Harm Reduction in PR w/ Rafael Torruella PhD


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This may be due to the recent earthquakes that they've had Donna. Puerto Rico also. We're certainly wishing them the best With all that so His website is intercom videos. I N. T. E. R. C. A. M. B. I. O. S. P. R. DOT ORG into combos. Puerto Rico is the name of the corporation Dr Raphael Toyota. Oh you A is. The Executive Director of that of that organization and the organization is really just dedicated to harm reduction. Harm reduction being that PHILOSO- philosophy of meeting people where they are and helping them to Slowly and gradually escape from the death grip of drugs and Out Imagine any other vice right so I'll let Dr Tore you tell you more about him in his organization Unfortunately like I said I tried to get his bio tither other review the website at at this time and it seems to be down at the moment. However you know we're hoping that everything can get back up but I met Dr Tore you a at? They drug reform conference that I went to Saint Louis Missouri back in two thousand nineteen November two thousand nineteen we had a great conversation And we recorded awarded the episode live in Saint Louis in the hotel so there is a little bit of background noise but that does not stop the message from coming forth loud and clear. Dr Toyota is dedicated towards helping people where they are in meeting their social needs right and you meet their social needs Their the trauma of pain that they're going through and that and through the meeting those needs will be an avenue to get them off of any type of harmful and addictive of drugs and other behaviors. So that's what we got going on for today. This is a continuation of the series. We're doing about about JUST DRUG REFORM IF WE'RE GONNA GONNA meet community where we need to be. The community is going to be any better than We we need to meet them where they are. I think that that only makes sense in demanding the ending beating on our table and saying straighten up fly. Right get yourself together pull yourself over your bootstraps doesn't work all the time. And we I would question in many other experts questioning whether it even works at all. So that is the path the Duck Dettori and many other people Ayu listened to the episode with Dr King Turner. you know that this is a growing phenomenon. Harm reduction and trying to help people get off drugs and trying to help people become the best them that they can be in acquitting drugs. Cold Turkey may work for some people however It doesn't work for everyone so we we wanna meet people where they are and do the best. We can to help them to become the best that they can be so nothing me rambling on here is the interview with Dr Raphael Tore You of Intercom Combos. Puerto Rico we are at the international drug policy reform conference hosted by The drug policy alliance and catch a hunter and a have a special guest for today is names Roffe. Oh Tori way okay okay and You are with the Intercom Bells. Puerto Rico that's correct so tell us a little bit about what that organization is eh right so so I guess the first thing I say is thank. Thank you for your time and that feel very lucky to be back in my Country Bring Puerto Rico leading this amazing team of individuals that do harm reduction. That do what a likable say. Say they want to do that. We should do in society. But don't this team actually does and what what does that is. Just you know building respect with the drug using committee community building ties and building solidarity with people who use drugs actively listen to to them understand them and provide services based on evidence again being solidarity's no charity want to save the world when all WanNa save people who are dying on drugs. Of course we want to do that. But that's not the perspective perspective is there are a lot of people there that need help in our communities that have been forgotten by the government pushed aside by the government push aside by many forces in society by capitalism itself in a corner right an Puerto Rico. We're all you know win. I can tell you we've been devastated by many forces you know I would say I by colonialism. Second by okay bye race relations in party states. We don't even count right so we don't have to vote. Where do we go which is crazy in crazy relationship is? That's what it means. People are saying Johnny doesn't mean trump is our president who but we didn't vote. Oh for him. We don't have the right to vote. I mean just how can I let that sink in. We don't have the right to vote if you. US citizen moved to Puerto. Rico you lose your right to vote for is. It's not because we're both going to freeman as because you're Puerto Rican because if you move to the unincorporated territory of Puerto Rico you. Don't I have the right to vote and you have one representative to Congress. Right now is a woman. She doesn't have chicken only yell kick and scream but she has no votes. What's behind her? Nor can she vote on committees or in general right so if there's no power bro that that's that's what it boils down to end colonialism and beyond the racist classist Paul picks that rule over over the island because we are beholden to Congress period. We're under the plenary power congress. So that's a basic battle and then how does that trickle down to the reality. Or there's there's a lot of drug use. There's very a little services for drug use. Because