This is a timely story about addiction, suffering, and how one tenacious woman found her purpose in life. Everyone I’ve talked to about this story has been fascinated, full of questions. That got me more and more excited about sharing it.
Sometimes I just pinch myself that I became an accidental journalist. This week more than ever. Interviewing people like Elon Musk, Richard Branson and Meryl Streep is thrilling. Being in the same space as the Dalai Lama, or witnessing the first solar-powered plane take off from a Silicon Valley runway is inspiring, but this month’s assignment for the BBC outshines all of that. Raising awareness about a relatively unknown, and potentially lethal syndrome, and helping to save lives, gives my work a more profound purpose. My research shows the syndrome is growing in prevalence and severity around the world.
Katie Nava, a nurse in California, almost died from this syndrome, but she’s now helping people recover. I’m so thankful to her for sharing her vulnerability and her inspiring story so candidly.
“I gave up weed and went to my Facebook page. I’ve found my calling. It was an unfortunate way to find it. I owe my life to the page. We’re spreading awareness.” Nurse, Katie Nava.
We’re all aware that the impacts of the Covid pandemic on our mental health has been brutal. The data is only now coming to light and experts say it’s just the tip of the iceberg. So, if one of your coping mechanisms has been to start using, or use pot a wee bit more than you did previously, please read on and share this with friends who might be over-indulging their love for cannabis. And tell your friends in the medical field how to identify this syndrome.
Keith Humphreys is a professor at Stanford, an expert in addiction, and one of my favorite academic experts to interview. He sums up the problem like this:
“Everyone in public health needs to be engaged and not fall for the line that cannabis is unlike any other drug in history. Every drug can have a bad effect. That’s the reality of our experience, the reality of chemistry.” Keith Humphreys
Here’s a longer version of the transcript: Alison van Diggelen: When Katie Nava had her first experience of Cannabinoid hyperemesis syndrome, CHS, she felt like she was going to die…
Katie Nava: It’s the most painful thing. You want to commit suicide in the middle of an episode.
The intensity made me nauseous. I’d spend the rest of day on the floor throwing up in this excruciating knotted up, doubled over pain. Like someone took a knife and twisted it in your stomach. You can’t stop it. We’ve coined the term scromiting: screaming while you vomit. My pain was always in the exact same place: It’s right where your stomach and esophagus meet. It’s just on fire. My throat would always be on fire, I had post nasal drip all the time…
Alison van Diggelen: For four years, Katie Nava, a licensed nurse in Southern California, was in and out of the Emergency Room, and had countless appointments with gastro, ENT and other specialist doctors. She had CAT Scans, colonoscopies, and doctors even suggested surgery to remove her gall bladder. Despite a digital trail of medical evidence from her Kaiser doctors, no one could identify what ailed her.
Katie Nava: I started thinking I was crazy. They would say nothing is wrong with me. I was getting labeled as a drug seeker. It hurt so much.
Alison van Diggelen: Finally, a nurse at another hospital recognized the symptoms and asked Katie Nava if she used marijuana. She was diagnosed with Cannabinoid hyperemesis syndrome, also known as CHS.
The first mention of CHS in the medical literature was not that long ago. In 2004 Australian doctors noticed a link between 19 cases of cyclic vomiting in people who used marijuana. Since then cases have been recorded in the UK, France, Australia, the Netherlands, Canada, Spain, New Zealand, as well as here in the US.
The bouts of vomiting, nausea, and severe abdominal pain tend to impact long term, heavy users of marijuana, though some younger people who smoke concentrates only a few times a week have had it too.
Kevin Hill: The precise mechanism is unclear at this point. It’s thought to involve the dysregulation of the body’s naturally occurring endocannabinoid system. There are receptors located throughout the body, primarily in the brain, sometimes in the GI tract.
