Speaker 1: Welcome to tonight's classic episode fellow conspiracy realist, the Sackler Family.
Speaker 2: They did it? Wait wait, the Usher.
Speaker 3: Family exactly shout out to follow the House of Usher.
Speaker 3: I think, honestly, of all of the opioid epidemic kind
Speaker 3: of dramatizations, it gets it the best.
Speaker 4: You watched it, finally, Matt, I've watching it. I think
Speaker 4: it's it kicks ass.
Speaker 2: It's so good.
Speaker 4: But obviously a really serious topic.
Speaker 3: We know that some of the pieces have fallen in
Speaker 3: the game of chess, that is the US government's prosecution
Speaker 3: of the Sackler family. Of course, the top, top, top
Speaker 3: members of that family have largely gone, you know, with
Speaker 3: its laps on wrists, and that's just unfortunately how these
Speaker 3: kinds of things go.
Speaker 2: But is it just them that's right now?
Speaker 3: Of course, Yeah, there's a lot of nuance to this
Speaker 3: conversation and a lot of players and moving pieces in
Speaker 3: what actually created the opioid epidemic? Was it manufactured?
Speaker 2: You know?
Speaker 4: Was it a conspiracy from the highest levels?
Speaker 1: And now in twenty twenty three, we can once again
Speaker 1: look back at this and remember the old adage, if
Speaker 1: the punishment for a crime is a fine, then the
Speaker 1: ultimate crime is just being poor. From UFOs to psychic
Speaker 1: powers and government conspiracies, history is riddled with unexplained events.
Speaker 1: You can turn back now or learn the stuff they
Speaker 1: don't want you to know.
Speaker 2: Welcome back to the show. My name is Max, my.
Speaker 4: Name is Noel.
Speaker 1: They call me Ben. We are joined with our super
Speaker 1: producer Paul Deckett. Most importantly, you are here. You are you,
Speaker 1: and that makes this stuff they don't want you to know.
Speaker 1: Today's episode deals with some issues that people may find
Speaker 1: personally very disturbing. But we are here to shed a
Speaker 1: little bit of daylight into a murky world and a
Speaker 1: catastrophic occurrence that the US and other countries are experiencing
Speaker 1: as we record the episode today, the subjects conspiracy Realist
Speaker 1: is drugs, drug use, drug abuse, manufacturing and manufacturing. Oh
Speaker 1: that's the most important part. Yes, whether we are talking
Speaker 1: legal drugs, illegal, recreational, or purely medicinal, it's no secret.
Speaker 1: There's a huge business, a multi billion dollar business. And
Speaker 1: each day across this planet of ours, millions of people
Speaker 1: depend on some form of drug to either what prolonged
Speaker 1: their lives, to combat an ongoing incurable disease or condition,
Speaker 1: or to escape their problems, whatever those may be. In
Speaker 1: many cases, consumption of recreational drugs leads to injury or death.
Speaker 1: And depending on where you're from, this is a question
Speaker 1: for everyone. You may have grown up in a school
Speaker 1: system with an anti drug program. I think we the
Speaker 1: three of us, mentioned it before on the show Dare
Speaker 1: Here in the United States.
Speaker 4: Yeah, yeah, yeah, they ought to call it scare because
Speaker 4: I have this really distinct memory of being in elementary
Speaker 4: school and somebody giving this speech about when they were
Speaker 4: addicted to crack cocaine and talking about like, and I
Speaker 4: looked in the mirror one day and what I saw
Speaker 4: was a skeleton looking back at me. And in my
Speaker 4: third grade mind or whatever grade mind, I thought he
Speaker 4: meant really like he saw a spooky skeleton looking back
Speaker 4: at him in the mirror, and I was like, drugs
Speaker 4: are terrifying.
Speaker 2: Yeah. Yeah, the old drug abuse resistance education program it was.
Speaker 2: It was rampant in my school. Dare to say No.
Speaker 1: Yes, Dare to keep a kid off drugs, Dare to
Speaker 1: give a kid some hope. These are lyrics from the
Speaker 1: song They Make You See.
Speaker 4: Now it's just been relegated to a trendy hipster thrift
Speaker 4: store shirt. Yeah, you get your hands on one of those,
Speaker 4: you're living large.
Speaker 1: Yeah, Yeah, I think it's it's great to have them.
Speaker 1: I still have some of my old Dear shirts, and.
Speaker 2: I would say I, I I'm not against this idea
Speaker 2: of having drug abuse resistant programs within schools. But there's
Speaker 2: there's more to that story, but we can get into
Speaker 2: that later.
Speaker 1: Yeah, I'm not against it either in theory. It's I'm
Speaker 1: torn because I think in many cases some of those
Speaker 1: programs encouraged kids to experiment with drugs.
Speaker 4: Well, they did it throughout my education high school, high
Speaker 4: school too, And I remember in high school somebody came
Speaker 4: in with this like suitcase with replicas of all the drugs,
Speaker 4: and I was like, I want to try that. I
Speaker 4: want to try that. I want to try not really,
Speaker 4: but it's it just it has this like candy vibe
Speaker 4: to it, where everything looks like a fun little thing
Speaker 4: you want to check out.
Speaker 1: It's a little weird, and their success remains a matter
Speaker 1: of debate today. These sorts of programs. You know, how
Speaker 1: many of those how many of those kids in high
Speaker 1: schoo would Okay, The joke at a school I attended
Speaker 1: briefly was that you could tell all the kids who
Speaker 1: won the essay awards for Dare because they were the
Speaker 1: biggest potheads by senior year. Wow, every single one. And
Speaker 1: maybe that's just that school, right. But today we're talking
Speaker 1: about a certain type of drug, one that you may
Speaker 1: have seen in that suitcase that Noel had just mentioned
Speaker 1: when you were a child, One that previously launched numerous wars,
Speaker 1: one that has shaped a lot of human civilization and
Speaker 1: experienced the sinister renaissance in the modern age. Today we're
Speaker 1: talking about opium, specifically the opioid crisis. So here are
Speaker 1: the facts. First, what is opium? What is opium? What
Speaker 1: is an opioid? How they how do they measure up?
Speaker 2: Right? Opium is this old substance that's been around for forever.
Speaker 2: It's a bitter, brownish, addictive narcotic drug. It consists of
Speaker 2: the dried latex that surrounds immature seed capsules in this
Speaker 2: this happy little flower plant called an opium poppy.
Speaker 4: It's interesting to me because a lot of marijuana legalization advocates.
Speaker 4: One of their arguments is, well, it grows from the ground,
Speaker 4: so it's got to be okay. Well, you know, so
Speaker 4: do poppies, and so do the coca plants, so kind
Speaker 4: of it kind of kills that argument dead.
Speaker 1: Yeah, that's a good point. And also, of course hashtag
Speaker 1: not all poppies. The plant is that there's a specific
Speaker 1: type of poppy, the opium poppy, that is used to
Speaker 1: create this substance, and it.
Speaker 2: Has been cultivated over millennia.
Speaker 4: Yeah.
Speaker 1: Yeah, yeah, it dates way back and people loved it
Speaker 1: when they first discovered it because it produces a lower
Speaker 1: state of anxiety an increased sense of well being. You
Speaker 1: get drowsy, you get a little apathetic, it's tough to concentrate,
Speaker 1: and there are physical effects that you will hear people
Speaker 1: relay as ways to encounter, ways to tell physically if
Speaker 1: someone is under the influence of opium or an opioid.
Speaker 1: Like a lat of law enforcement spends time teaching their
Speaker 1: officials to diagnose on the fly, which is relatively unscientific.
Speaker 4: I think it causes constriction of the pupils. For example,
Speaker 4: they get very tiny.
Speaker 2: Yeah, and there's also a euphoria associated with it when
Speaker 2: taken at certain levels with doses.
Speaker 1: Yeah, that's why people chase the dragon, right, So they've
Speaker 1: been chasing this dragon or people who use opium and
Speaker 1: been chasing it for more than five thousand years. The
Speaker 1: first references to growth and use date back to three thousand,
Speaker 1: four hundred BCE, when Mesopotamians cultivated the opium poppy. Mesopotamia
Speaker 1: is more or less where we would picture Southwest Asia today,
Speaker 1: and Samerians referred to it as whole gill the way plant,
Speaker 1: which makes sense.
Speaker 2: Yeah.
Speaker 1: They passed it on to the Assyrians. The Assyrians passed
Speaker 1: it on to the Egyptians. Greco Romans, of course, were
Speaker 1: in the game. They also they saw it as a
Speaker 1: both a painkiller and a something to do with bowels.
Speaker 1: I can't remember if it was supposed to stop you
Speaker 1: up or let you go.
