that they're being slave to the drugs, that it's a pact with the devil
[00:20:31.920]that once you start using, you cannot quit and that they feel that trouble.
[00:20:38.240]You broken Shamrock tussle to find the money.
[00:20:41.320]They they have to find a place where the drug is going to be sold.
[00:20:45.000]Called Puntos in Puerto Rico, and then they need to find a vein.
[00:20:49.400]That's harder than it looks.
[00:20:51.600]If you know, this population has started injecting what they were 20 under around
[00:20:56.680]40 now it means they're being injected on and off for 20 years.
[00:21:01.880]But only you will know this, but you know,
[00:21:03.560]first you start injecting in your arms because you're going to hit them
[00:21:07.640]and also the veins are really good, are they say you go here
[00:21:10.880]and then you go here, then you know, after the well?
[00:21:15.400]They form these, you know, it's harder
[00:21:18.400]to keep going in the scenes, but then you go to your arms.
[00:21:21.840]Then you go to your hands. Then you go to your feet.
[00:21:24.640]Then you go to your legs. And then you funnel.
[00:21:26.800]You have placed through places like here and here or here, right?
[00:21:29.920]But it's very hard to inject and hit the vein right away.
[00:21:35.720]It requires many, many attempts.
[00:21:39.800]It's bloody. I've seen them in the shooting galleries.
[00:21:42.200]They have blood all over because it could go in and see in the way
[00:21:45.920]you see, if you hit the vein, if you hit the vein
[00:21:48.200]and then you think you think a little bit of blood.
[00:21:50.200]And if you see the blood in this mix with the dog,
[00:21:52.760]it means that you hit the vein.
[00:21:53.960]If not, you have to keep trying and trying and trying.
[00:21:56.600]So it's really hot.
[00:21:58.160]So whether, you know, because of the pressure they they inject,
[00:22:01.800]because they need the drug to avoid the effects of heroin withdrawal.
[00:22:05.880]They want to avoid what burns me I was feeling when I started this talk.
[00:22:11.280]In addition to Speedball, they use cocaine.
[00:22:14.760]So Speedball cocaine is stimulants, so
[00:22:18.560]heroin relaxes them and allows them to function and grow
[00:22:22.960]normally through the day, and cocaine gives them a burst of energy.
[00:22:26.920]So Puerto Ricans particularly like this combination
[00:22:29.800]spiral is a way of self-medicate in order to not deal with a bodily pain,
[00:22:35.040]but also the stress, the boredom of the eye witness, the eye witnesses,
[00:22:38.240]a notion developed by social media.
[00:22:41.720]And it means that you do it unconsciously.
[00:22:44.480]You do it because you've been doing it for so long.
[00:22:46.520]It becomes part of your identity after you've been shooting drugs for 20 years.
[00:22:51.440]Using drugs structures
[00:22:52.880]your day, you wake up, you're looking for drugs.
[00:22:57.120]Then as day progresses, you, you look for more money to use more drugs.
[00:23:01.920]And then at the end you have to go to bed, try to sleep, thinking
[00:23:06.720]I have to have the drug for tomorrow early morning when I wake up.
[00:23:10.560]So structures are day in that way. And you know, it's unconscious.
[00:23:13.880]You don't think, Oh, I need this.
[00:23:15.960]But it becomes part of your identity, as you said that you know,
[00:23:19.360]that's what you do. That's what you are. That's what you become.
[00:23:22.520]So that's why they keep doing it.
[00:23:23.560]It doesn't mean, however, that there's never no pleasure.
[00:23:29.800]Pleasure is rare.
[00:23:32.400]I want to be clear with these very rare, but it's possible
[00:23:35.760]if all the conditions that I'm going to describe here
[00:23:39.840]are present. A lot of things have to happen for a high order
[00:23:45.200]not to be possible.
[00:23:46.800]They have to find a job because we all have to be pure.
[00:23:50.440]This usually is very deluded.
[00:23:52.880]The deal is put a lot of things in the drug to make it larger
[00:23:56.560]to to maximize their profits, so the drug has to be relatively good quality.
[00:24:01.680]And then they have to find the vein, which I what I shall
[00:24:05.160]screen is like a very hard to find a vein.