we get blocked grants for Medicaid. We got a block grant. And then you use it. Not The exchange data data bomber. Set up you can enter into that system. We can't enter into permitted stuff moves different states. But it's not it's letting Americans agreements not in our work is working with drug users and providing them services then we provide advocacy and then we provide technical assistantship in Puerto Rico. The Caribbean and Latin America. Let me break that down services provider interchange. We go to people. If you need to arrange us we'll give you some interest dose ranges that you have that had been previously used giving us runs. I'll teach you how to shoot up correctly and you tell people how to shoot up correctly. That's crazy that's crazy but you know what if we don't do that. People are going to check wall and that's how HIV and hepatitis come into our communities. Oh do we help him get out of drugs. Yeah we do when they're good and ready as in and I don't want to be new meaning not everybody who says I want to leave drugs. Now is one hundred percent achievable. You need to prepare the person a little bit and more than anything. You need to prepare the system. Because it's not that easy we don't have access to care as in like I snap my fingers and I have somebody making this person up taking them to detox or taking them to a buprenorphine or Methadone program. I don't we don't have that. That's not available like that. There's no what we call treatment on demand so you need to. You need to be you need to make the linkage. We do that too of course meal. We have a team of three doing syringe exchange. We use pure worker so people who know intimately the problem of the drugs problem of using drugs that personal struggles community struggles that social struggles. Those are the ones that do it. I don't have to allow more people more equipped than me or any other so person that has studied people in the community need to take that on and we need to give those jobs to people in the community right that we're that we're beholden to we. We also provide along with that team a nurse case manager. We had another team that does substance users order From the beginning of Treatment Mental Health Counseling Drug Abuse Counseling and case management in order to get people who only suffer from. I'm from problematic drug use and a Corcoran disorders to have like a depression. Inciting any other Diagnosis of mental health and are homeless. We get them into permanent housing right so we got different projects in order to work with evidence and with compassion and with and from a human rights perspective to change positively the lives of these people who need help and again. And we're in solidarity we we we. We can only offer so much but we offer all that to somebody to better their lives and and that's our work and then we also advocate Kepala change because we need to educate people who are less educated. And I don't mean to community I mean. To policymakers are less least educated. The community knows until in many ways. The community knows that we shouldn't be arresting. People for small possessions of Marijuana. I mean community knows that all see makers don't get I don't want to get it right right. I don't want to change the laws so people don't have to arrest and that's what we need to change. It's important Jordan for drug user to change some behaviors and risk. And that's what we do but it's also important change the laws that are racist and don't work and are stacked against our own own communities right so we need to change that and then we're for changing battles and that's got to be incredibly difficult because as you mentioned there's no power right you have one representative a AH in because you're no voting power as far as we can vote into office so as far as the president of the Federal Right so oh that's got to be incredibly incredibly difficult so let me ask you this can can you change the laws strictly on the island so there's no war on drugs even though the war on drugs would the United States. Can you stop it as far as going on Puerto Rico but we can stop some things right. I mean we can if the federal off says you gotTa do X. Y.. Why and we have no power to change our loss ambien contradiction? Local Law cannot be in contradiction with federal. We need to follow follow federal law. That's where the power resides right but to answer your question. Yes we can change things in Puerto Rico to soften the blow of the one drug trade change in the war on drugs big and massive. It's not just about the loss. It's about markets it's about rebuilding communities. It's about now that we're creating cannabis markets letting people in that were incarcerated by the warned drugs because there were selling cannabis ver- so the Pie. Yes you were selling plan you go to jail and and and that's good. When when when it's low social economic Puerto Ricans doing it in the corner but when it's legalized for medical purposes services like we have in Puerto Rico then you get the White Puerto Rican with money coming in and the law that's ridden is taken people who have been caught the felony or around the drug world right till it straight up racist and are they keeping people out right so and those are difficult discussions because now you have a market the people who really need the money and need jobs to have small businesses? No about we'd know about cannabis can't build it because