RFK Jr. The Defender - Drug Addiction and Recovery with Rene Zegerius VIDEO

In this episode, we talk to Renee Zagarias, who is the leader of Drug Policy in Amsterdam and has had a chance to look at what policies work, and what don t, in the Dutch city. In the mid-80s, there were 3,000 deaths a year from drug overdoses in Amsterdam. Today, there are only 300 such deaths per year, and Amsterdam is now really a model for how to solve these problems, and the methodologies and protocols that they ve developed there would be useful for other cities. In this episode we discuss: 1. Acknowledging that there is a problem and not papering it over 2. Working together to solve the problem 3. Treating the problem as a problem, not as a political problem 4. Working with the police, social workers, and housing 5. Building interstitial spaces 6. Helping the homeless 7. Providing support 8. Building a plan 9. Stabilizing the streets 10. Establishing interstitial space 11. Connecting the dots And so much more. Listen to this episode to learn more about the problems we re facing, and how we can solve them and what we can do to solve them. If you re struggling with a drug addiction problem, or are struggling to get help, please reach out to someone who can help you. Don t hesitate to us. We re here to help. We re listening to you! Thank you for listening to this podcast and sharing it with us on social media! Please rate us your thoughts, comments, suggestions, suggestions or suggestions about what we should do to improve the podcast, and we ll do more of this podcast! on the podcast or share it on your social media platforms! We ll be listening to the podcast on the next episode! and we'll get back to you in the podcast next week with a new episode on our socials! . Thanks for listening and sharing your thoughts and stories! Timestamps: 1:00:00 - What do you think of this episode? 2:30 - What are your thoughts on this podcast? 3: 5:50 - What would you would you like to hear from me? 6:15 - How do you want to help us solve a problem? 7:40 - How can we solve it? 8:00 9:30 - What should we do it better? 11:10 - What can we do more? 12:40

00:00:00.000 It's a pleasure for me today to conduct this conversation with René Zagarias, who is the leader of drug policy in Amsterdam and has had an opportunity to look at what policies work, what don't work.

00:00:14.000 Amsterdam in the mid-1980s looked like San Francisco today.

00:00:20.000 The Dutch government made many of the same mistakes that Many of American cities are making today.

00:00:30.000 And there were 3,000 deaths a year, overdoses in Amsterdam alone annually, very, very similar to what we're seeing in San Francisco today.

00:00:41.000 There were open drug markets in the street.

00:00:44.000 There were people Drug addicts shooting up in doorways.

00:00:49.000 The tourism was affected.

00:00:51.000 The businesses were affected.

00:00:53.000 There were homeless problems that were amplified by the addiction.

00:00:58.000 And Amsterdam today, in all of Holland today, there's only 300 overdoses a year.

00:01:07.000 And Amsterdam is now really a model For how to solve these problems and the methodologies and protocols that they've developed there would be useful for other cities.

00:01:23.000 Rene has had the opportunity to look at a lot of American cities, has a very clear idea of what, of course, the pathway out of the current crisis that we have.

00:01:36.000 And it all begins with first acknowledging that there's a crisis and not papering it over.

00:01:41.000 And René, after that long introduction, welcome to this conversation.

00:01:47.000 Yeah, thank you very much.

00:01:48.000 You have a very good impression of what we did.

00:01:54.000 And you know how we make a lot of mistakes in Amsterdam.

00:01:59.000 And it would be silly if you made the same mistakes.

00:02:03.000 And that's why I'm very...

00:02:05.000 I'm honored to have this conversation with you, just to help you, that you are able to make other mistakes than we did.

00:02:12.000 Because the situation is very similar.

00:02:16.000 And you have some different laws, but at this moment, we have 40 deaths a year in the Netherlands.

00:02:30.000 How many?

00:02:32.000 40.

00:02:33.000 Only 40?

00:02:35.000 Yes.

00:02:37.000 And that's down from thousands.

00:02:41.000 Yes.

00:02:42.000 So we're good at the moment.

