« The Weeds

Understanding the opioid epidemic

2017-07-07

Drug policy reporter German Lopez joins Matt for a close look at the biggest drug overdose crisis in American history.

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This is an unofficial transcript meant for reference. Accuracy is not guaranteed.
What can we do? Can we build a warm welcome to another episode of the weeds on the box media Potass network? I must replace yes and that what we gotTA especial episode here being joined by Lopez, one of our top reporters here at a box, I come a lot of people been asking task of months of Facebook, group and elsewhere for us to talk about the opium epidemic shoe, you wanted to do it, but but really I be doing, is served loosely paraphrasing stuff from on his as written that that I've read so that we could do to have him on an and talk about it, while, while the team short staffed and unpeopled summer vacation. So we can pop some pills and enjoy yourselves slots on pops into simple, no furthest enough people are doing
The first thing to think about here just to come said this up is like took on a scale of the problem. Are we talking about I was on a vacation last weekend. I was there, you know DR and render rent a car, so we had the serious exam satellite radio- and I was listening to my might nineties- Alternative Rock station. so I would normally do, and it was a reminder like half the songs, are about heroin overdoses from early nineties is it. There was certainly like a cultural perception that, like there was a huge problem, time and then earlier in the in the seventies, coming out of Vietnam. That was like a big wave of of heroin usage. this a certain cyclical omen to these things like they come and go, but were looking at now is, is actually much big right. Bright say this is just just to get, but the top number out is that this is a deadly struck overdose epidemic in recorded history, so and in America anyway,
Oh it's you like. Every year we get another shocking statistic about its own lake and two thousand fifteen. The statistical as the drug overdose is now kill. More people than HIV Aids did at its peak. So have you cared about HIV Aids should probably care about. Drug overdose is going to send people the latest one from Sudan. Sixteen in this space, my preliminary data, but it's now drug overdose has killed more people than the entire war. In Vietnam, I mean you can free the different ways, but that the general point is that drug overdose, killing a lot of people, the latest official estimates or to those fifteen. Fifty two thousand people died. A drug overdose is about, two thirds were related to opiates, meaning painkillers and heroin and feminine and those kinds of drugs it's a lot of people dying and and also that there have been forecast coming out that for the next ten years, how many before are gonna die and on the worst estimates suggest. Six hundred fifty thousand people die in the next ten years and the average
of all the the forecast which is. This is something start new states that we should give them some credit for, but all the average is five hundred thousand. That's that don't lie- and this is in the face of what's really an improved medical technology for treating drug overdose is right, I mean compared to twenty are or forty years now we have more people dying, but actually it would be even more just based purely on on the usage as the Kosovo private interests, but how accessible. This better treatment is a huge problem, but we do generally have better understanding of addiction. There's a stigma attached to addiction. It's less about. This is a moral, furthermore, but a legitimate medical issue and we have met Asians that, like they reduce mortality of opium addiction by half. So these like methadone, deeper Norfolk, NOM, brantome sportsmen and now talks on which its branches with petroleum
these drugs seriously help people in their not anywhere near as accessible as they should be in the? U S, but they're, more accepted by doctors and more swollen they weren't. So we're talking about basically, a tremendous increase in the sort of population of users, rights achieved what we had its of much more means stream, I don't know how s house he would put it then sort of previous waves of a drug Yeah it's awfully right. I mean there are some states that are more carefully more afflicted the nerves like West Virginia Ohio, Pennsylvania, New Hampshire and New Mexico summit But if you look at the numbers, these are some of the worst state and exports of an outlier there, but in general it's like raw belt states- and this is us as advocate always tell me, it's like a fifty states. item if you look at survey data most american.
