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Facebook Is Censoring Posts That Could Save Opioid Users' Lives

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High Wire is Maia Szalavitz's reported opinion column on drugs and drug policy.

As Facebook rolls out its campaign with the Partnership for Drug-Free Kids to “Stop Opioid Silence” and other initiatives to fight the overdose crisis, some stalwart advocates in the field are seeing unwelcome changes. In the past few months, accounts have been disabled, groups have disappeared, posts containing certain content—particularly related to fentanyl—have been removed, and one social media manager reports being banned for life from advertising on Facebook.

In its efforts to stop opioid sales on the site, Facebook appears to be blocking people who warn users about poisonous batches of drugs or who supply materials used to test for fentanyls and other contaminants. Just as 1990s web security filters mistook breast cancer research centers for porn sites, today’s internet still seems to have trouble distinguishing between drug dealers and groups trying to reduce the death toll from the overdose crisis. VICE reviewed screenshots and emails to corroborate the claims made in this story.

“My email is apparently a violation of community standards on Facebook,” said Louise Vincent, executive director of the Urban Survivors Union (USU), an organization created by and for people who use drugs.

Vincent has herself used opioids and lost a daughter to an overdose at a rehab that unconscionably failed to stock the antidote, naloxone. In her work, she provides naloxone and clean needles and educates people about how to protect themselves and their loved ones. This style of practice and advocacy that focuses on minimizing damage associated with drug use—rather than demanding immediate and complete abstinence—is known as harm reduction.

Recently, when Vincent has tried to post her email address on Facebook, the post wouldn't appear. And worse, a website she set up on Workplace by Facebook, the site’s free collaboration tool for businesses, suddenly disappeared. She described how she had created connections with user unions around the world—going rapidly from just three groups to 21 active collaborations. “Everyone was organizing on this page,” she said, “Now, we can’t get in.”

In previous interactions with Facebook, Vincent said that the company had been responsive. For example, Facebook had taken down some articles about fentanyl and material related to USU’s “Reframe the Blame” campaign, in which people who use opioids write living wills opposing the prosecution of their friends or connections if they die from an OD. Those posts were restored. But her attempts to communicate about more recent issues have gone unanswered.

“We did a year’s worth of work on there that I can’t access,” she said.

Facebook seems to be especially focused on fentanyl. Claire Zagorski, a wound care paramedic at the Austin Harm Reduction Coalition in Texas, said she informally surveyed other harm reduction groups about their experiences. About half a dozen reported problems with reduced distribution of posts or outright rejection—especially if they were trying to report a specific, local instance of fentanyl-tainted drugs. Two of the organizations affected were a harm reduction group called Shot in the Dark in Phoenix, Arizona, and Southside Harm Reduction Services in Minneapolis, Minnesota.

“I think it’s important to remember that they’re not being like, ‘Hooray drugs!’" Zagorski said. "They’re saying, ‘Be warned that this contaminated supply could be lethal.’”

Devin Reaves, executive director and co-founder of the Pennsylvania Harm Reduction Coalition, who hasn't personally had posts blocked, said: “Facebook wants to address the opioid crisis, but when harm reductionists try to inform their communities about what’s dangerous, their posts are being blocked.”

Colin Marcom is the social media director for a company called BunkPolice, which sells tests that can detect fentanyls and other substances in drugs; BunkPolice staff travels to music festivals to help people avoid tainted drugs. But recently, he said his account was permanently banned from placing ads on Facebook.

Around three months ago, the group submitted an ad that was approved and ran for seven days, Marcom said. As seen below, it shows a fentanyl test strip, which looks like a pregnancy test. The trick is that unlike with pregnancy, one line means positive, while two means negative—in this instance, that fentanyl and related drugs haven’t been detected. The ad shows how to read the data and provides ordering information.

