Philippe Bourgois on the Lives and Thoughts of Drug Users

any type of drug. One of the most popular episodes the Psychoactive to date has been the one where I invited my friend Julie Holland to service my co host and answer questions with me from you the audience. So we're going to record another one of those episodes, and we need your questions. Leave us a voicemail with a question as d he tells us possible at one eight three, three, seven, seven nine sixty, or you can record a voice memo and send it to Psychoactive at protozoa dot com. I'm

sure it's going to be a great second go with this. Hello, Psychoactive listeners. Today's episode is the first time I'm actually inviting a previous guest right back on to do a

second conversation, and it's Philippe Bouguas. And the reason I'm doing this is because when we talked last time, we really focused extensively on his research, first in East Haarlem in the nineties and then more recently in Philadelphia, which focused especially on people involved in selling crack and sometimes other drugs, and we got so caught up in that discussion that all his other work, um a whole another part of his work, which focuses on injecting drug users

and others in San Francisco and Los Angeles, even in Tijuana, we barely touched on that. And there are some similarities between the conversation we had there, but a whole range of new themes to address, And so you know, I wanted to have a Philip back for a second time so we could delve more deeply into this other line of work. So Philip, thank you ever so much for coming back on Psychoactive with me, and thank you for

for bringing me back. I think a shorter way of introducing me is just probably to say I'm an obsessive, compulsive researcher on drugs since the mid nineteen eighties. But

thank you. I should then thank you for being an obsessive compulsive and applying your subsessive cold energies to this area because I tell you what I what I had done before we talked last time, and I refreshed myself this time was taking out this book, Righteous Dope Fiend, which you co authored with a graduate student of yours,

Jeff Schoenberg. And it's not just a written book, it's actually a photo ethnography that it's full of these stunning and incredible, you know, black and white photos, and it was based upon the research that you it for I think twelve years from to two thousand and six, basically living with essentially homeless drug injectors, mostly heroin injectors in

San Francisco. My first question for you is when you look at that community that you got to know back then, and obviously there were certain things that were distinctive about them when they were born, the time they grew up, etcetera. But do you think that many of the observations you made and the generalizations you came away with and the insights would be generally true of a range of drug

using communities today around the United States. You know, frankly the age old French saying pluenge produced m M shows is the tragedy of of drug use. At the current moment, it's actually gotten worse because of how the prohibitionist policies have pushed drugs into greater toxicity, namely fentanel and now

even worse than fentanel. The combining of animal tranquilizers zylazine to the fentanil to remediate some of the disadvantages of fentanil but keep their psycho you know what injectors see as the psychoactive um advantages of fent nil over over heroin, so that over you know, poppy plant based heroin. So that is the the current situation that's hitting the streets now across different parts of the United States at different rates, with of all places, Philadelphia being the epicenter of all

of this is the addition of zylazine to fentanil. So it's the two most toxic products that when mixed together, create a whole slew of bodily problems. Basically, zylazine, to put it in popular terms, asphyxiates, you know, sells randomly um, so it isn't the abscesses that pop up that are so horrendous are are not even popping up necessarily at the site where someone injects. Zylazine is also a different

kind of sedative. It's not meant for human consumptions. Zylazine has meant, you know, to put elephants to sleep, you know, when you transport them. And the reason why it came first to Philadelphia is because the horse breeders, who you know often win the sort of biggest you know, US horse races, raise their thoroughbreds in the highlands of Puerto Rico because it's cheaper where it's just a great environment

for horses. And the stable. The people working in the stables, they were underpaid, partially employed for only part of the season, and because these horses are so valuable, they obviously knocked them out with zylazine. So the zylazine made its way into the drug supply that the that that the stable

users had gotten involved in. And one of the big poorest migration routes between rural Puerto Rico and the United States is through the poorest neighborhood of Philadelphia, which just so happens to be the four state mid Atlantic headquarters for distributing retail level drugs to the United States. Philip, let me let me interrupt your second So I just

want to get a handled on this. So you know, we know, going back a number of years ago, when we begin to see the emergence of fentinel, there's all sorts of obvious reasons why fentinel starts to become more on the president, first in certain neighborhoods and then increasingly around the country. And that's because it's, you know, it's it's cheaper and easier to smuggles a fifteen hundred times

more potent than heroin. You can, you know, just put it in the mail and effectively sentence or hundreds of thousands of doses. It was a way of cutting heroines. Basically, dealers could say, you know, make more money on their sales.

And my collection from talking to people in the harmonduction world and elsewhere was that initially people preferred the heroin, but over a period of time, you know, you now have a whole new generation that actually prefers the fent anyl, And in fact, fentimyl has become kind of on the present and it's a powerful opioid, So it kind of makes sense that it would have gotten out there and the way it did with all the deadly, deadly consequences.

But when you're talking about zylazine, what was the incentive A on the part of the suppliers and the dealers to put it in there was a similar defentanyl? And B is there in fact a real demands? I mean, are there people on the street who are saying I want that combination? And why? Yeah? No? And it's a simple it's a simple answer. Longer legs to the high. The problem with fentanyl is that precisely what makes it more psychoactively fun to people is that it doesn't last

as long. It's half life is shorter, so you get that more manic up and down own, which is where people who like who, who adore that pleasure get their pleasure. With the addition of xylazine, does it gives it what they call on the street longer legs, So fentnille has short legs compared to poppy plant based heroin. The other caveat um Ethan is that drug users are like wine aficionados.