Extensive use may lead to changes in function of the receptors. Ultimately those receptors in the GI tract, in the gut, appear to be affected in an adverse way, that’s when abdominal pain, nausea and vomiting can result. …
Alison van Diggelen: Nurse Katie Nava describes it more vividly:
Katie Nava: Your endocannabinoid system is like a fuse box and someone ripped it out. It’s like spaghetti wires misfiring everywhere. It’s why our bodies can’t thermo-regulate, it’s why our brains can’t talk to our stomachs properly. It doesn’t help that we’re so dehydrated, and why it’s the number one thing that kills CHS patients: kidney failure.
Alison van Diggelen: As well as the non-stop vomiting, patients also often experience dramatic weight loss, a rapid heart rate and dangerously low potassium levels. One piece of the puzzle that might help doctors to diagnose it is: if patients tell them that hot showers or baths help to alleviate these symptoms.
So does Dr Hill think it might be possible to identify those most at risk?
Kevin Hill: It’s very likely there’s a genetic component to it. Most people who use cannabis don’t have this problem, so it’s something particular to a subset who use it. What we do know is, if you use cannabis, this is a possibility and if they present with symptoms they need to stop using. If not appropriately diagnosed, you can have very serious consequences.
Alison van Diggelen: It’s been reported that two people have died from CHS. And the dehydration caused by vomiting can have long term impacts on the heart and liver. Once relatively rare, CHS is becoming more common around the world, especially where marijuana has been legalized. Dr. Hill estimates about three million people have suffered CHS in the United States and his hospital has treated thousands of patients.
Kevin Hill: I’m at Beth Israel Deaconess Harvard teaching hospital. I routinely work with folks in our emergency department… They’re seeing these cases more and more.
Alison van Diggelen: Some ER doctors in SF are seeing it on every shift. Other nurses in Denver see it about once a week, but it’s on the rise.
Keith Humphreys is a professor of behavioral sciences and a leading addiction scholar at Stanford University.
Keith Humphreys: The majority of Americans have access to recreational cannabis. At least 80-90% have access to medicinal cannabis… There’s always been a wink and a nod as to what medical cannabis is in the United States.
THC is the principal intoxicant in the plant. In the 1980s, 1990s, a typical plant might have 5-7% THC. Studies of the current legal market show they have 20%. Some products have 50-80%: DABS and wax extract. It’s dramatically stronger.
Speaking as a scientist, I don’t really know much what they do: there are fundamentally novel products I wouldn’t want to generalize, any more than I’d say: You can understand what it’s like to drink a pint of vodka, if you’ve had a pint of beer.
Great Increases in the dose of the drug can have effects you can’t infer from the low dose.
There’s been a great increase in the number of people who use cannabis every day… Perhaps tied to potency: More people are addicted. More users look like cigarette smokers; all day long they have cannabis going. That was uncommon in the days of lower potency.
Alison van Diggelen: One study from the Netherlands found that the concentration of THC (tetrahydrocannabinol) – the compound that makes you feel “high” – in cannabis sold in retail outlets had roughly doubled between 2000 and 2015. (from link above)
Humphreys says the number of people using cannabis in the United States is growing about 3-5% a year, but the volume of cannabis sold is going up much faster. Kevin Hill: The purity and potency of any cannabinoid you use, including whole plant cannabis, is critical to know because it does appear the adverse effects of cannabis are often dose dependent….When I talk to patients, about what they’re using, I want to know specifically and ask them to bring in labels.
You have to know what you’re putting in your body, to know the potential outcome can be, either good or bad.
Alison van Diggelen: So – what’s more dangerous? Vaping, smoking or edibles?
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Kevin Hill: In terms of health effects, smoking is the worst possible thing you can do. Vaping is slightly better than combustible cannabis, but oral cannabis products are better in that way. We want people to be thoughtful…
There are always risks involved. You wanna get products from a reputable source. In general oral consumption is the least harmful, depending on the dose involved. If you get to the point where your use is creeping up… Sometimes intervention is necessary. Talk to a healthcare provider.
