Fentanyl Is in Everything

Around 2013, fentanyl started percolating in the United States street opioid supply, which was heroin-based at that time. Over the next few years it steadily pushed heroin out of the East Coast, and once the COVID-19 pandemic hit it rapidly did the same on the West Coast. As crackdowns have pushed the drug supply to evolve more quickly and chaotically, fentanyl has gradually begun showing up with non-opioid drugs.

Media and law enforcement, however, tend to describe it as an additive that predatory distributors mix into whatever they’re distributing—cocaine, meth, heroin, marijuana, vapes, pills that look like pharmaceuticals.

Fentanyl sometimes ends up in meth and cocaine supplies, probably not intentionally. This varies a lot by region and isn’t as common as most local news stories would have you believe, but is important to be aware of.

A pressed pill sold as Percocet or Oxycodone might not contain fentanyl, but you should assume that it does, if you don’t have the means to check. Same goes for anything sold as Xanax. A pressed pill sold as Adderall could conceivably contain fentanyl, but that would make it a pretty significant anomaly; what you should assume that it contains is meth.

We tend to fixate on whether something does or does not contain fentanyl, but that binary distinction isn’t what determines the risk. Someone opioid-naive who buys a fentanyl pressed pill that they believe to be real Percocet will still be okay if the amount of fentanyl in the pill is small enough. Conversely, someone who smokes what they know to be fentanyl pills off foil every day will be overdosing within minutes if they get one with more fentanyl than they were expecting.

Has fentanyl been found in marijuana? It has not. Periodically there are news stories or other vaguely credible-sounding claims to this effect, but none of them ever stand up to scrutiny. The one that got arguably the most traction was a 2021 statement from Connecticut health officials, announcing “the first lab confirmed case of marijuana with fentanyl in Connecticut and possibly the first confirmed case in the United States” and citing 39 incidents “where only marijuana use was reported but naloxone was required.” Later it turned out that this boiled down to a single case of minor, accidental cross-contamination among people who also used opioids.

You can immediately write off any claims of fentanyl being smoked with marijuana, or smoked with anything else using a combustion process rather than a vaping process. Fentanyl can’t be smoked with an open flame; it gets burned and rendered inactive.

A very small number of vapes appear to have tested positive for fentanyl. For one thing, this would probably happen with literally any physical object that school boards across the country started continuously testing for fentanyl. But the important takeaway is that the more credible claims involve vapes that had clearly been modified intentionally for personal use, not vapes that had been designed that way and marketed to children. You can still pick out any news story that describes a middle- or high-school student nearly dying from using a “fentanyl-laced vape”—even the stories circulated by elected representatives—and reliably find that it has either since been debunked or does not mention any actual laboratory confirmation of fentanyl, despite whatever the headline said. Usually the source for the claim is the student or their mom.

Higher-Potency Opioids Need Extra Doses of Naloxone

Naloxone works by binding to your mu receptors—the specific protein molecules that opioids also bind to—and kicking off whatever opioids might already be there. The clinical dose of naloxone, 0.4 mg/mL, is what’s usually sufficient to reach about 50 percent of your mu receptors, or enough to reverse an overdose. That’s why 0.4 mg/mL is the dose contained in a vial of generic intramuscular naloxone.

A Narcan nasal spray contains a 4-mg dose of naloxone. Intranasal administration can’t be directly compared to intramuscular, but it’s the less efficient of the two and so Narcan is designed to deliver more than the clinical dose. A 4-mg Narcan was more than enough for most heroin overdoses, is still more than enough for most fentanyl overdoses, and is also still more than enough for most overdoses involving fentanyl analogs, nitazenes, orphines and whatever novel synthetic opioids are found in the supply next. Naloxone’s effectiveness doesn’t change based on the opioid’s potency, since it acts on the mu receptors rather than on the opioids themselves.

When cops or well-meaning bystanders share stories about someone needing five doses of Narcan to wake up, and how this just shows how much more potent the supply is these days and how naloxone doesn’t cut it anymore, this almost always comes from the same mistaken assumptions about overdose reversal.

Naloxone takes two or three minutes to kick in, which is why it’s important to administer rescue breathing while you wait. But because the two minutes that you’re supposed to wait before administering a second dose can understandably feel like an eternity, especially to anyone not experienced in these situations, the temptation is often to pump in a second dose pretty quickly. Or a third dose, or fourth, or fifth, and so on until the person wakes up. When someone wakes up after a fifth Narcan, what you’re really seeing is the first dose kick in. All the extra naloxone did nothing to help, and for people with a physical tolerance to opioids it can precipitate withdrawal and put them at increased risk of overdosing again. At a proper dose, reversing an overdose with naloxone doesn’t require waking the person up at all.

In 2021, the 8-mg Kloxxado nasal sprays hit the market and marked the beginning of the naloxone arms race. In the five years since then, the Food and Drug Administration has approved a 5-mg intramuscular autoinjector—meaning it delivers about 12.5 more naloxone than the clinical dose—a 10-mg nasal spray that launched earlier in 2026. It’s also moved beyond naloxone to a different, longer-acting opioid antagonist, nalmefene. The first nalmefene nasal spray, Opvee, has already been followed by a nalmefene auto-injector. And government contracts investing in nalmefene as a preventative measure for fentanyl nuclear war. And biased research inventing meaningless metrics that are supposed to justify any of this as necessary.

Naltrexone Is Safe and Effective

Technically, the US has three approved medications for opioid use disorder (MOUD). In reality, we have two MOUD that are shown to be safe and effective, and we have naltrexone. Methadone and buprenorphine (Suboxone) decrease overdose risk. Naltrexone’s labeling is required to carry a warning that it increases fatal overdose risk.

Naltrexone is commonly known by brand name Vivitrol, the injectable formulation touted in county jails and other correctional settings. While methadone and buprenorphine are opioid agonists, naltrexone is an opioid antagonist—like naloxone and nalmefene. It purports to work by blocking the effect of opioids, so that even if a patient tries to use opioids they won’t feel anything.

What this effectively does is reduce tolerance, which is why the FDA labeling has to warn that deaths have been documented “at the end of a dosing interval, after missing a scheduled dose, or after discontinuing treatment.” The warning about risk of fatal overdose from “[a]ttempts to overcome blockade” is similar to the warning carried by the two approved nalmefene products, Opvee and Zurnai.

Unlike methadone and buprenorphine, naltrexone requires detoxing prior to initiating the medication—going into withdrawal for at least a week, maybe two. That alone makes it a non-starter for a substantial portion of people at risk. A recurring theme with research supporting naltrexone’s efficacy is that it doesn’t count the people who tried to start the medication and weren’t able to get through the detox process, preferring to factor in only the cases where people did manage to onboard. Or it uses the framing that once detox is out of the way, “naltrexone is about as effective as buprenorphine,” which still isn’t true.

