Sex, Drugs & Science

Samuel Friedman: Drug User Activism

Valerie Earnshaw & Carly Hill Season 1 Episode 10

Dr. Samuel Friedman is a Research Professor and faculty member at the Center for Opioid Epidemiology and Policy in the Department of Population Health at NYU Grossman School of Medicine. He is also the Senior Theoretician and Associate Director of the Infectious Disease Epidemiology and Theory Core at the Center for Drug Use and HIV Research (CDUHR). In this bonus episode, Sam and Valerie discuss their role in activism as it relates to academia. Sam also talks about his role in drug user activism in the 1990s, specifically a demonstration at the Department of Health and Human Services which involves a 12 foot tall replica of a human backbone. 

Read more about Dr. Friedman's work here: https://med.nyu.edu/faculty/samuel-r-friedman

And here: https://www.nyu.edu/about/news-publications/news/2012/july/nyucn-center-for-drug-use-and-hiv-researchs-drsamuel-friedman-awarded-a-nida-2012-avant-garde-award.html

Valerie:

I'm Valerie Earnshaw.

Carly:

I'm Carly Hill.

Valerie:

And this is Sex, Drugs and Science. Today's conversation is with Dr. Sam Friedman. Sam is a research professor and a faculty member at the Center for Opioid Epidemiology and Policy i n the Department of Population Health at New York University's Grossman School of Medicine, He is also the associate director of the Infectious Disease, Epidemiology and Theory Corp at the Center for Drug Abuse i n HIV Research.

Carly:

Today's bonus episode is a brief one. Unfortunately, we had some technical difficulties during our recording, but our fantastic editor, Kristina Holsapple was able to piece together a few bits of the conversation. So we hope you enjoy it.

Valerie:

Alright. So in this first segment that we were able, that Kristina was able to salvage for us, we asked Sam about his thoughts on being a scientist and an activist. So essentially, you know, whether there is a contradiction there. So first off I should say that Sam just doesn't identify as a scientist. So that was good to know. He identifies as a scholar, so maybe I'll need to sort of dig into some of these identity issues in season two.

Carly:

I think so.

Valerie:

Double check that the people we're interviewing identify a s cientist, who they are a little bit more deeply. But more generally, I mean, this, this conversation around science and activism is one that I'm really interested in. I'm really curious as to whether scientists, especially in our field identify as activists. I think that there, some people perceive that there's a risk that identifying as an activist m eans that y our objectivity is sort of clouded. And I h ad n ever really thought about this until I was at Harvard Med School. So I was a faculty member there and we were hosting a symposium. It was on LGBT bullying, and it was like so interesting. So there was a panel discussion, which means that there were a group of people sitting on the stage and they were talking to each other about different issues related to bullying. And it was, it was a great panel. There were, you know, about, I think it was l ike just about half of the folks on the panel w ere researchers and the other half w ere community members, including some youth from the LGBT community in Boston. And somebody raised their hand and they asked t he panel if they were activists, and like who identified as an activist? And I'll never forget it. Like all of the youth r aised their hand. One of the scientists, you know, one of the P hDs on the panel raised a hand and then two of them didn't. And I was just, I was really surprised because these two scientists in particular are people who do a lot of research on structural stigma and who, who have done amazing work on stigma. A lot of it, which I think is like calling for social change. And so I was just really interested that they did not identify as activists. And then they took a poll of the, of the room, like of the audience. And it was still like, i t was about like 50/50.

Carly:

Which is that like, it doesn't line up, you know? Unless it's one of those things where like, you get so deep into the research that it's just like a part of your everyday life. And it doesn't seem, I feel like the term activism comes with some sort of like, charge about it, you know? Like there's like a hard definition of that. That seems sort of radical, I think, in a lot of c ontexts and like, you know, so maybe once y ou're, you're doing all that stigma research t hat like you said is so, you know, calls for activism, you know, most of the time that you just, not that you're numb to it, but it doesn't feel so radical when that's the work that you're doing e very d ay. But.

Valerie:

Yeah, no, I think that's a really good point. And so that's why I kind of c ircled back. I'm like maybe, maybe the idea is that if they identify as an activist, a ctivist, then they worry that their objectivity is clouded, that they like, you know, can't be a s trusted with the d ata or something. But I mean, I've always s howed up to protests. I mean, on our Instagram account, we have some photos from Stephanie Chaudoir was on the podcast out protesting. I went with her to the Women's March. And I went most recently to a very super socially distance protest at our Acme. I don't know if I told you about that, which is our local grocery store.