there were arrested right right when is bad. It's it's it's it's for poor communities when it's good as for more rich more white communities right in the problem Hum Dot can be fixed. Puerto Rico internal. That's our fight right. It's like well no. This is unjust. Even if we wrote it as Puerto Rican and Puerto Rico when we need to fix that We can change himself to. We can add harm reduction service programs so people say for for some people drug users bad and if it's if if that's not enough the worst would be walkout with HIV and hepatitis. C. Right So yeah there there are. Some things are under our control and that's our battle. That's why we're trying to change right as as part of a small nongovernmental organization how much power do we as an organization. Asian Community based organization have vis-a-vis. You know the Political Class Puerto Rico which is also not wanting and to change things for drug users because that many of them are deeply corrupt and like in the United States and Puerto Rican corruption has been in the news recently but it but it's still hard pool internal Puerto Rico. Talk about harm reduction. Let's turn our police officer so I'm not this whole world. It is really new to me. And I'm enjoying maxine. Join a learning about so harm reduction. What does that mean? It means that you're going to have a different look at drugs. I non non judgmental and second non criminalising right and it's understanding that not. Everyone who uses drugs has a problem. Would drug use the little addicts say correct. Correct harm reductionist China's focusing none necessarily on drug use itself but focusing on. What does that person need in order to make their quality of life and their or functionality? Better if you're not functioning in means that you're GonNa take the best of science and apply that not necessarily what you think about drugs. It would need to be done with with drug users. For example people think that tough love is the only thing a person who has problematic drug use needs but we know that a lot of tough love doesn't work actually make stuff worse worse it re traumatizes people that have been traumatized through their lives or for us in Puerto Rico by colonialism by lack of political power by lack of controlling our own future rights or its own type of messed up slavery. Right that we're living right right. So that has that that creeps into your being not having political power and be able to say where your community and your life is going going because the Fed simply simply think. It's it's not what they want right now. We're under Fiscal Oversight Board so we have seven people who are not elected by US controlling all of our finances all of our lives right and dictating policy and a lot of people turn into drug use. Were so harm reduction. Action is not judging that person helping that person be more in tune with society if they're not an helping them through when ten if they have coming from There's a lot of reasons why people turn to drugs. You have talked about cook. Colonialism the effects of that long last year the obviously my African American heritage of traumatize slavery Jim Crow. All that's our history but if that's true it's also so true. That problematic drug use also comes because of this situation is that we live in right now right which is again no control rule. You know having no access to adequate John's having no access to adequate schools not having access many times to to supermarkets you. You know for for a part of my life. I lived in in the South Bronx and I can tell you supermarkets the same thing as when you crossed over to Manhattan so it's a living conditions you're at. I'm not saying that if you had. If you don't have the right supermarket you can turn to drugs. I'm just saying I don't want to raise the living conditions that that we live in a lot of people turn to drugs because drugs work. What do I mean by that that they drugs many times? Cover things in life that we need to get covered like exciting like trauma so we turned to drugs for tons of reasons very personal reasons a very social reasons but what would actually help us get out of drugs is jobs is equality is talking about racism and dealing with racism. These many many times rugs are there to to heal wounds many times not positively. It's not the right answer but that's still reality. Value of why people use drugs to so when we talk about changing drug policies. Roseau talking about trying to build a more just world that if an African UNAMERICAN person gets caught with cocaine it's not way worse for them. That is a white person gets caught with cocaine. And you know I don't know about you. The heavens never seen a limo being stopped at certain you know what I'm saying. I could tell you what happens with right so so there's gain saying they're probably getting cooked up or whatever have you. It's privilege right so so when we talk about drugs we also talk about a more just world in many ways right so it's not this horrible living conditions that that people can overcome and then there's the other part as I mentioned before not all drug use is problematic drugs. We really need to understand for example what what's worse person smoking marijuana once or being calm and weight of the law. Aw Marijuana coming down on you and Puerto Rico's three years if you're caught if you're caught with a small amount of marijuana for personal use up to three years to detail