[00:24:08.200]But if everything goes as expected,
[00:24:12.840]right after hitting the vein, the participants feel what they call
[00:24:15.920]a calling storm, it's a warm feeling of the drug,
[00:24:19.720]you know, going through the rain and going through their body, it's warm,
[00:24:25.000]so they feel mellow, relax.
[00:24:27.240]And for a period of time, all their body pains cease and they
[00:24:30.840]can feel normal and function.
[00:24:33.400]So what do they do when they feel OK that they can do things?
[00:24:38.720]Well, they do normal things. They take care of their pets.
[00:24:42.040]They play with their pets.
[00:24:43.280]They take care of their gardens.
[00:24:45.840]Some of my participants have beautiful one size, for example.
[00:24:51.800]Oh, there's just chill out there, watch TV.
[00:24:55.080]The problem is that in a few minutes,
[00:24:58.520]the effects of the shot went down,
[00:25:02.960]and then they have to start thinking again
[00:25:05.400]about what the money's going to come out and the next shot.
[00:25:09.280]So they're finishing and they're already thinking about,
[00:25:12.440]you know, where the money going to come on.
[00:25:14.840]Who, who, who can I get to find with to use again?
[00:25:22.000]This is just a description.
[00:25:23.320]I don't think we have to go through it, but it helps you understand that
[00:25:28.400]there's no pleasure because this is the physical setting. Most people
[00:25:33.240]are homeless or cannot initiate at home,
[00:25:35.280]sometimes out of respect, they say, for their families.
[00:25:38.520]But they end up shooting up in abandoned houses.
[00:25:41.880]No running water, no electricity. There are no doors.
[00:25:44.640]There's no French because everything has been stolen and resold for drug money.
[00:25:49.640]So it's an awful environment for HIV, and everything is not pleasurable at all.
[00:25:55.880]And it's not conducive to pleasure either.
[00:25:59.800]Another finding or another pain,
[00:26:02.160]participants have to deal with the hepatitis C epidemic.
[00:26:06.160]Most of our participants tested positive for hepatitis C, which, like
[00:26:11.560]HIV, is also transmitted through the blood contained in syringe on in the works .
[00:26:17.760]And it's not that.
[00:26:19.520]They're using or sharing syringes.
[00:26:21.560]Everybody tries to have their own syringe, but they're forced to prepare the drug
[00:26:28.440]and divide it using the same.
[00:26:33.640]Cougar water and cotton.
[00:26:36.720]So that's it, that's a really problematic situation behind this epidemic.
[00:26:42.000]What they do is something called cover your cover, use an arrangement
[00:26:46.160]in which two or more people pool resources, pool money to buy the drug
[00:26:50.760]and then they have to divide the drug.
[00:26:54.240]The drug is a powder.
[00:26:56.160]You cannot divide the drug without including it.
[00:26:59.120]The best way to divide it?
[00:27:00.600]See a bag or two bags of heroin.
[00:27:03.400]It's not to seek or this is small bag.
[00:27:05.800]Let me see if I get half and you get half.
[00:27:07.520]No, they put it in a container, in a container, in a cooker.
[00:27:10.520]They put water and then they pick it up with a syringe.
[00:27:13.320]The syringe has numbers and you can see exactly say you have 100 milliliters.
[00:27:19.600]If there are two participants, they put the syringe side by side
[00:27:23.440]and they compare and see that everybody got the same amount.
[00:27:25.920]So that's how they do it.
[00:27:26.800]And to do that, they need to use the cooker.
[00:27:30.040]So some people do it almost every time or do it almost never.
[00:27:34.360]It's not a ritual.
[00:27:35.960]It's not something they do because they were not born.
[00:27:38.440]They do it because it's a rational way of buying and sharing drugs.
[00:27:43.280]And I have an example there that shows you how it would work
[00:27:46.960]if you want to have to buy a box of heroin on one of cocaine, it would be $23.
[00:27:52.040]You can choose to hustle for one or two hours until you get all the amount.
[00:27:56.360]23? Well, you can just hustle for half an hour or whatever it's going to take.
[00:28:00.640]You get half of the amount and then partner with somebody else
[00:28:03.920]and then you should earlier and then you feel better
[00:28:06.920]and you can do Croslin and you can move along in during the day.
[00:28:12.120]So they do it because.
[00:28:14.960]It gives them these peace of mind that at least they are getting something
[00:28:18.640]that is relieving or preventing them from having the heroin withdrawal.