People stabilize on methadone and buprenorphine because those MOUD help manage cravings and withdrawal symptoms. But studies tracking naltrexone outcomes never show anything long-term. Conclusions that it reduces cravings come from short-term data, and any evidence of its efficacy is based on negative urine drug screens after a few weeks or at most a few months. This research is never concerned with what happens after that. The idea of naltrexone remains popular because it fits an abstinence mentality, it’s punitive and it’s an easy out for corrections departments. Not because it’s helpful.

Syringe Litter

As popular as it is to demonize syringe service programs (SSP), the arguments against them don’t see too much innovation. There’s the complaint that SSP increase “crime,” which is not true. There’s the complaint that they increase drug use, which is not true. The most substantive complaint is that they increase “syringe litter.” This is also not true.

Neighborhoods that open SSP are overwhelmingly associated with a decrease in publicly discarded syringes, for a few different reasons. They’re often more convenient than sharps-disposal bins in parks, which require people to make a separate trip just to have fewer syringes than before. They provide portable sharps containers that are small enough for people to carry around, and larger ones people can keep at home. And they employ peer workers who do daily walkabouts picking up any syringes they see on sidewalks or other public areas.

At the heart of the syringe litter myth is the suggestion that children are at risk of contracting HIV from stepping on a needle while playing at the park. This is an easy one to debunk: It has never happened. There has never been a single documented case of anyone, child or adult, contracting HIV from a publicly discarded needle. It’s just another myth.

The human immunodeficiency virus is very fragile and relies on our immune cells to survive. Once outside the body, exposed to air, it dries up and dies almost immediately. This is why the only confirmed HIV needlestick transmissions have all involved health care workers in hospital settings, and even then they’re extremely rare. For the public, transmission risk is limited to situations involving blood, semen, vaginal or rectal fluids, or breastmilk delivered directly to a mucous membrane or into the bloodstream.

The hepatitis C virus can actually live for several weeks outside the human body, but globally there have been maybe three documented cases of hep C transmission from accidental needlesticks in community settings; none in the US nor involving children. Hep C can be easily and painlessly cured with oral medication, and doesn’t begin to damage the body for years or even decades.

As often as the media runs stories about syringe litter, you might notice that the accompanying photos often show a syringe with the front and back cap still on, sterile as the day it was born, thoughtfully arranged in the middle of a ditch. I was going to make a joke about how eventually they’ll show one of those individually packaged 27-gauge 1 cc syringes still in its individual package, but this has already happened.

Secondhand Overdose From Drugs in Prison Mail

After that viral video with the San Diego County Sheriff’s Department deputy in 2021, the online harm reduction community got the rare satisfaction of rallying around a talking point—you cannot overdose from touching fentanyl—and seeing the media actually take notice. A lot of news stories will now add some kind of disclaimer when referencing passive exposure, though this remains pretty hit or miss. You can’t overdose from skin contact. You can’t overdose from breathing in fentanyl molecules floating around in the air; fentanyl has a very low vapor pressure and barely releases any molecules into the air anyway. You can’t overdose from any other kind of passive exposure. The public is now moderately more aware that there is no such thing as secondhand fentanyl overdose. However, like everything else in harm reduction, this development has not made it into the prison system.

US prisons and jails have a completely different drug supply than the free world. There is fentanyl, but the mainstays are generally synthetic cannabinoids (K2; Spice) meth, Suboxone, tobacco and strips, a catch-all term for the ubiquitous strips of paper soaked with what could be anything, but is often synthetic cannabinoids or household solvents like insecticide. In recent years, many facilities have seen synthetic cannabinoids and/or strips replace meth or other contraband similarly to the way fentanyl replaced heroin in the outside drug supply.

Countless press releases and Facebook announcements have described how corrections officers required Narcan (multiple doses!) and were hospitalized following exposure to dangerous synthetic cannabinoids and other drugs concealed in incoming mail. This does not mean the officers were harmed. It does not mean the officers were ever in harm’s way. It does not even necessarily mean the officers were exposed to any drugs. It means that officers gave themselves Narcan and took themselves to the hospital. Synthetic cannabinoids are not opioids and are not affected by Narcan, but the whole situation is so far beyond logic that we don’t have time to stop for this.

The only one of these incidents that’s ever cited actual harm was in 2024 at USP Atwater, when mailroom supervisor Marc Fischer reported feeling ill and then died at a hospital about two hours later. Initially the cause of death was undetermined, pending toxicology, which gave media outlets across the country an opening to run headlines about “possible fentanyl exposure.” The Merced County Sheriff’s Office did not respond to Filter’s February 2025 coroner records request, which is fine because a week later documents filed in US District Court for the Eastern District of California revealed that the cause of death was a heart attack. Neither the AP nor the Los Angeles Times nor any other media outlet that ran a “possible fentanyl exposure” headline ever published anything further. The Bureau of Prisons, Correctional Peace Officers Foundation and various other agencies continue to honor Fischer’s memory by not acknowledging the autopsy, and praising his sacrifice in the line of duty while handling synthetic drug-soaked mail.

There is no evidence to suggest that secondhand exposure to synthetic opioids or cannabinoids poses any kind of risk. Many corrections officers know this, since they’re the ones bringing in most contraband drugs anyway. But they continue to bravely share their stories, and Occupational Safety and Health Administration investigations conclude that mailroom staff need head-to-toe personal protective equipment and HEPA-filtered biosafety cabinets, and federal corrections officers unions use those findings to call for the expansion of digitized mail-scanning.

And that’s what all of this is really about: understaffing and the nationwide push to privatize prison mail services, and cut incarcerated people off from receiving physical letters. Along with in-person visitation, and book donations, and any other “privilege” whose physical form can be replaced with a digital service conveniently offered by a handful of for-profit contractors. More than three out of four people incarcerated in US prisons no longer have access to physical mail.

At this moment, somewhere in the US another corrections department is drafting another press release breathlessly recounting how over the weekend one or more officers were hospitalized following exposure to deadly synthetic drugs, and pleading for Congress to recognize that no one should have to risk their life just to do their job of opening other people’s mail. Media and legislators will circulate it with no scrutiny whatsoever. To date, there are no confirmed reports of any corrections officers ever having been harmed by exposure to drugs in the mail.

Meth Overdose Crisis

Opioid overdose is potentially fatal because opioid molecules can bind to the brainstem receptors that regulate breathing; the mechanism of death is respiratory depression. Meth, like synthetic cannabinoids and various other stimulants like cocaine, doesn’t have any particular mechanism of death that accompanies overdose in the same way.