Say they know somebody affected by this issue like somebody who is either suffering from about addiction or had died from a drug overdose. So it's clearly become a very big mainstream mission. There, a lot of people die. Ok, so. where does this come from I mean I will call the Glee. I'm not like a drug policy. Guy but I will call having formed the opinion at some point in their dusting, pass that America was too harsh in puritanical about drugs in general, which I think is what most younger people believe that people should probably be able to get marijuana. I thought that one sort of, A number of America's like moral panic about drugs was that it was too hard for people to get useful pain, medical
treatment that was, I don't know who told me that, but this was definitely a fact. Implanted unbreadlike war on drugs mania point a. We have nonviolent offenders in jail for no good reason. Why be we have this pretty soon, not that unhealthy drug marijuana being treated much more restrictive and alcohol point three: like doctors, don't want to give people pain medicine Because- they'll be treated like their drug dealers right so yeah in the eighties, and particularly the nineties, when it really started as that how to draw under a lot of pressure to treat pain as a serious medical problem, and it is a a serious medical problem that affects a lot of people. I think the latest Institute of Medicine Report found that it's about a hundred million adults suffer from some level of chronic pain. I mean this isn't like necessarily debilitating chronic pain for all those hundred million, but it's a lot of people suffer Latin cry pay, so it serious issue, and then there was a
campaign going on that. You should take him more seriously and pharmaceutical company stepped in and they were like. Hey we're producing these new nice opioids are safer, more effective, at least that's what they said and they kind of like convince doctors to go ahead. They they told him that they're afflicted the They used as opium phobia that sort of suggesting that they're, like irrationally, scared, pleasing opiates and they really push them already. There were some studies. There was one one recent paper that came out looking at this five sentence, study that came out of the eighties and that five sent us study which had no hand about its methodology. Because I mean it was five sentences, it's hard to see how good of a study that can be. But it basically suggested that most people on opiates will not get a directive, like only a very, very small, fraction of them well and pharmaceutical companies really with this really push this hard on doctors and and said, look belonging to get addicted our drugs. You should give them more easily to pay and the idea was that these opium drugs are opiates, had been used in medicinal settings.
A hundred bright years ago, something like that way to me. If you watch Deadwood she's gotta, prescription bird, I don't know what it's opium, or or morphine or or something Ipad and was in the twenty is that legal restriction article nineteen fourteen, on the other side and really ramping up the conditions and restrictions We sort of had had this sum version of this cycle where people had been like hey you could take these drugs and you'll feel better and then a lot of people are addicted and then Congress Right was ignored Actually, this dangerous right and southern starting in the in the eighties and and Ninetys they develop new pill phrase that they were not can have these problems the baby? is actually cotton which came out in the MID ninety nine years and they really push these drugs are wanting. That's interesting about this. Is that a way of framing this historically is that there has always been the search for the safe code on quotas.
Hope you would Heroin actually was invented because they were looking for the safe opiate and we know how that turn out. It did not turn out to be the very safe opiate. So simple, the original onset. What MRS Opium, as there was an opium and from then they they made morphine and morphine, was really what launch it s like this. Is us import medical device but enjoy What we ve seen time and time again as when they put out these new opiates, they do not turn out to be safer or more effective. Purdue farm at the company who made oxy cotton has already paid like hundreds million stars of fines, because their marketing was deemed misleading in effect of an and one other claims. If they were safe, was not good, and I should say that hundreds of millions of ours fund finally, a lot of money to you and me so much money to produce farmers so in the end, not a bit. So what what we're supposed to be safer about African? What was that- the pitch, the pictures that they change the name of form, as also like slow, releasing an answer they had like want each other. Just like it's going to be harder to abuses.
because it won't take effect as quickly as like, say here. If you inject heroin well, so it's gonna be harder to abuse. I mean in the end, though, the problem was a people which has crush these pills and snort them or reject them or do all sorts of other things, and then they were pretty much not exactly the same chemical composition as heroin, but pretty damn close, so people started abusing them misuse then I'm some people just took them regularly. Image took to Martin, and even that gave him a high and eventually might lead them to overdoses and one and also there's the safety issue which is like. How likely are you two overdose on this? But then is that tendency issue, which is: how likely are you to sort of become addicted right right? as we are talking about like that, the different sort of variants of Opium Lloyd's The people are using the fact that those aren't the same thing you don't becomes