[00:28:22.640]If there were a reach. Of course, they wouldn't have that problem.
[00:28:25.920]But that's not, you know,
[00:28:29.040]the situation they are in the loss.
[00:28:33.200]I spoke with many participants
[00:28:35.720]over the years, and they all have this sense of profound loss.
[00:28:39.320]They lost cars. They said they lost.
[00:28:41.400]They lost marriages, family members,
[00:28:46.840]almost everything.
[00:28:48.360]But I really wanted to have a sense of how people talk about their experiences
[00:28:54.520]with drugs and about pain because I knew the pain was there.
[00:28:58.160]But if you ask them, you know, is it painful to use drugs
[00:29:00.280]or do you worry about your loss or how you you don't get much?
[00:29:03.600]So what we did was
[00:29:06.360]with the sign, like a photo studio in our office.
[00:29:10.000]We put this black background and we gave every participant a paper
[00:29:15.720]and we told them to write how they felt about using drugs.
[00:29:20.520]We didn't say, say something bad or say something good.
[00:29:23.760]No direction to write about how you feel.
[00:29:26.240]And unanimously, they wrote certain things
[00:29:30.280]that but I'm just showing you this is all we've used. 30.
[00:29:33.560]He was in his early thirties.
[00:29:35.840]He lost his leg when I arrive in Puerto
[00:29:38.880]Rico to have his leg, but he had a very bad ulcer.
[00:29:41.920]He was always infecting the also because he was homeless
[00:29:44.720]and shortening the shooting gallery.
[00:29:46.440]Well, after a couple of years, he went to a hospital to what he thought
[00:29:50.000]was a regular visit, but came out without a leg.
[00:29:53.600]And what he says is this meaning using drugs and injecting drugs is not easy.
[00:29:58.920]He doesn't leave anything, but it takes away everything.
[00:30:02.920]I lost my leg. And this is
[00:30:07.200]the chili cheese.
[00:30:08.880]She was in his late thirties and she says.
[00:30:13.600]Look at me. What else can I tell you about laws for health care?
[00:30:18.760]It was very evident everything that the drugs and drug use
[00:30:22.480]has been taken away from her.
[00:30:25.640]She, you know, she says, Look at me.
[00:30:29.800]Suddenly, both early and late, Schilling died in 2021.
[00:30:35.560]There's an epidemic of fentanyl related deaths on overdose.
[00:30:40.920]I'm not sure if it was fentanyl, if it was the effects of COVID
[00:30:45.160]or a combination of other things, or we've had mental
[00:30:47.960]health issues and also was diabetic.
[00:30:51.120]So it's very hard to say,
[00:30:52.480]probably a combination of things, but I think that's the ultimate loss
[00:30:56.280]because after you lost everything, the only thing you can lose is your life.
[00:31:02.560]And just to finish this talk, I want to talk about a double whammy.
[00:31:09.000]In September 2017, Maria devastated the island was the worst.
[00:31:12.920]Hurricane in warfare is
[00:31:15.960]very stressful because a lot of participants lost their homes
[00:31:19.440]or their relatives lost their homes.
[00:31:22.960]Treatment was shut down.
[00:31:24.840]Access to syringes was also interrupted for months.
[00:31:27.960]Sometimes there was no electricity in some places for almost a year.
[00:31:34.040]On the other hand, the Maria Decent didn't interrupt the drug supply.
[00:31:38.600]Drug dealers were selling drugs the next day.
[00:31:41.600]I have participants that told me that the next day, after Maria
[00:31:45.360]subsided a little bit, they were climbing over trees
[00:31:49.240]that were like laid down in the middle of the road, blocking the roads.
[00:31:53.280]They were like just jumping over trees on debris
[00:31:56.880]to go to the to the to the point just to buy drugs.
[00:32:00.360]So Anna Maria coincided with the arrival of fentanyl,
[00:32:04.400]which is a synthetic opioid 88 times more powerful than morphine.
[00:32:10.040]Now, almost every bag has of heroin has fentanyl in it
[00:32:16.440]that increases the risk of overdose.
[00:32:19.720]This is a participant, Monica says.
[00:32:22.560]Nobody knew what it was when you just arrived fentanyl, right?