00:02:46.000 And what I saw in San Francisco, what I saw in Denver, and what we saw in Atlanta, it's awful to see.

00:02:58.000 A lot of homeless people, drugs on the street, a drug market on the streets and the police is just walking around.

00:03:09.000 People are living in shelters on the streets and ambulances go on and off for overdoses by opioids.

00:03:20.000 So it's a similar situation.

00:03:25.000 You have no-go zones, just like we had, where the police is not welcome and ordinary people are also not welcome.

00:03:38.000 And we had that situation.

00:03:41.000 So it starts with the fact that everybody says, yeah, this is a problem.

00:03:47.000 And one of the things that I said to one mayor I will not...

00:03:52.000 Tell who it is, but they said, probably this problem is not big enough, otherwise you would have changed it.

00:03:59.000 And that's where it starts.

00:04:02.000 It starts with the fact that you have to acknowledge that there is a big problem, and you have to acknowledge that the government has to step forward, and you have to acknowledge that there's not a problem that you can solve by yourself.

00:04:14.000 You need other parties Other participants than just the health service.

00:04:24.000 You need the police.

00:04:27.000 You need the local government.

00:04:30.000 You need housing cooperation.

00:04:33.000 You need sheltering.

00:04:34.000 And all those parties have to work together on every particular case.

00:04:41.000 And that's what we found out, that if you do case management from out of the government, And you make sure that every particular drug addict is having a plan where everybody sticks to.

00:04:58.000 There are changes to make.

00:05:01.000 I'm not going to say that it's going to solve the whole issue because there's always a rest, but that would be a start.

00:05:11.000 Acknowledging And the government, local government or federal has to step forward to say, this enough is enough.

00:05:20.000 Paul Jay Well, let me, and you know, we have the problems that you describe, I've seen firsthand in San Francisco.

00:05:29.000 Where there's an open-air drug market with hundreds and hundreds of people selling drugs, shooting drugs, smoking drugs, and right across the street from the federal courthouse, where I tried the Monsanto cases in 2019, and right now it's a dangerous place to go.

00:05:49.000 It's unsanitary, as you described.

00:05:53.000 There is a steady stream of ambulances coming in and out all day long, picking up.

00:05:58.000 We saw it twice, two ambulances, pickups in the brief time that we were there.

00:06:04.000 A fire engine came by at one point, paramedics.

00:06:10.000 But to describe your methodology, let me make an attempt at summarizing it, and then you If you can fill in the interstitial spaces or errors that I make in my description, you get the social workers, the addiction specialists, the housing specialists, and the police all to work together.

00:06:33.000 Every addict is picked up, every homeless person is picked up, they're assessed, and some need to go to jail, a small part of them.

00:06:46.000 Some of them want to get help.

00:06:48.000 Some of them are willing to be helped.

00:06:51.000 Some of them should be routed to rehab.

00:06:55.000 And then after the rehab, long-term treatment or housing where they can stabilize and detox and get their lives back on their feet again.

00:07:11.000 And the social workers have to work with police so that the police aren't trained to deal with this kind of problem.

00:07:18.000 And I saw in San Francisco what you described as the police standing across the corner doing nothing.

00:07:25.000 And they don't know what to do.

00:07:27.000 And they're not trained what to do.

00:07:29.000 And the social workers have to come in occasionally and say to the police, okay, we'll handle this.

00:07:34.000 You need to back off on this.

00:07:37.000 And then make the assessment and make a determination for each drug addict.

00:07:42.000 As to what happens to them.

00:07:45.000 And then we need long-term treatment available that is, you know, that is cheap or free.

00:07:52.000 So will you, is that pretty much how it works?

00:07:56.000 Yeah, pretty much.

00:07:57.000 Pretty much.

00:07:58.000 Yeah, pretty much.

00:08:00.000 One of the things that you do not have and what we use is what you call tough love.

00:08:11.000 I didn't know what it was, but it's a carrot in the stick.

00:08:17.000 You have to give someone something, but in return you can ask something.

