Sex, Drugs & Science
Sex, Drugs & Science
Brandon del Pozo: Policing, Opioids & Implementation Science
Dr. Brandon del Pozo is a postdoctoral researcher on the consequences of substance use and addiction at Rhode Island's Miriam Hospital and the Warren Alpert Medical School of Brown University. His interests include studying systems-level approaches to delivering substance use treatment services, overcoming the stigmas that obstruct evidence-based responses to the nation's opioid crisis, and confronting our growing stimulant epidemic. Brandon talks with Valerie and Carly about implementing evidence-based strategies to address the opioid crisis as chief of police of Burlington, Vermont. Valerie asks Brandon about how his training in philosophy informs his work, whether academics or police are more hierarchical, and his thoughts on police discretion as a critical point of intervention.
Read more about Brandon’s work here: https://brandondelpozo.com/
Follow Brandon on Twitter: @BrandondelPozo
I'm Valerie Earnshaw.
Carly Hill:I'm C arly hill.
Valerie Earnshaw:and this is sex drugs and science.
Carly Hill:Today's conversation is with Dr. Brandon Del Pozo. Brandon is a postdoctoral researcher at Rhode islands, Miriam hospital, and the Warren Alpert Medical School at Brown University. He studies approaches to delivering substance use treatment services, ways to confront the stimulant epidemic and how to overcome stigma so that we can better respond to the nation's opioid crisis.
Valerie Earnshaw:Before focusing on stigma, full-time Brandon spent 23 years in policing. He started with the NYPD and later became the chief of police in Burlington, Vermont. The, we spoke with Brandon about his experiences using science-backed approaches to respond to the opioid crisis while he was chief of police. And then we dug into his current research interests. We hope that you enjoy this conversation with Dr. Brandon Del Pozo. Dr. Brandon Del Pozo. Thank you so much for joining us on, uh, Sex, Drugs and Science,
Dr. Brandon Del Pozo:Dr. Earnshaw, Great to be here.
Valerie Earnshaw:No one calls me, Dr. Earnshaw, so I feel very, um... So I'm so excited to have this conversation with you because we've been chatting over the past couple of months about your research, about some stigma, scale development and intervention work that you're interested in doing. And I'm grateful for this opportunity to kind of like dig in a little bit more into your background and how it's shaping the work that you're doing. So thanks again for making the time. We know that you're like you're in crunch time for grant writing and paper writing. So we're grateful for your time today.
Dr. Brandon Del Pozo:This is going to be a fun break though. So, so thanks for having me.
Valerie Earnshaw:All right. So if we can start our, uh, slow walk through your background, you grew up in Brooklyn, in New York.
Dr. Brandon Del Pozo:Yeah, no, that's right. I was, I was born in my monities hospital in the, in the mid 1970s. Grew up in Brooklyn. My father was a Cuban immigrant. He came over from Havana. His family worked for the radio station. And when, when Castro took over the radio station, there was no more ad sales. There was no more of anything. So they had to leave. And my mom was, was this, this Jewish girl from Brooklyn. So she was dating this like very respectable wedding photographer. When my dad came on the scene and convinced her to bring home to her Jewish grandparents, like, like this guy kind of right off the plane from Cuba. And then here I am.
Valerie Earnshaw:Oh, wow. What a great romance story.
Dr. Brandon Del Pozo:They're still together. It's great. They still, they live two doors down from where I was born in and my mom grew up. So yes,
Valerie Earnshaw:That's really neat. So I was actually just thinking about this. So if you let us means that you had some of your formative years in the eighties and early nineties in New York, and that was, that was the time of sorta the, like the cocaine and like the crack epidemic a little bit. Is that right? Like, do you, Was that?
Dr. Brandon Del Pozo:Yeah, no, the crack epidemic was a thing. It was this thing. If you were like some conscientious student going to a math and science high school, traveling on the train every day in the subway, an hour to get to school, the crack epidemic, right? It wasn't this thing I was contending with, thankfully in my home, it really wasn't very present in my neighborhood, but you could feel the tension in the streets. You could feel the effects of, of the stimulant crisis. You could feel the, the related crime, the violence, it was a difficult time to be in New York. Especially if you look at how violent of a place it was. And a lot of that was fueled by not only the crack epidemic, but by the response to it.
Valerie Earnshaw:Okay. So then we fast forward a little bit into the nineties and you go off to Dartmouth and you pursue a bachelor's degree in philosophy, and I've already warned Carly that I'm like, I'm really fixated on your degree in philosophy. I want to know all about this. Like why philosophy? Yeah. Let's start there. Why did you, why did you choose to study philosophy?
Dr. Brandon Del Pozo:Yeah, it's so interesting. So I went to a math and science high school, and I took eight years of math while I was still in high school, meaning like the regular curriculum plus a research class every, every semester, two years of calculus, by the time I graduated and I thought that I I'd want to study science or be an engineer, but I started having these philosophy conversations with some kids at the school. It was just Stuyvesant, it was a public school, but these kids went to like, they took a class on Kant at Harvard in the summer. That's just listen that's maybe.
Valerie Earnshaw:Yeah.
Dr. Brandon Del Pozo:My parents were not sending me to do that in Cambridge. I was working at the airport doing freight my sophomore summer, but I started having these conversations about philosophy. And I realized that what interested me about math was really the concepts that the, the just set theory, logic, the relationships that made certain fields in math possible, like calculus, you know, this idea that these two points are getting infinitely close together and you're looking at their slope. And then philosophy is just the meta of that. Right? It's all the format of questions. So I just became really interested in philosophy. And not only that, like the metaphysics, but also in terms of morality, in terms of ethics, like getting to the first principles. And by the time I went to Dartmouth, I sat down to take the math placement exam to see if you could start right at calculus. And I knew I could do that, but in the middle of it, I just said, you know, I'm just going to be a philosopher. So listen, in my defense, I did take like physics for engineers and a few, a few like reasonably, I had a little bit of science and math one a few days. But by the time I was in college, I was just fascinated with the very basic concepts that underlied the structure of reality and ethics, virality became a philosophy major.
Valerie Earnshaw:I love this trajectory, my, my husband's math teacher and he asked people these like really abstract questions about like how thinking mathematically has shaped, how they think about other things. And most people are like, what? So it's really interesting to hear you talk through that progression and how it sort of came along,
Dr. Brandon Del Pozo:And, and as, as you know, you know, your husband and my wife are both math teachers and for my kid-- like one day, they're gonna appreciate it-- but when they're a teenager, there's gotta be nothing worse than having like a philosopher and a mathematician parents. You don't get away with anything.