relevant ride so leg. It may be that the ox cotton pills are not like a Superfund recreational drug for most people or pose all that great, an overdue, risk? But when you using them for chronic pain management, you're, still generating a lot of baseline addiction, bright right, which gets people on a road, to trouble right. There's there's two kinds of one is like dependence, which is I mean everyone who takes opiate over time. I shall everyone. Some people do not have dependence, literally at all, which is weird, but most people who take up your time will become dependent, meaning that when they start taking the bill, we'll have withdraw. That doesn't necessarily mean your addicted addicted means that that dependence is actually like hurting you in some way. Like I said, turning your life outcomes are social outcomes and whatnot but in general, when you up the amount of people taking these districts, which is what happened
Two thousand twelve. There were enough pills out, therefore, every adult in America to get their hands on a bottle pills but lot of drugs. So once up it by that much, even if only a small percentage of people are getting addicted vigour, giving tens of millions of people pills at still millions of people getting addicted, and that essentially what happened that you just, Greece that the amount of people getting addicted and that would read not not just to hire overdose rest but to them going on to other DR site, similar, obviously Heroin And what I mean you you mentioned earlier: a hundred million people who are suffering from one form or another of chronic pain. and that sort of an issue? Why is that the difference between prescribing a drug in an acute kind of case like you, have a surgery, the euro
directed to recover from, and I mean I've hour. I have made my wisdom teeth and I was given something some kind of pillar with opiates in it, but the expectation by everyone was like whether I took their pill or not within three or four days. I was gonna feel completely better ready, wasn't intended to be a treatment for a long term condition and that's different from. If you have chronic back pay in and you're saying, ok here, something that's not gonna, you could have a treatment that cures you in sums. Hands, but if you're talking about a pain, medicine that you're back is still gonna, hurt and you're talking about long term use of an addictive brush to say, I think Two things to separate from that is like one is the acute economic like. I was also given my camera, which opiate it was, but I was given opiates for my wisdom When I got and taken out- and I remember distinctly way more than I needed so that's like one aspect of the problem-
even if your prescribed for acute pain- and you only need them for three days by your proscribed thirty days, which is to be pretty standard. That's like what are you gonna do with us extra pills. Alot of people are like I'm gonna sell them, because I like money, so white and money is get their money is generally goods. and though Solomon Owl or the baby are teenagers will find them in their path. Medicine, cabinets and whatnot- not so that's like one way that even acute pain played a role in. Unlike any these pills out there, the other is it with chronic pain? As you mentioned, I mean these are people who are taking these drugs for years may be decade, and the research is very good on this that the longer you are taking opiates, the more likely or to become dependent and addicted to them That's measure both in like how long you're taking them and the dose retain so like the higher the dose. The more likely are to become dependent elected. Retain under more like the earth, become dependent on directive and its essential. What happened with a lot of these chronic pain patient I mean I want to say that like chronic pain patient want this way, because some of the best
Do that, like it's about eight percent of chronic a long term, opiate users will become addicted. So it's not like everyone on them. Some service suggest a number should be higher, but in general the thing to pull away from. That is that, even if that eight percent numbers true when tend to me, the people are getting. These rose again, but still millions of people get right. So it's it's when you philosophically sort of turn the page as they will work, any use opiates to treat chronic pain, and you have a country where a lot of people have chronic pain, even if it's a real ITALY, small share of them who get addicted you're. Talking about a lot of people like what point pain in the United States is on a rare medical condition. And developing obeyed dependence, if you're a long term user is also not it's me minority of people, but it's not all that rare either right. and I should say one thing about that's important to pull out about this- is that the research on how effective opiates for chronic pain is
terrible, I mean we know the kids are good for Cuban. I think anybody who has taken them for like a cute, pink and testify to that they make you feel good for a bit but for chronic pain, Studies that have come out suggests that there are not that the divergences every weak on this and in general that because all medical treatment for chronic pain are pretty bad day, you have to like do this on an individual case by case basis. Opiate might work for some people. They might be absolutely terrible for other people, but that's important point out just because when farmers we'll companies ran ahead and doctors ble bought into this idea that opiate are good for treating chronic pain. That really wasn't that any good evidence to support them so in a big way like basis for this epidemic started, could have been avoided. If people dislike picked up a study- and I looked at it and believed it anyway- Amanda better evidence for what they were doing. Why so part of it is why we have not ever found good solutions for chronic pain and part of it is that A are well known for short of that has allowed or drug czar.
