In our inaugural Vanilla Club episode we kick off with a very special guest, Dr. Alex Wodak. In a disarming, matter-of-fact style, he plunges us right into the HIV/AIDS crisis of the 1980's, pulling no punches about his role in applying civil disobedience to effectively shape government policy. The confluence of social stigma toward alternative lifestyles at the time, coupled with a shonky public understanding of the logarithmic effects of infection in epidemic situations, meant that Dr. Alex in 1982 had no choice but to take action. If addicts were to at least have access to clean needles, the incidental, totally avoidable infections of HIV could be halved, perhaps, is what he posited. It was a nascent "harm reduction" philosophy in action, the idea being that public health benefits from less "moralising." We dig into some controversial topics, including whether vaping is a good thing (namely because it is displacing a worse thing, i.e. smoking), the Opium War, and other charged topics. He shares with us decades of experience in addiction medicine and harm reduction, challenging traditional punitive approaches to drug policy.
Dr. Alex was Director of the Alcohol and Drug Service at St. Vincent’s Hospital in Sydney from 1982-2012. He played a key role in the establishment of Australia’s first supervised medical injecting centre in notorious Kings Cross, and helped pioneer the needle exchange program to combat the spread of HIV. This was a program, which believe it or not, was illegal at the time. Dr. Alex's conviction was so strong that he admits today his actions were in fact technically illegal, yet civil disobedience was the only option available in response to a society that was not ready for fundamental "harm reduction" concepts, ideas we today take entirely for granted; if you have ever seen a needles disposal box in a public bathroom, that is "harm reduction" in action; Dr. Alex bears witness to a world in the 1980's and 1990's where many of these ideas faced extreme aversion.
In the episode, we challenge consequentialism, airing Jason's personal experience with smoking cessation in New York City. It is only when NYC took a "rules-based" stand that indoor smoking was bad, did Jason actually realise that instead of smoking being the vehicle to join the party, in fact smoking meant having to leave the party, which were the baby steps that ultimately led to him reconsidering the enterprise of being addicted to cigarettes.
Dr. Alex advocates for realistic, compassionate public health strategies over incarceration. The conversation also addresses the ideological battles surrounding drug policy, emphasising the necessity of moving beyond prohibitionist mindsets to embrace evidence-based, consequentialist approaches.
If the Simple Wellness framework that undergirds this new podcast stands for anything it's that wellness should be simple, and it should have one principle: reduce complications. That is it. Not eliminating complications, because a "Blitzkrieg" mentality often begets more problems. But reducing them. Harm reduction as a consequentialist idea is such a fascinating topic because we see how, as in Dr. Alex's flagship example of the clean needle access, it literally reduces complications. Nevertheless, for certain addicts who are less than hell bent on using, and using, it's hard to see how some level of ground level moral judgment (small "d" deontological claims), that yes, certain classes of drugs are harmful, and you should try to stop using, mightn't be a bad thing.
This was an engaging conversation confronting many relevant issues of the day straight on. We thank Dr. Alex for taking the time to speak with us on such important topics with the level of candour that he brought!
We hope you enjoy.
1 hr and 22 mins