Speaker 4: I think it stops you up. I think that side
Speaker 4: effect of opiate addiction is a chronic constipation.
Speaker 1: So they understood its medicinal use in that regard.
Speaker 4: But of course, would you want to do that if
Speaker 4: you had like diarrhea, you had some kind of.
Speaker 2: You die from diarrhea.
Speaker 1: Yeah, But regardless though, the the primary appeal of this
Speaker 1: substance had has always been the way it makes you feel, right,
Speaker 1: uh pooper non poop aside, and the demand for this
Speaker 1: increased internationally in early international trade opium play an increasingly
Speaker 1: significant role. It it's easy to grow, so people in
Speaker 1: the right climate would say, why do I have to
Speaker 1: buy this stuff from this shady you know, the shady
Speaker 1: Roman or the shady Assyrian or whatever, when I can
Speaker 1: just take a poppy and then grow my own and
Speaker 1: maybe you know, take care of my supply and then
Speaker 1: sell it. So other countries began to grow this industry
Speaker 1: and they expanded its availability. The old rule of supply
Speaker 1: and demand still played a role here, so opium got
Speaker 1: cheaper too as more countries were growing it.
Speaker 2: And it quickly becomes a cash crop for a lot
Speaker 2: of places.
Speaker 4: Yes, as it remains so today, places that maybe lacked
Speaker 4: other means of making money because of climate or location,
Speaker 4: rocky terrain. I think that's part of what makes opium
Speaker 4: so appealing to grow is because it's pretty adaptable or
Speaker 4: it can grow and not the most ideal of situation circumstances.
Speaker 1: And also it's easy to transport, you know, that's a
Speaker 1: big thing. So people began cultivating it all along the
Speaker 1: various trade routes through Eurasia which are collectively known today
Speaker 1: as the Silk Road. So from the Mediterranean through Asia,
Speaker 1: finally to China, opium was growing at this point. Let's
Speaker 1: fast forward. That's a very high level look. There's some
Speaker 1: excellent history podcast about this growth of opium in ancient
Speaker 1: history right to us. If you want to hear them,
Speaker 1: we'll send them along. I can safely say that these
Speaker 1: are great because we didn't do them, so it's not
Speaker 1: us bragging. They're objectively good. But one of the first
Speaker 1: and most historically significant conflicts or catastrophes caused directly by opium,
Speaker 1: it was a series of conflicts known as the Opium Wars.
Speaker 1: The first one occurred in eighteen thirty nine through nineteen
Speaker 1: forty two between China and Britain, and the second Opium
Speaker 1: War occurred shortly after that in eighteen fifty six to
Speaker 1: eighteen sixty. This was sometimes called the Arrow War, and
Speaker 1: in that second one, Britain and France teamed up against China.
Speaker 1: In each case the Western Powers were victorious, and in
Speaker 1: each case the Western Powers were the bad guys.
Speaker 2: Categorically, they're the ones that were They were pushing the
Speaker 2: opium trade on back onto China because China was trying
Speaker 2: to get away or stop the opium crisis that was
Speaker 2: occurring within their country.
Speaker 4: Now, is this one they would have had like these
Speaker 4: opium dens or opium clubs or whatever, where people was
Speaker 4: recreationally using it and it had become a problem socially
Speaker 4: in the country.
Speaker 1: Yeah. There, and in India adjacent to China. What essentially
Speaker 1: happen was a trade imbalance. So there was a huge
Speaker 1: demand for certain Chinese produced goods, silk, porcelain, stuff like that,
Speaker 1: and the West wanted this stuff. It's consumers wanted it.
Speaker 1: By consumers at this point for those kinds of goods
Speaker 1: I generally mean the really wealthy people, the aristocrats and such.
Speaker 1: But the problem was there was no reciprocity. China didn't
Speaker 1: want anything that France and Britain were making.
Speaker 2: Yeah, but they did.
Speaker 1: But Britain particularly did control these opium producing regions, and
Speaker 1: they knew that they could engage a more successful trade
Speaker 1: if they if they had something that the population of
Speaker 1: China wanted, even more importantly, if they could create the
Speaker 1: demand for something, if they could make people want it.
Speaker 2: And can we just go back and just say they
Speaker 2: were controlling those regions through colonial means, yes, through capturing
Speaker 2: regions that were resource rich or in this case poppy rich.
Speaker 1: Right, the East India Company and one of the most
Speaker 1: one of the first globally successful corporations and definitely one
Speaker 1: of the most brutal. So the addiction rate amongst the
Speaker 1: Chinese population soared. They said, look, we're banning all opium,
Speaker 1: don't bring it in. Britain started smuggling it through the
Speaker 1: areas they controlled in India, and then they decided to
Speaker 1: fight dirty. Ultimately, when they were victorious, what they got
Speaker 1: were trade concessions and some subjugation, but they didn't They
Speaker 1: did not succeed in colonizing China. It's too big and
Speaker 1: not as not as vulnerable in a lot of ways
Speaker 1: the other nations were. They also had no interest in
Speaker 1: the spread of Western religion.
Speaker 2: There you go, and I mean that's a huge deal.
Speaker 2: You got indoctrinate as you move forward and colonize. And
Speaker 2: we have made two videos on this subject. They're available
Speaker 2: on YouTube and our website. One of them is called
Speaker 2: have Countries really fought Wars over Opium? And the second
Speaker 2: one is do the Opium Wars continue today? And they're
Speaker 2: highly informative videos and they pull on a lot of
Speaker 2: stuff that other our colleagues have done on the opium
Speaker 2: wards in the past.
Speaker 1: Right, like stuff you missed in history class. Stuff you
Speaker 1: should know all hits, all classics. Hey, Matt, do those questions?
Speaker 1: Do those videos still hold up? Would you say they're
Speaker 1: still relevant in twenty eighteen?
Speaker 2: Yeah, definitely. Well, and these are historical accounts of the
Speaker 2: opium wars, so the first one is at least and
Speaker 2: the second one really has to do with kind of
Speaker 2: what we're talking about today.
Speaker 1: Ah, I see, yeah, And speaking of today, what is
Speaker 1: the legal status of opium? Right? This thing that launched
Speaker 1: so many wars like an evil hellen of Troy. Today,
Speaker 1: opium is considered illegal in most countries, including, oddly enough,
Speaker 1: the countries where tons and tons literal tons of it
Speaker 1: are produced each year, such as Afghanistan. It's still illegal there.
Speaker 2: And again you're talking about substance that can fund anything
Speaker 2: else in the country because there is so much money
Speaker 2: to be made and not a lot of other resources
Speaker 2: to be produced.
Speaker 1: Yeah, yeah, that's I mean, that is a crucial point here,
Speaker 1: I think.
Speaker 2: So.
Speaker 1: In the US, most opiates and synthetic opioids are considered
Speaker 1: scheduled to narcotics by the DEEA Drug Enforcement Administration, and
Speaker 1: because of this, they have to be prescribed by a physician.
Speaker 1: They are highly regulated currently. Of all the opiates, opiate
Speaker 1: or opioid being something derived from actual opium. Of all
Speaker 1: of those things, heroin is the only one that is
Speaker 1: Schedule one, which means the US government Uncle SAM considers
Speaker 1: it that it has a high potential for abuse with little,
Speaker 1: relatively little real medicinal value. Like to the US, this
Speaker 1: is just a drug that does damage.
Speaker 2: Just when it's heroin, and it's so fascinating, which is interesting.
Speaker 2: Take half a step and then you've got all the
Speaker 2: other drugs we're going to be talking about today.
Speaker 1: And of the estimated global opium production, almost half of
Speaker 1: it is legally produced for processing into these medicines that
Speaker 1: you just mentioned, Matt. Any country can do this. Any
Speaker 1: country in the world can apply to the UN. They've
Speaker 1: got a thing called the Commission on Narcotic Drugs to cultivate, produce,
Speaker 1: and trade opium legally because of this convention signed in
Speaker 1: nineteen sixty one, the UN Single Convention on Narcotics Drugs,
Speaker 1: and they'll have some supervision from another UN body. But
Speaker 1: as of two thousand and one, there were eighteen countries
Speaker 1: that do this legally, including countries you might expect like
Speaker 1: Turkey or India who had historically produced opium. I'm not
Speaker 1: doing a stereotype just based on historical But then other
Speaker 1: countries like Australia and the United Kingdom also fall under this,
Speaker 1: so they're also producing opium. I just want to be
Speaker 1: clear about that. So that's opium. But we're going toward opioids.
Speaker 1: What exactly is an opioid?