beyond. It's not an effective way of policing or leaving for anybody right. But would you have a lot more chances. If you're poor and black than if you're rich and wait to get caught you know so when we talk about drug policies we talk about that so we thought about social the justice. We talk about you know. Harm reduction reducing the harm and not being judgmental and also changing those structures that make things stacked against some people and unfavorable to others. Yeah so yes. They're also culprits of wanting to end racism and wanting to end search. Look good thing is you gotta start somewhere right now. We're starting with drug users because you can see that the warned drug doesn't work. It doesn't work for any any of us because it's not working for anybody in Rico sound working for anybody in the United States except for those who are profiting from it right and that's what's wrong so their lofty goals but they're also have a very specific thing that we can do about it stop arresting drug users drug users that have problematic drug use do not belong along in jails and prisons deemed along. And if you have if you have a problem with drug use you belong in treatment center of your choosing what works for are you. That's where we should be investing money so our communities are more healed than just being continually pummeled by the warned drugs which we know is racist. Classes and doesn't work drugs are now more potent. Drugs are now more prevalent and anybody can get drugs drugs in Puerto Rico. Thirteen year old kid can walk up and get drugs or be selling the drugs right so the war on drugs is not working breath greg so we advocate for stuff like regulation of the markets. Marijuana people go you want to know precisely. Because I don't want kids to have access to marijuana and drugs I want to regulate the market so only people who are adults and and have like for medical marijuana have the permit and for recreational. Whoever's in adult that doesn't run counter to that system can actually access data responsible way right? 'cause then that's the way we begin Kintu Organiz and better form response. To what right now has no plan being truthful right now. We have no plan in Puerto. Rico ornelas dates to finished drug war. It's all about more policing more cops more cars. And that's part of the response but hasn't been working may types. You've talked to police officers officers and I'm like I don't know why I'm doing. We know I keep arresting kids with marijuana. It's worse for them to marijuana itself. What's worse the the effect of the marijuana which some joy and now it's medicinal so in many ways so people would actually say it's a good thing for probably not kids but arresting them? It's probably worth absolutely I can remember when one of my first experiences when I was on F. T. O.. That's training field training and I was a brand new officer and so during the process. You have to sit with another senior officer so another senior officers. is monitoring my reports seeing how I'm interacting with public and all that kind of stuff so my first arrest was a woman who was. She was probably in fifties or associated white woman and she was caught from stealing. I think it was a stop and shop local grocery store. She steals whatever she steals security catches when we get there and we had to lock her up. I'm talking to this lady eighty throat so bad for because she said she was hooked on Practices Nineteen Ninety five or so. She's hooked on crack and she in her reason for stealing feeling. Whatever she stole was so that she could get more? You know crack and I felt so bad for and it was. This was the first experience that I had with understanding outstanding the social implications of bright. So she she's stealing in order to satisfy this need but you know and then I look at also where where does the need come from. This need to write that. She masking the pain. As you talked about. Four does she go through through some type of traumatic event and I felt so bad for I had to go not what I do my job but obviously twenty years twenty plus years later. I thought at the time I see it today that this needs to stop. It needs to change. We need to divert doc so we need to make police officers not being the heart spot we can. I Say I think the police force can be guided to other issues. That need your attention. You're like in Puerto Rico. We need more police officers to focus on corruption. You know what I'm saying. Pretty sure leaders say that if you're going to say that you know and it's a different type of policing but whatever it says we're the resources go and who are resources directed to and for what the war on drugs directly to the poor black and brown communities release and as for social control because ain't fixing anything right so we need to find a fix to this right we. We need to find what works and science points a direction of how we can treat heroin users and there's a debate about how to implement before Ffynnon Methadone clinics and all that but we know Methadone work. If it's applied correctly you know and humanely and not not to be the you don't want warehousing I think people and all that you don't WanNa mess either but the medication does work. Six years of science is how to apply correct because it has the ability of getting people from that need. I need that many times pushes some people some people not everybody steals to steal and then get caught and have