00:08:27.000 It's very useful to let the please be the stick. 0.95

00:08:32.000 If you act on what we are saying to you and you make steps, even if they are small, You cooperate with us and you are willing to change it a bit, even though that we provide heroin in Amsterdam for people who are not able to stop using opiates.

00:08:56.000 That's also part of treatment.

00:09:01.000 It's one step too far for you, but the tough last thing.

00:09:06.000 The colleagues of police are my best colleagues.

00:09:11.000 They are responsible and reliable.

00:09:14.000 And if they know what to do with someone, they'll do that.

00:09:19.000 If they know that someone is cooperating with the system, they will help him.

00:09:25.000 And if they know that someone is doing the opposite, they'll also help him.

00:09:32.000 But the other way.

00:09:36.000 But everybody knows that.

00:09:38.000 Also, the people who are involved know that if I do this, that will be the next step, whether or not it's jail temporarily or anything else.

00:09:50.000 So it's very clear what we're doing.

00:09:54.000 And one of the things that we do is that we examine people by doctors, by psychiatrists.

00:10:02.000 To see whether or not someone is mentally disabled, psychotic or whatever, or just using opiates.

00:10:11.000 That's what we do.

00:10:12.000 And that's what we make.

00:10:13.000 That's one of the bricks that we make to build that plan.

00:10:18.000 Because if you make a plan and after two years you find out that someone is mentally disabled, you can't see that from the outside. 0.92

00:10:28.000 It doesn't work.

00:10:31.000 It doesn't work for the particular addict, but it's also not working for the system.

00:10:36.000 So you have to find out whether or not someone is a patient and what kind of patient, and you have to make a program, a plan for those patients.

00:10:45.000 But it's also tough love, because the fact that someone is living in a tent It's front page in Amsterdam.

00:10:59.000 It's not allowed.

00:11:01.000 It's not allowed to use drugs on the street.

00:11:06.000 And we started...

00:11:08.000 One of the things that we do, we made shelters where they were allowed to use, provided by the government.

00:11:19.000 That's the things that you can...

00:11:23.000 Yeah, it worked for us.

00:11:26.000 Just to make sure that they didn't overdose, just to make sure they were not on the street when they used, and they had a shower, and we had lots of them.

00:11:37.000 At this moment, we have one of them because of the fact there is no use for that.

00:11:42.000 So all those particular things, the fact that you know 80% of what I'm going to say means that it's not I don't want to be impolite, but it's not that difficult.

00:11:57.000 The fact that you understand it, and that 80% of what I say is in your mind, and you can say whatever or not is good.

00:12:06.000 So you...

00:12:08.000 What do these shelters look like, Rene?

00:12:12.000 Because that...

00:12:12.000 They have all kinds of shelters.

00:12:14.000 ...in this country is the price of housing, the cost of housing.

00:12:19.000 Yes.

00:12:22.000 I had an argument also with the mayor because I'm not a very polite person.

00:12:34.000 So if you talk, how should I put it nicely?

00:12:42.000 If it doesn't make any sense what you're saying, I will mention it.

00:12:49.000 So one of these things, so we had all kinds of sheltering because there is no such thing as one solution because all those clients are different and also different in what they need.

00:13:03.000 So one of the mayors said to me, I'm going to start with housing first for all of them.

00:13:09.000 I said, then you make three problems out of one because not everybody is able to To live in a house.

00:13:21.000 If you are housing someone who's very addicted and you give someone a house, there will be neighborhood disturbance.

00:13:31.000 He or she will take a dealer inside.

00:13:37.000 And at some point, he or she will get an overdose and he or she is not on the street.

00:13:43.000 So you will find him or her dad in that department.

00:13:47.000 So that's not the solution for...

00:13:51.000 It's one of the solutions.

00:13:53.000 But there are a lot of...

00:13:56.000 The solutions that you have to make because of all those plans that you have of particular patients, you have to make sure there are groups in that, and for those particular groups, you make that.

00:14:06.000 And it's a sort of stepping.