Alison van Diggelen: Professor Humphreys believes that alongside people learning more about what they’re using, healthcare professionals need to be aware of CHS – to catch it early.
Keith Humphreys: People who work in hospitals need to be aware of it and generally are not. We need more public health messaging to counter the industry message which is: it cures everything and has no downside!
We don’t tolerate that for other substances like tobacco, alcohol because we know it can harm people. We need it not just for CHS, but for memory problems, concentration problems. People do worse in school if they’re heavy users.
Public health is in a defensive crouch about cannabis, compared to tobacco and alcohol, in part because they have a powerful industry on the other side of the table. It’s also more cultural: no one wants to be a finger-wagging, blue rinse activist saying: bad bad cannabis! Once it’s legal, that argument is over. Now it’s just like any other thing.
This is really in the hands of our political leadership and regulators. Will we learn the lesson of alcohol and tobacco? If we don’t regulate we get a lot of public health damage. Are we going to treat this as a cash cow and let industry sell as much as it wants? Or will we say: wait a minute, if we take all the controls off, you get a lot of suffering. Everyone in public health needs to be engaged and not fall for the line that cannabis is unlike any other drug in history. Every drug can have a bad effect. That’s the reality of our experience, the reality of chemistry.
Alison van Diggelen: Katie Nava has learned the hard way about the risks associated with cannabis use….
Katie Nava: We’ve created a super plant – don’t abuse it! If someone had told me: don’t smoke 20 joints a day, I woulda listened. Now it’s too late. I’ve completely ruined my body, my endocannabinoid system’s wrecked.
Alison van Diggelen: Giving anti-nausea drugs and replacing the minerals lost during vomiting with electrolytes are central to treating CHS. Antipsychotic drugs like Ativan and haloperidol can also help. But the only proven way to cure CHS is to stop cannabis use entirely.
Katie Nava: It’s literally a game of Russian Roulette…it’s a ticking time bomb.
Alison van Diggelen: Nava stopped two years ago, and she even avoids foods like black pepper, truffle oils, and broccoli that contain cannabinoids. Helping run a Cannabinoid Hyperemesis Recovery support group on Facebook keeps her busy. Founded three years ago, the support group now has over 12,000 members from around the world. Membership is growing about 10% a month. (8500 of the members are in the U.S., 1400 in Canada, 400 in UK).
Katie Nava: It was my AA (Alcoholics Anonymous) meeting. It helped me stay sober. It was my exchange. I gave up weed and went to my Facebook page. I’ve found my calling. It was an unfortunate way to find it. I owe my life to the page. We’re spreading awareness.
Alison van Diggelen: What else does Nurse Nava think should be done to raise awareness?
Katie Nava: If dispensaries would just put up signs saying: Hey this is what CHS is! Then, if someone comes down with it, they wouldn’t spend four years in misery like I did.
Last week, as demonstrations and outrage continued across America, I received an invitation that made me very nervous: I was invited to join a live BBC World Service program to discuss the view from California. I felt ill-equipped to contribute. What could I say that would be valuable to the dialogue? This is a challenging time to opine on the tinder box that is America, particularly if you’re a white immigrant. But I did my homework, listened to a lot of diverse commentary and read widely.
I can’t claim to have all the answers (who does?) but in preparing for the program, I did some personal growth. I changed from from feeling tongue-tied and unworthy, to fired up about speaking out. How? My research taught me three important things (see below).
Or listen to the Fresh Dialogues podcast below which features highlights of our discussion and more about what I discovered.
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We began by discussing Trump’s executive order introducing police reforms, and then listened to the insightful perspective of Philip McHarris. A researcher at Yale University, McHarris is a vocal member of the Community Resource Hub for Safety and Accountability. He makes some excellent points about the need to prioritize education and economic opportunity for the black community, and has written a provocative New York Times Opinion piece that concludes: “We need to reimagine public safety in ways that shrink and eventually abolish police and prisons.”