Stimulant overdose, or overamps as they’re sometimes called, don’t necessarily produce stereotypical symptoms like paranoia or hyperactivity. Often they make people fall asleep. Occasionally they might cause seizures. But then they resolve, and that’s that. The harms tend to come from exposure to law enforcement, rather than the physical ordeal itself.

Meth-involved overdose deaths in the US began rising more noticeably around 2019, peaking in late 2023 before starting to gradually drop back down; the same trajectory as fentanyl-involved deaths, but less drastic. It’s clear that more people are using meth compared to a decade ago, which means more people have meth in their system at the time that they die. But it’s not quite clear that meth is what’s causing them all to die, at least not on the scale being suggested by the media.

US death investigations are a mess. Depending on the state, they might be carried out by medical examiners, elected county coroners or local law enforcement. In Nebraska, for example, cause of death is determined by prosecutors. In most California counties, the coroner is also the sheriff. Forensic pathologists are still required to sign off on the death certificate, but there are only a few hundred of them in the whole country and many jurisdictions now use forensic pathologists who aren’t board-certified. In Canada and other wealthy countries full autopsies are considered standard for suspected overdose deaths, but in the US they’re rare. Where not mandated by state law, they’re pretty much reserved for cases where law enforcement could potentially use the evidence to prosecute someone, or the family could afford a private one.

In suspected overdose cases, the death investigation often consists of toxicology and an external examination—medical history plus a long look at the body and any evidence found at the scene. None of these can reveal a heart attack, or heat stroke, or pneumonia. But they can reveal meth, and even without fentanyl that’s all that’s needed to wrap the investigation, particularly for people who die without housing. No available medical history? Well, clearly their medical history is that they used meth.

“If they had a heart death, I think [any meth] is going to get attributed as a cause of death. Because that is the bias of the system,” a toxicologist who signs off on drug death reports told Filter in 2023. “It’s like: Here’s someone that was found in a tent, we can’t contact their next of kin, we did a [urine drug screen]. They’ve got meth in their system; keep it moving. We’re not going to do an autopsy.”

Some research has suggested that meth is linked to about two out of three US deaths among people without housing. Local-level studies have found similar patterns in places like California and Oregon.

Deaths attributed to just meth, with no fentanyl present, tend to be among people who were over 45 and had a history of cardiovascular disease. To which chronic meth use may have contributed, but it wouldn’t have been the only thing. When a non drug-user dies from a heart attack in a hospital, we say they died from a heart attack—not from a sedentary lifestyle or refined carbohydrates. When a meth user dies from a heart attack and they weren’t in a hospital, their cause of death was a heart attack. But we might say it was meth, if drugs were the only thing we checked for.

Novel Synthetic Opioids, Even Deadlier Than Fentanyl

No matter how much we sensationalize fentanyl and its potency, after hearing about it for so many years the public has somewhat acclimated to the idea. So fentanyl headlines lose their power, and the only way for media outlets to combat this is with something even more potent than fentanyl.

First it was fentanyl analogs, followed by nitazenes and most recently orphines. All have the potential to be more potent than fentanyl (as well as less potent, not that this is of interest to anyone). The problem with news outlets pouncing on each novel synthetic opioid (NSO) as it hits the supply isn’t so much that they misrepresent the potency; it’s that they misrepresent the prevalence. Each NSO is presented as a harbinger, like behind the first couple of reports is a dam about to break, unleashing the substance that will replace fentanyl the way fentanyl replaced heroin. That will usher in the next wave of the overdose crisis all on its own.

Outside of North America the emergence of NSO could have a very different significance, if fentanyl hasn’t already saturated the opioid supply the way it has here. But at the moment, there’s no real reason to think that any fentanyl analogs, nitazenes or orphines are poised to overtake fentanyl in the US supply. Some of them, like carfentanil or cychlorphine, have become more recognizable names, but we’re still talking about substances linked to a very small portion of overdose deaths, and that’s including the cases where they were detected at all not just the ones where they were detected alone or determined to be the cause of death.

Most of these substances arrive mixed in with fentanyl—though some are occasionally found on their own—and aren’t really distinguishable from fentanyl, from a user perspective. Health departments will take whatever one or two talking points exist , which are probably just the location where it was detected and how many times more potent than fentanyl it’s supposed to be, and stretch them over a public bulletin that doesn’t help the public do anything differently. There’s a NSO in the supply. It’s been detected six times, in these two states; you can’t test for it and it’s not distinguishable from fentanyl. You should still use naloxone and take the precautions you were taking for fentanyl. This kind of thing is for the benefit of website traffic and re-election campaigns, not the public.

Not all recent additions to the supply are interchangeable. Xylazine and medetomidine, both non-opioid veterinary tranquilizers, have come with distinct complications and forced harm reduction groups to evolve overdose response protocols around each of them specifically. NSO have certainly reshaped how we criminalize the supply, but they haven’t really reshaped the supply itself. Even carfentanil, which has been in the US about as long as fentanyl and remains the most potent opioid we know of, has ebbed and flowed at the edge of the supply and never grown into something with a market of its own. None of them have.

No matter how potent, a substance can’t really be more deadly than fentanyl if it isn’t causing more people to die.

The post The Drug War Myths People Still Believe appeared first on Filter.

Considering what I do more closely reveals a kind of paradox, however.

If I view tobacco harm reduction (THR) from the outside, it seems as if nothing changes. The task—to inform and convince policymakers that THR is simply harm reduction, and that we already have the tools to dramatically reduce the world’s biggest cause of preventable death—is ostensibly a simple one. But the message seems incomprehensible, inconvenient or plain unwelcome to those in power. 

If something’s not stagnant, there is hope: Change requires movement.

If, on the other hand, I step inside the THR world to report on it, I’m never short of things to write about. Why? Because despite the ubiquitous common obstacles, the detailed landscape is mercurial—there’s always something happening. And if something’s not stagnant, there is hope: Change requires movement. Reflecting on this made me realize how much there is to be optimistic about.

Nicotine consumers are at the heart of this optimism, just as they’re at the heart of the THR movement. They’re bombarded with misinformation, stigmatized for their choices and faced with many barriers to accessing products that could save their lives. Yet despite all this, despite the knee-jerk, reactionary anti-THR policies, as many as 150 million people worldwide now use safer alternatives like vapes, snus and pouches or heated tobacco products.

The vast majority have adopted these safer nicotine options in order to quit (or reduce) smoking. In many other cases, the availability of these options for people who may have a “common liability” to nicotine use means they will never pick up cigarettes in the first place.

Yes, the message that safer nicotine products save lives would have gotten through much faster, and to far more people, if governments and health authorities wholeheartedly promoted THR instead of blocking and denigrating it. Yet it is getting through to an extraordinary degree in these circumstances—and given the power of peer-to-peer word of mouth, that is likely to accelerate.