00:14:08.000 If you do well, you go to the next step.

00:14:10.000 And if it goes wrong, we're not going to stop helping you, but we do it differently on a different place.

00:14:21.000 That's the way it works.

00:14:24.000 Some of the American mayors are operating under a judicial decision in the Western states that I think would make some of this difficult, which is a supposedly constitutional interpretation that says you can't remove these people from the street unwillingly.

00:14:46.000 No, but the thing is that- Mayors talked to you about that issue?

00:14:51.000 Yes, yes, yes, yes.

00:14:52.000 They were very interested in the way we use cameras in neighborhoods, in all kinds of places.

00:14:59.000 But the thing is that if you, from my point of view, you see a patient on the street, Suffering of schizophrenia.

00:15:10.000 Suffering of the fact that he or she is using drugs.

00:15:13.000 Suffering of the fact that he or she is homeless.

00:15:19.000 You have to do something about it.

00:15:21.000 And you can say that it's his right to be there, but it's not a right to make the neighborhood disturbances.

00:15:35.000 So in our opinion, there's always a way that police get involved.

00:15:41.000 But not only the police, because the police is not going to solve it.

00:15:45.000 Otherwise, they would have solved it a long way ago.

00:15:49.000 So I know that there are laws in your country that are different than in ours.

00:15:56.000 But the fact that you have patients on the streets and that you do not act on it, That's the same in both countries.

00:16:04.000 And there's no law that says to me that I'm not allowed to help a patient.

00:16:10.000 Because if there is in the Netherlands, we would discuss that.

00:16:16.000 Now you leave patients on the street.

00:16:21.000 And what has been the reaction of the mayors who have come to visit you?

00:16:25.000 Just talk about which cities have come to visit you and then If any of them have adopted your protocols, and which cities are doing the best?

00:16:37.000 I think Miami is working on it.

00:16:42.000 I think San Francisco, what they do is not working at all.

00:16:49.000 Danfra has, to my opinion, a big problem, but it's small.

00:16:55.000 And the local community is very aware of the local government is working on it.

00:17:05.000 Atlanta is a little difficult, what I saw.

00:17:10.000 But it depends on the political will, whether or not it's going to be successful or not.

00:17:24.000 And that concerns me.

00:17:27.000 Generally speaking to the mayor's Were they impressed by what you were doing?

00:17:32.000 Did they say, okay, we're going to take this home and learn from it?

00:17:36.000 No.

00:17:37.000 No.

00:17:38.000 The thing is that I'm not...

00:17:41.000 What I say is not a religion.

00:17:44.000 So you have to steal whatever you can use.

00:17:48.000 And make other mistakes.

00:17:49.000 That's the way I'm in this situation.

00:17:53.000 So I'm fine with everything.

00:17:55.000 But if you do not do anything...

00:18:00.000 I told one of them, probably the problem is not big enough, otherwise you would have changed the situation.

00:18:08.000 And that's how I feel.

00:18:12.000 And those laws, I understand that it's more difficult, but there is something in between doing nothing and changing the situation.

00:18:26.000 Why do you say Atlanta is particularly difficult?

00:18:31.000 I didn't see that the local government...

00:18:36.000 The thing is that I spoke to those mayors, so I have to make sure that the conversation that I have with them stays between him and me.

00:18:48.000 So I'm trying to be polite.

00:18:55.000 Yeah, okay.

00:18:56.000 I get it.

00:18:57.000 But it doesn't work.

00:18:59.000 You actually went and visited the cities, right?

00:19:02.000 Yes.

00:19:03.000 And which of the cities was worse?

00:19:05.000 San Francisco would be my guess.

00:19:08.000 Yes.

00:19:09.000 And then Denver second?

00:19:11.000 Yes.

00:19:13.000 But I've been to Los Angeles.

00:19:15.000 I've seen a lot of Dallas.

00:19:22.000 I've been to Dallas, Houston.

00:19:26.000 But it's not that big in Dallas and Houston because of, I don't know why, but it's not that big.