Speaker 4: Yeah, opioids. It's kind of like this overarching umbrella term,
Speaker 4: but it's used to describe substances that tick at least
Speaker 4: three of the opium receptors in the brain that interact
Speaker 4: with them. It's a class of drug that includes illegal,
Speaker 4: the illegal narcotic heroin, but it also includes synthetic opioids
Speaker 4: like fentanyl and other pain medications that can be obtained
Speaker 4: legally with the prescription, like oxycodone. We've got some brand
Speaker 4: names here, which is OxyContin, hydrocodone, or vicodin, codeine, morphine,
Speaker 4: and tons of more. So, Okay, a little more on
Speaker 4: the way the US and the DEA schedules drugs. There's
Speaker 4: a system in place. Opioids vary from Schedule one. We
Speaker 4: talked about earlier heroin being the only one that is
Speaker 4: considered that meaning it has no medicinal use whatsoever and
Speaker 4: high potential for abuse, and it goes to Schedule five
Speaker 4: and depending on it, it's all depending on this perceived
Speaker 4: medical usefulness, abuse potential, safety, drug dependence profile, which sounds
Speaker 4: like a very high level way of saying.
Speaker 1: Addictability, right, yeah, yeah, yeah, which is different from abuse potential.
Speaker 1: Abuse potential is how likely would someone go overboard to
Speaker 1: chase a particular effect to the fuzzies, And dependency is
Speaker 1: how likely would somebody have to be normal with it?
Speaker 4: And dependency and the argument or discussion surrounding that is
Speaker 4: a huge part of today's story, which we'll get more
Speaker 4: into in a bit. And heroin remains completely illegal to distribute, purchase,
Speaker 4: or use outside of any kind of medical research, where
Speaker 4: I don't know what that would look like.
Speaker 1: Medical research in this sense would mean that a board
Speaker 1: like clinical researchers or groups of doctors, often through a
Speaker 1: university or government sponsored treatment center, will be able to
Speaker 1: access opium or create heroin from it for the purpose
Speaker 1: of creating maybe a new opioid, for the purpose of
Speaker 1: learning more about how heroin itself affects users and it's.
Speaker 2: Kind of similar to the like testing some of the
Speaker 2: hallucinogen's right now, sure, see how they affect people with
Speaker 2: either post traumatic stress disorder or something.
Speaker 1: That's like MDMA R.
Speaker 4: Yes.
Speaker 1: Yes, And speaking of users, we would say one of
Speaker 1: the most important parts of this story, let's learn a
Speaker 1: little bit more about usage statistics for opium and opioids.
Speaker 1: After a word from our sponsors, Okay, everyone, this is
Speaker 1: the point where we dive into some numbers which are
Speaker 1: fascinating and damning.
Speaker 2: I would say, yeah, and important, and please try do
Speaker 2: your best not to gloss over and soak these in.
Speaker 2: There are a lot of numbers in this section we're
Speaker 2: coming on too, but they are highly important.
Speaker 1: So we dug up some relatively recent numbers. Just going
Speaker 1: back a few years, the International Narcotics Control Board reported
Speaker 1: that in twenty fifteen, ninety nine point seven percent of
Speaker 1: the world's hydrocodone, known by its brand name vicodin, was
Speaker 1: consumed in the US alone. Zero point three percent of
Speaker 1: the world's vicodin is consumed outside of the US.
Speaker 4: It's insane.
Speaker 2: Do you think that has anything to do with our
Speaker 2: ability within this country to promote drugs through advertising?
Speaker 1: Yeah, that's true. Yeah, we've mentioned it before, we should
Speaker 1: mention it again. Will you break that down for anyone
Speaker 1: who didn't hear this in earlier episodes? And is it
Speaker 1: from the States.
Speaker 2: In a lot of places outside of our grand little
Speaker 2: experiment here you are, you're not allowed. It is illegal
Speaker 2: to market prescription drugs to people, to try and sell
Speaker 2: it as a product to purchase or to use.
Speaker 4: Wait, so you're not allowed to have a happy housewife
Speaker 4: dancing blissfully across the playground to her child waiting on
Speaker 4: the swing sets.
Speaker 2: Yes, no matter how many precautions you put at the
Speaker 2: end of your ad, you cannot show it in many places.
Speaker 4: With neon green grass and perfectly as your blue skies.
Speaker 1: And very very vague. It's only allowed in New Zealand.
Speaker 1: In the US, bonkers.
Speaker 4: And I was even gonna bring up, like, what's that conversation,
Speaker 4: like where you decide we're gonna call it vicadin? Is
Speaker 4: there any etymology in the names of these drugs ever
Speaker 4: at all? I've always wondered the case by case.
Speaker 1: Yeah, it's similar to so, because this is private industry,
Speaker 1: there's the marketing decision really comes down to conversation between
Speaker 1: the CEOs the pr firms and maybe the people who
Speaker 1: actually made the drug.
Speaker 4: But I don't think the FDA would have any any
Speaker 4: way in potential.
Speaker 2: Because there because these groups present it to the FDA.
Speaker 1: Right, yeah, and the FDA often is a series. They
Speaker 1: will have some guidelines about this. But the FDA in
Speaker 1: theory on paper and the FDA in practice are two
Speaker 1: very very different organizations, unfortunately for most residents of this country.
Speaker 1: But yeah, it's it's true. It's a case by case thing,
Speaker 1: so they'll have there will be some policy conventions. There's
Speaker 1: not a law, but there will be policy conventions such
Speaker 1: as you can't name this.
Speaker 4: Cansecure havy fun fund pills.
Speaker 1: Right right, right, But I would argue that things like
Speaker 1: Lyrica are pushing the line on that.
Speaker 4: It sounds nice, yes right wow, just saying it out
Speaker 4: loud makes me have a warm, fuzzy feeling.
Speaker 1: Right, So it's it does go down to marketing. If
Speaker 1: you are listening to this and you are you have
Speaker 1: participated the naming of a drug, we would love to
Speaker 1: hear your process.
Speaker 2: Absolutely, yeah, Tyland, all get at us right.
Speaker 1: Exceedrin's a good one because he's had the root of
Speaker 1: excel in there. That's an excellent. So throughout twenty sixteen,
Speaker 1: regardless of what the names for these drugs were, there
Speaker 1: were more than sixty three thousand, six hundred overdose deaths
Speaker 1: in the US. Of those, sixty three thousand, six hundred
Speaker 1: forty two, two hundred and forty nine involved an opioid,
Speaker 1: that's sixty six percent. That's over sixty six percent, and
Speaker 1: that if we want to math it out a little bit,
Speaker 1: that equates to an average of one hundred and fifteen
Speaker 1: overdose deaths just from opioids every single day in twenty sixteen.
Speaker 4: Do we have a statistic as to whether there were
Speaker 4: street opioids or prescription opioids, and I would love to
Speaker 4: see a breakdown of that. Probably hard to.
Speaker 1: Tell, well, yeah, because they gather that information, they assess
Speaker 1: cause of death, and sometimes it might be difficult to
Speaker 1: figure out how that got in their system. So I bet,
Speaker 1: I bet you if we drill down enough we can
Speaker 1: we can find something there, or we can find a
Speaker 1: good guess. But that statistic is just some sort of opioid,
Speaker 1: But still it's they're dead.
Speaker 4: But given the prescription rate and the numbers, it sure
Speaker 4: feels like a big chunk of those are probably legally
Speaker 4: obtained and prescribed or sold by someone who legally obtained
Speaker 4: and prescribed them to someone who maybe shouldn't have had.
Speaker 1: Them from what they call pill mills pill mills.
Speaker 4: Considering those numbers, we said at the top of the
Speaker 4: show about how many people in this country rely on
Speaker 4: prescription medication.
Speaker 1: Yeah, and we do have stats on the number of
Speaker 1: opioid prescriptions in nineteen ninety two. This is troubling. It
Speaker 1: goes to your question about how we can ascertain which
Speaker 1: particular type of opioid people were trying, like street or prescription.
Speaker 1: Nineteen ninety two, there were one hundred and twelve million
Speaker 1: prescriptions written for some sort of opioid. By twenty twelve,
Speaker 1: that had peaked to two hundred and eighty two million.
Speaker 1: I'm sorry what, Yeah, per year, not per day. Well overdoubled. Yeah,
Speaker 1: well overdoubled. The good news is it began to decline
Speaker 1: after that by but not by that much. Two hundred
Speaker 1: something million is the new normal. Now in twenty sixteen,
Speaker 1: the number had fallen to two hundred and thirty six million,
Speaker 1: so it's still more than doubled.
Speaker 2: My gosh.
Speaker 4: Yeah, and surely it's not a product of some kind
Speaker 4: of massive population boom, right. You know, we definitely obviously
Speaker 4: know that our population is growing, but certainly not by
Speaker 4: that kind of number.