This thought is almost guaranteed to stop me feeling enervated—and that’s just as well.

My THR reporting for Filter stands in stark contrast to the stories published in giant media outlets, which again and again contradict powerful evidence and ignore the human agency of people who smoke, in favor of narratives rooted in hardened ideology. Plenty of times, I’ve wondered if there’s any point in my work when my colleagues and I are up against this misinformation juggernaut. It’s David-and-Goliath when you’re fighting to be heard over the din of the World Health Organization and organizations backed by Bloomberg millions. It’s hard not to feel small and insignificant amid the cacophony of voices hellbent on telling you you’re wrong.

Writing about THR is also about celebrating its wins, which are just as important to report—after all, this is why the movement exists.

But before I get too disillusioned, along comes the news that Sweden has become the world’s first “smoke-free” country because of safer nicotine products. News like that, I’ve always felt, is a privilege to report. This is THR in action: Saving lives, improving quality of life, keeping families together, reducing health inequalities, and carrying special value for populations that have been most sidelined and ignored—such as people with mental health conditions and people who use banned drugs. 

These are stories that need to be written and read. And they remind me that being a journalist in this space is not just about correcting flawed science that somehow managed to get published, or criticizing bad policies, of which there is a never-ending supply. Writing about THR is also about celebrating its wins, which are just as important to report—after all, this is why the movement exists. And there are enough positive stories, even in the last few months, to convince even the most hardened of cynics that the times they are a-changin’.

In July, for instance, I wrote an article on how nicotine pouches are becoming increasingly popular in the United Kingdom. Anti-vape sentiment plays a role here, but the adoption of a new safer nicotine option is a good thing; choice is key. And with women leading the way, I can’t help but be optimistic that perhaps, in the not so distant future, we Brits might replicate Sweden’s success.

In May, I was able to report on how Argentina ended its 15-year prohibition of vapes and other safer nicotine products. Sure, further improvements need to be made, but it’s a big step in the right direction. Things are happening and moving: The landscape is mutable.

That same month, I wrote about calls to integrate THR routinely in HIV care. And yes, much of that article concerned stigma and other barriers to this common-sense approach. Yet in speaking with experts who have witnessed the trajectory of improved HIV care over decades, it was impossible not to entertain the idea that THR, delivered to high-smoking populations, might similarly have a better future.

THR advocates have faced derision, ostracization and slander. They have made things happen all the same. The victories belong to them.

And in April, I reported on an uplifting project, built by consumer advocates, to systematically collate the kind of lived experiences of safer nicotine use that are almost entirely absent from media narratives.

I am not an advocate in the strictest sense of the word, nor (by any stretch!) a scientist. I’ve seen myself as a conduit between the world of THR and those who are open to knowing more about it. To play that role at all effectively requires the help of experts, and I’ve gotten to know many who have inspired me.

People like THR maven Clive Bates, consumer advocate Skip Murray, Michael Siegel of Tufts University School of Medicine and Damian Sweeney of European Tobacco Harm Reduction Advocates (ETHRA) have been integral to my own learning. Their incredible knowledge and perspicacity, generously shared, have helped readers and me to understand nuances of THR, the repercussions of ill-conceived policies and so much more. In a field that can often feel bleak, the passion of these experts, and many others, makes me feel that the future of THR is bright.

THR advocates have fought against the odds for a better world. They’ve faced derision, ostracization and slander. They have made things happen all the same. The victories belong to them—to a whole ecosystem of scientists, policy experts, smoking-cessation advisers and consumer activists determined to help others benefit as they have. This fills me with hope. Sometimes, change comes almost imperceptibly—or perhaps, “gradually, then all at once.” I think we’re on our way. 

Photograph via PublicDomainPictures.net

The post Finding Optimism in the Tobacco Harm Reduction Maelstrom appeared first on Filter.

The survey covers mental illness, substance use, treatment and recovery for respondents ages 12 and up. The 2025 NSDUH, published in late July, reflects 60,447 completed interviews in person or online; in recent years it’s typically reached around 70,000.

Based on the 2025 respondents, SAMHSA projects that 69.8 million people—around 24 percent of the population over age 12—used at least one unregulated drug at least once within the past year. This refers to marijuana, hallucinogens, cocaine, methamphetamine, heroin, and “misused” prescription opioids, stimulants or tranquilizers/sedatives.

The 2022 NSDUH was the first to include street fentanyl. But it instituted a weirdly nonintuitive format that keeps street fentanyl siloed from the main section on opioids—effectively framing it as an afterthought while keeping the focus on prescription analgesics and heroin.

Respondents aren’t asked about street fentanyl until after they’ve completed the section covering substance use disorder, so the SUD statistics intentionally exclude that data. The same is true of opioid use disorder statistics, which are designed to include “misuse” of prescription fentanyl but nothing about street fentanyl. This format has been repeated in each subsequent NSDUH, including the 2025 edition.

The data show that past-year use of street fentanyl averaged around 660,000 people between 2022 and 2024, then jumped to 768,000 people for 2025. This represents a change from about 0.2 percent of the population over age 12 to 0.3 percent. However, you wouldn’t know that without looking at supplementary materials or data from previous years. The 2025 NSDUH itself simply states that for each year from 2021 to 2025, and across all age demographics, there was no change in the number of people using street fentanyl.

“[Q]uestions about the use of illegally made fentanyl (IMF) have appeared after SUD questions in the NSDUH questionnaire since 2022. For this reason, overall SUD, drug use disorder, and opioid use disorder measures do not capture disorders arising solely from the use of IMF,” the report states. “As discussed in the Illegally Made Fentanyl Use section, however, the estimate of IMF use in the past year among people aged 12 or older was low in 2025 (0.3 percent or 768,000 people).”

The “Illegally Made Fentanyl Use section,” which totals four paragraphs out of the 157-page report, acknowledges that this is “almost certainly an underestimate of true IMF use.” But it discusses street fentanyl almost as a novel opioid emerging in the heroin supply, rather than the one that emerged a decade ago.

In several places, the commitment to the five-year trend framework effectively erases any conclusions one might have otherwise drawn about 2025. For example, take the following graphic illustrating past-year cocaine use:

You might say it shows use among the 18-25 demographic decreasing for several years, then in 2025 going back up. SAMHSA’s characterization of the data, however, is that from 2021 to 2025 cocaine use decreased among the 18-25 demographic, and other than that there was no change.

The same thing happened in the broader section on “misuse” of central nervous system stimulants.