00:19:36.000 And how long did it take you to start seeing results?

00:19:41.000 It took us about a year or two, three to get small results and the big results after four, five, six years.

00:19:53.000 And do you have lots of...

00:19:54.000 Does the public in Amsterdam realize what you've done with the program?

00:20:01.000 No.

00:20:02.000 No?

00:20:03.000 No, no.

00:20:04.000 The thing is that your cameraman is much younger than I am.

00:20:11.000 And he thought it was going bad.

00:20:15.000 And he googled it.

00:20:23.000 And the next time that we saw each other, he said, yes, it was really bad.

00:20:28.000 So what we have, we have two things that are important differences.

00:20:37.000 One, we had that situation 30 years ago.

00:20:45.000 And people do not use heroin or opiates because of the fact that they think it's a loser drug.

00:20:54.000 You didn't have that situation.

00:20:58.000 We think it's a loser drug. 0.93

00:21:00.000 My cameraman is not going to start using opiates because he knows it's a loser drug.

00:21:08.000 If you see people who've been using opiates or heroin for longer periods, It's not a very good advertising.

00:21:19.000 So we know that it's a loose drug.

00:21:23.000 And there's another difference in law.

00:21:27.000 When we prescribe opiates because of pain, we have a national-wide registration on who we give opiates.

00:21:40.000 And we are not allowed to give opiates that long as US doctors can.

00:21:49.000 At some point, we have to stop.

00:21:51.000 And if we do not stop, the government will ask us, why didn't you stop the opiates?

00:21:58.000 So that's a difference in law and a difference in how we prescribe opiates.

00:22:08.000 Are there any drugs that your cameraman considers winter drugs?

00:22:12.000 A coke.

00:22:15.000 And he's laughing about it because I know what it is.

00:22:18.000 Cocaine is a winter drug.

00:22:20.000 Okay.

00:22:21.000 Excuse me?

00:22:24.000 How about mushrooms?

00:22:26.000 Mushrooms.

00:22:27.000 Nobody uses mushrooms in the Netherlands because they make you sick.

00:22:33.000 Yeah, they make you sick.

00:22:35.000 I'm not going to ask.

00:22:37.000 But they make you sick.

00:22:39.000 It's not going to work because you have to eat it.

00:22:41.000 Everything that you have to eat, you can't register.

00:22:47.000 How should I put it?

00:22:49.000 It will overcome to you.

00:22:52.000 And at some point you're stoned and you can't move and you have to wait until it's gone.

00:22:58.000 So everything that you eat is...

00:23:02.000 Now, if you are experienced, I'm not.

00:23:07.000 But if you are experienced, you're not going to eat anything.

00:23:10.000 So mushrooms is not a big thing.

00:23:14.000 Neither is...

00:23:16.000 We use a lot of wheat and marijuana, but that's the same in the...

00:23:27.000 Crack cocaine.

00:23:29.000 Excuse me?

00:23:30.000 Crack cocaine.

00:23:32.000 No, no, just cocaine.

00:23:35.000 And so there are some cultural differences.

00:23:39.000 Yeah, there's cultural differences.

00:23:40.000 But did you do, in the Netherlands, I know they had a big opiate problem at one point.

00:23:46.000 Was there advertising that said we're telling people this is a loser drug?

00:23:52.000 No, no.

00:23:53.000 At some point, everybody sees how it works and everybody sees how people look like after 10 years of using opiates.

00:24:04.000 Heroin is not a very nice site.

00:24:08.000 Yeah, and how does it work?

00:24:12.000 How does legalized heroin work in the Netherlands?

00:24:16.000 Only by prescription.

00:24:18.000 Only by a small amount of institutes.

00:24:22.000 In Amsterdam, we started with 200 people who were very ill physical or mentally, people who suffered from schizophrenia.

00:24:31.000 And they were allowed to use heroin.

00:24:35.000 We didn't give them heroin.

00:24:38.000 They have to sit in a polyclinic, use it, go and come back.