I agree with his call to reimagine public safety, but it’s hard to imagine that abolishing police and prisons will ever be a wise idea. What do you think?
BBC transcript (edited for length and clarity).
Philip McHarris: Police are largely arresting people, and putting people in jail and ruining lives and communities, when people need resources and opportunities, and not a prison cell and policing.
Defunding police means shifting resources away from policing and getting at the underlying causes like not having quality schools, employment options, housing healthcare. The communities that are the safest don’t have the most police but they have the most resources. Because of specific decisions and political inaction, housing policies have created legacies of racial and economic inequality. People often are forced into survival economies which are then criminalized.
So the first step is funding community resources and institutions. The other side is developing alternative emergency response systems where police –– who have guns and a license to kill with immunity –– are not showing up when people need a wellness check, a mental health intervention or domestic violence support.
Jamie Robertson: Alison, this idea of defunding the police…is it getting traction? The idea of withdrawing the police and replacing areas of police enforcement with social workers?
Alison van Diggelen:There is support for defunding police and looking at the root causes (of police brutality). The fact is: We all have bias. It’s what we do with it and how we manage our first impulses (that matters most).
The police force needs to build new protocols and new partnerships, as Philip said, with social workers and psychologists. It needs to invest more in anger management and de-escalating violence, rather than inciting violence. And perhaps making Malcolm Gladwell’s book Talking to Strangers mandatory for police officers?
This pandemic has exacerbated the tinder box of despair and rage in America. Perhaps America also needs to face its horrific history of slavery. That legacy continues today. We need to borrow practices from South Africa and Rwanda and hold Truth and Reconciliation hearings.
Here are the three things I learned in preparing for the BBC program:
Speak out: As influential psychologist and author Adam Grant says:
“Just as sexism is not only a ‘women’s issue,’ racism is not only a ‘black issue.’ In social movements, research has repeatedly shown that when majority groups stay quiet, they inadvertently license the oppression of marginalized groups.” Adam Grant
So, no matter who you are or where you’re from, this is time for speaking out against injustice and inequality. It’s also a time for mindful listening, reading purposefully and amplifying the voices from the black community.
“Let’s not excuse violence, or rationalize it, or participate in it. If we want our criminal justice system, and American society at large, to operate on a higher ethical code, then we have to model that code ourselves.” Barack Obama
It’s a version of Michelle Obama’s powerful mantra: “When they go low, we go high.” Here’s her full explanation of the mantra:
“‘Going high’ doesn’t mean you don’t feel the hurt, or you’re not entitled to an emotion. It means that your response has to reflect the solution. It shouldn’t come from a place of anger or vengefulness. Anger may feel good in the moment, but it’s not going to move the ball forward,” Michelle Obama.
3. Champion what works
The United States has a appalling history of slavery; but it’s not the only country that’s ever dealt with systemic racism. Think about the last century of German and Rwandan history. And in South Africa, racism wasn’t just systemic during the Apartheid era, it was an integral part of the constitution and the law of the land. Many people predicted a bloodbath when apartheid ended, but instead Nelson Mandela helped to make a peaceful transition. The country’s Truth and Reconciliation Hearings were an integral part of this.
My fellow BBC contributor, Barrett Holmes Pitner writes eloquently about what we can learn from other countries and concludes:
“Rwanda, Germany, and South Africa have reckoned with their troubled past to make a better future, but America has long preferred to ignore the past, and proclaim the inevitability of progress. America today must define and confront the Original Sin of slavery.” BBC contributor Barrett Holmes Pitner.
Here are some other insightful perspectives worth reading:
Perhaps you weren’t shocked by the college applications scandal that recently broke in the United States? I must confess, I was deeply upset because it reveals a low tide mark in our society’s ethics today and underlines the absence of integrity in so many people’s lives. But I’m also saddened because “Operation Varsity Blues” has wider implications for our colleges and our communities. Fresh Dialogues host, Alison van Diggelen reports for the BBC World Service.