a run in and that's a crime and etc etc.. Methadone and Buprenorphine can help if they're used and provided correctly. Rachel so we know how to fix this but we also need resources right now. There's another I guess there's a few drugs like like Methadone. And what I understand it prickly wrong so some people who you are those who are going to for lack of better turn to lower classes and there's some socks or some other type of medication that more affluent people are are using and they get to use it at their homes in the in the. Yeah there's nothing on. And then there's people Norfolk and one has more research behind it than the other but not to say that. We shouldn't have both because I think we should method on has been more more traditionally us because it is has more evidence and it came into the market of providing treatment services earlier in states. We have about six years of of of of evidence. Ain't nothin works. Works for what it works for somebody to be in long-term medication that keeps you from meeting and to use heroin so you're literally can kick heroin by using Methadone and then the many people say well. Methadone is is addictive and yeah. It's you need the medication in order not to go back to heroin but necessarily the victim. It's your medication. A heart medication We don't say oh. You're addicted to heart medication. You need to stop heart medication. No heart medication is keeping you from dying if you have a cardiovascular disease we don't say you're oh you're you're addicted to insulin if you have problems with diabetes right but suddenly because of the stigma and discrimination say keeps you addicted. If it's Methadone right till some people are going to need medication. They go through some type of withdrawal if they've got off of them episode Nep but there's also been orpheum but a lot of people will only just medication for long periods of time and that's okay you know why because this medication keeps them focused on like and it gives them new possibilities to not wake up sick dope sick anything to go and get the same thing. We've seen I guess in some places Ah Methadone might be more for lower class and then buprenorphine for our class but at least in Puerto Rico we're have access to Methadone and buprenorphine. We now is coming more at to be more attractive now because as being applied in better ways they don't silo people so much you can have it within the privacy of your of your patient doctor relationship you know. I don't have to go to Methadone clinic every day. I can do me my medication and the the doctor can give it to you if he or she is trained and can give you up to a month so I don't have to go every day and be singled out and as as as as a drug user because I'm in this clinic and can't get jobs. Get Get thirty days. Medication can go home and take every morning or every night depending on what prescriptions and that can be an incredibly humiliating people. I had to go to this method could as police officer one of our extra duty assignments that we did for extra pay was the standby a Methadone clinic and he knows that because of the doctors whatever. Don't trust the to get the patient or the medication at one time. That's that's part of it and it's built around that has been built built around just take drug users out of regular care and put them into special clinics which had its time. It's also time to integrate services. I mean if if you go get services now that the talk is integration of services enough and it's also the integration of patience. I mean many drug users looks like you and I. They don't have to look like the quote unquote junkie a prototype and stigmatize. Look that we have in our brain. A lot of people use drugs and run into problematic drug use than you might never know 'cause they're ashamed to tell you and there's a lot of stigma and discrimination you do say you're a drug user and might not want to beat go be going to to Methadone clinic for the better ways and why built methadone. Thanks to begin with and that way we can build a system that you you have a you have problematic drug use. You can to regular doctor tell them I have this issue and the doctor should also be trained and knowledgeable or most of many of them are not most some of them are and that can do this right they can. They can actually provide medication. Interesting interesting. So talk about this Social social work so we want to talk with integration of services so somebody has a drug problem of diction whatever and we want to get them a job you want to fix fix the psychological problems the social aspects of life Prato. So this is all predicated. Aided in the there's no cure for this this is not like a wounded. Have you have in your arm and you know you you get it soda a little bit. And then you put the patch on and you'll be fine and heels. It's not like that. It's it's what we call it. Many times a chronic condition so it goes up it goes down in cycles and comes back right but you you're gonna live with it so you're not GonNa get here you just need to attend to it and working with it and how do you do that well you have a we call bio psychosocial psycho social model rather than shaming people telling them. They're not worth anything telling them died. You need to change your ways. That doesn't work that well. What actually we? We know by silence that works is bio psychosocial model which attends I hear biology biological needs that which