Speaker 2: And all you're asking about a number that you could
Speaker 2: point to to how many prescription deaths there have been.
Speaker 2: So from nineteen ninety nine up until twenty fifteen, there
Speaker 2: were roughly an estimated one hundred and eighty three thousand
Speaker 2: deaths from prescription overdoses opiate overdose, which.
Speaker 1: Means that's what the average of ninety one overdose.
Speaker 2: Deaths per day since ninety nine.
Speaker 1: And as a result, to put this in perspective, this
Speaker 1: means we have we have a lot of folks who
Speaker 1: listen to this show while they're driving. Yeah, so this
Speaker 1: might be good news for you. You are more likely
Speaker 1: to die of an opioid overdose than a car crash. Yeah,
Speaker 1: so you're safer in your car at least.
Speaker 2: Man, you know, driving and work today. Four cars ahead
Speaker 2: of me, some dude was trying to get off at
Speaker 2: the fourteenth Street exit coming south on eighty five. This
Speaker 2: is for all you Atlanta listeners. And as he's trying
Speaker 2: to get over, he's trying to do it, you know,
Speaker 2: right at the end, right before there's the guardrail and
Speaker 2: every one of those and he couldn't make it. So
Speaker 2: he like swung his car back to the left, made
Speaker 2: another car get out of the way of him, and
Speaker 2: ran into a truck just a couple of cars ahead
Speaker 2: of me.
Speaker 4: And so even a in Atlanta traffic, you're safer in
Speaker 4: your car. You are taking prescription opius.
Speaker 2: Yes, in a crazy place like this.
Speaker 1: Statistically speaking at least, right, but yeah, that's that's a
Speaker 1: sobering point. And as of twenty eighteen, more than two
Speaker 1: million American residents have become either dependent on, or have
Speaker 1: abused prescription pain pills and street drugs. So luckily at
Speaker 1: least that's the total for the illegal trade as well
Speaker 1: as the quote unquote legal one. And we have to
Speaker 1: ask ourselves, at what point does this become an epidemic.
Speaker 1: Most would argue that having this many people addicted to
Speaker 1: some derivative of opium or a similar narcotic means we're
Speaker 1: already in a crisis. But if that doesn't tip the scale,
Speaker 1: if two million is not enough, then what does move
Speaker 1: the needle? More deaths, a higher rate of addiction. Is
Speaker 1: it a crisis when it's five million people? Is it
Speaker 1: not a crisis until it's ten million.
Speaker 2: Yeah, who decides that?
Speaker 1: Well, I think recently the current president did declare that
Speaker 1: there was a crisis.
Speaker 2: Right Well, there have been cries to call it a
Speaker 2: crisis for a long time, and the news, the media
Speaker 2: has been calling it a crisis for years and years.
Speaker 4: But didn't he stop just short of there being really
Speaker 4: any real action behind it? Like I think declaring a
Speaker 4: state of emergency or something allows some kind of federal
Speaker 4: money to kick in to help mitigate a problem. And
Speaker 4: I think his declaration stopped just short of anything real happening.
Speaker 4: It was more of a symbolic gesture than anything.
Speaker 2: Well, yeah, it's a question of do we use tax
Speaker 2: money to actually combat it or do we say, yes,
Speaker 2: it's a crisis and let's get more private institutions working
Speaker 2: on it.
Speaker 1: And right now that fight is going state by state,
Speaker 1: and it leads us to another question, how did this
Speaker 1: all happen? What caused this? It's sort of like that
Speaker 1: trope in film and televis where you get to a
Speaker 1: freeze frame and someone you hear a voiceover say, you're
Speaker 1: probably wondering how I got here? That's our question? What
Speaker 1: brought us here? Here's where it gets crazy. According to
Speaker 1: numerous critics, policy researchers, government officials, medical experts, and more,
Speaker 1: the cause of the current opioid epidemic isn't solely the
Speaker 1: fault of say, like some illegal drug cartel over the
Speaker 1: border or in the Golden Triangle somewhere. It's not street
Speaker 1: level dealers like Pooky in the wire. Instead, they argue
Speaker 1: the blame for the present crisis falls squarely at the
Speaker 1: feet of the pharmaceutical industry, the lobbyist it employees, and
Speaker 1: the government officials with whom these lobbyists interact. I mean,
Speaker 1: if we take a closer look, nearly seventy five percent
Speaker 1: of people who are receiving treatment for heroin addiction didn't
Speaker 1: just start doing heroin. They didn't wait up one day
Speaker 1: and say, you know what, carpe dum. They began their
Speaker 1: addiction by being prescribed opioid painkillers.
Speaker 4: Yeah, typically for.
Speaker 1: A painkilling thing, right. And these are often people who
Speaker 1: don't have a history of drug abuse.
Speaker 2: Yeah, And many times it has to do with being
Speaker 2: prescribed a certain amount of opioid, so over a threshold
Speaker 2: of days. I think the safe threshold is like seven
Speaker 2: or something around that, and many of these begin when
Speaker 2: you get like two weeks three weeks worth of prescription painkillers.
Speaker 1: Yeah, and the weird thing is that this statistic that
Speaker 1: seventy five I think the number may have increased to
Speaker 1: eighty percent now that the vast majority of people are
Speaker 1: in treatment for heroin addiction in the US started heroin
Speaker 1: after they could no longer get legal opioid prescriptions. This
Speaker 1: is absolutolutely a well known fact, but it still has
Speaker 1: yet to stop the rise in opioid prescriptions for pain relief.
Speaker 1: That over the past ten years, the number of prescriptions
Speaker 1: handed out has risen by three hundred percent.
Speaker 4: Well, get this. There's an article from the Washington Post
Speaker 4: from twenty fifteen, so not incredibly up to date, but
Speaker 4: still The headline is why a bag of heroin costs
Speaker 4: less than a pack of cigarettes, And it has a
Speaker 4: map for the entire country showing about how much a
Speaker 4: bag of heroin costs. And by bag, we're saying that's
Speaker 4: that's about a dose. Maybe it's two doses, I'm not sure,
Speaker 4: point being it's between seven and ten dollars for an
Speaker 4: amount of heroin that could potentially kill you. It would
Speaker 4: be enough to completely put you put your button, the dirt,
Speaker 4: you know what I mean.
Speaker 1: But how much does that how much does a heavy
Speaker 1: heroin user use per day? Surely more than water two doses, absolutelysolutely.
Speaker 4: And here's the thing too, I just looked up OxyContin
Speaker 4: pill price and it says when legally sold, a ten
Speaker 4: milligram tab of oxycotton is about a buck twenty five,
Speaker 4: and an eighty milligram tablet will cost six dollars. When
Speaker 4: illegally sold on the street, it can cost between ten
Speaker 4: dollars and eighty dollars for one pill, depending on the dose,
Speaker 4: So it's usually about a dollar a milligram, So an
Speaker 4: eighty milligram oxy content is about eighty dollars.
Speaker 1: And a tab is just a pill a pill, Okay.
Speaker 4: So you can see maybe if you can't get it
Speaker 4: legally prescribed and you're relying on those pill mills or
Speaker 4: buying it illegally from someone who does have the prescription,
Speaker 4: which is certainly how a lot of this stuff gets
Speaker 4: into circulation, you could see the attraction of buying those
Speaker 4: seven dollars bags of heroin if you're really addicted to
Speaker 4: that particular you know, buzz yeah.
Speaker 1: And then people would say, well, I'm not. I'm doing
Speaker 1: this as a stopgap, right, and I'm not going to
Speaker 1: shoot it up. I'm not going to take it intravenously.
Speaker 1: I'm not going to insulfate or whatever. I'm just going
Speaker 1: to maybe smoke it or snort it. Yeah yeah, right,
Speaker 1: maybe get to snorting it, but never shooting it. So
Speaker 1: one of the big There's some demographics that fall into
Speaker 1: this too that we would be remiss if we didn't mention.
Speaker 1: We'll get to them by the end of the episode,
Speaker 1: but for now we can say that opiate manufacturers know
Speaker 1: how much money is at stake. They've spent more than
Speaker 1: eight hundred and eighty million over the past ten years
Speaker 1: just to not to make new drugs, but just to
Speaker 1: keep control over the making and distribution of these substances.
Speaker 2: Yeah, we almost said products, but it just makes you
Speaker 2: want to bomb it a little bit, right, It's true.
Speaker 1: And this money, where did this massive amount of cash
Speaker 1: come from? Where do we get this number? It comes
Speaker 1: from their lobbying and campaign contributions. And this has been
Speaker 1: used in large settlements with anyone looking to challenge what
Speaker 1: is commonly called big pharma. I know, when you hear
Speaker 1: that phrase makes it easy to dismiss this as some
Speaker 1: looney tunes conspiracy theory. But there is a huge industry,
Speaker 1: it's real. Call it big pharma and call it whatever
Speaker 1: you want. It's not going to stop them.