They develop these tastes and there's groups of them, Like one thing, groups of them that like another, but they really sort of know too much about what they're talking about. And so it's, you know, like any high art, it's this sort of to use populist psychobabble language, you know, obsessive, compulsive, you know, love for the effects. What someone figured out was, you know, you add it's called trank on the streets of Philadelphia. Just the name itself tells you what the

drug feels like to some extent, trank. And when you you know, when you're doing ethno rafe there, you you know, you're walking around, you can't quite believe what you're seeing. People are sort of moving around it almost in slow motion, just completely just sedated, beyond what you've ever seen with

normal you know, with normal fetanel or normal heroin. So, Philip, you're saying that, I mean, we're talking here that about a drug combination that the drug consumers are actually seeking out because they like the sensory psychoactive effect, but that unfortunately as health consequences that are even more devastating for their lives. Yeah, but it's it's it's more tragic than that.

You know, there's a huge section of them that seek it out and then the rest of them have it totally imposed on them, so it's sort of a self fulfilling thing. It's easier for the sellers to make more money and bring in new people. It's started basically measurably in two thousand sixteen in Philadelphia, where the first you know, place where public health sees it is in the corners reports. So it's in the in the poor people, you know, in the first overdoses who occur on a large scale.

And this is what's so sad when you look at the per capita overdoses, you compare Philadelphia even just to New York City, you know, it's just like way, way, way, way more. There's no way to look at it and tell the difference with your you know, with the naked eye. That's the problem with the prohibitionist way we do drug testing and drug monitoring. If we monitored drugs to protect citizens, you know, protect residents, protect human beings in the United

States from killing themselves, damaging themselves, and damaging others. We would be able to have clear data that's rapidly alerted to people so people understand the risks of what they're doing. People don't realize it. They just think it's fun, you know, think of it. You're you're seventeen years old. You know, you want to have fun, and you're you. You think

that you're immortal. And that's the tragedy. You know, when you're walking down the street, and and it is interesting because because it's so sedating, you know, you'll see people bickering and so forth, but it's not like they're moving fast and you know, and able to punch each other or you know, get angry at each other the way you can when you're taking a stimulant. I can hear

outside you are about the current work. But I do really want to pull you back just a little bits who to some of the earlier work you did and the book Righteous Dope theme, because I've just immersed myself in its absolutely fascinating. I mean, you spend thousands and thousands of hours with people living under the freeway, in in in back areas. I mean essentially you know either a percent homeless or mostly homeless, people who were totally

committed to heroin. At one point, there's a phrase you used. You said that you began to understand this community as forming a community of addicted bodies that is held together by a moral economy of sharing. Just explain what you mean by that and whether that still applies today, which I assume it does. It does. And actually I want to also, you know, shout out to Jeff Schoenberg. For every five hours I spent out there, he spent fifty literally,

That's how and why he got such good pictures. I mean, he's a talented photographer, just in and of he just has that knack. But then when you become you know, such a skilled ethnographer and so dedicated at it. He was working at it full time and didn't have any other responsibilities. He was able to really and and and and he's also a gentle nice person. People appreciated him, and they invited him in, and he was giving people, you know, copies of the photographs he was taking of them,

and they really appreciate it. They started decorating their encampments with Jeff's photographs. And so that made this what we call photo ethnography possible um and it tempers you know, the intense you know, academic analysis that's also in the book, because I wanted to set it in the context of d industrialization. What comes through in the book is it goes a lot deeper there. I mean you and especially Jeff I guess. I mean, you are sometimes spending the

night in these homeless encountenments. You know, you're sharing foods, you're sharing money, You're getting to know their families, um, and you know, unlike say some of the crack sellers in Philly or Harlem, you know, you're also living with people who are sometimes having bathed in weeks, who are in horrific you know, health, who can smell terribly, who are shooting themselves and puking. I mean, you describe a lot of this kind of being around. Did it take

some getting used to to just be part of that community? Yeah? First you feel like a kuk and you're embarrassed. I was. Yeah, I was chair of medical school department at the time at UCSF. I would park my car on the corner where they hang out, and I'd still be dressed in you know what you have to dress as a chair, and I would you know whatever, you know, go outside dressed like that and then see, you know, every everyone walking by would think that I was the upper class

addict going to get their fixed. That was what actually I was most embarrassed about. Initially, I was just embarrassed that everyone thought that I was, you know, you know whatever, a drug addict. After a while, I just didn't care, and I didn't even notice the passers by, just the way they don't in some sense, and the passers by didn't seem to notice me anymore. I don't I don't quite know how that magic takes place. It was interesting. I remember vividly the first time I brought Jeff down

to the scene. I just couldn't believe that he was able to hang out in the scene that we were in without being freaked out by it. He could see both their desire to be documented, their need to tell their story, and and they they want their story to be heard. They're proud of who they are, you know, outlaws in that sense. These were people, you know, at the at the end of a long life of being

in drug use. But I think you pointed out that very few of the white um you know, the white homeless, the white drug addics, had actually been in juvenile delinquent institutions as opposed to the blacks. Pretty but it was just to go back though fully today that free as you use, a community of addicted bodies that is held together by a moral economy of sharing. Just elaborate on sure well, I was funded by the National Institutes of Health to reduce HIV and hepatitis C, you know, and

I'm a conscientious researcher. I wanted to get practical data on how one could you know, reduce the transmission of blood borne diseases through shared needle use. As a result, I looked, you know, much more more, much more closely than is normal on site to sharing practices as they occur, and I would discuss those practices and what people understood about the risks and what they understood when I would tell them the public health perspective on what they were

doing and the risks they were taking. So I got tremendous amount of detail on that, and I realized that what public health was defining as you know, sort of

a self destructive, pathological thing. Sharing was seen as an ethical responsibility by them because what what they all organized their lives around is not becoming what they called dop sick, not going into the horrible, horrible withdrawal symptoms that are so you know, that are so devastating to anyone who's physically dependent on heroin, and you know, it's super visible. It's like it's you know, the person is sweating, the person is getting irritated, the person is fidgeting. None of

their cells are behaving normally anymore. So you know, the skin cells are itching and getting irritated with ashes, and they can no longer hold any food in and so forth. So when someone is like that, you you want to help them. I mean you, even if you're a schmuck, you want to help them, you know, I mean, you you feel sorry. You can't not feel sorry for them.