reading up like a tolerance and a kind of that, a spiral of dosage that that you need. So you know, maybe for some period of time the seems to be working well, but if you're not talking about a cure, you turn met a treatment. And it's gonna lose efficacy, and not that there is actually some evidence that they might make your pain worse in the long run, because they make a more sensitive to pain. Theirs. research on this head, that's kind of I mean it. It were, but like We understand, as I I've talked to a wonderful disinfection extra before the way that she should treat some patients their pain actually get better after they get off opiate because after they get through the withdrawal, which is really in full. They realise that a lot of the pain they were feeling when they're there need felt like I need to take another pill was actually the beginnings of withdrawal pain and in way by not having that withdrawal pain anymore, because the detox their overall pain score, improved
and like that's one way that opiates can actually make your pain. Worse, is by making you dependent, but other otherwise also just seem to make you more more sensitive to payment general way, did I think you know anyone who you know like me gets until I come coffee addiction, spyware readily. You can lay right at a certain point in your life? This is like helping you, up in the morning and you're like more alert and on point. But then you know ex years into it like you wake up in the morning in your way worse than you are few weeks and even better go, come tolerant way, you know, and so then it's like yeah still true that drinking your morning cup of coffee cups, going in the morning, but that's because you ve set your baseline right like such a shitty play zero, and I mean I would imagine- also with pay in that there is a question of the underlying causes-
like for a while. I was having painful issue with my left knee and I let little physical therapy around it. But I also was just sort of tied, told instructed that, like I have to not do certain things or it's going hurt. My knee- and this is a big thing with like chronic pain treatment- is, I mean the way the people, but is that you should learn to manage your pain that consign counter cold like just deal with it, is how a lot of pain business, but there are like actual strategies you can use like instead of going out and trying to like if you're working under gardens chopping down trees or planting as many likes leaning over in like doing all sorts of things. I can hurt your back. You just don't do as much of those things anymore, and I mean that sounds something like it's a young person what sound like horrible to me like, I don't want to get old and want to have all these random aches in my body, but
the reality of like growing older and like that, something that you need to learn to manage. And if I mean if the alternative is take these actually deadly drugs, then maybe it's better than just cut back on, like some of the activities you're doing before they can potentially her you and that's what I thought I would imagine if the drugs do work, at least in the short term right, that's going to encourage you re, possibly keep doing feathers that are causing the injured yeah. That's that's another vote like you can actually work in your liking pop a few pills and you think you're, fine, you'd start chopping down trees and pretty soon your your backards, like it up the pills were oftener backwards, even worse than they did before, because you were injuring it without even knowing ok, so so what happen. We ve started getting this sort of large kind of like install base of people taking oxy, cotton and other new generation slow release pharmaceuticals. You know under patent They cost a good bit of money, they're, making good money for pharmaceutical companies too.
overdose on them. You gotta have crushed the mob. You know, do some kind of awful able use and now I mean I remember ten years ago, that was a story right people tongue, bad oxy was I kill Billy Heroin, there were starting to see reports of people doing like robberies of pharmacies like that, but didn't seems like more recently. Things have kicked into a higher gear, brought usage. Two things that happened: one is the garment crackdown on what they called Pell Mell, which are basically like clinics where you could go in their pay cash, and you would just get a bunch of bills, not really how many questions ass. So the government began shunning those down locking up the doctors who are really doing shady things. and I mean if european patients at that point, the situation we left with is, ok well, I still have this pain. I still want these pills. I want to go through withdrawal. What do I do and a lot of people started buying pills, illicit leave like from the,
market and a lot of them went to heroin because it way cheaper than pills on the black market, so that that one day and in General de the other thing that happened is up some patience. I mean overtime, they're, just natural gonna lose her prescriptions regardless of government crackdown, or they might say, I want a better high and all naturally go to heroin. That way sets What really happened? That's what I've been our started, getting really really bad because not only do those are going to heroin, but like drug dealer started like sing the heroin with fat, no, which the very potent no good in some of the Ets Analogue finals actually a whole set of drugs that are much more potent than like traditional heroin painkillers make an next move with square squares square space is a service that lets you make beautiful, unique websites with a great unique domain
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curse. Understand that that's what was going to happen when they crack down the decimal? but some of them did. I've talked to some people to drugstores office before who I've said that, like yeah, they knew this was a problem, but they weren't just going to let doctors get away with what they were doing and I think the the most generous way It is that they were dealing like there's two sets of problems here. One is a stock of the stock of current opium users, which those are the ones who who got these pearls and were already addict in one eye, but there's a flow of opium users, which the future generations that might get addicted, and the idea was walking down on these pill, mills was stopping more future generations of getting addicted. There's a good argument that, if you stop doctors from getting these pills out, then your people are going to get on them to your people are going to get addicted. The problem is that with the stock, hope, users, there still not enough drug treatment out there till I get these people and to care and get them to stop using opiate so
