Drug Use, Harm Reduction, and YouTube Hyperventilators

Photograph Source: tytvault – CC BY-SA 2.0

Any criticism of left-leaning YouTube commentators should begin with a basic endorsement of civil liberties. Many people now get much of their news and views from social media, and not from the older legacy media of newspapers and TV broadcasts. Since the barriers to participation in new media are less restrictive, the YouTube shows and platforms (ranging across a wide political spectrum) can be considered as a real extension of free speech and democracy.

Left commentators on YouTube periodically raise alarms about the algorithmic bias on YouTube that favors right wing outlets and broadcasters. The algorithm is not a mysterious ghost in the machine, but is instead an outcome of dominant corporate interests and investments. Indeed, the left leaning YouTubers often criticize right wing disinformation campaigns, offering their own commentary as a more truly informative counterbalance. They encourage viewers to press the Like button, of course, and to become not just subscribers but financial donors.

As a general rule, it is true enough that the left tends to lean toward reality, and the right tends to lean away. Important distinctions will be lost, however, if we only follow general rules.

The Young Turks (TYT), hosted by its founder Cenk Uygur and co-hosted by Ana Kasparian, was a pioneer in the creation of progressive and left leaning platforms on YouTube. TYT grew to become an extended platform of platforms, and over the years some of their earlier commentators (including Jimmy Dore and Kyle Kulinski) left to start their own popular shows.

Notable features of the YouTube left have become clearer and more prominent over time.

The commentators often refer to themselves as content creators, which means they must always beat the clock to turn out product for the coming episode. Sometimes they have done their homework and do have informed opinions. Just as often, they are content to be performers pitching their hot takes to loyal fans and subscribers. Many are busy clawing their way up in ratings, like proverbial crabs in a barrel, and post clickbait subject lines that promise knock out punches with competitors.

Arm waving and hyperventilating outrage is all part of the scene, spanning the political spectrum from right to left. In this sense, Alex Jones is not far removed from Jimmy Dore and Cenk Uygur, or indeed from World Wrestling Entertainment. Yeah, and the white guys outnumber everyone else on the YouTube left. A few of the outstanding talents do include a black woman, Briahna Joy Gray, who brings an analytical mind to any issue she raises. She is also more often willing to say, “I don’t know.” Likewise, Mike Figueredo at The Humanist Report is one of the few queers among prominent YouTube lefties, and is notable for his humor, irony, and ambivalence.

Only a minority of the YouTube lefties take pains to follow evidence wherever it leads. In a sense, this is just a consequence of their primary job as performers. A few state honestly that they talk for a living. The viewer is always free to vote thumbs up or thumbs down on whether they like a performance or not. What is at stake is not really a public conversation in which there might be a quest for the truth. In politics, this would mean a quest for the empirical ground of a public policy, perhaps in healthcare, housing, or education.

Now watch this recent episode of The Young Turks (TYT), in which Uygur and Kasparian discuss drug use and harm reduction:

A Dangerous New “Zombie Drug” is Taking Over American Streets
The Young Turks (TYT), Mar 4, 2023

As a cofounder of a harm reduction project in Philadelphia in the previous century, and as a socialist still working in the healthcare movement, I am dismayed by the performances of Uygur and Kasparian.

Xylazine, known in drug slang as tranq, is a non-opioid drug originally used as a horse tranquilizer. The early epicenter of tranq use was Philadelphia (especially in Kensington, the site of one of the first harm reduction sites founded by Prevention Point Philadelphia, which was a branch project of ACT UP Philadelphia.) Tranq has since spread to other cities and towns and is used for cutting heroin. It is also found mixed with fentanyl and other drugs. Naloxone is not sufficient to counteract the inhibitive respiratory effects of xylazine. See the link and excerpted text from NIH here.

“In the event of a suspected xylazine overdose, experts recommend giving the opioid overdose reversal medication naloxone because xylazine is frequently combined with opioids. However, because xylazine is not an opioid, naloxone does not address the impact of xylazine on breathing. Because of this, experts are concerned that a growing prevalence of xylazine in the illicit opioid supply may render naloxone less effective for some overdoses. Emergency medical services should always be alerted to a suspected overdose. Learn more about stopping overdose from the CDC.”

At TYT, Cenk Uygur and Ana Kasparian are in the business of shooting off their mouths on any issue tossed up in the news cycle. In this TYT episode, anyone unfamiliar with actual harm reduction programs might conclude from their talking points that harm reduction is simply a misguided effort to let drug addiction take its course.

Cenk Uygur rages against a vague regiment of “the crazy left” he accuses of being right wing libertarians. That is both boring and demagogic. Unwittingly, Uygur reveals his reflexive commitment to the partisan “centrism” that has migrated quite far to the right over the past thirty and forty years.

Kasparian does not seem to understand that harm reduction was never designed to reverse rising rates of fatal overdoses as a stand-alone program. She is certainly not properly acquainted with the basic science of drug addiction and treatment, nor the necessary integration of harm reduction into comprehensive healthcare. Addressing harm reduction in public policy does not require Kasparian to become a doctor or scientist. But she proves herself more eager to deliver opinions than to do responsible journalism.

