Substance use and destigmatization: SDG 3 and Me interview with Paige Lemen, PhD candidate
Published in Public Health
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What SDG3 target(s) is your work and the work of the organization most closely aligned with?
Among the targets listed, we are most aligned with the mission to “Strengthen the prevention and treatment of substance abuse,” however, we also focus on reducing the stigma of drug use as well. Not all of those who use drugs, including opioids, have a substance use disorder. Not all who use opioids outside of doctor’s orders are “abusing” the drug. Who determines what is considered abuse anyways?
Substance use disorder is a spectrum. It can range from healthy and responsible drug use to uncontrolled and chaotic drug use to a full disorder. Oftentimes, this depends on the individual’s quality of life. For example, someone who has all their needs met and can pay all of their bills is more likely to be able to control their drug use compared to someone who is experiencing homelessness, abuse and trauma, exploitation or some other issue that many of our most vulnerable people in our society experience.
Instead of policing drug use and taking a “punish and control” approach, we need to be focusing on the underlying causes that lead to people using drugs in a risky way in the first place.
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Do you feel there is something missing from the specific SDG 3 targets of the areas you are most interested in?
We want to show the importance of including the experiences and voices of those who use drugs. As our paper mentions, “Those with lived and living experience have unique insight into the complexities of overdose and the effectiveness of naloxone. They can provide valuable information on how a higher dose formulation may impact their ability to respond to an overdose. Additionally, they can offer insight into other factors that may contribute to overdose, such as polysubstance use or lack of access to harm reduction services. By listening to those with lived and living experience, we can gain a better understanding of the challenges and barriers faced by PWUD [people who use drugs] and make more informed decisions about how to address overdose in a way that is effective, equitable, and inclusive.”
Another important target for us is to bridge the gap between researchers and those working “on the ground,” as in directly with drug users and those with substance use disorder (SUD), or drug users themselves. From personal experience, I have worked with scientists who struggle to design studies that provide results that could be translated to treatment and prevention in humans, especially within our current society and policy landscape. This is because they lack the knowledge of how drug use and SUD occur in real life.
I’ve also worked with harm reductionists and drug users who could benefit, either in their work or personally, from understanding the science of drugs and SUD, or even how the scientific process itself, research, and funding works.
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Who (or what groups) would you like to work with, or would like to be in contact with, to push forward your ideas/projects?
As a PhD candidate, I’ll soon be Dr. Lemen and want to use my training in biomedical sciences to improve the lives of those who use drugs and those with SUD. However, I’m not sure in which way I’d like to go about that; scientific advisor, post-doc (continue doing the research I do now in academia), industry, or maybe even scientific journalism.
Academia needs SUD researchers with real world experience and have undergone the unlearning process of all the drug war propaganda that many scientists don’t even recognize they’ve fallen for as well. In that case, I’d love to work with like-minded researchers that have funding for post-docs.
I’m also interested in getting more involved with policy work or journalism in this same field. In that case, I’d love to connect with the Drug Policy Alliance and the Harm Reduction Coalition. However, it is possible to do both and one does compliment the other!
Paige M. Lemen is a PhD candidate at the University of Tennessee Health Science Center, studying the neurobiology and genetics of drug use and substance use disorder (SUD). She specializes in opioid use disorder (OUD) by using rats to model social determinants of health and adolescent adverse experiences, including social isolation, and how they play a role in drug use and the risk of developing OUD in adulthood. However, her research interests stem from years of experience being personally affected by OUD and the overdose crisis. Paige grew up in Cincinnati, Ohio, which has one of the highest overdose rates in the US. Here, she experienced a lot of stigma and misinformation about drug use and harm reduction which led to losing loved ones to overdose, incarceration, and harmful policies changes that involved treating drug users and harm reduction workers as the enemy. One example is the use, or lack of use, of naloxone. She is currently working on publishing another paper on naloxone that looks at genetic variation among the differences in response to morphine and naloxone-induced withdrawal. Paige hopes to bring the knowledge of people who use drugs and harm reduction workers to those actually studying and advocating for policy changes surrounding the proper use of naloxone, including the benefits and the risks.
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Harm Reduction Journal
This journal publishes research and commentary on approaches diminishing the harm of stigmatization, marginalization and criminalization of public health, human rights and social justice issues, as well as rebuking the de facto criminalization of marginalized and stigmatized communities.
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