Speaker 2: Yeah. A small group of very profitable companies.
Speaker 4: Yeah, very powerful, and they have, you know, a lot
Speaker 4: of money for lobbyists to wield legislative influence and make
Speaker 4: sure that that pill money keeps on a flowing.
Speaker 1: Yeah. In the nineteen nineties, pharmaceutical companies reassured the medical community, doctors, researchers, hospitals,
Speaker 1: medical institutions that patients would not become addicted to prescription
Speaker 1: opioid pain relievers. This is different from heroin. This is
Speaker 1: a morphine, right, or opium. This is FDA proved this.
Speaker 1: We have specifically made this to mitigate or ameliorate some
Speaker 1: of those concerns about the possibility of addiction. And then
Speaker 1: healthcare providers began to prescribe them at these drugs rather
Speaker 1: at greater rates. And when they say they persuaded them
Speaker 1: and reassured them that that's where money comes into play.
Speaker 1: It's a little bit of a euphemistic thing.
Speaker 4: Well, you know our mousepads, right, Yeah.
Speaker 2: I think we just have to say right here at
Speaker 2: the top that there are a lot of people everywhere
Speaker 2: on this planet that are in constant pain that just
Speaker 2: kind of live in some kind of pain. Yes, sure
Speaker 2: that exists, and it subsists, and the invention of these
Speaker 2: products what is and was kind of this amazing miracle
Speaker 2: thing for people who are just constantly in pain. You mean,
Speaker 2: I could take a pill and I don't hurt always.
Speaker 1: Right, It's not a cure, but it's a it's not
Speaker 1: it lessens the curse. Yeah, chronic and curable pain.
Speaker 2: It almost the idea of it at least gives the
Speaker 2: lives back to people who are taking it.
Speaker 1: Right, That's powerful.
Speaker 2: So you can see you can kind of see here
Speaker 2: where a lot of it is mental from the manufacturers
Speaker 2: to the end user of I'm doing something good or
Speaker 2: this is helping me, this is giving me my life back. Yeah,
Speaker 2: I just want to throw that.
Speaker 1: In that that's a brilliant point. In the nineteen nineties,
Speaker 1: everyone wanted to believe these statements, yes, by the pharmaceutical companies,
Speaker 1: and perhaps you know what, you know what, man, perhaps
Speaker 1: they believed it too. Yeah, let's just look, maybe they
Speaker 1: did either way, whether they were purposely being deceptive or
Speaker 1: whether they honestly just somehow didn't do even the most
Speaker 1: cursory research on this stuff. Whatever happened, it led to
Speaker 1: the misuse of these medications and eventually became clear that
Speaker 1: they were highly addictive, and anyone who said otherwise was
Speaker 1: either lying or cartoonishly wrong. And first, it is valid
Speaker 1: for defenders of these companies to say you cannot blame
Speaker 1: drug companies for legally selling something the FDA approved, But
Speaker 1: the problem with that is pharmaceutical companies didn't just sell
Speaker 1: these opioids. They also brutally suppressed legislation that would have
Speaker 1: limited addiction among patients, including, for instance, a bill in
Speaker 1: Tennessee that was designed to reduce the number of newborns
Speaker 1: who were born addicted to opiates. For some reason, the
Speaker 1: drug companies heavily lobbied to kill that bill and successfully.
Speaker 1: In New Mexico, there was another proposed bill that was
Speaker 1: supposed to limit the initial prescription of opioids for acute
Speaker 1: pain to your PA point MATT to seven days to
Speaker 1: a week, and that make addiction less likely and produce
Speaker 1: fewer leftover.
Speaker 2: Pills, which is such a idea a.
Speaker 1: Big problem, but that legislation got killed as well. And
Speaker 1: let's be even more fair here, they didn't just kill
Speaker 1: certain bills or proposals. You don't want to make it
Speaker 1: sound like that they were instrumental. In fact, this might
Speaker 1: surprise some people in supporting several key pieces of legislation
Speaker 1: related to opioids. They were huge fans of a bill
Speaker 1: in Maine that required insurers to cover the company's abuse
Speaker 1: deterrent painkillers. Do you like that phrase abuse deterrence?
Speaker 2: Right? Wait, what are what are these abuse deterrent painkillers?
Speaker 2: This is a special version.
Speaker 1: Well, the idea is that they aren't there, you're less
Speaker 1: likely to get addicted again. That's how they were sold.
Speaker 4: Things like time release kind of like stuff like that,
Speaker 4: because I know that like early on you would always
Speaker 4: read that with oxy content, for example, you could crush
Speaker 4: them up and snort them like we were talking about.
Speaker 4: And we found out that the that the companies knew
Speaker 4: that was being done, that there was that kind of abuse.
Speaker 4: But then later there were versions of them that you
Speaker 4: could not do that with. They had some special coding
Speaker 4: that you could not break or it would fundamentally change
Speaker 4: the nature of the drug, and it prevented you from
Speaker 4: doing this is that the kind of stuff you're talking about.
Speaker 1: Yeah, those would be a couple of examples. And I
Speaker 1: don't know if there's anything that's industry wide with that,
Speaker 1: because again, these are all private companies, but it would
Speaker 1: be stuff like time release, for instance, or something that
Speaker 1: coding you mentioned is fascinating everyone to read more about that.
Speaker 1: But I'm glad you're bringing up specific examples because we'll
Speaker 1: get to some specific examples of instances wherein these pharmaceutical
Speaker 1: companies became let's say, controversial. Sure, after a word from
Speaker 1: our sponsors. All right, twenty seventeen.
Speaker 2: Day, I am there. Let's see what's going on.
Speaker 1: It's it's it's about a year ago.
Speaker 4: Oh, oh, you're right, Okay, much much the same.
Speaker 1: What's going on?
Speaker 4: First? We love? What what season of Game of Thrones
Speaker 4: are we on at that point?
Speaker 3: Right?
Speaker 1: Right? Is it?
Speaker 4: We're still wrapping up the last one?
Speaker 2: Right?
Speaker 1: I think so? Yeah? And you know, the four of
Speaker 1: us are all still devastatingly handsome, h reasonably witty.
Speaker 4: Man, you devil, I'm a sly one.
Speaker 2: Right.
Speaker 1: And there's also a senator named Claire mccaskell, Democrat out
Speaker 1: of Missouri, who releases a report about an Arizona based
Speaker 1: drug maker named in ciss I n s y S. Yes,
Speaker 1: they make an opioid called Subsis s U b s ys.
Speaker 1: It contains and in this senator's support again this twenty seventeen,
Speaker 1: there are a ton of internal documents from the company,
Speaker 1: from Insists itself describing how it works to get over
Speaker 1: these barriers called prior authorizations. Subsists the drug is meant
Speaker 1: for one thing, and one thing alone, for cancer related pain.
Speaker 1: If you want to get it for anything else, you
Speaker 1: have to get prior authorization from your doctor. So it
Speaker 1: turns out internally Insists had a whole department within the
Speaker 1: company just for doing this, just forgetting these prior authorizations.
Speaker 2: And it was not above board.
Speaker 1: No, no, no. The employees in this department would call
Speaker 1: pharmacy benefit managers, who are in charge of these prior authorizations.
Speaker 2: You've got to love the terms.
Speaker 1: Yeah, and they would pretend they were with a doctor's
Speaker 1: office to get the sign off for Subsists to be
Speaker 1: prescribed to a patient who did not have cancer.
Speaker 2: Wow.
Speaker 1: So my question is is that not fraud?
Speaker 2: I think it is. I would argue that it was
Speaker 2: like it like.
Speaker 1: The definition of fraud it's illegal for us to call
Speaker 1: a pharmacy and pretend to be a doctor's office.
Speaker 2: Yeah, m all right, is it all right? We see
Speaker 2: you in sis.
Speaker 1: And then there's there's another example, which is one that
Speaker 1: I think really stood out to all of us. This
Speaker 1: company is one of the most well known cases of
Speaker 1: we're going to be alliterative pharmaceutical perfidy.
Speaker 2: Oh wait, word of the day, perfety. What does it mean?
Speaker 1: It's deceitful, untrustworthy, treacherous, duplicitous, perfidy.
Speaker 2: You're word of the day.
Speaker 1: Okay, thank you, Matt So. Purdue Pharma is a company
Speaker 1: that aggressively marketed oxy cotton and they made it. They
Speaker 1: made it, and that's the brand name for Is it
Speaker 1: hydrocodone or is that vicotin?
Speaker 4: I think it's oxy codone.
Speaker 1: Isn't it oxy codone? I think yes, you were correct.