Valerie Earnshaw:Oh yeah, no, there's going to be some deep,
Dr. Brandon Del Pozo:Well, you don't get to make a statement without like being on eggshells, like which one of my parents is going to dissect my statement?
Carly Hill:Philosopher let alone like former police officers.
Dr. Brandon Del Pozo:Yeah.
Carly Hill:Probably not getting away with a whole lot at all. Uh,
Valerie Earnshaw:Multi positionality household. Some really fun stuff. Yeah. All right. You do this degree in philosophy and then you return to New York, right? You joined the NYPD and maybe this is just a, um, a stereotype that I hold of police officers. So please correct me if I'm wrong. But I just, I have the feeling like there's not a, there's not a whole ton of philosophy majors who are police officers. So, how did that transition happen?
Dr. Brandon Del Pozo:But there's a few, and there's a few that went to Dartmouth. One of them still, two of them were still on the forest. And the NYPD in my old Burlington. When I went on to be chief, one of my best cops was a Princeton grad, but you're talking about philosophy. It, you know, it just that I did not want to be a banker or a consultant. And I had okay grades, but they weren't the grades for, you know, Yale or Harvard law school or something like that, or some, some top tier school. But at the same time, New York city was a really, really violent place. When I was in high school. I alluded to that earlier here, talking about the crack epidemic. And at the time, you know, we're, we're in this very tenuous relationship with between America and its police now, but at the time it wasn't like that, right. Bill Bratton had just finished being the commissioner of New York city. I used to drive to the bars on the west side, from my house during break to, you know, to pursue love and just taking the trip, you'd see crack dealers and crack users and prostitutes. And I got robbed in high school. My friend was killed on the way home from school playing pool, like a lot of violence, right? And, and there was a change to that. The NYPD was putting cops on the corners of, of a lot of places. It did seen a lot of violence. They were really getting guns off the street, arresting folks. They... and Murder was going down and robberies. And I said, you know what? This is, the change in the city was palpable. And not just for wealthy white people, but even in the poorest neighborhoods of the city, I've said this story before, but one of my good friends in junior school was a kid named Damian Oliver. He lived in Flatbush, Brooklyn, which was predominantly black. I lived in Bensonhurst, which is predominantly white and our parents wouldn't let us visit each other on the weekends because they were justifiably afraid of what would happen in each other's neighborhoods because of racism and because of violence. And that was changing in New York in the nineties. And I had paid for college with the army scholarship. I was inclined to wear a uniform. I was inclined to do something sort of active. So I said, you know what, let me be a cop for a few years. It would be a really interesting way to give back to my city and to like see things I would never otherwise see. And I ended up doing it for, you know, all in 23 years.
Valerie Earnshaw:That's awesome. Yeah. That's an impressive go. Yeah. You know, you're collecting other degrees. Your CV is littered with degrees. The master's in public administration from Harvard got the criminal justice degree from John Jay. And I'm curious as to how this, this like perspective from philosophy and maybe some of the other graduate work that you had been doing at the time was, was that shaping like your, your view and your experience?
Dr. Brandon Del Pozo:Yeah. I mean, I got this, um, time will tell, but it's about the wisdom behind this, but I got a tattoo right before I became a cop it's on my arm. It's three Chinese characters and it's one[inaudible] in Mandarin, which means like path or way of the scholar warrior or the philosopher warrior. So I got it. I didn't like walk, I got it in San Fran. I didn't walk into some tattoo parlor and like look through the book. And like,"I want those tattoos!" I brought it with me.
Valerie Earnshaw:A warrior on the top page.
Dr. Brandon Del Pozo:Well, I'm sure they, I mean, there's all sorts of, you know, Chinese calligraphy in the tattoo books these days. But I was reading this philosophy book, Eastern philosophy back, it was not academically. I just bought it at the bookstore. And it was about this idea that to be a successful person and to live a worthwhile life, you had to have a balance between your love of art, your love of intellect, your love of philosophy, and then your ability to actually exist in the physical world. That was the warrior part. So they would have these noblemen in ancient China who would have these competitions where they would do debate and calligraphy and philosophy, but they'd also do horsemen, horseback riding and archery and swordsmanship. And so I thought that was a great balance. And you can kind of see that in my, my life, it gets a little, you know,"schizophrenic" at times, but I never lost track of my love of philosophy, but I thought it would be important as a cop to get an advanced degree in criminal justice policy to learn about evidence, how to incorporate evidence into policing, to learn what the trends in criminal justice were. Right. So I took my study design stuff. I went through this really, really old. I went to my old papers. I had to like design a grant at, at John Jay, and it was like, I had to call myself the principal investigator and say, what percent effort my work would be. It sent chills down my spine to realize I did that in like the late nineties and how now I'm like living that. But anyway, so that right plus, so that was very, very vocational in a certain way. Right. And then public administration at the Kennedy school was one step, less vocational. It was about the principles of public administration and public leadership. And then by the time I'd finished those degrees, my, my advisor, the man who helped me get my master's at John Jay was a philosopher and ethicist. And he's like, Brandon, you need to, you need to get your PhD in philosophy. Like that's, I said, it's going to take forever. He said, and I tested his patience. It took like, I think 12 years, but I ended up finally bringing it all back home to a doctorate in political philosophy.
Valerie Earnshaw:That's such a great story. So first when Carly and I were looking through your CV and your writing, you're a Renaissance man. And so that's really interesting this connection back to like, you know, the balance between all of these different components of self. So that's really cool to, or, you know, interesting to hear you talk about that and reflect the thing that we can see just by looking Through,
Dr. Brandon Del Pozo:you know, no, no, thanks. And it's interesting with phases in life, like, cause you can't always, for a while, I was able to successfully balance like my studies and some of the more intellectual things. And I think that's what helped me respond to the opioid crisis was the balance between like implementation and practice and like the underlying theory of what I was dealing with, like addiction, right? Addiction science, but then in life, right? You can't just always be constantly walking that line. And what I'm seeing now is that coming to grips with the transition between a person who I was a cop, I was a precinct commander. I worked in intelligence. I ran a police department. Now I'm doing research. And maybe there's just, not only is there this constant balance, but maybe there's also phases in your life, right? Where you transition from practice to theory or vice versa.