what, while they were doing all this prevention stuff. Stopping all these pills, these patients were just stranded and because there were less random without adequate drug treatment they resorted to. Illegal drugs, and I'm just made the problem more. So that is the case on the flows. Issue is that there is a set of people who would not just wake up one day, go down to some corner somewhere and by heroin, but who could very plausibly get on an addiction treadmill via the medical system that there's just good studies. The back up that that idea. They are. One of the recent studies show that, like three fourths of people's signing into drug treatment for opioid started on painkillers. The total switch from how it was in the seventies, most people used to start on Heroin and the CDC also some data showing that if you are addicted to painkillers you,
forty times more likely to be addicted to heroin. So I mean that that there was a basis for that. The problem is like mentioned earlier. The current stock promise not press at all right. So so you can have even in a sort of optimistic case where you could. We might look back twenty years from now and say ultimately, this kind of worked, but you would still have this slight car ball tragic interlude in which a population of already addicted people was being more or less liberally like shunted into more dangerous right situation. We must die in and took to sever the connection between like mainstream society and access to opium, Lloyd's right you're, taking people who were in the middle ground, unlike shoving them into this incredible life threatening bread? It's not because there is no solution for the star problem. I'm in the there's there's deftly salute
since Ford being dropped, and spending way more on it. As a country, I mean that a certain general ass, released, a report that an addiction and it found that only ten percent of people who have a drug abuse disorder only ten percent of these people actually get specialty treatment. That's a very number. If we had that for like heart, disease or diabetes, it would be seriously concerned about what we're doing terms of healthcare. So these people need care and we could spend way more money on giving them that care, but we're just now right now, so, ok, so this year, then that gains to that to them question I mean one difference is that everybody more or less, who gets diagnosed with cancer, seeks treatment for for the cancer? Its is not the case that everyone whose addicted to drugs is like trying to get
treatment in a in a clear way, but what is the sort of mismatch between demand and and availability fur for good treatments, So there's there's a bunch of reason. One of the big ones is obviously stigma. I mean there's there's lake theirs stigma around addiction, some people still saves moral failure, so like submitted two. I can beating care esteem light your a moral failure enjoying subject, but don't you gonna want like come out to friends and family coworker ruddy, I'm addicted to heroin, brandy it how they want to try to do what they can to sort of get along in life, but the another aspect which is really big as the than the surgeon General report really emphasise. This is that we just do not happen, treatment facilities around. If I'm a doctor in West Virginia, which has one of the worst opiate problems, and unlike I need to get this patient off painkillers, I dont want how this patient anymore.
in a lot of rural areas. I'm not going to have a treatment of nearby treatment center to refer them too much less like an effective treatment center, because they're all these places that, like demand, abstinence and there's, no good good evidence for just like totally quitting cold Turkey opioid, but there's the treatment centers like medication for bottom or not. I might not have a good referral for them to get them into treatment at all, just might not be any options. That's a big thing and like there are multiple causes for that. One of those that addiction, specialist in general, paid, less Savior doctor or at the upcoming med school students your. Probably unless you care about this issue are going to be less incentivize to actually join the addiction field and a bunch of these caught. Those kind of factors come together to really make so there's just a severe shortage. Clearly in rural areas for addiction care. So what does? What does effective treatment? Look like broadly Four opiates its did. There are these medications, which
century what these medications do. Is it stave off your withdrawal? So you might Some people need taken for a few years. Some people will take them for the rest of our lives were basically don't have this. These cravings anymore, that used for these opiate and By doing that, people are much less likely to actually seek out painkillers enhance its lot of the time. They're, doing it not to get high there safe this. This phrase in the head world, are you stay you're getting strayed, because it's not even a pleasure thing anymore? I just you want us to keep off the withdraw. So that's why these medications were really effective. They just make it so you don't have worry about that withdraw anymore, and you compare that with, like traditional psychotherapy, compared parallel with anais session. and whatever, whatever social sinners, narcotics anonymous here, they're, whatever social support, Roupell will work for you, but the bottom line is that these medications are really effective and there are like
There are restrictions on methadone is one of them and you can only get that by going to a clinic by twice a day, to get your methadone once or twice a day. So that's office not accessible to a lot of people who have jobs and demanding schedules and what not an Buber morphine witches box on its it's. You can take home, but there are restrictions farm by the federal government on how much doctors can prescribe of this. So that's it another way that this this drug is restricted and when you like out of these barriers up? That's that's how you are getting to the point where, like not only is it the case that we don't have enough drug treatment in general, we also don't have the best structure emergencies, these medications and And so you don't? You have people who in many cases are a regionally in this pipeline because of chronic pain issues. You probably also want some kind of treatment reform that something