Speaker 1: Thank you. Oxy Conton, marketed by Purdue, was claimed to
Speaker 1: be one of those things that was going to be
Speaker 1: less addictive, right than a heroin and have all same
Speaker 1: great benefits, same great taste, far fewer calories, very American
Speaker 1: in the marketing, right, but they also claimed The company
Speaker 1: claimed that they were unaware of the growing abuse of
Speaker 1: oxy contin, which I think is also called in some
Speaker 1: some parts of Appalachia at least is called hillbilly heroin.
Speaker 4: It is right, and I spoiled a little bit of
Speaker 4: this earlier, but let's get into some details here.
Speaker 1: So it turns out that a copy of a confidential
Speaker 1: Justice Toon Apartment report surfaced, and it shows that federal
Speaker 1: prosecutors investigating Purdue found that Purdue knew about quote significant
Speaker 1: abuse of this drug, in particular in the first few
Speaker 1: years after they introduced it in nineteen ninety six, and
Speaker 1: then they covered it up. They were aware that people
Speaker 1: would do insane things to satisfy oxy cotton. They saw
Speaker 1: that pills were being sold illegally and then crushed and
Speaker 1: snorted or cut with other stuff, you know, and that
Speaker 1: they would be stolen from pharmacies, sometimes in violent robberies.
Speaker 4: Yeah, like drugstore cowboy style if you've ever seen that
Speaker 4: Gus van Zam movie.
Speaker 1: And then they would some doctors were being charged with
Speaker 1: just selling prescriptions. Just come into my pill mill where
Speaker 1: the address changes every few years, give me fifty bucks,
Speaker 1: tell me what you want.
Speaker 2: It's despicable, and guess what they did. They went on
Speaker 2: ahead they pushed forward and they said, no, no, no
Speaker 2: oxy cotton. Guys, this is less own to addiction then
Speaker 2: other prescription opioids. It's the better choice for you and
Speaker 2: your family and then family.
Speaker 1: Yeah, exactly. And today Purdue maintains that it had absolutely
Speaker 1: no knowledge of the abuse potential until two thousand, again
Speaker 1: despite internal memos from the higher ups, multiple memos and
Speaker 1: conversations that clearly contradict this.
Speaker 2: Can we go ahead and just talk about the Sackler family, Yeah.
Speaker 1: Lay it on the meat.
Speaker 2: This is just really fast.
Speaker 1: So the Sackler family, ultimately they're the owners of Purdue.
Speaker 2: Yeah, there's there are about twenty individuals that share the
Speaker 2: wealth of this one family that owns Purdue, and it's
Speaker 2: it's fascinating. I think they have a net income or
Speaker 2: a net family worth of around thirteen billion dollars right now,
Speaker 2: at least that's according to Forbes.
Speaker 1: They're eating pillion dollars.
Speaker 4: The you would say that, I love that. Yeah.
Speaker 2: Yes, they bought this this drug manufacturer a long time
Speaker 2: ago in nineteen fifty two, the one that was just
Speaker 2: kind of around.
Speaker 4: It's fledgling, young upstock drug manufacturyarium.
Speaker 2: And they were making things again. According to Forbes like
Speaker 2: uh ear wax remover and laxative.
Speaker 4: Tonics, no doubt.
Speaker 2: Yes, you know. Thing well, I mean it's nineteen fifty two.
Speaker 2: They're making they're making prescription drugs and stuff like that
Speaker 2: to cocaine and.
Speaker 1: I'm sure mother's little helper, right but.
Speaker 2: Yeah, But apparently they didn't have really much going on,
Speaker 2: as you know, a way of bringing money into the
Speaker 2: company until they made this drug oxycont and in nineteen
Speaker 2: ninety five that's when they officially were making it or
Speaker 2: like made it, and from that point on that was
Speaker 2: the thing. I mean, it's literally the cash cow or
Speaker 2: the heroin that they came upon.
Speaker 4: More like oxy Koching.
Speaker 1: I mean, there we go, yes, yes, worth it.
Speaker 2: Yeah, but they're the number nineteen most wealthy family in
Speaker 2: the world right now.
Speaker 1: Insane and they made that money. They made the bulk
Speaker 1: of it off of this particular.
Speaker 4: Product.
Speaker 2: Yeah. Oh I'm sorry, number nineteen in America.
Speaker 1: Oh okay, world, there we go. You know, it's still
Speaker 1: kudos to you Sacklers.
Speaker 4: If you want to dig a little deeper into that,
Speaker 4: there's an article in The New Yorker with a fabulous
Speaker 4: headline it's the family that built an Empire of Pain.
Speaker 4: The Sackler dynasty's ruthless marketing of painkillers has generated billions
Speaker 4: of dollars and millions of addicts.
Speaker 1: That's a great title and surprisingly accurate. Let's look at
Speaker 1: those distribution statistics. Between twenty seven and twenty sixteen, the
Speaker 1: most widely prescribed opioid was Actually it was an oxycodone,
Speaker 1: not this time. No, it's hydrocodon vicated, which you might
Speaker 1: remember from some of EM and M's earlier lyrics.
Speaker 4: Yeah, and you know movies from the eighties.
Speaker 2: Yes, or you know, just any of your relatives or
Speaker 2: friends who have been prescribed it. Yeah.
Speaker 1: In twenty sixteen, six point two billion hydrocodone pills were
Speaker 1: distributed across this nation. Six point two billion oxycodones. Not
Speaker 1: even the OxyContin. Rather, it is not even the second
Speaker 1: most prevalent. The second most prevalent is another version of oxycodone, percocet.
Speaker 1: That that topped out at five billion tablets or pills
Speaker 1: distributed in the US.
Speaker 2: Oh my god.
Speaker 1: People have been taking notice, you know, not just not
Speaker 1: just us, not just a couple of reporters here and there,
Speaker 1: but the government too. In two thousand and six, after
Speaker 1: a four year investigation, the Justice Department and the prosecutors
Speaker 1: recommended that three top executives at Purdue be indicted on
Speaker 1: felony charges, including conspiracy to defraud the Unite Kid States.
Speaker 1: And this would have resulted in prison time if these
Speaker 1: people have been convicted.
Speaker 2: This okay, so it just go ahead. That reminds me
Speaker 2: of maybe the market crash of two thousand and seven,
Speaker 2: two thousand and eight. Yeah, where all the guys in
Speaker 2: charge were supposed to get indicted and and charged and
Speaker 2: they'd be in trouble.
Speaker 3: Mm hmmm.
Speaker 1: Yeah, I'm glad it reminds you of that.
Speaker 2: So I'm hopefully just just like that situation, all those
Speaker 2: guys went to prison, right, oh boy?
Speaker 1: Yeah, okay, So what happened was officials in the George W. H.
Speaker 1: Bush administration did not support this prosecutorial move.
Speaker 2: Oh.
Speaker 1: Instead, they settled the case in two thousand and seven.
Speaker 1: And we have a quote from a New York Times
Speaker 1: article on this debacle.
Speaker 2: Some would call it Prdue Pharma pleaded guilty to a
Speaker 2: felony charge of misbranding and oxyconton while marketing the drug
Speaker 2: by misrepresenting, among other things, it's risk of addiction and
Speaker 2: potential to be abused. So there were three executives, the
Speaker 2: company's chief executive, Michael Friedman, it's top medical officer, doctor
Speaker 2: Paul D. Goldenheim, and mister Udell, a gentleman who died
Speaker 2: in twenty thirteen. All of these guys pleaded guilty to
Speaker 2: misdemeanor misbranding. Yeah, and it solely held them liable as
Speaker 2: purdues Purdue pharmas responsible executives and did not accuse them
Speaker 2: of any wrongdoing.
Speaker 1: And the company had to pay.
Speaker 2: Oh.
Speaker 1: Along with the executives paid six hundred and thirty four
Speaker 1: point five million dollars in fines, and although they did
Speaker 1: not go to jail, they were required to perform get
Speaker 1: this community service.
Speaker 2: No member.
Speaker 1: By the way, the prosecutors did not accuse any Sackler
Speaker 1: family members of wrongdoing.
Speaker 4: Let's just remember that, you know, six hundred and thirty
Speaker 4: four mill seems like a ton of cash, but this
Speaker 4: family is worth upwards of thirteen bill.
Speaker 2: Well and at the time the breaking in about one
Speaker 2: point six billion dollars a year with their farm industry.
Speaker 1: So it's like with banking regulation, is that just the
Speaker 1: cost of doing business at this point?
Speaker 2: I mean, it's a huge cost. It's like over one
Speaker 2: third of your your cost of doing business.