Valerie Earnshaw:One of the, one of my favorite, it's actually like a career development program and they talk, they give advice on, you know, this is mostly for academics on thinking of your career trajectory and they call your career a book with many chapters and they encourage you to think about, okay, so this is the chapter that I'm on. Now. Maybe I'm focused on this type of research. Maybe someday I want to engage in more community-based research, not it'll be the next year, or maybe I want to write books. That's a future chapter. So there, so I love that because I am someone who has like a million interests at any one time. This like book with many chapters is so useful to me because I can be like, okay, well in this chapter, no matter how short I'll have that to be, cause I have like a million other chapters I want to write, but you know, this is what I'm going to focus on and, and deep dive on and then, you know, I have other chapters to take on. So that, yeah, that's a really neat Idea.
Dr. Brandon Del Pozo:No, it's interesting. And sometimes I think you, you answer questions to your satisfaction and then you move on to the next question.
Valerie Earnshaw:Yeah. Yeah. That's true. Well, so this is so interesting that it was an advisor who looks at you and says"you're a PhD in there". So when you got that feedback or when that was reflected to you, were you like, oh, of course I'm a PhD or was that a surprising thing? I mean, how did that land for you?
Dr. Brandon Del Pozo:So John Kleinig, who was my advisor and I still keep in touch with them. And for the, we just co-authored something in the American journal of bioethics. And it was, it was a short paper on, um, decriminalization and the ethics of public health and policing. But, um, he spent his life flushing out the ethics of criminal justice and policing. And I think he saw that there was a lot of, of just honestly like crappy ethics out there. And he felt maybe like he was practicing in a fairly limited field. And he saw something in me. I don't know my thesis on, on the ethics of small gratuities and policing like won the award for best thesis in my year. And that was one of the things where he was like, listen, that's, you've got something here. Like let's, uh, pursue it. I wrote him recently and said, I didn't understand why you wanted me to get a PhD then. But I understand now that I have one and thank you for, like, waiting 12 years for me to sort all that out.
Valerie Earnshaw:Wow.
Dr. Brandon Del Pozo:Yeah.
Valerie Earnshaw:Well, when you look at your work, it's like so clear that the universe would be pushing you towards getting a PhD. I mean, this, the research that you're doing, which we'll get to, you know, in a few, but I mean the perspective of your advisor saying, you know, there's just, there's not a big playground here and we need more thinkers and we need more people can do this. I mean, not only do we need more people, but sometimes now as an advisor, when I look over our classroom, I'm like, you are,"you are a PhD in the making". I don't know if you know this, but it is like my duty to go and tell you, because either the way that people think about things or the way that they are thinking about for me, it's often, you know, like they're thinking about scientifically. I mean, there's just something about sometimes the student where you, where you can see it. So it's, it's, it's neat that he saw it, that he was like, come to this playground
Dr. Brandon Del Pozo:Yeah, no, a part of me, the part that was..."the improper motivation", which I had was like, it would be great to be a chief of police and have a PhD so that when I go to meetings with researchers, they have nothing to say, they can't lorde anything over me.
Valerie Earnshaw:would that have been worth it?
Dr. Brandon Del Pozo:No. I mean, sort of it would have been like,"Hmm", like, yeah, it would have been worth it for like a day just to like, get that out of my system. I remember her saying that to someone. Yeah. When the researchers come in and they're like, well, at least at least we have a PhD and I'm like, okay, I joined the club, but no, you could tell, I love taking ideas apart and seeing what's under the hood, I love getting to the foundation of things and seeing, seeing how concepts interrelate and I love when arguments come together to make a point, right? Whether it's scientifically, as I'm trending towards now or even just in the very basic sense. And he saw that and really encouraged me. And he said, it's also a meal ticket. And he didn't mean that in a bad way. He said, no matter how good your ideas are or how much you want to put forth a concept. Like if you have the PhD, it gets you entree to the spaces where you can do that. More like it gives you a platform and an entree, and that's just life. The best implementation researcher I found is, is it Laura? Damschroder have you studied her work? Um, she wrote the consolidated framework for implementation research. She was the first author. That's her all over the place with implementation research. She has a MS. But I think that's, uh, an exception, right? I think that when you want to get into the rooms where you're throwing ideas around, they want you to have the doctorate. So part of it was just that too.
Valerie Earnshaw:That's fair. You know, this is, uh, something I was wondering about when I was looking over your work. So with, um, because you straddled these two spaces of police and academia, one of the things I feel about academia is that it's one of the most hierarchical places I've ever been, but everyone's pretending there's no power difference. There's no hierarchy. You know, like we have promotion and tenure, real strong hierarchies there. You've got students versus faculty. Like, it's just, it's a lot of hierarchy, but everyone's just like, pretending that that does not exist. But, and then you have police where, and I, it looks to me like there's a lot of hierarchy there and I'm just curious, like, are both spaces, similarly higher hierarchical is policing more? like,
Dr. Brandon Del Pozo:That's so interesting. You asked that because it's true. And it's made me really attuned to the hierarchies in academia. I had somebody write a recommendation for me to get my postdoc. And they said, you're getting, this is what they said. And they're a fan. Right? They're writing a recommendation. But they said, you're getting an associate professor for the price of a post-doc. And now granted, like when we talked before the show about my Chronbach's alpha, you're like, no,"I don't know if you're getting.. I don't, I don't know if that's associate professor level", but the recommender was asserting, you know, something that I was bringing a lot of background and concepts. So in policing, right? Like the, the supervisors and the cops don't use the same lounge. They don't have the same locker room in the NYPD they don't have the same bathrooms in most cases. Everything is done in order of seniority for when you're something, when something crappy is going to happen, usually, the least senior person has to do it, you know, as a Sergeant and above in the NYPD like I had a driver and the guy or gal doing it, wasn't like... they were a subordinate, but when you're in the car with them for hours, you know, you have to have somebody, you truly respect and you get along as, as colleagues. And if you're doing police work, you're both two human beings that are doing it. But very hierarchical. Academia, I think it's a little more insidious because it's definitely there, but people are in denial that it exists, right?
Valerie Earnshaw:Yeah. Yeah. They're in denial or they see it and they don't wanna talk about it.
Dr. Brandon Del Pozo:Right. And just even the assistant postdoc assistant and associate professor distinction gets at me because my friend's like, oh, it doesn't make any difference. If you become an assistant professor, you'll be golden. And I'm like, no, the associate professors are still going to be like,"we're associate professors".
Valerie Earnshaw:Well, I just say, as like, As a woman in academia, transitioning from pre-tenure to tenure definitely has had a feeling, to it, to people. And when I talk to men and I say, you know, how does assistant to associate feel? And they're like,"oh, it's the same". I do not feel like it's the same. I feel much more empowered to speak up, to say things like, you know, there were moments before tinier where there were, you know, conversations that I felt like had a, had a maybe, a gendered lens or things that happened that I think probably wouldn't have gone that way if I wasn't like a junior woman, that now with tenure, I'd be like, oh, I would love to relive that.