So as a result, you know, they would you know, give them part of their needle, and you know, in that process, you know, most likely infect them if the person wasn't already infected with hepatitis C. But the thing that they were getting most of all was abscesses, blood borne abscesses from the sharing of needles, and also just from the fact they didn't have they didn't have obviously running wood. So you just you can't you can't clean your hands, you can't clean your body, you know, effectively

or consistently, and so forth. It was that very visible dynamic of suffering that was based in an ethics of sharing, and there was no communication of of understanding between their perspective and priorities versus you know what the outsider perspective,

the rational perspective of public health and clinicians is. Since I was working in a medical school, I told all the doctors that I explained that I said, I was trying to teach them how to engage, you know, talk to someone about the priorities of their life, how they can manage less destructively their their veins, you know, and what they need to do about, you know, their nutrition

with respect to how much they can enjoy drugs. They only want to hear things in terms of how can they maximize either minimize the pain of their withdrawal, depending on what stage they are in their relationship to the drugs. You know. All many of them just thought themselves as staying well. They weren't trying to get high anymore. They were just trying to keep withdrawal symptoms at bay, whereas others were still in the ecstasy of pursuing I'm I'm

I'm having fun every day. Um. They're also drinking huge amounts of cisco berry. Right, that's a completely legal toxic you know alcohol, right, cisco berry, you know, fortified wine and getting h cirrhosis of the liver and smoking huge amounts of of cigarettes. And in addition to the crack they were smoking or the crack that they would melt

into their heroine. So you know, they were being bombarded also by you know, sort of predatory industry that makes so much money off of killing people simultaneously, and it just happens to be called legal. We'll be talking more after we hear this ad, Philip. You know, I'm just wondering, I mean NIA and it's I mean no longer as much today. But you know, they were anti harm reduction. They would tell people seeking grant funding, uh not to use the phrase harm reduction. They were reluctant to get

on board on needle exchange, the whole thing. And they've never been all that big on funding, if not bography in a big way. You know, it's old brain science and addiction and all this kind of stuff. But somehow you were successful in getting funding that resulted in these fascinating, fascinating books and articles you've read in How did you manage that? Well, you know, this was the pre extreme

right wing turn in the United States. Ethan. They reached out to me, they reached out to me actually way back under crack, because I was like the only you know, the only person at least that the press was interviewing that knew what crack looked like, how it was used. They didn't even know if it was smoked or swallowed or or injected, right, They were that ignorant. There was an awareness that they didn't know what was going on. They didn't even know what the problems were and were

being blindsided by everything. So there was a project officer who did believe in needle exchange. Actually, his his name, actually he's retired now, was Richard Needle. Ironically that's his real name, not not his This was in the late eighties, early nineties. Yeah, yeah, exactly. And so he actually realized that I, you know, it was clueless about the N I H and could never write the right kind of things.

So he just through a little tid, tiny tidbit of money at me, you know, anthropologists never have any money for the research, and said, you know, tell us, you know, tell us what drugs are the drugs of preference and what's going on. We don't know anything. And so he started inviting me into their things. And then I actually realized my gosh, this is just you know, it's boring to write these grants, but you can do it. You

just got to use their language. But what I wanted to do actually is prove that my qualitative participant observation. Anthropological methods are really important quote unquote scientific methods. They are scientific methods. They tell you about reality. They're actually also very subtle because you have to pay attention to your own biases in order to be able to trust your own observations, because it's you that's doing it with

your biases. So when you're self critically self aware and do it with a vision to trying to document reality, knowing that you're distorting reality because of your biases, you can actually do important work documenting reality, or at least try to. They're they're a health thing. They care about

blood borne diseases. This was the height of the HIV epidemic, the height of you know, hepatitis C epidemic, and you know, they still didn't know whether, you know, whether sex was more risky than you know, injection drug use or which one you know, how it was being transmitted in terms of his relative risks, and people hadn't you know, thought of for some reason. It's so, you know, why didn't they think of it. They hadn't thought of looking at

how people actually inject. When do they share, how do they share? What do they mean about sharing? Who do they share with when they say they share? And you know, all they had was quantitative data and interviews that are embarrassing to the person being interviewed. You know, do you use a condom? Well, you want to say no, I don't use a condom and sound like a creep. No, you say, yeah, I use a condom. You know, oh, every now and then you know it might you know,

I might forget or it might whatever. You know, you can actually have those conversations in a real way, in a non stigmatizing way when you make friends with someone. So I wanted to find out useful things on how diseases were being transmitted in a practical way. And also, you know, anthropology doesn't tend often to force itself to

try to be humbly useful. I wanted to be humbly useful, useful to the people I was studying, so that there would be more information on what could be done to reduce, you know, how obviously devastating their use of heroin was on them and the way they were being policed, and the way that services were mismanaging them and mistreating them even when it wanted to help them. It's crucial. I mean,

I think listeners are psychoactive will know that. One of my pet beeves is the inadequate funding that's come from the National Student on Drug Abuse for ethnographic research on drug use and drug markets forever and ever. And when we look today at the problems around cententyl and not knowing much about how and why Centinel is being used, much less how it's being distributed and how it's getting into the drug supply. I mean, that's just a failure of of directing funding in the right way in the

right area. And if they were doing it, it might actually be saving tens of thousands of lives. Yeah, with with a with a cheap ethnographic project, you can actually find out what's really going on as opposed to the

self self desirable responses people are giving. Exactly, Philip, I mean, just you know, reading it though, I mean, it's just an immersion into this world of people living at really maybe in one in some respects the lowest wrongs of American society just seen as basically refused by by so much of America. Right, and you describe you know, complicated lives. All of the people living on the street have kids,

sometimes many kids. Although they're typically not much in touch with them, they still some of them, you are in touch with their families. So they're going in and out of legal jobs, illegal jobs, hustling, begging, selling, you name it, but allies that also revolved it seems around this kind of daily more more than daily practice of sharing heroin where you know, it's everything where you know, where people's characters and needs come out about about their about greed,

about generosity. I mean, people are getting you know, dope sick because they don't have their fix. I mean it just you describe this incredibly intimate um scene of folks kind of you know fighting, You're getting violent another and then and yet then backing one another up in these in these situations, and you guys are basically living it.