pharmaceutical right and that you can get into like the the root causes of addiction Alot. One of the big ones is obviously this pain like a lot of these people that addicted, because they started seeking trim for the pain, and this is another thing that our health care system is really bad out. There are treatments for I give I. If I wanted illicit treatments for pain, I would Alyssum alternative medicine things like acupuncture and chiropractor. There's like makes evidence on those, but there's also stuff like physical exercise is teaching. You about how to manage your pain, like we talked earlier. These things are very expensive. For a lot of people- and they may not, they might not be covered, I health insurance and even if they are covered by health insurance law, people don't have health insurance. So the problem gets worse there because p just. This is one of the reasons the doctors for so quick to resort to appeared because they offered a cheap, easy answer to this pain problem that, because he's patients couldn't get it to the more complicated, but perhaps better
It means for their pain, yet mean you know in in, like in Silicon Valley. Widened in the business world is a big obsession with with ideas is not just like this is I d have merit, but is it scale all right- and you know I know, might my mother laws of physical therapist, and you know I think she's she's gotta her job. She helps people, but a basic problem with the kind of work, but she dies is that it doesn't scale right. It's like her in a room with one person working on some exercises, working on some strategies for recovery and pain management, whereas, like a factory, if it has a pill, they can, you can make a LA and you can pay them out to people quickly and and and stuff like that, so uniform an insurance company perspective from dollars incense perspective.
I just looked so much better to to push people toward a pill based solution. Almost any kind of problem, rather than towards aid like human being face to face working with you across multiple sessions of appeal, it of money right right? Unless you have some very strong counter incentive the basic operation of an insurance payment framework or adopt? compensation schedule is that, if there's any sort of plausible scenario in which a writing someone a prescription is the right answer. That's the one you can one reach for writer and doktor complain about this all the time that they don't have enough time with patience and one of the west that problem is obviously just writing a prescription of people to the really easy solution you don't have to do all the other, complicated stuff that run all these tests and run all these like physical exercises for panda. That might be missing and then how much of this has to do with just sort of I think of me-
organs are pretty well known in the developed world for a sort of poor state of health in general, from from our lifestyle prospect, and is that- is that one of the reasons why this issue seems so much more severe here. the United States or were there very different approaches to it, descriptions ordered by that. What why is there such an american problem? I think that biggest one. When I talk to experts about this is definitely just sat. We let drug companies advertise these drugs more easily them Europe and Canada do according to first amendment- and this I personally find this very stupid, but the first amendment supposedly protects commercial speech so because of that, the FDA and other, regulators, have a hard time really clamping down on these o opiate another drugs. And what that means is that these farmers?
companies can really convince doctors and all sorts of like really egregious ways. Markers loft, unlike set up meetings with doctors and lunches and buy them gifts, and things like that and studies show that when you do that the doctors are more likely to prescribe the product that that you're trying to sell them. So, like that's one of the biggest things the other stuff, the other part of this is that in general it seems America has on I'll know how good the research on this particular, but like that, there's this, like general despair, trend where these deaths of despair have gone up like not just opiate opiate or a big one, but also suicides and alcohol. Related deaths have gone up in the past few years, so it see like something is going on. There were people arduous in general, suffering, more and resorting to drugs. When I asked people that, as you can really get into, Every issue on the planet about like how to address as like wholesale universities. Again, for how that I mean legged, literally every issue imaginable but like that seems to be a big part of
is that in general, people are feeling this this level of despair that perhaps is now present in other countries, but the better the marketing, both sort of direct to doctors and also mean in America. We have you turn on my cable news during the day as people in the media often do or about the the other p watching, cable news in the middle of the day are senior. Citizens are, maybe maybe the horror unemployed for some reason or another. And is a tremendous amount of pharmaceutical. The advertising like direct to consumers, which I think you don't have any snuff, The same extent, in most other developed nome with most other developed countries, will like very strictly regulate that some countries bandit altogether. I actually Iceland recently just started doing a bunch of my son, has one of the biggest drug problems in Europe and
it really started. Cracking down on on drugs are doing all sorts of different programmes for and one of the first things it is like band, not these kinds of pharmaceutical advertisements, and these are dangerous. Addictive frogs. I don't think people think of them in the same way as they might think of like tobacco, but if we allowed tobacco to be advertised anymore, because we have this it's from illegal settlement, there's no technically no law allowing this, because I remember the first amendment protects tobacco companies bag. I think. So it's like a giant legal settlement with a bunch of states that stop tobacco companies, advertising, but we just don't have for other drugs, even other justice addictive and just a potentially just as dangerous when when a lot of people are taking them, so a sentiment that I sort of here. A fair amount at and social media is a kind of.