Dr. Brandon Del Pozo:No, it's interesting because in relation-- not, not related to gender, but I have a friend who's a criminal justice professor and he's, um, I think he's full now, but he's definitely, well, he's definitely tenured, he's associate. And he throws firebombs online about criminal justice. If he, if he disagrees with you, he will tell you because he's like, your theory of policing is wrong, or you're failing to account for the fact that crime is simply up and this more violence, whatever. And he says it because he has tenure. He's like,"if I didn't have tenure, I wouldn't be talking to other professors this way". And to be really honest as a person at the lowest rung of the doctoral food chain as a postdoc, like, I'm very, very cautious about what I say online. Now. I agree with a lot of what's going on in the criticism of policing. It's true and it's overdue. Some of it though, I think has gone overboard, but I kind of bite my lip until I'm in a stronger position to talk back, to put a very fine point on it, about what, I mean, I have seen ecological studies that have made the craziest associations between policing and bad outcomes that I'm just like, that just defies everything. And the only reason you're saying it is because you have that one little throwaway at the end of your paper,"This is an ecological assumption, and this is an ecological study and be caution, causal inference". Right? They say that, but the headline is like,"POLICING DOES THIS TO EVERYONE". And I'm like, you can't...
Valerie Earnshaw:it's communication ethics.
Dr. Brandon Del Pozo:Right. I guess I'm like hedging, like just coming out and saying it. Like, this is one, like the paradigm study for me is this one that shows like one, two or three incidents of police killings in the metropolitan statistical area in one year is associated with an increase in unprotected sex in that NSA among people of color the next year. And I'm like, that is just a terrible study. Like, cause it's like a very low"n" it's like one, two or three police killings in an MSA metropolitan statistical area, one year. But they're also not looking at what the rate of unprotected sex was during the year of the killings, to see if it's gone up. They're comparing like this many police killings in this year, like associates with STIs with this transmission with... Hey, this, and this is the podcast that... Sex is in the title of his podcast. So I was wondering how we were going to work it in here. Her we are. So I was worried it would be false advertising, but it's not. So get the model, like it's almost like dilation, like a certain number. Like if there's a certain number of police in the statistical area in this year, let's say it's 2015. Then in 2016 that associates with, with greater rates of sexually transmitted infections. But not that they'd gone up just that like more corresponds to more across years in an ecological sense.
Valerie Earnshaw:right.
Dr. Brandon Del Pozo:I'm like, I want to tell the world that this should never, there is no need to ever replicate that study again,
Valerie Earnshaw:stop here.
Dr. Brandon Del Pozo:I'll say it here in the podcast. But there are limits to what I'd say academically, because who knows when that person is going to be like reviewing my paper. And my papers matter, right now.
Valerie Earnshaw:Yeah. Yeah, no, I mean, that's the thing, like your paper, your grants, your, and your materials. There's lots of ways in which, I was just about to say, there's lots of ways scientists can be like police each other, that can hold power. Which is interesting, but all right, well, so you're picking up this PhD in philosophy and, you know, partway through that, you mosey up to Burlington and you become the chief of police and that was 2015. And it really, you did. I mean, just speaking of like the Scholar Warrior Renaissance-man, you worked on a lot there, a lot of different initiatives, but sex, drugs and science would, I'd really like to focus in on, your work with the opioid crisis. So first I'm kind of curious what, what was going on in Burlington in 2015 in regards to the Opioid crisis.
Dr. Brandon Del Pozo:And I guess it was 20-, it was either the state of the state address in 2015. I believe not 2014, but I think 2015, which is before I got there, governor Shumlin, the governor of Vermont spent the entire state of the state address on the opioid crisis. And he made national news for doing that. Like it took a lot of courage for him to say,"people are dying. No one wants to talk about this. It's terrible, but I'm going to spend the entire State of the State talking about the opioid crisis" that really energized my mayor, Miro Weinberger who's um, left-leaning Democrat to say, listen-- And by the way, a left leaning Democrat in Burlington is like a troubling swing to the right. Like this is where Bernie Sanders lives, s ocialists c ontrol the city council at this point. So when the democratic mayor gets elected people, t hey're like having an existential crisis because it's a Democrat."How much further to the right can we get?"
Valerie Earnshaw:Uh Huh
Dr. Brandon Del Pozo:It's the type of place where like I arrested Ben of"Ben and Jerry's" like, yeah, yeah.
Valerie Earnshaw:For what I have to know?
Dr. Brandon Del Pozo:Well because the F-25,F-35? The F-35, you have 35 fighters. We're going to be based out of Burlington, replacing F 16 fighters that were already there, but they were noisier and Ben and Jerry's don't want fighters in Vermont. Fighters and ice cream don't mix. And so they put like huge speakers on the back of a truck and drove it around town deliberately like replicating, like jet engine noise and everybody's ear to like wake them up to the problem of the F-35's. But I got a call from his lawyer, like"Ben wants you to arrest them for violating the noise ordinance". It's like, well, he's definitely violating the noise ordinances.
Valerie Earnshaw:You're like,"Happily!"
Dr. Brandon Del Pozo:Yeah, no, no that, yeah, he's doing it. And so there is like, you know, I, so there, I was like, I remember I got the call, like archetypal Vermont. I get the call that this is going to happen, like on a, on a ski lift. And I'm like, okay, when I'm done skiing, I got to go arrest Ben Cohen. And I've said like,"my officer's made the arrest and I was on the scene." Cause he's not a nobody, like, it's going to make national news. And it did. But also Bill McKibben, who's another leading environmental activist. I've arrested bill McKibben too. So.
Valerie Earnshaw:He also call you and request an arrest?
Dr. Brandon Del Pozo:Yeah. And he was like,"listen, I'm going to--", um, he like shut down a gas station through civil disobedience. Like he, I forget how he did it, but he disabled all the pumps at a gas station and we arrested him for that. But so that's what Burlington is like, like Bernie Sanders lives there, the socialist control the city council, the mayor, who's a Democrat is a troubling swing to the right. And you spend your days when you're not addressing the opiate crisis, you're like arresting Ben and Jerry's anyway. So, but it's that type of place where people know each other, there's an intimacy. So it seemed like a good city to really try to do something. So it could really have an effect on the opioid crisis in a scalable way. Right. It wasn't so tiny that you couldn't scale things, but it wasn't so big that innovation would take years. It was right-sized for innovation. And that was one of the things that really appealed to me about going there
Carly Hill:Here in Delaware. We know a thing or two about that,
Dr. Brandon Del Pozo:Actually. Delaware's definitely one of those
Carly Hill:But like, so I know here, like we have, I think a lot of it for us is that we're this perfect storm of being like a port city we're right on the 95 corridor, right. Things, you know, we're in between all these major cities, like it's like an hour to Philly, maybe different things like that. So like, what is it about Burlington? Do you think that the opioid crisis like hit so hard there?