The NSDUH is pretty much the gold-standard citation for statistics on SUD and drugs, but the survey has always been marked by awkward data taxonomies that skew the results further away from real life than they would have been already. And by ambiguous language that makes it difficult to interpret even the more straightforward parts. After respondents “who reported ever using heroin or prescription pain relievers” were asked whether they’d been prescribed medication for opioid use disorder (MOUD), for example, and shown a comprehensive and accurate list of different formulations of methadone, buprenorphine and naltrexone, the report proceeds to state that MOUD “do not include the use of medications that are prescribed to manage withdrawal symptoms.”

The survey purports to represent the national scope of drug use and mental illness, but barely acknowledges that it isn’t offered to the populations most impacted by those things. It isn’t offered to people living outside or in their cars, for example, or in jail or prison.

The 2025 NSDUH does include data on whether people received treatment while in prison, jail or juvenile detention, though it doesn’t say what kind.

Top and inset images (cropped) via Substance Abuse and Mental Health Services Administration

The post SAMHSA Reframes National Drug Use Survey, Leaves Fentanyl Problem Intact appeared first on Filter.

Four different people stepped up and offered to let me stay at their place, for free, but all four of their addresses were rejected. Within 1,000 feet of a school, a church, a park. One was rejected because of an HOA.

Finally I found an “efficiency apartment” complex in Nashville that was known for renting to people on the registry. The address would be approved, if I could pay $1,600 up front and another $800 after I was released, for first and last month’s rent and the security deposit. That was two-and-a-half years of prison wages. But I was desperate to get out of the hellhole that is prison.

That apartment complex wasn’t a great place to live, but I was in the free world with a roof over my head. So I was truly thankful for that. In time I found a job and began to make friends with people who felt the same way about the system as I did.

“It’s not one issue, it’s everything stacked together—mental health, substance use, incarceration, low wages, rising costs. It builds until something breaks,” said my coworker Sabrina Westmoreland, who used to be an outreach worker in Los Angeles. “And when it does, we don’t respond with care—we respond with punishment. Laws. Tickets. Pushing people out of sight like that solves anything. It doesn’t.”

My friend Tom, who’s also on the registry, had been living on the street. I was able to help him get into the apartment complex. But he was struggling with drug use, and without the proper support he soon lost the apartment. The last time I saw Tom he was living on the street again, with a GPS monitor on his ankle. 

“We’re living in a time where housing is treated as a privilege instead of a right,” Westmoreland said. “And that belief that people deserve or don’t deserve a place to live based on how much money they make—that’s a moral failure.”

We’ve all seen people standing on street corners, holding cardboard signs that say: Anything helps. And we’ve all looked away, at least some of the time.

A nonprofit ministry called People Loving Nashville did outreach to the apartment complex, and through them I met so many wonderful people.

“Being seen is everything,” Lindsey Smith, People Loving Nashville’s community connections manager, told Filter. “That’s why I try—at the very least—to acknowledge people standing on corners. A wave. Eye contact. Something.”

One day I was sitting in my truck when an older woman walked up to me, trying to sell a worn-out bungee cord. It wasn’t worth anything, but I gave her two dollars for it. I had an unopened six-pack of Shiner Bock—the Tennessee Bureau of Investigation allows me to consume alcohol in moderation—so I asked if she wanted to drink one with me.

Her face changed instantly. She smiled—wide, real. I don’t think it was just about the beer. It was like she was smiling to be recognized as a human being, not as a problem to avoid, or as a quick transaction at a stop sign. Like she existed to someone, even if just for a moment. We sat on the tailgate and shared that beer. That moment stayed with me. 

We’ve all seen people standing on street corners, holding cardboard signs that say: Anything helps. And we’ve all looked away, at least some of the time. But now that I’m navigating life on the sex offender registry, I understand how important that wave or moment of eye contact really is. It’s why I looked forward to People Loving Nashville knocking on my door every Thursday. Even if it was just for the next few minutes, I knew I was going to be seen.

Image (cropped) via City of Wichita

The post The Sex Offender Registry Changed How I See Homelessness appeared first on Filter.

On June 21, the AP and Albuquerque Journal published stories about the DEA allowing numerous shipments of fentanyl to move through New Mexico between 2023 and 2025. The investigations stemmed from a 2023 whistleblower complaint filed by DEA Special Agent David Howell, who had been part of the surveillance assigned to some of the shipments.

“We poisoned our community to make cases,” Howell told the AP. “Through our own willful blindness, we get to say, ‘We don’t really know what happened to the drugs.’ But we 100-percent got people killed.”

Among other details, the AP described how the DEA’s widely publicized all-time largest fentanyl seizure, a 2025 operation in Albuquerque that resulted in around 3 million seized pills and 16 arrests, came after the agency allowed “millions” of pills to be delivered.

On June 24, New Mexico Governor Michelle Lujan Grisham (D) called for an inquiry into whether the DEA had potentially violated state law. Over the past two-and-a-half years, as the number of United States overdose deaths has gone down, Western states have split off into a separate trajectory that shows fatal overdose going up. The two states where overdose appears to be increasing the most rapidly have been Arizona and New Mexico.

“Shockingly, the federal government stood by while monitoring shipments, tallying exact pill counts, and watching as these deadly drugs hit the streets,” Lujan Grisham stated. “There are no words to describe how reckless and dangerous these decisions were. Make no mistake: the DEA knew people would die if these pills made it into New Mexico communities, and the agency let it happen anyway. The result: hundreds of New Mexican parents burying their kids. Hundreds of New Mexican kids growing up without stable parents. All while the federal government stood by.”

On June 26, New Mexico Attorney General Raúl Torrez (D) formally launched a state-level investigation, stating that it was “deeply disturbing” that DEA agents may have knowingly allowed fentanyl to hit the streets.  

“If those allegations are accurate, the consequences for New Mexicans were not abstract. They were fatal,” he wrote to Lujan Grisham. “I share your outrage.”

Meanwhile, DEA Administrator Terrance C. Cole requested the Office of the Inspector General (OIG) conduct an independent investigation, stating that he believed the agency had acted lawfully.

“This request should not be interpreted as reflecting any lack of confidence in the professionalism or integrity of DEA personnel or in the investigative decisions made during this matter,” Cole wrote. “Rather, it reflects my belief that allegations of this nature—particularly those that have received widespread public attention—are best addressed through an independent objective review.”

It’s always possible that some of the shock is genuine, but it’s hard to imagine how. The agency has never really bothered to cultivate an image based on anything other than arrests and reactive enforcement and big-ticket seizures that look good in a photo. Drug interdiction has never been shown to reduce overdose. Often it increases it.