Carly:

Yes.

Valerie:

Black Lives Matter movement. And so I just, I really don't see that as, as conflicting, especially because we have theory and we have research, I think showing that like social change helps to stop stigma. So if I'm helping to stop stigma through my intervention work through like my other projects, like why not help to stop stigma by like going to protests or engagement activism, like, you know, so anyway, I just, I, I did raise my hand, so yeah. So anyway, so we asked Sam this question and, and now you'll hear him, uh, think through and talk through what his thoughts are. So coming off, you know, thoughts of the revolution, one of the things I wanted to ask you about, especially since you were out protesting this week, was your thoughts on sort of the intersection between being a scientist and being an activist, and how you see those, those two roles? Are they complimentary? Are they contradictory? And as I previewed, maybe I've already answered this since you were out protesting this week, but I'd love to hear your thoughts on that.

Sam:

I mean, I mean, I see no contradiction. I'm not sure I'm a scientist. I tend to think of myself as a scholar. But, when I wrote my first book, which was called"Teamster Rank and File", and what a q ualitative study of an activist i n militant local union in Los Angeles of truck drivers. I made the point that there w as a lot of stuff I couldn't have understood or learned if I were not part of a movement that had worked with those truck drivers when they were on W ildcat strike. And that furthermore, as I think everyone understands the concept of scientific objectivity is bullshit. But you can have i s scientific integrity and honesty and attempt to understand your biases, but that doesn't mean get rid of them necessarily. You k now, it means understand what you were doing and that sometimes it's committed to things. One of the things I found when I first came to A IDS work was that all this stuff about objectivity and this, that, and the other on a certain level was utter nonsense because all of these researchers are ganging up on some poor virus.

Valerie:

Okay.

Sam:

And all of medicine is committed to killing germs. That's not objective, that's taking sides.

Valerie:

I've never thought of it that way.

Carly:

No, me neither. That was like one of those like mindblowing...

Valerie:

Yeah.

Carly:

Moments for me where I was like, huh, well, well damn.

Valerie:

Well, I do feel like Sam is the one to question everything.

Carly:

A ll r ight. So then Sam shared with us his involvement in drug user activism in the 1990s and the early 2000s, including a demonstration at the Department of Health and Human Services.

Valerie:

So could you tell us a little bit more maybe about what act, what activism, or I know you've written about, like social organizations or group organizations for drug users, sort of like sort of what those organizations and movements look like?

Sam:

It's hard to generalize. And there's been some historical change. To begin with, almost all of them were student councils for drug treatment programs.

Valerie:

Oh! So affiliated with universities?

Sam:

No. Affiliated with drug treatment programs.

Valerie:

Oh, okay.

Sam:

But you know, like a high school student council, which is a creature of the administration usually.

Valerie:

Oh, okay. Interesting.

Sam:

However, there were a few real exceptions, and I've written extensively about the junky in the Netherlands. And they were a clear exception, although not all of them, some of them were at least halfway in between. Let's put it that way. They were creatures of the drug treatment program, but that's at least in part because the people in the drug treatment program were halfway to being part of a junky move. It's, but for example, the, and then there were groups like the Amsterdam group, which I forget what it, the name was, which was actually in many ways an organization of the drug reform movement rather than of the drug user activist movement, but cooperative. So that I was kind of another in between thing. Now over time, huge varieties of different things. For example, in Australia, basically they funded drug user activism from the state government.

Valerie:

Oh, really?

Sam:

They wanted to have a voice on AIDS coming from drug users because it seemed to be working for gays.

Valerie:

Interesting. Okay.

Sam:

Now that is an interesting form of organization. Quite effective in many a nd certainly effective yelling at government officials at various times and did a lot of good outreach and similar work i n some organizing. Now we have international bodies that have been lasting in reasonable shape since about 2008. I mean, we'd had predecessor international bodies. And there's some continuity of them all the way into the early nineties. But none of them almost have ever become mass activists. There aren't that many drug users.