Harm reduction opens bridges to a range of health services. Yes, such services have to be improved. By raising the ground floor of healthcare, housing, and education, for example. When Ana Kasparian says some addicts need “intervention,” one would like to know exactly what she has in mind. Vast police sweeps of neighborhoods in Philly, New York, and Los Angeles? If the question is raised so plainly, we may count on her denial in some new episode of The Young Turks. The problem is that she is substantially ignorant on dozens of topics, and projects her ignorance through the megaphone of social media.

As Karl Kraus wrote early in the twentieth century, “The making of a journalist: no ideas and the ability to express them.”

Kasparian has a platform from which she might hold career politicians accountable. Her partisan “pragmatism” instead gives political cover for Biden and his party colleagues, since Biden campaigned with an explicit promise to veto any single payer healthcare bill that might cross his desk. Biden was also an early and zealous volunteer in the War on Drugs. No surprise, his son Hunter has access to high end drug rehab programs, underscoring the brutal fact that the War on Drugs was always and still remains a class war.

Kasparian is concerned that Republicans may gain traction with voters on issues of law and order. Sure, no one wants to be threatened or assaulted on the streets, and there are links between some kinds of drug addiction and some crimes of violence.

In terms of public policy, however, the moral squalor and organized lying proceeds from the top down, from the heights of state power down to ravaged neighborhoods. In crucial areas of public policy, including the ever-growing war budget and the strip mining of public goods and services, the corporate status quo is bipartisan. By all means, make honest distinctions between parties and candidates, but likewise study of the actual divisions of labor within a corporate command economy. Including the relations of power between career politicians and the voting public.

The Democratic and Republican parties keep each other in business. This structural codependency has consequences in bipartisan accords that advance the project of war and empire, and likewise in bipartisan privatization schemes that undermine public health, housing, and education.

Though harm reduction is essential to the care of all patients, it is also emergency work within the present reality of a broken health care system. Uygur is nearly incoherent by the end of the linked TYT episode, and warns that the Democratic Party has been bullied by “the crazy left” on drug policy. On the contrary, any sane and rational public health policy related to drug addiction is undermined by the sensationalist performance art of Uygur; and (much more importantly) by career politicians who agitate voters to dread a zombie apocalypse of drug addicts.

Kasparian quite simply makes a caricature of harm reduction. The founders of harm reduction programs in this country were also advocates for community clinics in which drug use could be medically supervised. Since Kasparian targets California as the state where harm reduction has presumably gone off the rails, a few facts are in order.

Governor Newsom of California campaigned in favor of single payer health care, but turned his back on this policy once he gained office. More recently, Newsom vetoed a bill that would have established harm reduction sites in Los Angeles, San Francisco, and Oakland. (Governor Jerry Brown had likewise rejected similar legislation in 2018.) I have a hunch this is among the crucial signals Newsom is sending out to clear a “centrist” lane in his future political career.

Truly, in healthcare as in politics a single strategy cannot solve all problems. For example, the pioneers of harm reduction hardly anticipated that Oxycontin would have a public and aggressive corporate promotion campaign. The chief drug mafia in this case, the Sackler family, have received a few fines that are only spare change drawn from their vast fortune, and have had their family name removed from certain art galleries and philanthropic projects. In this case as in so many others, the law of capital is a net woven with such cunning that it catches a multitude of minnows, but lets the sharks go free.

Test strips are available to detect the chemistry and safety of some drugs used in social venues and dance clubs, but the strips have to be specific for required purposes. This is the concluding paragraph (with a linked text) of a report titled “Perspectives of people in Philadelphia who use fentanyl/heroin adulterated with the animal tranquilizer xylazine; Making a case for xylazine test strips,” published in Drug and Alcohol Dependence Reports, Volume 4, September 2022, and available online at ScienceDirect.

“The use of test strips as a harm reduction strategy is promising, but test strips for xylazine are not commercially available. If developed, they would likely be used by people who use fentanyl/heroin. It is important to be responsive to the stated needs of PWUD [people who use drugs] and consider allocation of resources to the development of xylazine test strips.”

Did it ever occur to Kasparian that harm reduction programs might include specific test strips for addictive drugs such as fentanyl and xylazine? She emotes on schedule to produce the next episode of The Young Turks. Investigative journalism is not really in her job description.

The first quarter of the twenty-first century has all the objective signs of being an era of accelerating catastrophes. Sensational modes of political performance always had a near kinship with totalitarian regimes in the previous century. The distinction that matters most in this regard is whether public emotion is illuminated by public reason, or on the contrary becomes an apocalyptic mass rapture. When we encounter a chorus line of jerking knees in any political camp whatsoever, we might take several steps back to gain more perspective. In the early years of the AIDS epidemic, health care activists followed a good rule: Homework and hellraising. In that order. That, too, was a harm reduction project.