[00:32:26.360]And folks who are used to shoot up more than one bag and then they use
[00:32:30.280]fentanyl, 13 or 14 died only in our town
[00:32:33.880]and they was hospitalized, intubated due to fentanyl right now.
[00:32:38.320]There were folks that came right from jail, bought drugs use and died there.
[00:32:44.680]Almost all the participants have
[00:32:47.680]experienced an overdose
[00:32:50.640]or knew somebody that had overdosed and died.
[00:32:54.000]So the numbers hear a sound or effect because they're very small communities.
[00:32:59.360]But I think it's an accurate reflection of what's going on
[00:33:02.680]in the ground in Puerto Rico and
[00:33:05.760]here as well in the U.S..
[00:33:09.360]So in conclusion, people can shed drugs in Puerto
[00:33:13.200]Rico, are exposed to numerous forms of social suffering.
[00:33:17.160]They struggle to find the money for drugs, to find the drug, to find their veins.
[00:33:21.920]They also have to cope with poverty, incarceration, mental health and stigma.
[00:33:26.520]In the middle of a fentanyl overdose epidemic, there is also an infrastructure
[00:33:31.640]of medically assisted treatment that is totally insufficient and conspires
[00:33:36.040]against a desire to quit or manage and manage heroin use.
[00:33:41.160]Our study is not the only one, but like many other shows that
[00:33:44.800]people who inject drugs who want to change their practices
[00:33:48.200]have difficulties finding the resources that it would help do so.
[00:33:54.120]That's a very anthropological point,
[00:33:56.240]substance use and abuse, it's not only the product of individual
[00:33:59.400]biological characteristics, it's not genetic.
[00:34:02.200]Is not determined by biology.
[00:34:05.720]Addiction is also socially produced, decreasing.
[00:34:09.320]This is my argument.
[00:34:10.120]Decreasing social inequality
[00:34:11.680]and increasing social support will reduce drug abuse.
[00:34:14.400]Adobe good hands and of course, ending the war on drugs
[00:34:17.840]that penalizes poor, vulnerable people and their communities would go a long way
[00:34:22.320]into diminishing the pain and suffering of people who insure drugs
[00:34:26.600]not just in Puerto Rico, but everywhere.
[00:34:29.600]You know how I am done with this? What?
[00:34:33.480]Well, then, Senator, I had a
[00:34:36.160]oh, I felt sure this is the most boring,
[00:34:38.880]but probably the future research plans.
[00:34:43.240]There's two studies I want to do.
[00:34:45.480]one is the effects of natural disasters on access
[00:34:48.840]to methadone and Suboxone treatment in Puerto Rico.
[00:34:52.720]one of the common factors that shape the attrition, what it makes people
[00:34:56.760]that you should drugs to go into treatment are ones to go into treatment,
[00:35:00.680]to stay there, you know.
[00:35:04.520]I also want to understand this stuff and how to respond
[00:35:07.760]to past natural disasters and how to prepare for future events.
[00:35:11.600]And then this is important because Maria is not a one off.
[00:35:16.040]As we know, global warming is increasing the likelihood of dramatic
[00:35:21.320]events like Maria.
[00:35:23.480]So it's going to happen more and more in the future,
[00:35:25.640]not just in Puerto Rico, but in southern us and other areas of the country.
[00:35:29.600]So it's we really need to understand how
[00:35:33.600]people can shed drugs and people who use drugs and the staff
[00:35:35.920]at the clinics, a maneuver to deal with these emergencies.
[00:35:39.880]And the second point is related.
[00:35:41.240]It's an ethical explanation of how people contract drugs and stuff
[00:35:44.840]in San Juan, Puerto Rico or the clinics thinks about the changes
[00:35:48.160]introduced to the provision of services during COVID 19.
[00:35:53.000]It looks, you know, so if this is, this is not ending.
[00:35:56.280]You know, we have looks almost like a biblical thing,
[00:35:59.200]you know, hurricanes and then viruses and pandemics.
[00:36:02.360]But these are what we live in.
[00:36:04.600]They're totally related to global warming,
[00:36:06.520]both viral pandemics, sun and hurricanes.
[00:36:11.040]But as. As these events or big events, as somebody has called it,
[00:36:17.560]disrupt treatments, we have to understand how.
[00:36:21.640]These infrastructures of these health infrastructures
[00:36:24.160]can better accommodate and serve people when she grows, so that's my
[00:36:29.240]that's my area of research in the future, a good funded to do.