Valerie:

Yeah. That's interesting. I mean, we've got all of this attention on the opioid epidemic in the US. At least, you know, pre-COVID that was a big part of the discussion. And it's interesting because I have colleagues who, you know, will look at their data and there'll be like,"I don't know what's wrong with the data that I collected. There's not a lot of drug users in here, but that there's all this noise about the opioid epidemic. So where are all the people using opioids in my dataset?"

Sam:

Well, that's obvious. They're not telling them.

Valerie:

That is, yep. That is true.

Sam:

It's very hard in a general population survey to get people to admit drug use.

Valerie:

S ure.

Sam:

You know, we've made estimates. Other people have made estimates. Depending how you define it, or something like two or 3 million drug users, opioid users in the US, probably less than 1%.

Valerie:

Right.

Sam:

They're spread all over. There have been demonstrations with hundreds of people, but, you know, at least officially they're harm reduction demonstrations. It's safer that way. And often it is harm reductionists. Many of whom are always ex-drug users. Some of whom may not be so e x.

Valerie:

O kay.

Sam:

But, you know, I remember a demonstration in the mid 90s, I think it was at HHS in Washington, several hundred people screaming about needle exchange. Of the people who actually had RO1s at the time.

Valerie:

So the big research grants that we from the National Institutes of Health.

Sam:

Yeah. That is the people who might be identifiable to people walking by.

Valerie:

O kay.

Sam:

I mean, there are a few others who might be identifiable as project directors or things like that, or even postdocs, there were only two of us. And I've always been very, very impressed by David Metsker that he came. He also has roots in the drug treatment world after all.

Valerie:

Okay.

Sam:

But yeah, the two of us did it, and there was no retribution that I know of.

Valerie:

Okay. Well, given your career trajectory and your Avid Guard award and everything, I would say that you did pretty well despite, you know, despite the protest. So we did some research into this protest at the Department of Health and Human Services, or HHS. So we think that it was in 1997. And we found out basically that there were about 500 to a thousand people by newspaper reports gathered to protest HHS secretary, Donna Shalala, and president Clinton's inaction on lifting the ban on federal funding of needle exchange programs. So, you know, by 1997, there's good scientific evidence that these needle exchange programs can effectively like reduce the spread of HIV and is a really good HIV, HIV prevention strategy for people who inject drugs. So we have the data. And then the problem is that there's no federal funding for this thing that is super, super effective. So it looks like the protest was organized by the National Coalition to Save Lives Now. And my favorite part about this protest was that there were 12 protestors who were arrested for attempting to bring a 12 foot tall replica of a human backbone into the HHS building. And they had signs that said moral backbone for Clinton and moral backbone for Shalala. So this is just my favorite thing.

Carly:

That is such a boss move, you know?

Valerie:

Yeah, absolutely. So it really made me feel like, you know, for the next protest that I go out to, I need to like step up my game.

Carly:

Yeah. You got to get better, more powerful props, you know.

Valerie:

I know. Y eah. A t the last one I had, you know, like my sign and then I wore my Ruth Bader Ginsburg mask, which I felt like was pretty, pretty g ood.

Carly:

Yeah. Those a re, that's pretty b old too. I mean, it's no backbone, but...

Valerie:

I t's no backbone. Like I need to go more vertical. I n eed to like break out some paper mache.

Carly:

Yes, exactly.

Valerie:

Okay. Well, so we, we definitely appreciate some inspiring stories to keep us going in our own activism.

Carly:

Absolutely.

Valerie:

And moving forward, Thank you to the Stigma and Health and Inequities Lab at the University of Delaware, including McKenzie Sarnak, Saray Lopez and Alissa Leung. This episode was edited by Kristina Holsapple.

Carly:

Thanks always to City Girl for letting us use the music. And you guys can follow us on Instagram at Sex, Drugs, Science, no and for updates, or you guys can email us any comments, questions, concerns, et cetera, at sexdrugsnscience@gmail.com. So that's Sex Drugs, the letter N science at gmail.com.

Valerie:

Apparently Sex, drugs, and Science w as already taken.

Carly:

Yeah.

Valerie:

We'll have to send them an email a nd I'll figure out who they are.

Carly:

We can buy the rights.

Valerie:

Yeah. All right. Well, thank you all for listening.

Speaker 2:

[inaudible].