I'm telling you Methadone Saddam Buprenorphine so you don't wake up wake up with withdrawal symptoms meeting that substance right talk to a medical doctor. They provide medicine for your condition. So you don't go back to the space you work and you need. You need some treatment. You need some pharmacological treatment. Nurses can also do this. Then the psycho. The psycho is the mental health piece when you take drugs and life is not just about medicines. We don't want to just rely on medicines. You also want to walk into a space where we can talk about frustrations I can Puerto Rico. A lot of people started taking drugs because of the hurricane. And what's happening right. So we want to talk about the trauma of going through hurricane that you didn't have power for three four five months and FEMA decided not to do anything and president trump comes in throwing paper towels do you know how damning that's shaming and that doesn't work for a lot of people that somebody there's no treatment you need space to deal with that and I I want you to. Even when you're taking drugs have alternatives to be. I WANNA I wanNA give you out of that problematic drugs so I can give you away out of having a a medication that helps you and I. I want to give you a space with with with the mental health person to talk about this and work through issues and also want to give. You've euless social which is a social worker case manager that can help you with reconnecting with your family Rican. Maybe entering into housing housing. You know having a plan about life and how you WanNa rebuild your life or maybe go back to school or maybe you know change change a little bit treatment and will work at as a group. The Bio psychosocial is an approach in order to help you with your drug use and this is well documented by science. And I'm saying I'm saying about hundred is that that works better than putting people in jail in prison. Could you imagine that all that stuff that you mentioned revolutionary but not nine so it works so much better than the people in cages but we we need to talk through it because a lot of people say well. If you don't put people in cages than what are we gonNA do right this is gonNA fall. People are robbing stealing the streets and people are going to stop selling steel stealing feeling in the street. Because it's not that I'm okay with all drug use but I think the problem of drug use in the states in Puerto Rico. It's bigger than and just putting people in agents that's what I'm saying. It's not that revolutionary but it feels that way because we've been fed this idea of drug users or just bad people people and they're not bad people there good and bad people in very difficult circumstances that should feel more real and those circumstances have ways of getting you better not worse putting people in cages worse giving people adequate human rights based health services is better. That's that's where we advocate for science base evidence base humane health services and other types of services services. That is not a far cry from what we're asking in communities in general that's not a far cry for what G Q communities are asking. That's on a far cry void AH Puerto Ricans in poor communities are asking right to why can't drug users are part of our community. We might not like it but there are part of a community is their cousins daughters brothers. There'd be we know they're not as far away person nine could be. It could be your uncle could be your parent and right Ayton. Think about the orbit of people right so you arrest on one in the orbital around them that their loved one is now in jail in prison uh-huh for petty crimes and didn't work and that didn't work and now the children are traumatize. People gotTa Stop Take Time to work traveled to go business plan and all that even they leave you have a rap sheet can get a job and you're back in and then we talk about recidivism. Imprisons Oh yeah because not only would not get jobs ops now you have eruption. You can't even get a job at McDonalds. What are we doing right so so? That's what I mean by people who use drugs And commit many times without about a nonviolent cramps. I guess it's some type of language but people who use drugs that are in need of those drugs drugs and that is the cause of why they're there. They're getting involved in different types of crime. They shouldn't go to jail. They should be addressed with humanity humanity and the best of health and the best of assistance. Not Everybody needs medication. A lot of people just need to connect. That's what an also answering would harm-reduction is connecting at a human level to know. What do you need to be better? Better could be famous and functionality. Better quality of life. What do you need? Why are you in such disarray? Why can you stop using crack and cow? Can we honestly and from a humble place not like I want to get you out and rescue when being solitary Ladera. How can how may we help? Were tell me what can we do. A lot of people are pissed off and they turned to crap let people it just pissed off and turned into the needle. Then you just need to connect. They might or might not have an diagnosis but we can work with. I'm saying that that's a better view more humane. He'll be better for US individually assess communities and US as society as we address other bigger lofty goals and putting people in occasions. That's that's all it is and and creating a more just