You're part of it, right, just watching this stuff. I'm just I mean part of me thinks that you know, here you see people periodically trying to get their lie together and then engaging in the most extraordinary acts of self destruction. Um that one can possibly imagine, almost heartbreakingly. So, yeah,

you're right. And it was hard to understand as initially as an outsider, because you see, you know, total solidarity, and then the next minute a total betrayal by the same person to the same person, you know, to the to the same other person, and and and then all of a sudden you realize that they are operating with a with actually a very you know, sort of shared sense of moral ethics amongst among one another that isn't

recognized as ethics by outsiders. Right, it's Tina what the one of the main characters was profoundly, profoundly religious, and before eating she would insist on saying grace. And then when when when we would sleep in the encampment with her, she would read a page before she would let people fall asleep. She would read a page from the Bible.

And and this a person was, you know, as she would say, stomping on people when they owed her money or when she thought she could steal some money from them. So she was a very, very tough woman, but was operating in a set of set of ethics that she was constructing about her life. It sounds like some of them came from families where most of the you know, kids in the family had landed up getting messed up

or addicted or dying or into drugs and others. They were the only one in the family who had quote unquote gone bad in some respect, right, you say, most

of them growing up in poverty. Um, but you know, some of them, uh, you know, can maintaining fairly normal, typical lives until they're into their twenties and early thirties and then spiraling down and out for one reason or another, some of them having kind of places they can go sleep, or periodically having ordinary housing where they can live with family, and then coming back to live in these community and some of them, it seems that even when they have

the opportunities, you know, not just a shelter, but even when you know, there are some progressive housing programs where people have an option, continually being drawn back, you know, back to the encampments that that is, to some extent, their community and their world where you know, they find a sort of sustenance. Yeah. And it took us a while to realize this. We realized that on some level, even if they couldn't say it clearly, you know, you know,

in in in sort of therapeutic language. They realized they had to get the hell out of their families, that they were a destructive force to their children, they were

destructive force to their mother. And so they would dress up, you know, they would arrange to take a shower and dress up and and go to a family reunion once a year, but then remove themselves and go a wall, you know, you know for another year or until Easter, you know, until an East family reunion Easter celebration or or Christmas celebration or whatever this whatever the religious holiday would be. That was you know, very very you know, very clear to see. And you had different you have

different family structures also in distinct um ethnic groups. So the white families would um hate on their on their wayward children more than the African American families, which tended to forgive them and allow them back in much more rapidly and seek them out. So when when a family reunion was being planned, a mother or a cousin, or an uncle or a son would come seeking to find their father and would ask us to relay the message. Um, you know, they were still loved members of their family.

In that sense, it was possible for us to to analyze these things and set them in the larger context of you know, you know, you know us um, you know, forms of of both political economy and cultural sets of relationships, family and gender arrangements. I think might be the most fascinating part for me of the book was the ways in which you and Jeff describe the differences between the white folks and the black folks living in this community.

And there's always an exception to everyone. You know, there's some you know, some blacks who are more like the white or whatever. But I mean, you know, it seems to cover all areas. I mean, you just mentioned when I think about families, where you know, the blacks living in the in these in these encampments had you know, maintained a closeness to their families. I mean not maybe not children, but especially you know, the broader families than the whites did. But there seems to be other trends

as well. I mean, just talk about that. It's how they had different tastes and drugs, right, I think with crack more common, different ways of injecting. Just say something

about that. The chapter where we address that the most we call intimate apartheid because we wanted to try to explain, uh, to two outsiders, how what looks at first sight like a multicultural set of a sort of loose array of home us, you know, community was actually super super um separated, uh, you know, even if only by three yards um by by you know, racial antagonism and the exceptions were also dramatic, and the people involved in them would always explain them.

They would explain why they were the exception, and their analysis of it then started to make sense. You know. The other thing is how they interfaced with services. So the most obvious thing is how much more hostile the police were to the African Americans. There was just no comparison, right, Uh. And also most importantly was what passers by. Who a passer by is willing to give a quarter, two or

a dollar or five dollars or twenty dollar bill. The whites could collect a lot more money panhandling, so they didn't have to engage in as much illegal activity, They didn't have to take risks in some sense. And they what they did was they also learned to view themselves as broken down, why nose, So that's what they would project to the public, and that's a recognizable person they

would also present themselves as Vietnam veterans. Wait, wait, this is true both black and white in terms of presenting as Vietnam vets. Yeah yeah, right, yeah, yeah, that's universal. That's a universal American experience. But I mean, I mean you do also, I mean you sort of describe this thing not just public facing, but like you know, there's a kind of enterprising black outlaw versus the broken down

white bomb. And it's not just how they present outwardly and one's well dressed and one is in in ragged clothes, right, that that's extraordinary to scene. It's not ambiguous either, Yeah, I mean it's almost I mean, I mean, it's also