00:24:45.000 And there were about 200 or 300 patients that we do that with in Amsterdam.

00:24:50.000 There were other parts in the Netherlands where they also did that, but we had Together with Rotterdam, the largest amount of patients who use heroin.

00:25:02.000 At some point, they get healthy because you're not going to die of opiates.

00:25:10.000 If you use it well, you're not going to die.

00:25:13.000 So all of them are healthy.

00:25:17.000 So they're not going to die of heroin.

00:25:19.000 They die of the fact that they have lung diseases because of the fact that they smoke.

00:25:25.000 So they are healthy.

00:25:26.000 And what we saw is that some people stopped at some point using heroin.

00:25:33.000 And most of them, they had the opportunity to use three or four times a day.

00:25:40.000 They only come by once or twice now because they want to do something They are addicted, but next to the heroin, they use methadone and they have their normal life and once or twice a day.

00:25:57.000 So from a lot of using to a little using, that's the way it developed.

00:26:04.000 And now we have about 40 or 50 patients that use heroin.

00:26:10.000 So it goes down and down and down and down with this approach that we have.

00:26:16.000 And when the tolerance increases for the heroin, which is just part of the physiology of the drug, does the dose also increase over time?

00:26:27.000 No, no, no, no.

00:26:29.000 And because of the fact that we use methadone next to the heroin, you can stabilize it.

00:26:39.000 And how many methadone addicts do you have?

00:26:44.000 I don't know.

00:26:45.000 I think about a few hundred in Amsterdam.

00:26:49.000 The difference between using methadone and heroin is the fact that if you want to do something wrong, you have the time to think it over.

00:27:03.000 So we saw a decrease of criminal activity with that particular group because of their addictions.

00:27:13.000 You can think it over.

00:27:17.000 You will not get sick.

00:27:19.000 If you're sick, you do different things than if you're not.

00:27:27.000 You're more like extreme risky criminal behavior if you're getting sick.

00:27:32.000 That's what I'm saying.

00:27:34.000 So the police and the district attorney were very helpful to work with us if we provide their method, because they get mellow.

00:27:50.000 What is Miami doing?

00:27:52.000 There's awareness.

00:27:53.000 There's awareness of there's a problem and we have to do something about it.

00:27:59.000 And they had a lot of people like me coming over and ideas.

00:28:07.000 So they're making steps.

00:28:10.000 And the awareness of the fact that there is a problem, that's step one, two, and three.

00:28:17.000 And that's what they do there.

00:28:20.000 How about the rest of Europe?

00:28:21.000 Is anybody else doing it great?

00:28:24.000 We have no problem about drugs at the moment.

00:28:27.000 We have a problem.

00:28:29.000 You're all of Europe. 0.78

00:28:32.000 Yes, we have all of Europe.

00:28:35.000 We do not have a problem with opiates and drugs.

00:28:40.000 We have a problem with crime.

00:28:46.000 Because the Netherlands is a very small country.

00:28:50.000 When you drive three hours, you go from the bottom to the top or the other way around.

00:28:56.000 So we're 80 million people, so we're small.

00:29:00.000 And we are in the middle of distribution of mostly coke.

00:29:11.000 So we have a crime problem.

00:29:16.000 Which we can only solve, to my opinion, in Europe.

00:29:20.000 But we do not have a health problem with drugs.

00:29:25.000 Our alcohol problem, if it concerns health, is bigger than the problem that we have with drugs.

00:29:35.000 Rene, thank you so much.

00:29:37.000 This has been very enlightening and I'm so grateful to you for creating a template, a role model for the rest of us to be inspired by and perhaps to follow.

00:29:48.000 Okay.

00:29:48.000 Thank you very much.

00:29:49.000 Very nice to meet you.

00:29:50.000 You too, Rene.

00:29:51.000 Thank you.

00:29:52.000 Okay.

00:29:53.000 Take care.

RFK Jr. The Defender - October 31, 2024

Drug Addiction and Recovery with Rene Zegerius VIDEO

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