world and again we can talk and lofty things and in poverty and racism. Because we're in that line it's not like Oh if you don't put my people in your cages that I'm good I'm all back. No I'll keep fighting because this is also also fight against racism classism right now. It's about that we're just focusing on these individuals because it's very clear that many of these people are poor poor and black and brown communities and that's our fight so we kind of jump right into the conversation so tell us a little bit about your soft. Where's your Steve Fromm where you grow up? Where'd you grow up? I'm born and raised in Puerto Rico but I was I. I was lucky that I was A. I've been able to study in different places in the United States. I studied places. I did Florida for a few years. I went to Indiana Indiana not too far from here and kind of way for a couple of years and then I did my peachy and social psychologists social psychologist gone just by training in New York City And then I did my post doctoral studies in drug use and public health Specifically in the Puerto Rican population both on the island and off the island so New York And Taoist by National Institute of Drug Abuse. And those are my studies and now I'm just privileged to have not only worked in the United States and a lot of harm reduction polices or a few harm reduction places in New York but now there's an argument. I lead this Beautif organization with amazing people that are doing that. Work in where we're from right and Puerto Rico where specifically located in which is a northeastern corner and would provide services to over ten municipalities all all around the the northeastern sector for seventy municipalities. Who provide services to about twelve and services? Means that you know being out there in our reach and difficult locations in different spots Reaching out to what some people call hard to reach populations that The language in forest is not hard to reach. Because you know there are folk now. That's that's that's that's where we are beholden to and that's what we've worked with all the time and and that's who we WANNA make sure that their lives are better do you have. What do you have anything coming out? There you're right any books literature. A website tell us how we can. We have a website. It's called P. R. Dot org become use PR dot org. And and there you can find actually one report that actually talks about how drug users drug users civil and human rights are being violated basically every day in Puerto Rico And that's one report that we're really proud of and it's part of a report around Latin America Caribbean That was published a few years back And we're always fighting for more better services and just mostly focused on changing Jane drug law center new projects coming up more and better services hopefully in the next year or so. We're going to start a new project. See how we can provide comprehensive drug user health to people in the community so we don't I wanNA wait for people to come to us but us go to them and say again basically. What do you got a medical doctor here? I got a case manager. I got multiple services right here in the community for you because many times. What were we fail as we build? These places will not import essays. This places that many times is it not open door to our communities. You know beautiful. Amazing Hospital can can be useful amazing but if if if the community entity doesn't trust that beautiful hospital over useless for us right it can do amazing research You Know Baltimore suffers from this right in their amazing researchers and all that but sometimes relationship with these amazing blazers are not that great with some communities right and the drug using community. is really got to know what you're doing so you don't read to recreate that stigma and discrimination and just to get services. The shame of it caused people to use more in your opinion highly more. They're going dark corners in all kinds of stuff seeking hope which is why you have to go to them and the policing of drug users and the laws that meantime police officers need to follow our loss. That shouldn't be there because if you are looking for people who are using drugs. I wonder those people who are using drugs. UNDERDO GONNA hide and the representation of people who are using drugs is by large negative. So you're telling person who uses drugs you're bad you're dirty clean your dirty. Nobody's dirty. Take shower this morning and clean. Do you have the resources assist. Take a shower this morning. It gives you a homeless. Let me help you let me not put you in jail. You know what I'm saying so it's not persecuting. People who ooh might have an illness right is being more humane than yes if if you believe people and look for people who are using drugs assumes people are going to hide hide. They're going to be hiding places where you can't get them. Which means many times they hide behind garbage like this was this woman told us once this amazing thing that I hadn't thought about it? But she put in a very blunt way she she used to be a sex worker and and then she just got so heavy on her drug use. I one time. She just smelled really bad to her. It's like what what what do you ne- need let me help you. We have showers and she kept turning me down. That's fine. He doesn't have to do what I say you know. It's not about that but you know I every time I just said you know we still have that shower there. Whatever you need and she just said you know what I don't want to show like what's up says because if I do people start raping me you see what I'm saying? So she was using tat dirt in order to safeguard her body in herself. That Mike and Mike in my in my my the the hair the hair on my arms standing up right now right. 