(Photo credit above: Daniel Gaines Photography via Breakthrough Silicon Valley)
The stories of college applications doctored with photo-shopped pictures of athletes; blatant bribery and cheating on SAT scores made my blood boil. So I was delighted to have the opportunity to share my views on the BBC World Service.
These rich elites – venture capitalists, actors and prominent business people – confused their privilege for merit; and by cheating they crushed the hopes and dreams of the least fortunate and most deserving students in our communities.
The BBC’s Fergus Nicoll asked me about the reputation damage to schools and I shared an interview I did recently with former President of Stanford University, John Hennessy. At the time, he was outraged at colleges “debasing themselves” and forgetting their values in the pursuit of athletes over academics. Watch the video (@3:00): Hennessy is known for his tact, but here, his anger is palpable.
Previous commentators on the BBC program, including Stephanie Studer of the Economist in China, and Kay Hymowitz of the City Journal in New York, talked about the destruction of meritocracy. That’s definitely under threat, both here and around the world. But who’ll suffer most from this scandal?
The hard working students and families from less advantaged communities. Like the inspiring students at Breakthrough Silicon Valley, a nonprofit here in California, that works to mentor and nurture first generation immigrants to achieve their college dreams. For them, it’s a double whammy: First: The opportunity cost. For every rich kid who got into college through a side door, there’s a student who worked like a Trojan to get the scores necessary to win a place, and lost out. But it’s more than that: What will this scandal do to the aspirations of these students and families who feel that the playing fieldjust got even steeper? And more broadly, how will our communities suffer if these well deserving youth lose out on taking their shot at a better future? The opportunity cost is both acute and enduring, both personal and wide ranging.
Is it too much to hope that colleges and communities can return to decent values and bring ethics back from its long holiday?
We should all be outraged when such revered institutions fail our society by creating shortcuts for those with wealth and privilege when they could be a powerful force for equity in our society.
Certainly, the staff and students of Breakthrough Silicon Valley are frustrated. As Diana, a high school junior, put it, “I’m sad but not shocked. I’ve always known that there are people who play the system, it just hurts to have this out there when I’m working so hard to get my shot.”
For the past five years, my team has cheered Diana on as she works incredibly hard to get to college. She grew up in a family that grapples with the constant stress of financial instability. They got home internet access just last month, and few in her community have gone to college, but Diana is blazing an impressive path. She has a 4.29 GPA while enrolled in the most rigorous courses her district offers. She founded a community service club and helps facilitate Breakthrough’s after-school program for 7th graders. She is proud of her community service, her persistence, and her identity as a strong Mexican-American woman. Diana is not just “qualified” to attend college, she is ready to lead when she gets there.
When colleges reinforce class divisions through legacy admissions and bend to the will of deep pockets, they miss out on students like Diana. Read more here. (NB: Names have been changed to protect student privacy)
Over 100 Americans die every day from opioid overdose, that’s about 40,000 a year. What can be done to reverse the recent spike in fatalities? In San Francisco, a team of public health workers is focused on treating the most vulnerable: homeless people on the city’s streets. My latest report for the BBC explores how this special ops “Street Team” is finding and convincing people to get the latest medical treatment, wherever they are.
It’s a timely issue as next month, San Francisco voters will decide if the city’s largest businesses, many of them tech companies, should pay a special tax to help fund more homeless shelters and addiction centers like the one I visited. The debate is dividing the tech community. Marc Benioff of Salesforce says “homelessness is everyone’s problem” and backs the special tax, but others like Twitter’s Jack Dorsey say it’s “unfair.” Love it or loathe it, the ballot measure proposes more funding and action to tackle homelessness and drug addiction in our most vulnerable population. These are complex and deep rooted problems with no quick fixes, but I applaud Marc Benioff and others like him for taking a stand.