[00:36:33.960]The second point, so I'm happy to report that I'll be doing research
[00:36:37.480]in Puerto Rico over the summer, just this year and next year.
[00:36:42.080]So that's a good thing.
[00:36:43.880]And I really I am looking forward to your questions
[00:36:47.520]and to have a conversation about this again. Thank you.
[00:36:51.040]Thank you for coming here.
[00:37:02.320]Thank you, Roberto, if you have any questions,
[00:37:03.840]you can make your way to the microphone
[00:37:05.360]if you're joining us in person, if you're joining us at home via Zoom .
[00:37:09.880]You're welcome to put
[00:37:10.880]your questions in the chat and I will ask them on your behalf.
[00:37:30.040]OK, Chris, thank you again for your great lecture.
[00:37:33.760]I was wondering if the geographical location Puerto Rico obviously being right
[00:37:38.120]in between South America, the United States and prime spot like
[00:37:41.960]drug trafficking and cartels, as well as at the most risk for climate change?
[00:37:45.440]I was wondering after disaster struck in 2017 and you had
[00:37:50.720]people moving towards the mainland United States did P.W.
[00:37:54.960]Kids have like you noticed any trends with that
[00:37:58.080]and maybe reduce it of usage or if it was even harder
[00:38:02.640]barriers as they came to the United States?
[00:38:06.320]I have a friend that does research on people insure drugs
[00:38:09.080]in New York City from Puerto Rican origin and people.
[00:38:12.480]When they travel, they bring their habitats with them, right?
[00:38:15.920]So people who inject drugs in Puerto Rico are most likely to inject drugs in the US
[00:38:20.320]unless they are looking for treatments.
[00:38:22.200]There's more opportunities for treatment here that is in there in the US.
[00:38:26.040]So a lot of people migrate like the rest of the population in Puerto Rico.
[00:38:30.000]Looking opportunity sometimes is family reunification
[00:38:32.680]sometimes is trying to escape a difficult environment.
[00:38:36.840]They want to get away from drugs and from the people they know.
[00:38:40.760]But if they were using, they're they're going to be using over here as well.
[00:38:46.120]So I I don't think that coming here
[00:38:49.040]magically solves anything for them.
[00:38:53.040]I think I just read a statistic that showed that Latinos are
[00:38:57.600]disproportionately affected by overdose death in New York City
[00:39:01.440]and the first group most exposed to overdose deaths in New York City,
[00:39:06.160]where Puerto Ricans, followed by Dominicans and Mexicans.
[00:39:10.040]So. Hi. So my question is, I mean, knowing how
[00:39:21.880]addiction and P.W.
[00:39:23.520]IEDs are in the United States, it's
[00:39:25.320]a lot more crack cocaine or it's a different drug for an operation.
[00:39:29.760]It's heroin in Puerto Rico, it's more of a downer.
[00:39:33.440]So within that kind of difference,
[00:39:37.120]you notice new trends with violence compared comparing
[00:39:42.440]PWI, P.W., IEDs and Puerto
[00:39:44.680]Rico versus the United States. You are seeing.
[00:39:50.280]Are people who use drugs
[00:39:51.800]here more or less violence than people that are in Puerto Rico?
[00:39:56.200]I mean, I guess yes, but also is there a noticeable difference like the kind of
[00:40:00.400]like the culture around it because people, United States, obviously.
[00:40:06.240]I'm more. Likely to still commit crimes in order
[00:40:12.600]to see their habits, whereas the hustle as described in the article.
[00:40:17.080]Well, hustling hustling is all right.
[00:40:20.520]Yeah. You might find things right.
[00:40:23.920]So no drug drug use is very expensive.
[00:40:29.800]Right here in the US
[00:40:32.640]is cheap like a bag of heroin is $5, a bag of cocaine 56,
[00:40:37.720]but you don't use one.
[00:40:39.400]You use multiple bags along the day and that adds up and adds up.
[00:40:44.160]So crime is part of the mix. Right for some
[00:40:49.000]sexual workforces like
[00:40:50.600]shoplifting is Photoshop for is just doing honest,
[00:40:54.680]informal work because they don't like the idea of getting caught,
[00:40:57.280]or they don't feel like the morality doesn't
[00:40:59.120]allow them to do anything illegal , so it does know what they feel they are.