'cause heavy you know people living in and those conditions are to be safe. I can identify with that. I smell I smelled marry a prostitute when we arrest them when we we hope harass them for lack of a better term right off the corner move move around and so we are really close and we would we as officers and until secret here with joke about local. Who's sleeping with his? WHO's getting letting them in the cart and so that's very telling as to why they were intentionally some cases it's okay as exactly what I want to oversell anyway? This woman says wow. That's that's the that somebody needs to be dirty to be safe. Or what are we doing to these people career as a society. I'm not saying you're aware about. We are bad in certain ways because we're not fixing that's a human being they shouldn't be in that position Taking care of brothers and sisters so they are not in that position. What happened when the we leave them behind? When was it okay to be just dirty the streets and us not doing about it and then worse at our own community sometimes turn against ourselves that way because that's our community like it or not? That's who we are. I think that's a defense mechanism. Of course to say. These people have made their choices decisions and they will have to have the choices to really make about that. That's poverty are is poverty on our choice tweet when we really careful with that. You know what I'm saying because I'm pretty sure there. There are some Republican Puerto Ricans in some High Republicans now high on trump black folks say when you're choosing that it's not enough home choosing it. Nobody chooses to be poor and dirty. And then you might y y you know that's and those are the hard discussions you know. Why why is the system so stacked up against black and Brown? It's racism let's call it for what it is and racism and lack of jobs and a lease in Puerto Rico and can talk about their dismantling University of Puerto Rico one. They're making really expensive. They're they're closing schools out in most communities around Puerto Rico. You know we're going through austerity measures and people. We're getting taxed double like very highly as their fiscal oversight. Board is trying to make the minimum wage for the youth. Four twenty five five. That's what happening. And that's not right there condemning us to more for circumstances and then we need to leap Puerto Rico. That's what you're seeing more. Oh and bigger Puerto Rican communities in Orlando and Philly. Because they're kicking us out of our own island Subic through your ties. It in it could make whatever they want with. We're having no voice on it. That's not easy right choose. I didn't choose that I know I can't go. I know I didn't vote for the fiscal oversight site board and I know drug users getting worse as the economy gets worse excellent point you got to put those dots together right and then so what's a role of police officers right and police officers are in a real pinch because you've gotta follow law but if you've got some type of consciousness you know that that's wrong that's not an easy spot but it's you know it needs to be resolved so we need to get people into community treatment before they get to drug court stem anytime so work. That's the elephant in the room that we're not gonNA work tons of money. Oh that some people graduate and do well. Yeah but for the amount of money that's being put into it compared to community treatment that we know works better and it sounds so coercive. What does a judge know about about drugs? Anyway I think I got people in my crew that no more about drugs and treatment and services then a judge I wanNA talk down on judge but judge knows about law we know about drugs right. It's very complex. Complex on won't take your time. Dr Michael Store here is certainly appreciate your time. Thank you so just talk so I want to thank Dr Tore You for being on the podcast. Thank you so much very enlightening very informative and I hope that you all learn something as well. Listen ladies this gentleman you know being on drugs and being hooked on drugs. If you've never been enough place do not look down your nose. People who have suffered and struggled August with this type of disease or or problem You know there's are systems out there that can help you so point them in the right direction. Call your local NA. I talked to someone and do what you have to do in order to help them. If you you yourself are struggling with drugs or you don't WanNa do this anymore then You know reach out for help to your local. A conic synonymous or two organizations like Intikhab IOS In realized that There is help out there for you and for your loved one. So That's ladies and gentlemen. Please make sure that you rate subscribe in share. Thank you once again to Dr Toyota And I hope that everything is okay down in Puerto Rico and I hope that You know the help gets there soon in the good qualified. How we don't need anyone going down near throwing paper towels and anyone anymore? So That's ladies and gentlemen much love and peace.

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