how they're interacting with one another. You say, the whites are going to be more successful at begging than panhandling because basically some of the racism and that there was also more of a hustling culture in a way, a more entrepreneurial culture maybe going on in terms of black culture, right, And and they and the whites would get criticized for being lazy. Yeah, those guys are just good for nothing. All they do is beg. You know, I I have self respect. I'm out there hustling you know, I I

have a sense I dress well. I I spend time figuring out where to get clothes, and and I make efforts to wash, you know, in the bathroom of the McDonald's, you know, when the manager isn't looking and so forth. That was very, very clearly articulated by everyone and visible in that sense. Well, you also point out that sort

of black street culture is kind of dominant. I mean, not just in this community, but really in much of urban America where is there really is not much of a sort of white urban street culture anymore, you know. I mean, the whole biker gang Hell's Angels thing didn't really quite work here. And the kind of white street culture that one might have associated with gangs back in the earlier part of the twentieth century of Irish and Jewish and Italian and other gangs doesn't really operate either.

And so there's a way in which the black culture street culture kind of shapes and frames everything, and the whites don't really fit into that very well. Yes, certainly in this scene and in this generation. But on the other side of San Francisco, in the Hayde Ashbury, there was a thriving white young injector scene that was dominated by whites, and it's really interesting. It was really interesting

to see how people performed and did real violence. So you have whites, Latinos, and blacks, right, the Latinos were literally caught in between, and they could choose which camp they wanted to go to. They were in the minority in this scene, and then all of a sudden, their whole personality would change in terms of how they did violence, which drugs they were preferring, and how they were talking

in each of the two scenes. So, yeah, people we were able to sort of morph their cultural preferences, so to speak. Well, you know, it was interesting even when you get into something as intimate injecting. Yeah, that's incredible, you said. Even the ways that the whites and black's injected were different, different experience of the injecting, different ways of doing it, and different health consequences. Yeah, booting and jacking.

So it's you know, you put in the you put it in, then pull out so that some of the blood comes back into your syringe and so forth. A completely different way of also experiencing the rush of what you're injecting, whether it's a combination of cocaine, and heroin or just or or or just heroin, um, you know, with multiple rushes going in and out of your veins. Yeah, well you describe like whites almost injecting it was almost

like a perfunctory way. It's like I just got to get this into my system to keep from not even into the vein, just into the muscles, so so it even takes a few minutes for it to hit right, and as if I just got to do this to keep from getting sick, and dada da da, where as you describe the blacks were injecting like you know, doing this you know, way deep and intravenous and spending the time to find it. And then this kind of more kind of sensual you know, public you know, manifest enjoyment

to the experience. I mean that seems to be a whole another kind of cultural difference between the two groups living just a few feet away from one another. Yeah. Absolutely, And even the way you would do your your your public nod you know, this sort of the ecstatic experience of the heroin is to be, you know, nodding and

looking like you're drooling on yourself. And and that's what you know, sort of someone is seeking to do at the height of their pleasurable moment after injecting, and that can last for several hours, so people would would be

seeking that. What was interesting was the whites weren't admitting to it, so they wouldn't have the initial rush that you get when injecting directly a direct deposit of the drug into the vein, but they would you know, going into the fatty tissue with the capillaries, or or into the muscle with the you know, the muscle, then sending it on, you know, to the rest of the body. You know, it might take twenty minutes for the full effect to come on or ten minutes or whatever. I

don't know exactly how long. But they would then be nodding out, you know, intensely after that, and they wouldn't admit to it. Right, So what did you make of so many of them claiming they had been Vietnam vets, whereas none of them had been Vietnam vets and only a few of them had actually been in the military, right, You know, that was an interesting dynamic one Sometimes often you know, suspects that, but then one never knows because

there are Vietnam vets. The one person I do want to say, though, who was a legit VET and he did qualify for v A you know, whatever v A care. You know, he was a little bit younger, and I don't know if it was Grenada or what US invasion, you know, invasion of Central America he was involved in, or Panama or whatever. But he was saved by the v A and successfully saved by the VA when he

was finally able to prove his identity. And they had a great program that integrated him into a job at the v A a you know, and gave him a whole transition period with you know, with supportive housing. So he was the one, the one, you know, super positive outcome. So Philipe you, you and Jeff you called the book righteous dope fiend. I imagine you wouldn't to use the title if they hadn't been calling themselves righteous dope fiends. They were hoped to die with my boots on dope fiends.

Is how how they would you know, they would giggle saying that in some sense, you know, righteous is also you know, just a popular word for doing something well. You can be a righteous cook, you know, you can be righteously good at at anything. And so that's what righteous dope fne means. You are totally dedicated to focusing on your love of heroin in some sense. And it's said without shame. It's said with you know, with with outlaw pride in that sense um. And they would consider

the term junkie a slur in this setting. You know, different words take on different meanings for different generations at different moments in history. But you can read about, you know, the righteous dope fing in the nineteen fifties when it was a new you know, when it when it seemed like a new thing to the younger generation at that time. So let me ask you about this. I mean, you know, as they said at the beginning, you know, this is

a photo ethnography. So there's these very compelling black and white photos that your co author, Jeff Chamberg did. I want to ask you about this because you know, on the one hand, you know, you say, you know, there's the pictures says a thousand words, but you guys turn it on it on its head. I mean, there's a line where you say, letting a picture speak its thousand words can result in a thousand deceptions. But you know,

I just remember encountering this repeatedly. Where there was a documentary maker in Vancouver twenty years ago, Nittie Wilde, and she did this fascinating documentary about the injecting scene in Vancouver, and it was when the whole debate was going on around the safe injection sites, and she was very much an advocate of trying to get these sites set up.