I don't know exactly how to put it, but a sort of like liberal I roll lying at the national response to this open. crisis, because there's a sense that, when had crack epidemic in in the eighties, or maybe even heroin, and in the seventies that the perception was the drugs are being used by people of color, and so the political response was incredibly punitive, and this was like the war on drugs rhetoric and to an extent reality of of the growth and incarceration, whereas now we have a problem that impacting white people and suddenly were like were all tat. You feel III and Senate Republicans are asking for more of your treatment money. Is that correct this is the dynamic that's playing out its general correct them. More wipe Americans are being affected by this and like we're about crime, there's no way more white Americans have taken are are like addicted to opiates, then black,
because when you select West Virginia New Hampshire amid these are some of the widest yes, the AIDS it states that don't have a lot in common, otherwise than one of those sad reasons for that being the case, because doctors are more likely to set. Some studies have shown that the doctors are more likely to think that black people can resist pain better due to all sort like racial stereotypes, and why not so they are less likely to prescribe thereby patients, painkillers till it may have been protected from bad medical practice, thereby race, the countervailing, racist medical practice exactly so hurry that matter that the horrible part of the but in general the way I look at it is Chris Christie whose, like one of the better Republicans on it, issue he'll often talk about how he had a friend who suffered from addiction and died, and the way I look at it is like if you're criss crossed and your white man you're more likely to have white friends as because of residential segregation say, are more likely to see an epidemic that affecting white people than you are up
that's fucking black people, so you see that you're more likely compassionate for the people in your social circle and then you're more like a call for drug treated, doesn't necessarily like racism agrees. I am I mean I should say that their but almost certainly as some racism involve just direct prejudice that you you should just these people open for whatever reason, but in general it seems like, like people there There's a compelling argument that people are just reacting to their social side, or suffering more in the way you would expect them to react to their social circles of ram or I'm gonna meet. Conversely, I mean in parallel with this sort of before it really like pursuant to the mainstream, as this up, your problem was growing. I mean you did have a growing wrote a goal, push to. I mean to more decriminalization and legalization of marijuana to less jail time fur nonviolent dirt offenders, writing like people really put an effort into changing the national policy
where's he ever that's. Another aspect of this is like kind of like the loot Sattler rural narrative, that this is just because wiping horrified by what it really is the case I like due to the great recession state wanted to cut back on their prison rates and one of the things they did was say. Okay, we should lock up as many as these non vondra offenders. So now I like the victims of the appeared epidemic, are just some of the first beneficiaries of these policies, and it certainly looks bad because the mass incarceration problem is mostly affecting disproportionately black Americans and yet that these white victims are the ones that are benefiting first. It like the stuff, we not a good luck. Web idiots, it's like at the timing of up yes, somewhat pre existing policy. Exactly is now is not helping
so this makes you wonder, I mean you wrote a piece about how this epidemic has changed. Your thinking about treatment of currently illegal drugs tunnel, but about that cause. I guess I do think a lot of us has removed from that. People in jail for smoking pot is Don T like. Maybe all drugs should be illegal, It's like. Well, it's probably good that you, like can't buy heroin in seven eleven right, say I should previously by saying that, like this doesn't but what I am about to say, doesn't really upon a marijuana thing. Marijuana such relatively harm not totally harmless, but it's not harmful enough to Lake warranted, the kind of public outcry. Some fancy about it so like as far as like legalizing than I am ensure whatever in terms of the other harder drugs. If you talk to people who support the drug war
first thing: they will tell you at the like the best argument they will give. You is if you legalise drugs than companies, war, seldom market them and very very bad ways that will get people hooked and then on top of getting people who people die, and we ve seen this time with others of tobacco companies. We with alcohol companies. I mean it. It still goes on see like somebody, alcohol advertising honouring the Superbowl when kids are watching. It's like not the ideal public health thing so opium epidemic. We see that risk there talking about actually very prominently, these Oh boy, companies were allowed to do Sir drugs more freely and they were allowed to market their drugs more freely and exactly warn about happened. A lot of people got addicted and a lot of people have died and have continued dying and their there. are things that federal regulators and state regulators could have done about this. They D has the power to cap, how many opium!