The initial news stories, the subsequent AP spin-off stories, the open letters from elected officials, the new contributions from other media outlets and other elected officials that keep appearing by the day—all of them lean really, really heavily on talking points from the DEA’s “One Pill Can Kill” campaign, more so even than is typical for public discourse around fentanyl. Because in order to be outraged at the DEA for watching any quantity of fentanyl go by without stopping it, you have to validate the myth that seizing fentanyl actually keeps it off the streets.

Gov. Lujan Grisham had specifically asked AG Torrez to prosecute anyone responsible, including federal agents, to which Torrez had responded that no one was above the law although going after federal officers may be unrealistic due to “significant legal barriers.” Administrator Cole, in his letter to the OIG, had stated that “appropriate corrective actions” would be implemented if the OIG ultimately found them necessary, even though he didn’t think that would be the case.

Either way, the DEA still wins. The takeaway is that fentanyl needs to be seized and that when it isn’t, people die. Some government entity therefore must exist to do all the fentanyl-seizing, and it’s going to be the DEA.

Top image (cropped) and inset images of 2025 Albuquerque fentanyl seizure via Drug Enforcement Administration 

The post If the DEA Gets Bad Press for Not Seizing Fentanyl, the DEA Still Wins appeared first on Filter.

Many people nonetheless seem to believe that teenage nicotine vaping is rising. And this includes the administrators of US schools, as indicated by constant media reports of school systems all over the country installing vaping detectors.

In 2025 I testified in person at a state hearing on a proposed “registry bill”—effectively a vape flavor ban. I had five minutes to explain what CDC/FDA surveys actually show. I was followed by testimony after testimony from school officials claiming they were seeing a crisis.

Though I do not know why this huge gap between the evidence and schools’ perceptions exists, I have some ideas.

I had little chance of changing the lawmakers’ minds. When a high school principal shows up with two bulging bags of disposable vapes that have been confiscated in his school system, and parents testify about the impacts of the “crisis,” that weighs far more on the minds of politicians than accurate-but-dry evidence from official government surveys.

Though I do not know why this huge gap between the evidence and schools’ perceptions exists, I have some ideas.

What I do know is that the same CDC/FDA survey that was used in 2019 to claim a “teen vaping epidemic” now shows a 74-percent drop in teen vaping in the years since. (Granted, that figure is for “current use,” however occasional; frequent use, which may imply dependence, “only” dropped by 62 percent.) And I think it would be difficult to argue that teen lying on anonymous surveys has suddenly skyrocketed.

I can think of several factors that may explain why school officials’ perceptions currently—and very honestly and earnestly—are at odds with what I consider to be objective survey evidence.  In each case, I’ll attach a term for a well-known source of potential bias in scientific measurements.

First, teachers are now hyper-vigilant about vaping, thanks to years of loud media and political messaging on the subject. So they catch far more kids than they previously would. This is what’s known as sensitivity bias; the hyper-vigilance is self-reinforcing.

The fact that schools are now chock-full of vape detectors, again meaning they catch more kids than previously, is part of this sensitivity bias. Many US schools have detectors due to the Juul settlement, which sent nearly half a billion dollars to states.

And inevitably, schools that are chock-full of vape detectors will sometimes experience them going off without cause—a student using hairspray or perfume in a locker room, for instance—meaning a certain proportion of cases are what we call false positives.

The narrative of a vaping crisis in schools is driving truly harmful sin taxes and bans all over the US. The harm reduction community needs to confront it head-on.

Returning to sensitivity bias, this extends to the students themselves. They have been hammered with scare stories, so that today, more than in the past, many may think that vaping is super-scary and highly addictive. If they try a nicotine vape, they may rapidly fear they are becoming “addicted,” or at risk of horrific lung injury, and may even turn themselves in to a school nurse or a teacher for help.

Finally, people vape all kinds of things besides nicotine. There is no reason to think that school officials are experts at distinguishing between nicotine and THC, say, when the CDC itself fails to draw a clear distinction. Some school incidents recorded as “vaping” won’t involve nicotine at all. This conflation is known as lumping bias (or category bias).

If some or all of these hypotheses are substantially true, it would mean that in the past, far more students were vaping but fewer school officials were aware of it; whereas now, fewer students vape but those who do are far more likely to be caught, or to self-report.

I believe the gaping chasm between evidence and perception in US schools must be addressed. Just as the drug war has been justified as a series of child protection measures, the same is happening with nicotine today. The narrative of a vaping crisis in schools is driving truly harmful state-level sin taxes and bans all over the US right now. The community of tobacco control experts and consumers who support harm reduction needs to confront it head-on.

Top photograph (cropped) by SuSanA Secretariat via Wikimedia Commons/Creative Commons 2.0. Inset graphic by Charles Gardner.

The Influence Foundation, which operates Filter, has received unrestricted grants from Juul Labs, Inc. Filter‘s Editorial Independence Policy applies.

The post Teen Vaping Has Long Been Falling. Why Do Schools Think the Opposite? appeared first on Filter.

“Synthetic opioids pose serious risks for federal agents and first responders,” DHS stated in its announcement. “The risks include inhalation exposure to lingering toxic aerosols of fentanyl and ultra-potent opioids like nitazenes, which are up to ten times stronger than fentanyl.”

This is the third edition of the MQL, and the first to include nitazenes. Despite the announcement’s misleading characterization of their potency, the MQL itself doesn’t spend that much time on nitazenes.

Historically, law enforcement has been preoccupied with two main routes of so-called passive exposure: skin contact and inhalation. The MQL gets one of these more or less right, noting that skin contact with fentanyl is unlikely to lead to any adverse effects. Fentanyl is really not conducive to absorption through the skin membrane, which is why prescribed transdermal fentanyl patches have to be worn for such a long time.

“Synthetic opioid exposure can occur via several different routes; however, inhalation is the exposure route of greatest concern for emergency responders,” the guidance states. “While synthetic opioids can penetrate the skin, they do so slowly as compared to inhalation and injection routes.”

This, however, is a pretty egregious mischaracterization. DHS is conflating passive, accidental exposure with methods of direct consumption. First responders are not accidentally injecting themselves with fentanyl, nor are people deliberately using fentanyl by rubbing it onto their skin. Despite what DHS is implying, breathing air while standing somewhere in the vicinity of fentanyl is not the same thing as snorting a bag of fentanyl, which is why one of these will introduce fentanyl into your bloodstream and one will not.

Inevitably, DHS does endorse nalmefene-based products.

Though local law enforcement across the country rely heavily on colorimetric field tests that are notorious for false positives, DHS does correctly note that these aren’t reliable without confirmatory testing.

“Colorimetric test kits for opioids may give false positive results in the presence of common interferants, such as sugar and Excedrin,” the MQL states. “The use of a more definitive test, such as IR or mass spectrometry (MS) to verify the identity of a drug is recommended.”