Several medical workers and a heroin addict shared their ‘dream’ solutions to homelessness and addiction in the city. Their answers may surprise you.
If I had a magic wand, I’d just flash over the Twitter building, the Google building and say: hey guys, how about some compassion for folks, some kindness? When somebody talks to you in the street, look them in they eye. Planting that little seed of compassion and kindness goes a long way and I think that’s how the larger change in our city would happen. There’s a lot of hostility, a lot of misinformation. So if I had a magic wand, I’d just like flash it and say: compassion, compassion, compassion…kindness and a safe injection site! Ana Cuevas, health worker at the Tom Waddell Health Center, SF Public Health [Pictured above]
Here’s a transcript of my full report. A shorter version aired on the BBC World Service on October 24, 2018.
Atmos: San Francisco city street sounds: bus, cars, fans, people…
Alison van Diggelen: I’m here at City Hall in the center of San Francisco. Within yards of the building’s gleaming dome, there are clusters of homeless people, huddled in doorways, sprawled on pavements, or slowly pacing the streets.
Every week, Dr Barry Zevin and his team walk the city streets to build rapport with homeless people with addiction problems and offer on-the-spot treatment. Once trust is established, they encourage patients to visit the city’s public health clinic. Today, there’s a steady stream of homeless people…
Alison van Diggelen: Inside this clinic, known as the Tom Waddell Health Center, I meet James (not his real name) a former medic in the United States army, who recently started treatment for heroin addiction.
James: Right now I got a prescription refilled, and the doctor was like: do you need a shelter bed for tonight? Are there other things I can do for you? I’m very impressed with how kind and helpful they are…going above and beyond to find what else they can do for me.
Alison van Diggelen: James, who’s 30, has been prescribed buprenorphine to help wean him off his opioid addiction. Buprenorphine is a daily pill that reduces opioid cravings and the extreme physical pain of withdrawal. Despite being an addict for over ten years, James sincerely wants to change.
James: This medication allows me to do a detox less painfully and I no longer will have intense cravings for the substance of abuse. It’s definitely more comfortable than cold turkey…
Alison van Diggelen: James has been homeless in SF for about five months, after moving from Seattle. Being on the streets compounds his challenges as he faces fear and loneliness, as well as drug dealers.
James: I moved to this city not knowing a whole lot about it, so the areas I go, I’ve only operated in them under addiction scenarios. So being on something that blocks the receptors…I’m not so prone to go back to using it and therefore I can operate in these areas where there’s a lot of environmental triggers without having to…feel the same feelings of craving, to want to use.
Alison van Diggelen: Sarah Strieff is a registered nurse with the SF Public Health’s “Street team”. They regularly walk the city streets to identify vulnerable patients in need of healthcare and detox. As they pound the pavements, how does she and her team convince homeless people like James to start treatment?
Nurse Sarah Strieff [pictured above]:There’s two ways we identify people: our own outreach and street presence; and through other agencies in the city that bring people to our attention.
Alison van Diggelen: Sarah, who wears ripped jeans and a T-shirt explains how being inconspicuous, non-threatening is key to their outreach.
Sarah Strieff: It’s casual, we dress down, we don’t wear uniforms.
Alison van Diggelen:No lab coats?
Sarah Strieff: No lab coats. No! We talk to people where they’re at…We’ll go to Golden Gate Park, the Haight, Bay View…I do see a lot of people hanging out in the Tenderloin.
Alison van Diggelen: The clinic serves between 10 and 20 homeless people during its daily 4-hour clinic. No appointments are necessary and you don’t need insurance. Ana Cuevas works with Sarah on the “Street Team.”
Ana Cuevas: We try to build a relationship first and check in with folks. That’s the reason why our program is so successful. Everyone who works here sees people first, then patients. Check in and ask what they need and try to deliver, not impose my own agenda on them.
Alison van Diggelen: The clinic delivers a comprehensive health care treatment plan, prescriptions for detox medications and even helps patients find a roof for the night.