producing in the. U S did not use that power at all. In fact, If you look at the data files, it will openly admit that, like companies lobby, them- and then they raise the cap because companies lobbied them, unlike the I had the power to like really crackdown these drugs like make the labels harsher sailor. Hey this struck as dangerous, tell doc about these, though the rest, these rose and aid in really that for they ve started doing that now, but they didn't for years and years and years. I thought, and like I used to be a big advocate for drug legalization, like legalizing all drugs, I thought, while the war on drugs has failed, hasn't, like I mean the typical liberal arguments for it, but after seeing this epidemic, I'm now convinced that, like, if you look the warning that drug warriors gave is actually right. If you let these companies market their drugs, have you let them like? them for profit and unjust. Let them go free, You will see a lot of people getting addicted to distrust and dying, and, and that's really what what drove me away from supporting the
I mean there's a paradox in the american legal framework, which is that you can make heroin illegal so like by heroin to sell heroin to possess heroin all that serve as a crime. But you can't get illegal to put a mass market television advertising campaign for actually cotton on the air right when the drug is legal, then go you opened the floodgates I mean. That's only effective needs rightly you could I mean it. the question of constitutional jurisprudence, but like in a different country like you could create a legal category in which it is not a crime to be in possession of some kind of substance, but also where you can't do any marketing around it. We were like a european country, that's like friendlier to bigger tougher regulations on companies. Then I could see my stance may be. Shifting
but an engine. I think we can still decriminalize personal possession and other wishes walking of drug users and, like the I mean the cliches, that they need treatment, not jail and measure. Definitely true, but like America, for all sorts of reasons, just doesn't seem Kay bull of really regulating these drug companies in the way that would be ideal to public health. So we just should let them do it like a blanket ban, on them. Doing anything is way easier than trying to get into the messy regulatory framework, especially when we are these constitutional issues, about commercial speech It is true that, for a lot of things that aren't drugs, we take for granted that you can have
severe restrictions on what you are allowed to produce and sell as business without the kind of like harsh end user type. Punishments right so like like the automobile industry, is very regulate. There's only certain ways you can make a car, you can't sell a car without seatbelts. Skinner can't sell the car was headlights downward. You also bogot ticketed, if you're driving and safely, but this some like crazy prison system built around. You know what people are doing, what they buy it. It's done on the front end right that it's like you bill, cars and like this big factories. If you tried to make one that was not following the rules like you would get shut down, ran you could so you can do that right, like you. Can it doesn't have to be legal to have like the heroin planned, unlike the heroin shop and stuff, like that to be much less harsh on addicts who are found
in possession of of some kind of narcotics ray of the subway driving a method of a great example of this is like you. Can Deaf really separate these issues out of your just arresting someone, because he happens have heroin that that's not good strand but if your arresting somebody who's mass, using it and our backyard or something along those lines or, like somebody, who's the bigger but he was trying to accept her. I'm this'll be really weird. If a company was trying to like master, use and sell heroin. Only people who disagrees with like what legal immigration the unreal we me. Yes would be heroin, is like vodka yet. This is not what I mean we're seeing this exact same thing with marijuana right now, like big companies are getting interested, and I we see articles all down while it to back oh and alcohol companies trying stunning and involved in the marrow on a market. Unlike again with marijuana. It's not a dangerous enough drug to relieve for my recited care. That much is that this is happening. It's not gonna cause a mass overdose or anything like that with other drugs. It would mean that those issues were wet
I would thank you very much thanks for producer, Peter Leonard thanks to re, who is listening. I we're gonna be back next week with Ezra. Sarah up your will check this out and our weeds Facebook group. I recommend the pie cast your friends, your family, your neighbors, anyone you, you need it the dome clinic what what wherever I cast and or drug treatment found and well we'll see you next week.
Transcript generated on 2021-09-13.