[00:41:02.880]Some people will do
[00:41:04.280]what they have to do to get the drug, and some people will feel that
[00:41:07.240]that's something they will not do, and they are lucky
[00:41:09.360]sometimes not to do something they don't want to do.
[00:41:11.520]They think the answer that I want to give you, just like it's not clear that
[00:41:15.000]people in Puerto Rico or are more criminal or more violent or more
[00:41:19.840]anything that people here in the US drug use is expensive.
[00:41:24.560]So that's I think. Thank you. Welcome.
[00:41:34.920]I really appreciated your description.
[00:41:37.760]Rich description of sort of daily life of a drug user.
[00:41:42.480]But I know that it is driven more from trying
[00:41:45.600]to get away from pain than to seek pleasure.
[00:41:48.960]But I'm wondering if you, in your research have insights into why people start.
[00:41:54.920]Yeah. OK. They are.
[00:41:57.160]That's a really good question.
[00:41:58.840]Recently, the International Journal of Drug Policy had
[00:42:01.800]published a special number on pleasure.
[00:42:05.160]And the idea was that the premise was that drug use is pleasurable
[00:42:08.360]and that's why people all over the world and for millennia had been used drugs.
[00:42:12.600]Otherwise, people wouldn't use it. I agree with the premise.
[00:42:15.960]The what I'm arguing is like in certain conditions.
[00:42:19.320]It's very hard to achieve pleasure and also for heroin users
[00:42:23.680]and particularly for heroin users that have these awful heroin withdraw.
[00:42:27.160]Their motivation is avoid the pain more than seek pleasure.
[00:42:31.160]It's very hard. As I mention a certain things, it's got us
[00:42:35.760]talking about an assemblage, right?
[00:42:37.800]So certain things have to line up for pleasure to happen
[00:42:41.440]is the drug is poor quality. You won't get it.
[00:42:44.240]If you don't get the vein, you won't get pleasure.
[00:42:46.520]If you use so many times that you build tolerance,
[00:42:50.400]it's hard that you need a higher dose to achieve pleasure.
[00:42:54.000]So it's not a pleasure.
[00:42:55.120]It's not possible. It's like in the context of Puerto Rico.
[00:42:58.120]And for that particular population, pleasure is almost an afterthought.
[00:43:03.400]The main motivation is avoid the painful Adobe.
[00:43:05.920]They always like the idea.
[00:43:08.000]When you're starting your a fresh body like a bag of cocaine
[00:43:12.720]or heroin is going to produce a new fork effect or whatever.
[00:43:16.440]If it's cocaine,
[00:43:17.080]if it's going to be a model effect, you're going to love it and they like it.
[00:43:21.040]How people get into drugs. 1,000,000 ways.
[00:43:24.280]Drugs, the people that were dealing drugs.
[00:43:26.240]When you're dealing drugs, you are preparing the drug.
[00:43:28.160]You have to be in the car.
[00:43:29.920]You, you get the block and you have to cut any small pieces
[00:43:34.120]and you deal with different things to make it larger.
[00:43:36.720]And then you have to put them in a small box
[00:43:38.800]and you have to make sure that everybody has the same amount.
[00:43:41.160]You are touching it, you are breaking it.
[00:43:43.120]Somebody once said, that's how I got hooked into heroin
[00:43:45.920]because I was breathing it, and after a while I got feeling sick
[00:43:49.000]if I wasn't getting heroin, others in jail because you know,
[00:43:54.120]you're bored, you have nothing to do.
[00:43:57.760]You are so resentful, so pissed off the other participant
[00:44:00.960]that went through exactly that experience.
[00:44:04.120]He was a marijuana user being sent to jail because he was complaining
[00:44:08.560]he wasn't following orders from the judge to be at the audiences.
[00:44:13.360]So he went to jail and in jail, he started using drugs.
[00:44:18.200]So many different ways, so many different ways.
[00:44:20.200]There's no way in and there's no way out.
[00:44:23.280]There's no there's have no path.
[00:44:24.920]This means that you start using alcohol and then you use marijuana
[00:44:28.840]and then you use other drugs that are harder drugs.
[00:44:32.040]That's fiction. So.
[00:44:37.000]There's a question from the chat,
[00:44:39.360]so in your observations, for those who seek help,
[00:44:42.480]which strategies are the most effective in increasing access to health resources?