But I think the footage she collected of people injecting was so captivating that she had a lot of it, and I just imagined that not just myself, but many others were kind of almost being put off by that. And then I remember there was a book that came out twenty years ago, a big, almost like one of these you know, table top books anyone was called Cocaine Blue or something, which also had all these photos of

people at the height of the crack era. And I had this sense that there was a way in which the success at securing this really provocative photographage or photographic or documentary footage may have undermined their effort to really create a greater level of empathy and sympathy that we could help promote policy change. And I always felt very ambivalent about these projects, even as I admired their motivations. And I wonder when you were doing this book, how

did you deal with that? Well, we were very inefficient. We took a long, long, long, long time to do it, and then selected our pictures carefully to both tell reality but also to minimize how they could be, you know, hallucinated upon by a hostile reader in some sense. But at the same time, we also wanted to show the real suffering. And you can't sanitize something and do justice to making recognizable the suffering and making recognizable the bad

policy in a sense that the need for reform. It's really interesting also to see the differences in different countries when you show these pictures, and and how easy and clear it is two people in less conservative, less puritanical, less righteous, so to speak, cultural countries. I mean, you know, my father's French, and he would go, God, the US is such a stupid country. Why does it you know, why does it torture it's citizens? This is crazy. Why

not let them have their heroine. They would be completely harmless with their heroine. And it's like so simple in

that sense. And and that's what's so interesting about the um you know, the Swiss, I mean the Swiss of all people, right, the Swiss are the ones that you know, we're piloting the prescription of heroin to unrepentant drug users, and all of a sudden they started having better full I mean, this is hard to believe if full abstention outcomes, you know, leaving drugs completely, because once the person was like getting all the heroine they wanted, they weren't excited

by their outlaw life anymore. There wasn't the manic up and down pleasures that what for whatever you know, psychodynamic reason they were pursuing. And you know, they were just like hanging out with a nurse who is making sure they didn't give themselves an abcess, and they would say, well, maybe I should just like learn how to go skiing, and then they would get you know, free skiing lessons. Let's take a break here and go to an ad believe,

I'll tell you. I mean, it was interesting because I followed the developments around the heroin maintenance clinics in Europe very closely, and it's all true what you're saying. I mean, obviously didn't like people take the heroine home with them, but this really helped people stabilize their lives. It was specifically for people who had tried method on and not

succeeded on that. And interestingly, one of the biggest strows they dealt with was that, you know, most of these folks were generally older, in their thirties or forties, if not. You know, they were getting a point where they were tired of living life on the streets, but they were no longer not ready to abandon their lady love heroin. And so here they're getting basically as much heroin as they want each day. They can go to a clinic up to three times a day. It's either cost either

nothing or just a few franc a day. But the thing they struggled with, I think the most when they were in these programs was depression and the sense of loss of purpose in their lives. And I want to bring that back to what you know you were talking about in the book, where you know, at one point you talk about you know that you know at one point you were Jeff is walking along and you describe

the brisk, eager walk. Makes it clear that they're dope feends on their way to fix and that remain reminded me of sort of the Godfather of of drug study, ethnography and Preble who wrote a book called Taking Care of Business, and in the book Taking Care of Business, and he said, because you know, I mean, basically the way I know is if I see somebody lying on a doorstep, they're more likely drunk. Whereas if I see somebody walk in head bopping back and forth left and right,

I can tell they're on the hustle. They're looking for a place to score, they're looking for a place to do that, they're taking care of business. In fact, when you talk about the zyla scene phenomenon that's coming up now and how that turns people into kind of slow motion versions of who they were before, you can see that maybe that phenomen no I'm taking care of business,

begins to get diminished. What is all making me think about is that one of the things you find is I agree with obviously a d percent that that you know, that making whether it's method on or brupern orphane, or especially pharmaceutical heroin or now this drug hydromorphone, which is equivalent to heroin you know available in the US, um would make a huge difference for people who are addicted.

Defense and all this sort of stuff, But at the same time there's this element and you describe this at this period in nearly two thousands when San Francisco begins to adopt some more progressive policies and when the people are homemost have the option not just of a shelter, but even if having you know, a little room to themselves, and you describe some of the people who get out of the drug scene and then just fall into this

terrible depression and using a loan. Right. Absolutely, Yeah, that was that was sad to see and it made too much sense after it happened, and you know, is predictable in a sense, but the whole program was new. There were a bunch of cities doing it, but San Francisco is you know, managing to do it and claim that it was doing better than everyone else even when it isn't. So that was, you know, an interesting program, a housing

first program, that's a classic harm reduction program. Don't don't judge the person, get them housed before you you know, do any kind of you know whatever attempt to reduce the risk taking. And and that was really interesting to see when it worked and what some of the contradictions to it were. And it did it did work? Um, you know, for more people than it didn't work. You know,

injecting heroin alone is extraordinarily dangerous. It's such an easy drug to overdose on, and it's such an easy drug to revive someone on when you're next to them, you know, you you mean, most of the time, Um, you know, you can just shake the person and and wake them up.

But you know, obviously no one can shake you when you knock over, so that that is a tragic you know, I felt connected to what you were, I mean the senior describing because you know back you described, you know, the harm reduction programs and needle exchange programs that even though they're problematic in some ways and sort of trying to put in a kind of public health model that doesn't always make sense to the real lives to be

on the streets, they're nonetheless the most valuable thing going on. And that was the period where I had persuaded George Sorrows to become the number one private funder of needle exchange in the world, and we were funding those programs

and in the areas you were looking at. And then you describe the ballot initiative PROP thirty six and two thousand, which I am, my colleagues drafted, put together, raised the money for and one with you know, overwhelmingly in two thousand and that was the first major alternatives to incarceration ballot initiative to pass in the US all basically since the repeal of alcohol prohibition, and it doubled state funding

for drug treatment at that time. Right, and even though it's still had elements of coercion in it, the initiative was actively opposed by the drug court judges because we took away a lot of their more coercive tools. And so you described this moment there where in fact you know that that there is this sort of beginning of more services coming in, but it can help only so much.