Dr. Brandon Del Pozo:Well, it hit hard throughout Vermont and it's not the overall volume, but the death rate was fairly high in sort of Vermont was at the mercy of the distribution hubs for opioids out of Boston and New York. It was like at the vortex of that. So if you literally, the green mountains run north, south up the spine of Vermont, the east side of Vermont was a supplied by the Boston syndicates. And the west side of Vermont was supplied by the syndicates out of New York. Um, and it was interesting. It just so interesting because fentanyl came to Boston before it came to New York, just because of the difference in the supply chain. And it was literally like Colombian dealers versus more African-American and their various supply chains. So you saw the death rate rising with fentanyl related deaths in the Eastern half of Vermont, especially the Southeastern part before you saw similar effects in, in the west. And it was just sort of-- and it's explainable by who was supplying whom and what they were getting back home.
Valerie Earnshaw:So fentanyl is a super strong opioid synthetic, and it's something like the amount of like a penny could kill a room of people.
Dr. Brandon Del Pozo:Yeah. You're thinking of putting the, you know, there's always, they put the penny next to the grains of fence and all that can kill you. But so morphine is the original analgesic that was taken out of opium in the early 18 hundreds. It's 50 to a 100 times more potent than morphine and morphine is what ends up if you follow the, this chain of pharmaceutical development, morphine ends up morphing into hydrocodone and oxycodone and, and those analgesic pills that fentanyl, you know, as an aside-- It's just one of those interesting things where like you have to reign me in as I, as I nerd out on the, on the pharmacology and the history of it, but like heroine's an agricultural product that comes from, from the poppy plant. Right. And so there's limits to the potency and it's the natural limits, right? Fentanyl is completely synthesized in factories. And so not only does it make so much more sense because it's so much more compact and easier to smuggle and, and more powerful, but it's also just when you switch from heroin to fentanyl all as a cartel, you're cutting out like the last two thirds of your supply chain. So you're not like waiting for poppy to be grown in Afghanistan and somehow make it to you. You're like in a factory right over the border, getting precursors from China, just making this stuff right there. And it's easier to smuggle that this soda can, for example of fentanyl can yield the same profit as, as a case of soda cans with the heroin. So to speak, if you're thinking about smuggling. So it was a perfect storm, it created the overdose crisis we have now
Valerie Earnshaw:Just hearing you talk about the deep dives and like, here's the geography here is the, here's the, like the chemistry of it, like, that's why you need Scholar Warriors to work on this, or, you know, you just, you need like all of these kinds of like combining expertise.
Dr. Brandon Del Pozo:It's a translation. Yeah. I think I just changed my Twitter bio to"Something is nothing without translation and implementation". Sort of like, that's the, now I have to go look it up. But anyway, yeah. Good point. I mean, you could glamorize it as a scholar warrior, or you could just take like a implementation science perspective and say, um, yeah,"successful implementation is based on accessible translation". That was my, uh, my alliteration on my Twitter bio.
Valerie Earnshaw:Like any implementation scientists who are listening to this now are all going to go out and claim scholar warrior.
Dr. Brandon Del Pozo:Yeah. Yeah. When I see it on a grant application, I'll believe you. Yeah, there you go.
Valerie Earnshaw:Okay. So you mentioned that Burlington's like this great Petri dish, almost trying different, different innovations. So what were some of the things that you tried out in Burlington?
Dr. Brandon Del Pozo:Well, you know, really quick, the first thing that to his credit, the mayor gave me license to do, is go look at the science. And so I remember in the first meeting, the state attorney general, the governor, me, the mayor, some folks from the hospital that were talking about Vivitrol naltrexone, which is like, and I just was like, oh, I have no idea what the heck that is. Now I, like, I dislike it for other reasons, scientific reasons. But at the time I had no idea what it even was. And I realized I had to go figure all that out. So I started talking to researchers at Hopkins and UPenn, and I learned about buprenorphine, Suboxone, and methadone, like what treats opioid use disorder. And I came back to the mayor and I said, there are these like super effective medicines that you could give to people that when they're on opioids, it's not going to just cure them overnight. They still could relapse. They're still dependent on them rather than addicted, but they don't die of overdose. They can get their families back, they can work jobs. And we just, we've got to do what the French did a decade and a half ago.They would just give it out to everyone who needs it and we'll solve this thing. And the mayor was like, that can't be true. That's just too easy.
Valerie Earnshaw:Never heard of these medications? Like he just,
Dr. Brandon Del Pozo:Well, he knew About methadone, of course. Right, right. But I mean,
Valerie Earnshaw:Bupenorphine and Suboxone,
Dr. Brandon Del Pozo:not so much buprenorphine and Suboxone, but he's like,"Brandon, if that was true, we wouldn't have an opioid crisis because we would just do the right thing and give out these medicines. So you've got to have the science wrong". So then I went back to the doctors and they were like,"no, it's actually true!". And then I realized that it wasn't the science, it was the systems, right. It was, it was the stigma about the medications. It was the stigma towards people who use drugs. It was the systemic disincentives to build up these systems that deliver these medicines. And so when you're asking me what I did in Burlington, like I made it this very-- only a cop can be this simple minded, like, just dump the buprenorphine out of helicopters, but not actually do that. But you use as many simple systems as possible.
Valerie Earnshaw:to get buprenorphine to people who need it.