Speaker 1: But still, but those payments are negotiable too. It's essentially
Speaker 1: a layaway payment plan or they can they can appeal
Speaker 1: that and see what they did make a settlement. Yes,
Speaker 1: that's the problem. So they are on the hook some
Speaker 1: how to pay it. But once that stuff gets out
Speaker 1: of the news, you would be surprised how amenable both
Speaker 1: parties can be behind the scenes.
Speaker 4: And yet, Ben, if I get a parking ticket, I
Speaker 4: gotta pay that thing in full. Yeah, or any kind
Speaker 4: of moving violation or misdemean whatever it might be. Like,
Speaker 4: I've been the court only for parking and traffic stuff,
Speaker 4: but you have to pay it before you leave unless
Speaker 4: you give some kind of crazy mitigating circumstances.
Speaker 2: You know your your local government appreciates it's your business.
Speaker 4: Well, yeah, that's how it feels. But it's so crazy
Speaker 4: to me thinking about the back room scenarios that would
Speaker 4: go into scheduling payments for an astronomical amount like this
Speaker 4: when the company can totally afford it. I don't know,
Speaker 4: it's just rubs me the wrong way.
Speaker 2: Sacklers.
Speaker 1: And there's a pretty interesting anecdote that I think you
Speaker 1: found though, about protest with Purdue and the Sacklers.
Speaker 4: Yeah, I think we've talked about this on another episode previously,
Speaker 4: but I think this is a really nice way to
Speaker 4: tie this thing up. Earlier this year, an art gallery
Speaker 4: owner in Connecticut got arrested after he placed an enormous
Speaker 4: sculpture of a heroin spoon. You might have seen this
Speaker 4: in movies. So you take a spoon and you bend
Speaker 4: it backwards on top of itself so that you can
Speaker 4: take the powdered heroin. You place it in the spoon,
Speaker 4: and you light a match or a lighter or a candle,
Speaker 4: and it boils it up or burn. You put water
Speaker 4: in it and it becomes an inject double substance as
Speaker 4: opposed to a powder and this notion of being addicted,
Speaker 4: it's kind of an icon of addiction to heroin, very specifically.
Speaker 4: So this gallery owner placed an enormous sculpture of one
Speaker 4: of these heroin spoons right outside in the walkway of
Speaker 4: the home office of Purdue Pharma in Stanford, Connecticut. And Yeah,
Speaker 4: the owner of the gallery was named Fernando Luis Alvarez,
Speaker 4: and he collaborated with a Boston based artist named Dominique
Speaker 4: Esposito to commission this piece, and he has a great
Speaker 4: quote here, Ben if you shouldn't mind.
Speaker 1: He told Time magazine, the justice department in the country
Speaker 1: has to start putting some of these people behind bars
Speaker 1: because they go on and make a lot of money
Speaker 1: and then they pay a fine and so be it
Speaker 1: as just not the way it should be. And he
Speaker 1: got charged by the police, I.
Speaker 4: Think, yeah, for obstruction of free passage. It wasn't even
Speaker 4: in traffic, it was a footpath, and also for infering
Speaker 4: with the police after he refused to remove the sculpture,
Speaker 4: and it sounds like he's going to be charged, you know,
Speaker 4: whatever goes along with those misdemeanor violations, and also the
Speaker 4: cost of removing it because it looks like it was
Speaker 4: like bolted down to the concrete. So he's probably gonna
Speaker 4: have to pay some fees to patch up the sidewalk
Speaker 4: where he put it in. And removal of this thing
Speaker 4: would be no joke because it's it's about ten and
Speaker 4: a half feet long, and they had to, you know,
Speaker 4: the city government I guess or law enforcement had to
Speaker 4: remove it and also store it. So you know, this
Speaker 4: guy's going to get pretty hefty fine for that. Whatever
Speaker 4: they assess.
Speaker 1: However, we are a pretty resourceful team conspiracy realists. If
Speaker 1: you're listening to this, you happen to be in the
Speaker 1: area and you practice law, why not accept his payment
Speaker 1: that gigantic sculpture, get the guy out of out of court,
Speaker 1: and then plant it back. I love there is. We're
Speaker 1: going a little bit long on today's episode because, first
Speaker 1: because this is incredibly important and it doesn't matter what
Speaker 1: your personal beliefs are. The numbers are real and they
Speaker 1: have no opinion. There's something else we wanted to mention
Speaker 1: that we were talking about with our super producer Paul,
Speaker 1: who bought up a great point. This is obviously not
Speaker 1: only is it not the first opium crisis in the world,
Speaker 1: it's not the first drug crisis in the US. In
Speaker 1: the eighties, there was the crack cocaine epidemic, and the
Speaker 1: government handled it in a very different way. They didn't
Speaker 1: they didn't say, let's sort of soft foot around on
Speaker 1: a federal level holding pharmaceutical companies responsible. Right because all
Speaker 1: the powerful legislation for this stuff, we should say, is
Speaker 1: coming state by state, and we can tell you a
Speaker 1: little bit more about that later. But what they did
Speaker 1: instead in the War on drugs was add things like
Speaker 1: mandatory sentencing, add things like three strike laws for stuff
Speaker 1: relatively innocuous like possession, not even with intent to destroy,
Speaker 1: for the end user, for the end user, not the supplier,
Speaker 1: someone who was addicted to smoking crack is probably not
Speaker 1: also pressuring lobbyists right to let the market cocaine more effectively.
Speaker 1: So one of the huge differences here that you can
Speaker 1: also see in various news articles such as MPRS why
Speaker 1: is the opioid epidemic overwhelmingly white? Some of the really
Speaker 1: i would say revelatory media research in this thing is
Speaker 1: tracing it to the demographic of the end user. Right,
Speaker 1: because crack cocaine's user base was portrayed as predominantly people
Speaker 1: of color, and the opioid epidemic is portrayed predominantly as
Speaker 1: white people.
Speaker 2: It's a really I mean, it's an unfortunate point. And
Speaker 2: just see you can see how it's shaped the entire
Speaker 2: both of the entire processes. One thing we do have
Speaker 2: to point out here is that the crack cocaine epidemic
Speaker 2: is illegal substance, solely pedaled illegally, right, there's no legal
Speaker 2: prescription version of cocaine or crack cocaine now, and in
Speaker 2: this case, I think it's kind of the same point
Speaker 2: you're making, Ben. In this case, you've got somehow the
Speaker 2: same illegal substance change just enough that it can become
Speaker 2: a product that can be sold legally.
Speaker 4: Yeah, I think they that takeaway here is the money.
Speaker 1: Yeah. Well, there's also there's also an interesting thing in
Speaker 1: this article that is profoundly disturbing, and it goes back
Speaker 1: into stereotypes. Medical professionals have patients based on what they
Speaker 1: perceive the patient's identity to be. There's a drug abuse
Speaker 1: expert in this interview on NPR named doctor Andrew Koalagny
Speaker 1: apologies if I'm mispronouncing your name, doctor, and Colodeney notes
Speaker 1: that one thing he's seeing is that doctors tend to
Speaker 1: prescribe is a quote here, doctors tend to prescribe narcotics
Speaker 1: more cautiously to their non white patients because it seems
Speaker 1: that doctors themselves have stereotypes about addiction. So really, yeah,
Speaker 1: so that that sort of racially based or motivated attitude
Speaker 1: on the part of the medical professional may be playing
Speaker 1: a role too.
Speaker 2: Geez.
Speaker 4: There's an interesting analog or with something that's going on
Speaker 4: in the news right now. Matt. You mentioned the difference
Speaker 4: between or one of the differences in the way that
Speaker 4: the government handled it is the fact that heroin and opiates,
Speaker 4: there's a legal version of it that you can be prescribed.
Speaker 4: No analog exists for crack cocaine or cocaine what have.
Speaker 2: You, since they took it out of cocaine.
Speaker 4: So they took you out of coca cola. And you know,
Speaker 4: Mommy's little helpers or whatever. Right, And I've talked about
Speaker 4: this before, and it's just interesting because it really is
Speaker 4: an ongoing story. There is what's what's kind of built
Speaker 4: as an herbal supplement called kratom. It's a it's a
Speaker 4: crowned up leaf from a tree that's indigenous to like
Speaker 4: Malaysia or some somewhere Thailand. That's that's correct, And it
Speaker 4: has been on the DEA's watch list for a long
Speaker 4: time now because it has supposedly analog analogous sensations and
Speaker 4: effects to opioids, and a lot of people take it,
Speaker 4: and there's a whole you know, it's it's it's a
Speaker 4: billion dollar industry and there's all like an organization that
Speaker 4: is like the advocate for this substance, and people say
Speaker 4: how they take it to get off of prescription painkillers
Speaker 4: or to treat some of the things that prescription pills
Speaker 4: would be, you know, prescribed for and what have you.