In addition to being highly subjective and readily misinterpreted, the tests tend to identify opioids more accurately when they’re not mixed with other substances, which is almost never how they’re found in street-level samples. Not that this guidance will make highway patrol any more inclined to send their seized drug samples out for expensive mass spectrometry testing at a lab.

The MLQ correctly notes that naloxone is the standard antidote medication for synthetic opioid overdose, which is something; it’s become a common law enforcement refrain that naloxone doesn’t work on fentanyl, nitazenes and such. Inevitably, DHS also endorses nalmefene-based products, which have recently emerged as alternatives despite the fact that they offer no established benefits compared to naloxone and substantial risk of harm. 

“Intranasal nalmefene is a competitive, reversible opioid receptor antagonist with a longer duration of action than naloxone,” the MQL states. “Nalmefene nasal spray was approved for use by the FDA in reversing opioid overdoses in 2023 … and an autoinjector of nalmefene was approved in 2024.”

The danger posed by Indivior’s nasal spray Opvee and Purdue Pharma’s autoinjector Zurnai is that they can induce unnecessarily long precipitated withdrawal in people with a physical dependence on opioids; for everyone else, the experience of being administered nalmefene versus naloxone is probably about the same. While nalmefene’s continued existence in overdose-response products is detrimental to public health education, if those products have to go somewhere it might as well be to the federal agents who want something to self-administer whenever they think they’ve been exposed to fentanyl floating around in the air.

Image (cropped) via Indiana Department of Health

The post DHS Releases Questionable Synthetic Opioid Guidance for First Responders appeared first on Filter.

A coalition of media organizations had sued for the right to witness steps like the preparation of the syringe, and for the curtains to remain open from the moment the condemned person enters the execution chamber until they are pronounced dead. It is not clear where the ruling will stand on May 21 when the state plans to execute 57-year-old Tony Von Carruthers, who has maintained his innocence for 30 years.

“This is an important first step toward more transparency in executions in Tennessee,” Reporters Committee for Freedom of the Press attorney Paul McAdoo said of the initial ruling, according to the Tennessean.

News outlets fight hard for transparency around executions. Personally, I wonder if this is more about voyeurism than newsworthiness.

Executions were once public spectacles, and news coverage of them is still rooted in that perspective. Do journalists need to watch the syringe being prepared and administered in order to determine whether the punishment was carried out humanely? I am sure that it was not.

The death penalty is not an event; it’s a process. People condemned to death spend decades in tortuously restrictive conditions prior to execution. Where is the news media during this time? And a larger question: Where is the fight for transparency on behalf of the 20,000-plus people in Tennessee Department of Correction (TDOC) custody, who are also hidden from the public?

Only a handful of prisoners are executed each year; the number of in-custody suicides and homicides the state allows to happen is significantly higher. Where is the media coalition to object to that?

In 2025, 158 people died in Tennessee state prisons.

Media organizations often portray themselves as “watchdogs” over government processes. But since the 1974 rulings in Pell v. Procunier and Saxbe v. Washington Post Co. the Supreme Court has held that the First Amendment does not grant the press any more access than the general public has when it comes to prisons. And for the most part, the press accepts this.

TDOC does not allow media to bring cameras inside prisons. Outside journalists are not allowed to interview prisoners in person, nor can they speak by phone unless a prisoner adds them to their list of approved phone numbers, which is capped at 10.

TDOC policy offers one exception: Outside journalists “may request an interview with an unspecified inmate on a specific department program or topic.” TDOC will then hand-pick the prisoner who goes in front of the media to talk about the approved topic. It’s like having a hostage read a prepared statement from their captors. Yes, I am being treated well. The food is good. The programming teaches me a lot.

In addition to executions, news outlets are also eager to cover war, to report and photograph the horrific violence so that the public can make an informed decision about whether to support what the government is doing in their name. There is war inside prisons right now.

In 2025, 158 people died in Tennessee state prisons. At South Central Correctional Facility, the CoreCivic-run prison where I’ve been housed for the past decade, there is currently a 20-person Special Operations Response Team (SORT) team deployed because of the out-of-control gang violence.

People are being subjected to rape, torture and organized violence on a daily basis, but the media does not crusade for greater access to witness it and show it to the public, and so the public does not really understand. 

Our lives should be at least as important as our deaths.

Image (cropped) via Washington Courts

The post Media Fights for Access to Executions, But Not the Rest of the Prison System appeared first on Filter.

A young woman is strapped down in a black reclining chair, her mouth covered by an oxygen mask with a vape attached to it. It forces her to inhale vapor continuously. X-rays of the brain and lungs hang on the wall. Meanwhile rats investigate vapes, and nicotine pouches are strewn all around them. It’s macabre.

“When you use nicotine pouches or vapes, your body is part of Big Nicotine’s experiment …” the text reads. “You’re not just their customer, you’re their lab rat.”

It’s all part of yet another fear-based campaign designed to demonize the use of safer nicotine products:  “UNDO: End Tobacco Damage Now,” is currently being promoted by the California Department of Public Health.

It is hard to imagine any other public health campaign around drug use referring to people as rats.

It brazenly insults people who use safer nicotine products. “Are you one of Big Nicotine’s lab rats?” the campaign asks. It is hard to imagine any other public health campaign around drug use—alcohol, say, or even something as stigmatized as fentanyl—referring to people as rats. The hatred and discrimination that’s long existed against people who use combustible tobacco has been transferred to those who want to quit cigarettes through harm reduction.

Crusades against nicotine are usually framed in terms of villains and victims, and both keep changing. The original villain, “Big Tobacco” became “Big Vape,” and now, “Big Nicotine.” The victims used to be people who smoked cigarettes. Now it is those making the healthy decision to switch to a safer nicotine delivery device.

As is always the case in these zealous anti-tobacco harm reduction campaigns, the lies are staggering. Even the campaign’s name—“End Tobacco Damage”—is a lie, when the focus is on products that contain no tobacco and that reduce damage to public health.

“You are part of “Big Nicotine’s experiment,” UNDO states. “Each use makes you part of an experiment with your health at stake.” Nicotine is an “addictive poison.”

Nicotine is not a poison; it is a mild stimulant drug that billions of people have consumed safely over thousands of years. It is used ceremonially, medicinally and recreationally. Moreover, no one who ingests it is being experimented on, because the effects of nicotine have been exhaustively studied. 

Note that people who use nicotine patches and gums are exempt from the label “lab rats,” are not part of an experiment, and aren’t seeing their products targeted for prohibition. Of course, “Big Pharma” sells these over-the-counter “poisons,” better known as nicotine replacement therapies.

The campaign section titled “What this poison can do to you” is so full of demonstrably false assertions that you might spontaneously combust!