I mean, that's the sense I got. It's like, you know, it's good that those services are out there, but for a lot of the people you were getting to know living home in in those encampments, you know, they weren't really gonna take advantage of it for any extended period

of time. Their whole life they had been abused, Right, every previous interaction ever in their life with any figure of authority had always been an abusive relationship, A relationship of being you know, balled out, beaten up, you know, in put in jail, rebuked, you know, for being a

good for nothing and so forth. So you know, when all of a sudden these sort of new piloted you know, wonderful harm reduction services were being offered, they couldn't really believe it, right, They didn't even know how to absorb it or trust it. And the whites were the first people that the system recognized as quote deserving it, you know, and reached out to them, and they literally were the first ones to get housed and and you know, it

was like totally racialized in that sense. Although you described the whites being piste off because they felt that the blacks were getting favoritism, it's which wasn't really true. That's what everyone I mean, that's the American story, right, that's the American dream. Everyone piste off and everyone else. Yeah.

I think the most heartbreaking moment in the book, Philip was, you know, you're pointing out how almost none of the white folks have any relationship with their children anymore, whereas that with the black folks, they're more likely to have some relationship there and the more likely and extended family that's caring about them and will invite them back in.

But there's this moment where you were, Jeff um go and one of one of the black characters in the book, you know, his son shows up and he's so happy to see his dad, wants to meet the family. They arranged to meet in a few hours, and the hours go by, and you know, I can't remember which character was, but he's so happy, he's so happy, so happy, and you know they're going to take the bus and then just you know, lands up taking the bus fare to

buy some crack. And somehow the time goes by and they show up very late and the kids not there, and I just, I mean, I guess it was something, because part of what you're writing about in this thing is that there's something, you know, whether it's the drug itself, or the or the or the community they're living in that somehow breaks something off in times. It just, um, I don't know, I guess I just found it heartbreaking.

That piece of it. Yeah, that was heartbreaking. Jeff actually went to find his funeral and the family asked him to be the official photographer at the funeral, and and they also asked for copies of of his photograph and and his son and daughters. Um Carter was was the name we gave him. They had grown up without their father, and so the photographs were are now their memory, and they compare what they look like compared to their father, how their beard compares to how their father's beard looks,

you know, in the casket. So it was a very moving dynamic um And and it was sad. It's heartbreaking. I mean, their lives were harping. Every single one, you know, except for one person had died or two people had died by the time the book was published, not even ten years after. By the time the book was published, their mortality rate is so high. So you know, so outlaws suffer. You know, they get punished, they get killed by their bodies. You know. It's curious by the way.

I mean, here you and Jeff are spending so much time. You're sharing meals. Jeff is sometimes even I think sleeping over there. You know, you get other families. Did you ever share drugs with them? Did they ever press you two? Did you ever offer I mean whether it was just weed or whether it was cocaine or heroine. I mean, how did you handle it? You know? No, the I mean I slept out there, you know a few times. But like I say, for every you know whatever, half

a dozen times I slept out there. Jeff probably slept out there, you know, five or six or seven or ten more times. I remember, there was really cute. Tina went back out hustling so she could hustle up for Jeff's fix, which she had identified as coffee and so and it was called the wake up you know, you know, his his wake up, his wake up fix. He's gonna

need seventy five cents for his wake up fix. And they realized they were penniless, so she went back out and hanhandled it for Jeff because he had spent all his money, you know, buying buying food for them that day, so they would accept us for the nerds that we were. I did drink beer. Um. I tried once or twice to drink um fortified wine. I literally threw up the first time I did, and and have never touched it since then. That stuff is, I mean, it tastes like

cough syrup. Cisco berry is the nastiest thing. I mean, it's it's mostly sugar and syrup, I guess um and a bunch of alcohol. But each bottle is the equivalent of five shots of vodka? Is that what I read? Yeah, It's unbelievable, isn't it. Marijuana never shows up in the book more or less, I barely. I think that it's barely ever mentioned. No. Yeah, and the marijuana is completely

irrelevant to them. Yeah, And how do you explain that, especially when you read now that the ways in which cannabis can enhance the feeling of an opioid um and so often cannabis goes well with many drugs. Why in

your that world right there is basically marijuana essentially absent. Well, you know, it wasn't available in the same way that it's available now in a tight traded amount that you can buy in the store in California where you know, you know, even what mixture of whatever those things aren't canne Philip, So what I mean, marijuana was still omnipresent throughout this period, and they were already accessing heroin, cooka and everything else. Why do you think marijuana wasn't part

of that scene at all? I mean, it just it just seems odd to me, now that you say it like that, it seems odd to me. I didn't. It didn't even occur to me why they would possibly. It seemed obvious to me that they wouldn't want it in that sense, Whenever they had an extra penny, they would invest it, you know, despite what the white said. They often would too. They would invest it in crack. So

that was where their discretionary income is. And when you compare the psychoactive effects to crack and marijuana, it's not like the marijuana becomes even vaguely noticeable in the face of crack. So last question about this book here. You wrote this a number of years ago, and you know, you say in the book that you know, the language that people use, I mean, the folks you were studying, you know, it was it was racist, it was crass,

it was misogynistic. I mean, you know, filthy, terrible language. But in the book, right, so you say you temperate somewhat. But like when people are consistently using white people using the N word, you spell it out in the book. Yeah, I wouldn't do that anymore. No, you don't do that anymore. And I'm just curious, do you think that the fact that that the book does spell it out all the time, is that make it less likely that the book might