Speaker 4: And then of course there is also a people take
Speaker 4: it for anxiety, what have you. But there's also potential
Speaker 4: for abuse. But the latest is that the DEA is
Speaker 4: finally really cracking down on it, and it looks like
Speaker 4: they may make it federally illegal sooner rather than later.
Speaker 1: I meaned it, schedule it.
Speaker 4: Make it one.
Speaker 1: Wow.
Speaker 4: Can you know how many deaths have been attributed to
Speaker 4: this substance?
Speaker 1: Roughly zero thirty thirty And.
Speaker 4: I don't know the details about that, But how many
Speaker 4: deaths did we say we're attributed to prescription painkillers?
Speaker 1: Thousands?
Speaker 4: So why is the attitude so different? Why is this
Speaker 4: substance on the chopping block, and yet the others that
Speaker 4: we have massive amounts of data that show it is
Speaker 4: in fact deadly are not. I think it comes down
Speaker 4: to Big Pharma is pissed that this legal substance that
Speaker 4: you can buy in head shops and online or what
Speaker 4: have you is potentially taking away taking money out of
Speaker 4: their pocket.
Speaker 1: Yeah, I want to. I think that's a fantastic point.
Speaker 1: I want to go back, though, make sure we don't
Speaker 1: miss the point with what this doctor was saying about
Speaker 1: the way we handle these epidemics. And I think they
Speaker 1: tie in because in the doctor Kladney was saying that
Speaker 1: in this epidemic where we do see these legal analogs,
Speaker 1: he's saying, we're hearing from policymakers, even conservative politicians, when
Speaker 1: they talk about the crisis, they begin by saying, we
Speaker 1: cannot arrest our way out of this. We can see
Speaker 1: that people who are addicted can access effective treatment. We
Speaker 1: did not hear that during the crack cocaine epidemic. It's
Speaker 1: good that we're hearing it now, but it's too bad
Speaker 1: we didn't hear it then. And if kretom is a
Speaker 1: possible way to help people in need, then it seems
Speaker 1: just objectively, it seems pretty counterintuitive to remove that from
Speaker 1: the conversation.
Speaker 4: Absolutely, I didn't mean to derail the racial tones to
Speaker 4: this comparison. I think that is absolutely accurate. I think
Speaker 4: this is almost It just really goes to show that
Speaker 4: there is not only that bias in place in this discussion,
Speaker 4: but also that whole lining of the pockets. Absolutely element
Speaker 4: I think there is hand in hand.
Speaker 2: Yeah, well here's the thing. Does cretum then do you
Speaker 2: get kreatum clinics like method own clinics and are addicted
Speaker 2: to said there's potential for abuse.
Speaker 4: That's here's what the DEA has to say about this.
Speaker 4: One of their big beefs is that it's being supposedly
Speaker 4: marketed for those things that I mentioned earlier, withdrawal from opiates,
Speaker 4: treating things that would require a more professional medical opinion,
Speaker 4: et cetera. Supposedly, they say it's being marketed that way.
Speaker 4: So it says, quote, the FDA knows people are using
Speaker 4: Creative to treat conditions like pain, anxiety, and depression, which
Speaker 4: are serious medical conditions that require proper diagnosis and oversight
Speaker 4: from a licensed health care provider. We also know that
Speaker 4: the substance is being actively marketed and distributed for these purposes. Importantly,
Speaker 4: evidence shows that creative has similar effects to narcotics like
Speaker 4: opioids and carry similar risks of abuse, addiction, and in
Speaker 4: some cases death. But then you have people that use
Speaker 4: it and talk about it very openly that a part
Speaker 4: of these organizations that say it's just not the same
Speaker 4: that they were able to use it because as a
Speaker 4: similar effect to narcotics, but that they it literally allowed
Speaker 4: them to kind of integrate back into society in a
Speaker 4: way that is weren't able to do with the narcotics
Speaker 4: that they were on, the heavy doses of narcotics.
Speaker 1: So MDMA and PTSD.
Speaker 2: Yeah, what we need is a prescription version that we
Speaker 2: can sell for eighty dollars a tablet and then it's
Speaker 2: good to go.
Speaker 1: No cures, only treatments, you.
Speaker 2: Know, I know, we're wrapping up. We're going way too long. Sure,
Speaker 2: we didn't even really get into the fentanyl thing that's
Speaker 2: happening right now as part of the crisis. Like the
Speaker 2: reason why so many people are dying right now today
Speaker 2: while we're recording this because the heroin supply that is
Speaker 2: illegal that people are getting rather than the prescription drugs,
Speaker 2: is laced with this thing that's deadly in very very
Speaker 2: very small doses.
Speaker 1: Yeah, can you tell us a little bit about that.
Speaker 2: Well, it's just a fact fentanyl is a drug that's
Speaker 2: being laced within supplies of heroin coming into the United States,
Speaker 2: and it maybe it's a whole different episode for another
Speaker 2: show where we talk about like why is that happening?
Speaker 2: Is it just to save cost on the manufacturer's side.
Speaker 1: How does heroin get into the States?
Speaker 2: Yes? Well, yeah, and and what is the difference between
Speaker 2: fentanyl and all this stuff? And who would just who
Speaker 2: would be putting it in there?
Speaker 4: There's a there's a photo in this article from statnews
Speaker 4: dot com. The headline is why fentanyl is deadlier than
Speaker 4: heroin in a single photo, and it's these two inch
Speaker 4: tall vials. On the left is heroin and it has
Speaker 4: about a centimeter of powder in the bottom of it,
Speaker 4: and then the next to it is fentanyl. And it
Speaker 4: just looks like residue, Like there's like maybe ten grains
Speaker 4: that you can see. Wow, it looks like the leftovers
Speaker 4: in like a salt shaker.
Speaker 1: And that's an equivalent dose.
Speaker 2: Yeah, oh my god, Yeah, terrified. That's terrified.
Speaker 1: So maybe that is a future episode for us. Today,
Speaker 1: we want to thank you for thank you for taking
Speaker 1: this strange journey with us. It's only the beginning of
Speaker 1: something that has been ongoing for you know, not just
Speaker 1: since maybe since the nineteen nineties here in the States,
Speaker 1: but ongoing for thousands of years in terms of our
Speaker 1: species struggle with opium So, in short answer for today's question, yes,
Speaker 1: the opium epidemic in the US is at least partially
Speaker 1: the result of an active and very successful conspiracy on
Speaker 1: the part of pharmaceutical companies, some of them, not all
Speaker 1: of them, to twist the law or circumvent it entirely
Speaker 1: and push these painkillers on innocent patience. To biggest factors
Speaker 1: in this are private partnerships with politicians, with holding or
Speaker 1: suppressing of important information, and nowadays twenty eighteen, multiple companies
Speaker 1: claim they are in fact combating the crisis they or
Speaker 1: companies like them, did play a role in creating. None
Speaker 1: of these companies to date have acknowledged that they played
Speaker 1: this role, even when internal memos show that they consciously
Speaker 1: did so. It's pretty easy to see how critics don't
Speaker 1: trust these statements. Currently, the attorney's general of forty one
Speaker 1: different US states, inspired by aggressive legislation from Ohio, are
Speaker 1: joining forces to investigate these companies. The ultimate goal of
Speaker 1: these lawsuits is to force the manufacturers to change their
Speaker 1: marketing tactics offer better warnings as to how addictive these
Speaker 1: things can be. So far, all of these cases have
Speaker 1: been civil and not criminal, and gosh, we have war
Speaker 1: as a final As a final word, we want to
Speaker 1: hear from you. What are the consequences for these companies,
Speaker 1: What should they be? How can societies and grips of
Speaker 1: these epidemics hope to combat them. The answers have a
Speaker 1: wide range of approach and plausibility, but one thing is
Speaker 1: for sure. At the rate people are overdosing here, at
Speaker 1: least in our neck of the global woods, are projected
Speaker 1: five hundred thousand Americans could dive from opioid misuse in
Speaker 1: the next ten years. If you are one of the
Speaker 1: millions of Americans struggling within an addiction to opioid drugs,
Speaker 1: please reach out directly to one of the many free
Speaker 1: treatment centers in your area. There are numbers you can call.
Speaker 1: We guarantee you are worth it, and your time is
Speaker 1: worth it. The time of your loved ones is worth
Speaker 1: it as well. We'd also like to hear your story,
Speaker 1: and we promise we won't share it unless you give
Speaker 1: us the oka to do so.
Speaker 2: And that's the end of this classic episode. If you
Speaker 2: have any thoughts or questions about this episode, you can
Speaker 2: get into contact with us in a number of different ways.
Speaker 2: One of the best is to give us a call.
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