Dr. Brandon Del Pozo:So we, I started holding these every four weeks meetings that I call community staff, but it was comstat. It was based on the NYP, these management principles. And it's four principles first is timely and accurate intelligence and information. So you gotta know what's going on out there. And you gotta know what the death rate is. Who's at risk, what's working. What's not just standard data collection. We hired an epidemiologist and all that, dissertation criminologists to be the data engine, the analytical engine, right? For the first pillar, the second pillar is effective tactics and strategies. So you go to the experts and see what would actually work to produce the end goal of fatal overdose reduction. We just said, if we can reduce fatal overdoses, we're going to have to do a lot of other things that are really positive, but let's just get to that end goal of fatal overdose reduction. What effective tactics and strategies do that, right? So we set it to be a low barrier to buprenorphine. Then rapid deployment of resources is the third I'm taking the implementation, speak out of it, but just find out what these effective tactics and strategies need in terms of resources and rapidly deploy them. Right? And then the fourth thing is relentless assessment and follow up. Is it working? Have you done what we said we'd do? And they wanted to take out in Burlington, like the word Relentless, like that's not a very Vermont word, like, like thorough or, or like meaningful or conscientious assessment. I was like, no, heroin is relentless. Like everybody in Vermont goes to these like summer camps to spend the summer on the lake. Heroin doesn't do that. It's still there. It's still getting into people... We've got to be relentless too. And so they relented and we had relentless assessment and followup. Those are the four principles. And then to belabor the point, what we ended up doing every, we make promises to each other at this meeting. And so to continue with the, with the heroin analogy. So if you heard of the book naked lunch by, by William Burroughs,
Valerie Earnshaw:I'll put it on the list.
Dr. Brandon Del Pozo:It's, William Burroughs was a contemporary of Jack Kerouac. He was a beat writer. He was a, um, a real lifelong person with opioid use disorder. He did a lot of heroin around the world and he wrote a book called naked lunch about his descent into addiction and his partial pull out of it. But naked lunch in the book, he says, the naked lunch is, is it's a classic of, of heroine literature, uh, naked lunches, where everybody at the table sees exactly what's at the end of everybody's else's fork. So I said our community and the spirit of William Burroughs and heroin addiction, our community step meetings need to be a naked lunch where the hospital addiction services provider, the police, the prosecutor, the defense attorneys, the, um, sober housing people, the all of them, we all see what's on the end of everybody else's fork. And we make promises to meet each other in implementing these interventions. And if not next month, we're going to, we're not going to be evasive about the fact that we're not meeting our obligations. So what we did over the course of a few years was we worked with local legislators to pass a comprehensive medication-assisted treatment in prison. Bill, our local Charmain legislator wrote the bill. We brought up the experts from Rhode Island who were doing it, got them to write legislation in Vermont. That would do it in Vermont. We got that passed. So every prisoner and every person in jail could get methadone, buprenorphine if they want, and naltroxene which no one really does, to fight addiction. We got low barrier buprenorphine out of the emergency department at the local hospital. We have one big hospital in town. You could walk into the ed for anything. They screened everybody for addiction, regardless of what you come in for appendicitis, you were getting screening for opioid use disorder. And if you screen positive, you will offer buprenorphine right then and there.
Valerie Earnshaw:Wow.
Dr. Brandon Del Pozo:Knocked it right into treatment, right there at the ED for anything you could come in with a broken arm and get a buprenorphine prescription. Then we got buprenorphine low barrier at the syringe exchange. So that's a place that people who use drugs feel comfortable going, and they trust the people there. They don't feel judged. And if they're ready to try buprenorphine, they're not going to be told you have to do it this way. You have to come in, you have to pee in a cup. You have to take counseling. Like here's the buprenorphine from the people you trust. And the woman who volunteered to do that was a physician who was an OBGYN who lost her, um, her son to overdose. And so she had a lot of emotional skin in the game and she volunteered to do that. We also eliminated the waiting list for medication assisted treatment, by working hard with the state and other providers to open a second hub, right outside of Burlington, to treat a lot of people who wanted the more traditional hub-and-spoke model of treatment. And then my police department, that's like a whole other podcast, but we were doing, we had, I hired an addiction social worker to run a program that vetted all of our police work for public health outcomes. She ran a bi-weekly meeting to look at who is at greatest risk of fatal overdose, not just from getting arrested or overdosing, but working with other providers to see who was cresting and their acute needs to channel them towards treatment. We had a policy that we refuse to arrest anybody for, um, prescribed buprenorphan. So if you've got buprenorphine off the street and you didn't get it from a doctor, you got it from your friend. I was glad you had it. We wanted you to know we were not going to arrest you for that. We were the first are my prosecutor and we're the first people in the country to do that. When you add it all up a long story, getting to be long, um, within 20-, over 2018 and 2019, there was a 50% reduction in fatal overdoses in our county. And it went up 20% everywhere else in Vermont.
Carly Hill:That's amazing.
Valerie Earnshaw:Yeah. That's pretty incredible.
Dr. Brandon Del Pozo:Thank you for listening to the whole workup to that.
Carly Hill:That's what... I think about it all the time. You know, we had a situation, I work, I do data collection out of the methadone clinic o r our local methadone clinic here. And, you know, we have a new intake days are Tuesdays and you just have to make it there on Tuesday, or you can't get, you know,"on the clinic", as they say, and I'll never forget this guy came in and they, it was Wednesday. He had just missed it. And he was withdrawing and he had made this commitment to try and get sober. And they were like, well, see you next week. And he was like,"that's not an option". That's not i t. And that's what he said. He said, you know,"what you're asking me to do is go out and get more and try and stay alive until next Tuesday. Is that really what you want me to do?" And they were like, our hands Are tied.
Dr. Brandon Del Pozo:There's no reason in the world..
Carly Hill:we can't help you. But how easy is it to walk into an ER and get an opioid, right? Like, and it's just like, I think about that so much. And it's, you know, that if the access to, you know, whatever the, the medication might be, whether it be, you know, the methadone, the Suboxone, like if that was easier to get than opioids, wouldn't that?... It's so fascinating.
Dr. Brandon Del Pozo:It's because it's not entirely treated as a medical condition. If you come in with the acute symptoms of diabetes, they don't say,"well, Wednesday is the induction into insulin day" with the insulin. Right? That's the-- it's so troubling. And so we were able to do that. The researchers hated what I did because I just did-- when I say"I", I mean, it was an effort, but I led the effort. Like we, I had plenty of great colleagues. We did seven interventions at once, basically. And so they were like,"well, that's not random"."You could have at least done a step wedge". I was like, what do you like?...
Valerie Earnshaw:What it was that they didn't like what you were doing because they couldn't figure out? So precisely what exactly worked.