The ad text read: "We have fulfilled all of our fentkit backorders and are now fully restocked. Demand has been insane but we're prepared to keep up — visit https://www.bunkpolice.com if you need to re-supply! #harmreduction #fentanyl #testkits #bunkpolice #fentkits"

Marcom said he received a boilerplate email telling him that the material violated the terms of service because it “promoted” drug use. “That’s the opposite of what we’re trying to do,” he said, “We’re trying to save people from ingesting these things that are active at the microgram level.”

Many needle exchange programs distribute similar tests and research suggests that they do encourage safer behavior. Marcom was allowed an appeal and wrote a note explaining the rationale for drug-checking services and how they can help save the lives of people who are not yet ready, willing or able to stop using drugs.

Nonetheless, the appeal was rejected. And now it’s like the 90s and 00s all over again.

When the internet first took off, drug warriors spread panic about the accessibility of “partisan” information, as opposed to (presumably) objective government data. They raised concern that providing harm reduction information about how to reduce risks associated with drugs would encourage drug use.

The difference now is that there is much more data showing that those fears are ill-founded. Harm reduction programs that provide clean needles, for example, are proven to reduce the spread of HIV—without encouraging "children" to take up injecting. Syringe access programs also don’t lengthen addiction by preventing people from seeking treatment—in fact, participants are more likely than others to seek and receive help.

Even what seems like the ultimate in enabling drug use—providing free heroin itself—has not been found to incite new use or lengthen addiction, but it can improve lives by reducing disease risk, increasing employment and helping people reconnect with friends and family.

While some economists have attempted to argue that providing naloxone as a way to reduce harm does encourage greater risk-taking, dozens of studies by public health researchers and even other econometric studies do not support this view.

Why then is Facebook cracking down?

When reached for comment, a Facebook spokesperson said the company is investigating these incidents. After VICE contacted Facebook, the company restored posts from Southside Harm Reduction and Shot in the Dark, as well as Louise Vincent’s ability to post her email address, which apparently triggered a spam filter unrelated to opioids.

Facebook also told VICE that Marcom was blocked from posting ads due not to fentanyl test strips, but due to posts related to kratom, an herb used by some as a substitute for opioids. Facebook has decided that kratom is a “non-medical drug” and is removing posts and groups related to it—even though its use is considered to be a form of harm reduction.

Marcom said he hadn’t posted any kratom-related ads since 2018 and added, “It's extremely frustrating that they have chosen to ban a proven safe plant medicine, as Facebook used to be a space where tens of thousands went daily for help getting off of opiates and other pharmaceuticals.”

A Facebook spokesperson said “Our Community Standards do not allow people to buy, sell or [trade] non-medical or pharmaceutical drugs, or promote the use of non-medical drugs including providing instructions on how to use them. Our policies do allow for people to raise awareness of harmful drugs and share their stories of recovery.”

The spokesperson said Facebook is still investigating the removal of the Urban Survivors Union workplace site.

VICE has requested information on what Facebook considers to be an awareness-raising post per this policy; it sent us a link to their regulated goods policy, which states that people should not post anything that “Admits, either in writing or verbally, to personal use of non-medical drugs unless posted in a recovery context.”

When asked for further clarification about what a “recovery context” means, a Facebook spokesperson told me that the company is aware that this is a very blunt policy that could be interpreted to ban content as disparate as calls for psychedelic legalization based on personal experience and attempts by people who take heroin to reduce injecting risk. Their main goal, they say, is to reduce drug selling and promotion—not political speech or harm reduction organizing.

But regardless of the particulars, these incidents make clear the enormous unchecked power held by tech corporations like Facebook. One of the factors that allowed harm reduction to blossom and spread during the 1990s and beyond was the open internet, which offered information on alternative views on drug policy and previously inaccessible academic research, which rarely received attention in the mainstream media at the time.

Among the earliest users of the internet were fans of the Grateful Dead (like me, my introduction: 1990!) and others who were, shall we say, no strangers to illegal drugs. Breaking the stranglehold that drug warriors had over media coverage led to real progress: we need to ensure that the internet remains open to the expression of new ideas and does not return us to the time when “sending the right message” mattered more than telling the truth about drugs.

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Maia Szalavitz, BruceDayne