Lighting tobacco on fire to get nicotine is the problem. With the invention of vapes, nicotine pouches, snus and heated tobacco products, there are many ways to use the drug that eliminate combustion and work as alternatives that people who smoke actually want to use. This is something to be celebrated, not vilified.

The campaign section titled “What this poison can do to you” is so full of demonstrably false assertions that you might spontaneously combust! Nicotine blocks the brain’s ability to pay attention, it claims. But it’s the opposite; nicotine increases attention and focus. Up next; “Nicotine can deepen depression and amplify anxiety.” It’s the opposite; nicotine has been shown to decrease symptoms of depression and anxiety.

Then UNDO offers this whopper: Nicotine poisons the body; it makes you “nic-sick.” It does not. If it did, no one would use it!

There is a strong whiff of desperation in these ads and videos attacking the use of safer nicotine products. That’s because over a decade of science irrefutably shows they are safer to use by orders of magnitude compared to cigarettes, and are more effective for quitting smoking than patches or gums. But with smoking on the decline, public health groups seek to justify their existence by presenting harm reduction tools as the enemy. Moral panic and funding are easier to generate for the innocent “victims” of youth vaping than for the people who genuinely face severe health risks: the predominantly marginalized populations that still smoke.

Happily, millions of people around the world have ignored offensive disinformation campaigns like this one and made the switch. That makes the forces opposed to tobacco harm reduction angry. Moreover, they hate that people who vape nicotine actually enjoy it. Over time, their drug-panic propaganda has become less effective, so they’ve doubled down on the shock tactics and deception.

Then there is the Food and Drug Administration (FDA), which has authorized vapes, flavored nicotine pouches and snus as “appropriate for the protection of public health.” This fact is conveniently omitted in attack campaigns like UNDO because it undermines all their bald-faced lies.

With the widespread use of snus, which the Swedish government promotes, Sweden has become the world’s first “smoke-free” country. This remarkable human achievement is also ignored.

Because the goal of “Big Tobacco Control” agencies like the California Department of Public Health is the opposite. They want to deny access to safer nicotine products that can save the lives of people who smoke. Who are the real rats?

Screenshot showing detail of UNDO video via YouTube

The post People Who Vape Are Lab Rats, Says California “Public Health” Campaign appeared first on Filter.

The project stands against a status quo where nicotine consumers are treated as an afterthought, largely excluded from media representation and policy deliberations that directly impact them. Consumer advocacy groups have little or no funding, and their voices are drowned out by well-funded anti-harm reduction groups and a media landscape that credulously accepts their ideology.

“Consumers rarely get to engage where decisions are made,” as the website states. “This platform helps make those voices visible—at scale, across the world, and in direct view of decision-makers and decision influencers.”

“The stories shared by people who have used safer nicotine products to quit traditional tobacco are so vitally important, but almost never get attention in the areas it counts most.”

THR Global launched earlier in April, but it was catalyzed many years ago. The site was developed and built by Kurt Yeo—co-founder of the South African consumer group Vaping Saved My Life. Filter previously told the story of Yeo’s personal journey to smoking cessation and tobacco harm reduction advocacy, which began after his father died of a smoking-related illness.

“I have always felt that the stories shared by people who have used safer nicotine products to quit traditional tobacco are so vitally important, but almost never get attention in the areas it counts most,” Yeo told Filter.

“Consumers and consumer groups almost never get a seat at the table where decisions are made, or even at some conferences where tobacco harm reduction is discussed,” he added.

THR Global is looking to change all that, by consolidating those lost voices in a way that’s coherent, empowering and harder to ignore. Yeo said he hasn’t previously been aware of a place “where this data has been extracted, aggregated and presented” at scale.

Centering lived experience and the agency of directly impacted people is considered a basic principle of harm reduction in general, and the tobacco harm reduction space should be no different. Adhering to that, as Yeo noted, means benefiting from wisdom and knowledge that can’t be found elsewhere.

“If someone spends just 5 minutes with someone who has made the switch, they will be amazed by the level of detail many can share about their journey.”

“If someone spends just 5 minutes with someone who has made the switch, they will be amazed by the level of detail many of these people can share about their journey,” Yeo said. Whether it’s the date of the last cigarette a person smoked, the number of quit attempts it took, or the exact specifications of the vape, pouch or heated tobacco product that worked for an individual—when others may not have done—those details can be key to life-changing transitions.

One of the testimonies on THR Global is by Bengt Wiberg, from Sweden. He describes a harrowing time in his life, a “moment of extreme stress” in 1991, when he found himself in Riyadh, Saudi Arabia, as rockets were raining down. The experience, he writes, changed “the trajectory of my life” by spurring him to quit smoking. He calls snus—the smokeless tobacco product that has made Sweden “smoke-free”—his “lifeline,” which allowed him to leave his heavy smoking behind in what he calls a “personal victory.” The experience also turned him into an “Accidental Advocate.”

Another consumer, writing anonymously from Cape Town, South Africa, is looking forward to participating in a fourth half-marathon. This person smoked for 23 years before quitting with the help of vapes. “I am the fittest and healthiest I have been since 15 years old, turning 50 this year,” they write, adding, hauntingly, that smoking “does far worse” than kill; “it robs your quality of life.”

These and other testimonies on the site are clearly powerful, but Yeo explained that one of the biggest hurdles in getting the platform going was to convince consumers to share them. This, he said, is due to “consumer fatigue” and “apathy” stemming from years of being sidelined.

“Over the years, consumers and consumer groups have submitted written testimonials and responses to whatever the call for action required,” Yeo said—often, for instance, when regulators invited public comment on proposed regulatory changes. “But they have been discouraged when their voices seem ignored or not taken seriously.”

As a result, Yeo continued, many nicotine consumers “have little trust that their story could sway anything. My view is that the issue isn’t the story, but how these stories have been presented.”

“I urge all who are interested to encourage their respective communities to share their stories. Its success relies on participation.”

THR Global offers an “alternative approach”, Yeo said: “Have this data captured centrally and displayed in a way that highlights the scale and extent of tobacco harm reduction across all population groups and regions.”

THR Global is a multi-purpose website that also tracks global policies, trends and research. But at its heart is the consumer—and for the project to have the desired impact, many more voices from around the world will need to be added.

“I urge all who are interested to encourage their respective communities to share their stories and to consider THR Global as a platform for doing so,” Yeo said. “Its success relies on participation, and the success of having THR confirmed as a very real solution relies on evidence. Consumers are central to this evidence.”

Photograph (cropped) by Global State of Tobacco Harm Reduction via Flickr/Public Domain

The post New Hub Platforms Lived Experiences of Tobacco Harm Reduction appeared first on Filter.