Dr. Brandon Del Pozo:So I've, I have a paper under review called community stat and intervention to reduce opioid deaths in Burlington, 2018 to 2020. And it got rejected from a journal. Let's hit another one that says, like, it's just a great recounting of applying evidence to practice, but it's, there was no study. So what's the study. And my argument is like, no, this is an essay in implementation science. Like in my mind, I would stop. I would like, there's so much extramural research that I would just stop doing right now. Because we know the science, like we know that buprenorphine works really well. We know methadone works really well. We know that they work better than Vivitrol. We know that like low-barrier works. We know that opioids very-- the buprenorphine very rarely if ever shows up in the toxicology of people who die of opioid overdose, we don't want to stop the research completely, but we want to focus on implementation at this point. Right? So the, the whole other end of this is like the heal initiative, which is like this three year randomized implementation. And multi-sites across the US of opioid overdose interventions at like the national level. And the thing that's sort of a little tragic about that is that the sites getting the resources in that third year of the study, or like the third step in the wedge. They went two years without those resources, and people definitely died because of that.
Valerie Earnshaw:Yeah. Right. Yep. That's such a, I I'm really grateful that you're raising this. This is a really critically important tension. So some of these, like, you know, a step wedge design or these other designs, yeah. They would have asked you to hold off on an intervention strategy that you pretty much know, like it's going to save lives. Like connecting buprenorphine in ER, is going to save lives so that you can measure it. And I, and post, you know, people say, well,"if we don't study these different components separately, like we don't know which one's working, or we don't know like what dose of what intervention to roll out." But like, what you did is, uh, it's amazing, but it's, you can do that package of intervention, like that package of things in other places and observe how it's going. Like, you don't need to just be like, we only want to give buprenorphine out in ERs. We don't want to decriminalize... You know, like,...
Dr. Brandon Del Pozo:And part of the issue. And I think it's lost on experimental design is that like, part of it is creating an environment with so many changes that it re-norms things. And if you're only doing treatment in prison, but nowhere else, then there's this whole other space that people are in where the norm isn't access to buprenorphine or the norm isn't that it's okay to be on medication-assisted treatment. But if everywhere you look in the community, you're getting the same message, which is"when I go to the syringe exchange, it's okay for me to ask for"Bupe" and be on"bupe" When I go to the ED, they're willing to give it to me. When I go to the opioid treatment program, there's no waitlist, they'll give it to me any time. When I go to prison, God forbid I ended up getting the stuff. And then when I have it in my pocket without a prescription, the police don't arrest me. The sum, the whole is greater than the sum of the parts. And I think like incremental implementation to measure interventions, deprives you of this ability to try to really quickly like re-norm the whole essence of what you're doing
Valerie Earnshaw:This is so interesting. So I think a lot, especially with stigma interventions, there's, these, there's like this most design, and there's a near these other designs that can tease apart the different tools that we have or intervention tools that we have in this case to, like, deconstruct stigma. But in these other cases, you know, just to do anything and then yeah, you can see what works on, but that's such an interesting frame about, yeah, the whole being greater than the sum of its parts. And, you know, theoretically, you could test that with these designs, but when people are going to die,
Dr. Brandon Del Pozo:I feel strongly about that, I feel like I'm a lot more sympathetic to researchers as a person who needs to write proposals that like have rigorous experimental design. I'm not blaming them for that, but it is a problem with that. It does, if there's this disconnect between the action-oriented people and the researchers it's in this translation space, like it, it's unfortunate. And I think in nascent, like if you were developing the medications to deal with stimulant use disorder like methamphetamine, you would have to do a lot of really careful studies. We don't know anything about the medicines that work. We don't have any, like there's like decades of research behind agonist replacement between opioid replacement therapy. Like we don't have to be super cautious. And then I'll say, I'll nerd out a little bit. Like this is also what like synthetic controls and difference in difference. And propensity score matching is about like, is coming up with these quasi-experimental designs to allow public administrators to do these like multi-pronged interventions. And then, some super clever scientists figures out how to find another jurisdiction that didn't do it, but that otherwise matches and make that a synthetic control.
Valerie Earnshaw:I love that. So really come on now, scientists up your games. Yeah. Use Smarter designs to figure it out.
Dr. Brandon Del Pozo:Yeah, I'll say this, like, I was talking to a scientist, a social scientist about, I said,"how come this woman's?" I said, every time I go to this, woman's talk. All her, all she does is point prevalence. So all she does is like,"after n amount after c amount of time, this many people are taking the drug and this many dropped out". Like, that's it like, there's no... It's literally a bar chart at month six, right? that's it. I said,"how come she does that? And you were doing, and I'm going to like Monte Carlo, bootstrapping latent class analysis, like Cronbach's alpha principle component." And she says,"because she,... I am dealing with like big bodies of longitudinal data out there in the public of people living their lives. And she is spending months designing the perfect randomized controlled trial. If you perfectly randomize your trial and you design it perfectly at the end of the day, all you need point prevalence.""This many people are still doing it. And this many aren't", if you're dealing with the world, you need like all of this complicated math. So when I'm making an argument for is like... but yet that scientist, I just described with that, that point prevalence, like"this many people are still enrolled in treatment. And this many aren't" that's it that's all her math is like 12, 6.
Valerie Earnshaw:Yeah.
Dr. Brandon Del Pozo:Her stuff hasn't been implemented yet. But the other scientists dealing with the complicated stuff, or they're changing the warning labels on cigarettes, they're, they're allocating funding to certain types of programs. So the math begets results, but yeah, scientists like do your fancy math and out there in the world and let's meet up with public administration and get things done. Yeah.
Valerie Earnshaw:Well, Brandon, we've been chatting your ear off. There is one more thing I want to ask you about. Do we have time for one more question.
Dr. Brandon Del Pozo:Yeah. Yeah. We can talk longer and you can edit if, if I'm just going on and on about the boring science.
Valerie Earnshaw:No, none of this is boring. It's all gold. Before we even started this, I knew I was like, it could be like, stay up all night on zoom, like sleep over podcast with Carly and Brandon. But I just, I can't help myself and doing the research for this. I read more about your work on police discretion as critical point of intervention, which is something that I think you're heading more into with your research. So I want to first ask you, can you just talk about what that is? What is police discretion? Why is it an important point of intervention? And then I'm looking forward to clarifying what... I think I've had a miss- I've had like misinterpretation or misperception conversations about it.
