What to know about what you don’t know you know. #1: Intuition is very efficient—if you don't overthink it.
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I was a proud participant of the Portuguese Experiment with Harm reduction. I created outreach team where we met the hardest core homeless people where they were at, often starting with providing a clean syringe with a kind word. We provided and the teams still do, hot showers, food, coffee, medical and low threshold MAT (medically Assisted Treatment), along with dental work and shaving and barber/salon services. We never required a urine test and or blood work, a highly profitable business in this country. When people wanted to they had access to long term Therapeutic communities with stays of up to 2 years where they had the opportunity to forge new connections, rewire the brain and take time from going from a completely disorganized lifestyle to time to put their ducks in arrow. This country has even the concept of harm reduction wrong in some places. I went recently to a major clinic in another state and was disgusted by what they called harm reduction. It was lip service that did not match their abstinence model, with urine and blood tests and expectations that after 12 weeks of daily groups these poor fold would be able to turn their lives around. How could they? They were being threatened to be thrown in jail, lose their children, live in a shelter, and surrounded all day by better than thou clinicians who would not recognize harm reduction if it hit them in the face. Dr. Tatarsky, you know I highly respect your work, but I fear that this country has too much money to make from these mandatory treatments with urine tests, blood work and very misguided work. I have heard that Vermont is doing some interesting stuff and look forward to going up there and visiting. meanwhile I will be returning to Portugal in June and will be reuniting with my old peers who are still either in the trenches or accessible. If you go to the Harm Reduction meeting talk to Marta Borges, the woman who now heads the harm reduction efforts at the Portuguese department of addictions. And do not leave without speaking to DR. Joao Goulao, the man who has been at the helm of the Portuguese addiction services for more than 30 years. A very nice person, the amount of knowledge he has gathered is beyond impressive. Yet, still down to earth and with a great sense of humor. I am sorry that I cannot go but I know you will bring back fantastic information. And always, thank you for your courage! Your wisdom and your brilliance!
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