ever be assigned in university courses. Now, you know, I think you could even suggest it to the UH, to the publisher that in the next printing they do it with a dash, and so forth. The way, the way that the convention has changed. Now. The thing is, I wanted to use real language. I didn't want to tell a lie. I wanted in your face racism to be visible. I didn't want to soft pedal the racism of whites against blacks and the few Latin X character is against

blacks as well. That's what we felt at the time, is we wanted to rub it in the face of America, to face the fact that they might have politically correct language in their you know, upper class homes or or workplaces, but that's not the way that you know that that that people on the street speak, and and they aren't ashamed of how they speak. Do you think anything's lost? I mean, obviously everybody knows what the end dash. You know what it means. If you don't spell it out

now it isn't It's an awfully ugly word. I think it's too painful when I see it in my I can see it in my students it just distracts them. I don't want to waste time distracting them. I want them to see the important thing. And I don't want to have side debates that don't have steaks, because we we have so many problems that we can deal with and that you know, there are ways to reform in the United States, and so you know, if we get

two side tracked, it just isn't worth it. So listen, you're in l A now for a number of years, So are you on the streets again? Are you doing something in jail? Actually? Mostly, I mean that's all right, that's where all the public resources go. I shouldn't be there. And what exactly are you doing in jail these days? It's it's pretty intense. It's the mental health wards of

the l A County jail. It's the great tragedy of the United States where we closed down our hospitals and then the people that do need help are now instead of getting help, they're being punished in jail. So we we did stumble on a super interesting peer support program that even seems to be operating in the heart of the Beast in a very positive way. And we found, you know, a progressive sheriff who's open to expanding that program.

So we're just working very much with bare knuckles to expand a tiny space, you know, of humanity and help in in a setting that is, you know, obviously where no one with psychosis should ever set foot. On any

given day, there's between three and five thousand people. Um, you know, many of them you know, thinking that you're you know, a devil or the or a snake who's trying to eat them or a vampire trying to bite them, don't have any understanding of why they're being punished, and are most of them people of histories of of drug

problems as well. So it's both the drug of choice on the streets of l A is meth amphetamine, and methamphetamine is the thing that you know most fast throws you into psychosis when you have that tendency and when you use a lot of it over and over especially, and you know it can also trigger in someone long

term psychosis. So it smoked, um, you know, it's it's that extraordinarily pure crystal meth that comes up from Tijuana and it keeps you up for two three days, so it's really really strong and it doesn't take a lot of organization to get it. You know, injecting heroin every single day or or or going into heroin withdrawal takes a lot of organization. It takes a lot of hard work.

That isn't something something someone with psychosis can do, usually on a regular basis, enough to even develop a habit in that sense. And you're saying it's overwhelmingly smoking now, so very little injecting so far. Yeah, there there are some scenes of injection, and especially in Tijuana where you know that is the epicenter, you know, among the deported gang members who are both selling it and and using it and trapped at the border wall. But you know,

it's just more rational to smoke it. It. It has the same strong effect and is much easier, and you don't have to poke yourself twenty times, and and you don't have to miss, and it burns like hell when you miss, and so forth. So it's just rational to smoke it. And that's it's sort of the same way

crack is rational with respect to cocaine in that same way. Um, you know, smoking it is so much easier than injecting it, and and and with okay, now, it doesn't even reach your brain it won't even reach your The pleasure of effects don't even reach your brain if you don't get in a direct deposit so it can you You can waste your money completely. And is there's something different about the meth today as opposed to the meth ten years ago.

You know, I just get this from the secondary you know, the reports cartels are you know, are you know specifically sought out experts to make the best quality they could get that smokes the easier. You know, they want to open up their market with a product that outcompetes everything else. You know, it's more consistently good than it ever was. Probably, is what I would say in that sense. Yeah, but not qualitatively different. There's the meth of ten years ago

compared to the method today. You would not compare it to heroin um to FENITYL. It's not that big a difference between what was there before what is there now. Yeah, I agree with you. Yeah, yeah, no, Well listen, Philipe, I mean, this is fantastic continuing this conversation with you, and I so much admire the work you're doing. So let me just say thanks for doing this with me,

Thanks for having this conversation. Best of luck with the work in Los Angeles as well as in Tiahuata, and I really look forward to, uh, you know, your next writings in your next book about all of this. So thanks so much, great, thank you, and I look forward to listening to your podcast. If you're enjoying Psychoactive, please tell your friends about it, or you can write us a review at Apple Podcasts or wherever you get your podcasts.

We love to hear from our listeners. If you'd like to share your own stories, comes and ideas, then leave us a message at one eight three three seven seven nine sixty that's eight three three psycho zero, or you can email us at Psychoactive at protozoa dot com, or find me on Twitter at Ethan natal Man. You can also find contact information in our show notes. Psychoactive is a production of I Heart Radio and Protozoa Pictures. It's hosted by Ethan Nadelman. It's produced by Noam Osband and

Josh Stain. The executive producers are Dylan Golden, Ari Handel, Elizabeth Geeseis and Darren Aronotsky from Protozoma Pictures, Alex Williams and Matt Frederick from My Heart Radio and me Ethan Nadelman. Our music is by Ari Blucien and a special thanks to a Brio s F Bianca Grimshaw and Robert BP. Next week we'll be doing something totally different, heading out of my apartment up to East Tarlem to do an episode from the country's first overdose prevention center, also known

as a safe injection site. It's a shame that it's still controversial to open these sites in America, I mean in some ways in terms of harm reduction and what we could be doing over those prevention sites or safe consumption rooms or old news right, because they've been up and thing, if you know, all over the world, as you mentioned earlier. But as an organization, with our Washington heightsite and our East Harlem site, we've been tiptoeing up to this and preparing for this in a variety of

ways for years. Subscribe to Cycleactive now see it, don't miss it.