Dr. Brandon Del Pozo:Everybody has seen or knows of The Wire, right? That the multi-season crime show that took place in Baltimore created by David Simon. One of these classics in crime TV, McNulty is the detective in there. And he says to another cop as they're, they roll up on the scene of these guys, drinking malt liquor on the corner of Baltimore. And they throw them off the wall and start giving him a hard time. And McNulty said,"why are you doing that to those guys?" Like, well, we got to give you tickets. He said, the beat cop is the last true, despite in...."The Beat Cop is the last true dictatorship in America". He goes,"we decide who we give tickets to. We decide who we arrest. If we want to drink our life away on the bridge, we can do that. If we want to arrest everybody in town, we can do that. But it's up to us, and no one tells us otherwise." And that's true. And not because police have been given too much power. Some might argue that they have, but because the laws are written in ways that explicitly, except for things like rape, murder, that the big felonies are things where we rightfully expect the police to take action and bring people to the judge and not make the decisions themselves. But when it comes to almost all the little things, misdemeanor drug possession, misdemeanor syringe possession, public urination, drinking a beer, jaywalking, every traffic violation, speeding, red lights, stop signs. We can go on and on, disorderly conduct. All those things are things that police have discretion as to whether they enforce or not. Whether they an arrest issue or a warning, or I hope bring people to treatment instead of jail. And we want it that way because we want police to use the power of the law to solve problems, not just to be like statute-violation-detection robots, right? These statutes are not statutes that like the world doesn't hinge on. And like you can drink in public new Orleans. And in India, you can urinate in the side where they literally have urns where you urinate in the public. And no one bats an eye. They're not like these deep moral things and the statutes exist not to enforce the moral code against urination or the moral code against running a stop sign. You know, it's about like fostering and enforcing social cooperation, stopping dangerous behavior from becoming more dangerous, and figuring out how to use the law to solve behavioral problems. And that's why we have the discretion. And the tragedy in policing is when it gets misused, when it gets applied desparately to certain races and classes, which it does, that's a tragedy. But the idea that the police can use their discretion, is not the tragedy. That's the hope. It's getting the discretion to be used properly. That will get us on the right track.
Valerie Earnshaw:This is exactly what I realized I was wrong about when I was reading your work, because we've had some discussions about this idea. And I have been like, okay, well, when there-- what we know from other fields has been, there is more discretion when there's more ambiguity in what people are supposed to do or how they're supposed to respond. The solution is often to engineer the situation to remove the discretion or the ambiguity in order to stamp out bias, because it's these places of discretion, ambiguity, that bias kind of rear its head. Right? And so in some of our conversations, I've been like, oh yeah, just, you know, like tighten up! Behavioral design the bias out. But this, you know, in hearing you talk about it and reading more of your writing about it, the discretion is not maybe the problem or, or there's good, or maybe there's a reason to keep the discretion, but you need to, you need to extract the bias from...
Dr. Brandon Del Pozo:Right. So there are right and left lanes to the law, like case law circumscribes discretion and sort of the way you were talking about like, you can't just like noise complaints in different places have different meanings, like there's case law that says like in-- uh pick new Orleans, like you can't say someone like playing a jazz saxophone on a corner of bourbon street is like violating the noise ordinance. Cause he was noisy. Like that will go nowhere. Right. And free speech, like profanity is an example of disorderly conduct that almost every court in America, local court says you cannot arrest somebody simply for yelling a curse word. Right. So we do because laws like that are used to, you know,"Hey, when that African-American guy says the F word, I'm going to put the cuffs on him." Like that's,"I'll teach him." Right. But yet when the kid is screaming on the football field in Greenwich, Connecticut about like a referee making a bad play, like, he doesn't go to jail, like that's all BS. Right. So, so there are, there is case law that circumscribes discretion. Um, there are community expectations and values that circumscribed discretion, and there are systems like you can have. I just said like it was ultimately always a cop's discretion whether to make a buprenorphine arrest or not. I just said,"I'm taking that away. You may not make one". Right. But we still want to have police officers who can use discretion to solve problems because I'd like to think that it's almost always going to be bringing someone to treatment, but there are times where a person probably needs to be brought to a judge instead. Right? Or just simply warned about even not bringing you to treatment. I'm just or arresting you. I'm just saying, don't do this again. I'm bringing you back to your mom. And so getting officers to make the right decisions that way by right? I mean, produce better health outcomes. Don't yield disparate, negative outcomes and adhere to the broad values of the community. Like that's where we need to go.
Valerie Earnshaw:Well, that sounds like a full career's worth of work right there. And we're so glad that we have this scholar warrior. I'm never going to let that go by the way.
Dr. Brandon Del Pozo:Yeah
Valerie Earnshaw:But no, I mean, one of the, one of the other piece of advice that I got recently, which I think is, you know, I thought of you like immediately was"you need to work on the problem that you are uniquely suited to fixing" like you're at the right place. You're the right person. You're at the right time. And what I think is just like so interesting about your career trajectory and this problem that you're now working on, you know, like bias police, this like this area of discretion and opioid use is, like, you're the right person at the right time with the right problem. And so I'm just, I'm super looking forward to seeing that,
Dr. Brandon Del Pozo:oh no. That's so listen, I'm willing to place off money for the rest of my career if I can just get a foothold, if I can get talking about the academic pecking order, if I could just get the assistant professor title before my name somewhere, Rather than...
Valerie Earnshaw:it's like a matter of seconds before it
Dr. Brandon Del Pozo:For the postdoc. No, that's, uh, that's so kind. And, and what I love about research too, and you and I have talked about this, is if you're meeting the specific aims of your funding, you get to do so many other interesting things as well. No, one's saying,"why are you doing that?" They're like,"is he or she publishing, are they meeting their aims? Are there studies coming out that you can be doing?" Like all this other interesting stuff and it's good. Whereas in policing they're like, why is the chief of police doing another like opioid intervention? Like, you know, so yeah, because it's a dirty secret. I've looked at a million specific aims by now. And, um, I have a theory that they, that they don't correspond to as much effort as you're claiming on your grant application.
Valerie Earnshaw:Well, it'll be really fun for you to get this grant that you're working on. And then you can come back and report to us about all of the amazing additional stuff that you did along the way.
Dr. Brandon Del Pozo:No, no, We'll see maybe... But you do have to be fairly-- you do have to be focused at least in your expertise, but also thank you for the encouragement, but y ou k now, we'll see how it goes.
Valerie Earnshaw:Well, thank you so much for joining us today, right. And we really appreciate your time.
Dr. Brandon Del Pozo:Thanks. That was great. I love being here.
Valerie Earnshaw:Thanks to the Stigma and Health Inequities lab at the University of Delaware for their help with the podcast, including Sarah Lopez, Molly Marine, James Wallace, and Ashley Roberts.
Carly Hill:Thanks to City Girl for the music. As always be sure to check us out on Instagram@sexdrugsscience, and stay up to date on new episodes by clicking subscribe.
Valerie Earnshaw:Thanks to all of you for listening.[inaudible][inaudible].