Starting conversations about drug use is a sensitive process, and it takes weeks, months, even years for the Street Team to build trust with people on the street and at needle exchange facilities. For that reason, I wasn’t allowed to go on their rounds with them.
Ana Cuevas:It’s not hello: what’s your social security number, what’s your medical history? No, it’s like: who are you? How can we help you? We just listen… we just go with the flow.
Alison van Diggelen: Ana Cuevas describes the process as “Motivational interviewing” which involves a lot of listening, and no judgment.
Ana Cuevas:If someone comes in and says: Hey Ana, I’ve been using a lot. I’m not going to say: you shouldn’t do that! (instead): what are your thoughts around that? What’s happened with that? And then just kinda carry that conversation like that. One of the biggest problems with health care is that there’s often not enough time to listen. That’s the root of motivational interviewing: being present, listening and then figuring out solutions together.
Alison van Diggelen: Dr Barry Zevin is the Medical Director of Street Medicine and his team treats about 500 homeless patients a year, many of whom are addicted to opioids.
Dr Barry Zevin:When we treat them with buprenorphine or methadone – long acting, continuous stimulation of these receptors in the brain, without the sudden highs and sudden withdrawals that come with a short acting drug – these longer acting medications can really change and repair what the dysfunction of the brain is and all of the physiological stress responses people have. The physiology of someone using street opioids has really gone wrong, and that causes depression, anxiety, stress, physical disease, decreases in the immune system…a whole cascade of things go wrong that can go right when we replace that with long-acting, high affinity to the opioid receptor in the brain medication.
Alison van Diggelen: The health worker, Ana Cuevas, recalls a twenty year-old woman the team was able to help and within a week she was reunited with her family and on the road to recovery.
But Dr Zevin admits such cases are outliers.
Dr Barry Zevin:We’re in era of fentanyl contaminated drugs. It’s found its way into the drugs…They’re super potent…The risk of overdose is much higher now than it was 5 years ago. I’m talking with people every day and any day they’re at risk from having an overdose or fatal overdose bc of this new trend in drug supply.
Alison van Diggelen: The clinic treats a small percentage of the estimated 20,000 intravenous drug users in San Francisco, but Dr Zevin insists it has ripple effects. By targeting the most vulnerable people and achieving results, he’s convinced it inspires others to get treatment. He considers it a remarkable success that about one third of his patients are still in touch with the team and on treatment after a year.
Dr Barry Zevin: I always describe our model as effective but not very efficient.…We see them a lot. Once a week is not enough for some patients. With the level of instability, the level of things that can happen to people..If people are in a street or a park or a shelter, it’s a lot easier to bring the medical care to them, than wait in an office for them to finally make it to an appointment.
Alison van Diggelen: This SF program is just one of several similar schemes across the United States in Boston and in Texas. They’re often run in conjunction with needle exchanges and low barrier shelters, so that addicts can get the full support they need. Is the solution policy changes, more shelters and more funding? Healthcare worker, Ana Cuevas offers a more profound insight.
Ana Cuevas:Honestly, the most challenging part is changing the way our larger community views our population. Our folks, a lot of their humanity has been taken away…
If I had a magic wand, I’d just flash over the Twitter building, the Google building and say: hey guys, how about some compassion for folks, some kindness? When somebody talks to you in the street, look them in they eye. Planting that little seed of compassion and kindness goes a long way and I think that’s how the larger change in our city would happen. There’s a lot of hostility, a lot of misinformation.
So if I had a magic wand, I’d just like flash it and say: compassion, compassion, compassion…kindness and a safe injection site!
Alison van Diggelen: This viewpoint is echoed by James, the drug addict who recently started treatment.
James:It’s a matter of empathy I think. I would ask anybody in charge of policy…people might not seem kind or deserving of help, but they’re all people who may be in different stages of grief or suffering and to realize that it takes kindness to bring it out.
Alison van Diggelen: What are his hopes for the future?