[00:44:48.240]The resources have to be there in the first place,
[00:44:51.000]and I think that's a very tall order because the war on drugs prioritizes
[00:44:55.920]repression, the fantasy that if you cut supply,
[00:44:59.160]if people don't have access to the drugs, wouldn't use drugs.
[00:45:02.120]With that pretense, we have incarcerated millions of people
[00:45:05.320]and we're still failing in the middle of COVID.
[00:45:07.840]The economy shut down in third.
[00:45:10.480]The global economy shut down.
[00:45:13.280]The fentanyl still made their way
[00:45:14.960]from Mexico to the US, we had 100,000 people dead.
[00:45:18.760]A fentanyl overdose 2021
[00:45:22.440]was the highest ear of overdose deaths in the history of the US
[00:45:27.600]in the middle of a COVID pandemic that shut down the economy.
[00:45:30.560]So that shows you that cutting the supply is impossible.
[00:45:35.600]So intimidating.
[00:45:37.520]The war on drugs and putting more resources
[00:45:41.000]from repression to prevention
[00:45:44.360]and support would go a long way.
[00:45:47.240]But we've been saying the same thing for decades, and it doesn't.
[00:45:51.640]People don't listen because they're entrenched interests
[00:45:54.280]in keeping the war on drugs, you know, so it's this crushing.
[00:45:59.440]This research is discouraging because most of our recommendations,
[00:46:03.400]which are based on evidence, are totally ignored by a system
[00:46:08.360]that benefits from the running of things in the way they are run currently. So
[00:46:15.040]we're still trying.
[00:46:20.400]Sorry, another question, but do you notice people who are in
[00:46:25.480]your exact demographic breakdown of your area
[00:46:28.120]that you studied, but within Puerto Rico, there are indigenous groups?
[00:46:31.360]And do you notice any disproportionate effects on these indigenous groups
[00:46:35.080]within Puerto Rico compared to non-Indigenous people?
[00:46:38.480]You know, most of the people from Puerto
[00:46:41.320]Rico were not from indigenous groups, I don't think.
[00:46:45.360]They are not recognizable in the way they are here,
[00:46:50.400]so they're pulling in the population.
[00:46:53.800]So I'm not sure you can make that distinction.
[00:47:00.880]Thank you. It's not like here, here you have a big, big problem of alcohol
[00:47:04.960]abuse and substance abuse among Native Americans, particularly males. Right.
[00:47:09.080]So but in Puerto Rico, I don't think we have the same kind
[00:47:12.080]of tribal structure or the relationship with, you know, basically the Spaniards
[00:47:17.040]managed to eliminate 90% of the Native
[00:47:21.800]Americans or how we can solve the Americas in the first 30 or 40 years
[00:47:26.880]sometimes was violence was genocide and sometimes violent exposure.
[00:47:31.360]They were exposed to violence. They had no immunity for.
[00:47:34.520]So, you know, different.
[00:47:45.520]Do you find anything about the average age that people start using drugs?
[00:47:50.120]Well, the drugs and drugs, right, if you are asking me about injecting
[00:47:53.000]drugs, the age in our cohort was around 1819, but some reported
[00:47:58.600]using drugs at eight, 1012.
[00:48:04.840]There are many different reasons.
[00:48:06.640]one reason for starting
[00:48:10.000]interviews are substance use drama,
[00:48:14.960]personal trauma, sexual trauma, sexual violence.
[00:48:20.840]Many different results,
[00:48:23.080]but I think for for our population.
[00:48:27.760]Yes, a lot of violence, inter-communal violence, sexual violence.
[00:48:32.400]That explains some of the trajectories.
[00:48:38.240]They started early trial and they don't live long.
[00:48:41.800]You know, we recruited almost 400 people and a few
[00:48:45.040]had more than 60, but no more than 60 to 63.
[00:48:50.360]There are many things you could do from.
[00:48:52.040]You can die from overdose HIV FC.
[00:48:56.960]They have poor diets.
[00:48:59.040]So diabetes is very serious, among them
[00:49:03.320]car accidents. They disagree among themselves.
[00:49:06.200]They might steal money from drug dealers if they are dealing drugs.
[00:49:10.400]This moment of this operation where they don't care about the consequences.
[00:49:15.920]That's a death sentence.