James:I’m trained as a chef, I worked as a medic in the military. There’s things in both these fields I’d like to be doing…
This week’s report addresses gun violence in the United States. Many of us have been inspired by the fearless survivors of the Florida High School shooting on Valentine’s Day. Powerful speeches by teenagers, Emma Gonzalez and David Hogg have changed the conversation and I applaud them and the March For Our Lives Movement for their bravery and tenacity in their mission to reduce gun violence through sensible gun policies.
Hundreds of thousands of people took to the streets in DC, and hundreds of cities in the United States and around the world. Here are voices from the March for Our Lives in San Jose, California and a clip from my BBC report which aired on Business Matters on March 27th.
I’m here because I don’t want to be afraid to go to school. I don’t want to say ‘I love you’ to my mom, ‘I hope I see you after school.’ Ashley Wilson, 15-year-old high school student who took part in the March for Our Lives in Silicon Valley, California on March 24, 2018. (photographed above by Shannon McElyea)
Listen to the Fresh Dialogues podcast on iTunes or below:
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Here are some highlights from the podcast
First, I spoke with MacKenzie Mossing a 24 year-old resident of Silicon Valley, California.
Mackenzie Mossing: I’m here because I think our system is really broken when kids have to fear going to school, when I have to fear going to music concerts, when you can buy an AR 15 before you can buy a beer.
Alison van Diggelen: Do you have a message for the NRA Leadership?
Mackenzie Mossing: Why is your right to own a gun bigger than my right to live?
Alison van Diggelen: Do you have a message for Emma Gonzalez?
Mackenzie Mossing: You are a true inspiration. Keep doing what you’re doing. We need more people like you to invoke change in the world.
Ashley Wilson: Enough is enough. School shootings should not happen…I’d like to see much less school shootings, shootings in general….(and) gun control.
Alison van Diggelen: What role do you feel businesses should play in this? Companies likeDelta Airlines and several banks have stopped their incentives for NRA members. Do you agree with that and what more can companies do?
Ashley Wilson: I completely agree with that and I think more companies should join in.
Alison van Diggelen: Do you have a message for teens in Florida who’re taking to the streets in DC today?
Ashley Wilson: Know that the rest of the nation is with you, the rest of the world…We stand with you.
Alison van Diggelen: I asked 18 year-old Jacob Seichrist, a graduate of Branham High School in San Jose, and marketing manager, Chris Mossing, about the role of businesses in changing gun control policies.
Jacob Seichrist: I’m hoping these movements are getting out there to parts of America that are on the fence. They can see how important this is…we’ve had so many shootings already this year, it’s crazy to me.
Jacob Seichrist: I think that that’s important. These brands and companies are making their statements, picking the side they want to support. Sometimes that’s going to be the way to convince people who’re on that fence…when they see that the companies that they use are on that side. It’s not just some vocal minority, it’s really real and a powerful thing. When companies do it, for some people, it’ll be a trigger of: “Wow, this is a real thing, this is something important…maybe it’s something I should look into…”
If I were a CMO (Chief Marketing Officer) of a large brand, I’d be paying a lot of attention to what’s happening today in the streets of the United States. Millennials are looking for brands to be on the right side of social issues, whether it’s clean food, environmental policies or in this case: gun control.Chris Mossing, Silicon Valley marketing manager
My live report on the BBC World Service was cut due to breaking world news, but in the last five minutes of the program, I highlighted the March For Our Lives and what it could mean for businesses and brands.
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Find out more:
What do Amal Clooney and Rick Steves have to say about gun violence in the United States?
James: Right now I got a prescription refilled, and the doctor was like: do you need a shelter bed for tonight? Are there other things I can do for you? I’m very impressed with how kind and helpful they are…going above and beyond to find what else they can do for me.
Alison van Diggelen: The clinic delivers a comprehensive health care treatment plan, prescriptions for detox medications and even helps patients find a roof for the night.