[00:49:16.760]If you still drug money from a dealer,
[00:49:20.840]you're dead. You so they don't live long.
[00:49:24.640]They start in many different ways.
[00:49:27.400]They said young.
[00:49:30.360]I know it's not it looks bad, right?
[00:49:34.240]Are you? My job is to understand the
[00:49:38.560]the social basis of this suffering of this experience.
[00:49:41.560]This is not to say it's not that bad or is not.
[00:49:44.680]There's no violence in the drug scene.
[00:49:46.920]I think our work is to describe
[00:49:49.760]and then to provide context or some kind of explanation for things.
[00:49:53.960]But it's not to say, you know, it's good. It's good.
[00:49:57.360]No, it's not. It's awful. It's in the press you're suppressing.
[00:50:03.320]I just wanted to ask you said I think nine out of ten was male.
[00:50:07.480]Why is there such a.
[00:50:09.600]Why is it? I know I get that question a lot.
[00:50:12.240]I and the other it's for like 60, 40, 70, 30, depending.
[00:50:17.880]It's a standard practice.
[00:50:19.120]If you think about smoking or alcohol use, even in the US, you know,
[00:50:22.760]until the fifties sixties, it was more.
[00:50:25.960]Male dominated done
[00:50:28.720]women, so I think women have been catching up
[00:50:33.440]in other places, it's even you can see the same discrepancy in Asia
[00:50:38.360]for smoking or China or alcohol use.
[00:50:44.440]And certainly for for injection drug use.
[00:50:47.520]This is, I think, the more egalitarian a society, the more likelihood
[00:50:52.400]you will find a more even gender balance
[00:50:55.520]in terms of who's going to use drugs through the ranks.
[00:50:59.040]The more unequal the gender relationship, I think, the more
[00:51:03.000]you might find more males and females injecting.
[00:51:06.440]But that's a great point, because it means that it's a very masculine word.
[00:51:10.320]It's very much a world notion where your emotions be tough.
[00:51:15.320]Don't don't show your weakness because it's going to expose you to the other.
[00:51:19.880]So my question is what these masculine or mescaline mascarenhas
[00:51:24.240]word is going to do for the women.
[00:51:26.040]You know how it is to be a women in this environment?
[00:51:28.960]That's one of the questions I had.
[00:51:30.720]Instead of saying, Oh, that's not enough women.
[00:51:33.120]You know this? Not.
[00:51:34.880]And you know, I get this question, is it?
[00:51:37.400]Maybe they are doing drugs, but they are not out there.
[00:51:41.240]I've been there five years and it's a social network study,
[00:51:43.760]which means we didn't recruit the participants they recruit.
[00:51:47.360]Themselves, we were given coupons to people free coupons,
[00:51:50.840]and I will say bring three people like you did a study and over a three
[00:51:54.480]month period, I had 400 people, so it's not me that it went out.
[00:51:58.520]They had this incentive to recruit and bring everybody to work using.
[00:52:02.400]And also, we were there day in and day out.
[00:52:05.640]The women were not doing drugs, and there's a lot of studies that show
[00:52:10.360]if you're looking for that, women in Puerto Rico are not injecting drugs.
[00:52:14.920]Women from Puerto Rican origin
[00:52:16.800]in the US are not injecting drugs at the same rate that men are.
[00:52:20.840]It's just a general practice, you know, like many other things, for gender.
[00:52:24.760]I think it's extremely gender is gender.
[00:52:35.240]Any final questions?
[00:52:39.680]Well, thank you so much, Doctor, about having your talk,
[00:52:42.520]and thank you all so much for coming in person and via Zoom.
[00:52:46.560]And I hope that you'll join us February second
[00:52:49.680]for a special post Valentine's lecture by Dr.
[00:52:53.480]Tierney Lorenz from psychology entitled Sexy Times Call for Sexy Measure.
[00:52:58.120]I hope you have a good rest of the week.
[00:53:00.400]And Stacey, thanks again.

The screen size you are trying to search captions on is too small!

You can always jump over to MediaHub and check it out there.

Comments

0 Comments

No Pleasure: Addiction, Poverty, and the Everyday Lives of Drug Users | Roberto Abadie | CAS Inquire

Description

Searchable Transcript

Comments icon comment

Related Channels

Comments