CLASSIC: Who created the opioid epidemic?

In the U.S. doctors often prescribe opioids for pain management, and it's no secret that these substances are a big business for pharmaceutical companies -- and, increasingly, it's no secret that exposure to these legal pills are turning patients into unwilling addicts. So how exactly did the U.S. come to find itself in the grip of an opioid epidemic, and who should be held responsible? Perhaps most importantly, how can the nation recover?

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Episode Transcript

Speaker 1 (00:00):
Welcome to tonight's classic episode fellow conspiracy realist, the Sackler Family.

Speaker 2 (00:05):
They did it? Wait wait, the Usher.

Speaker 3 (00:09):
Family exactly shout out to follow the House of Usher.
I think, honestly, of all of the opioid epidemic kind
of dramatizations, it gets it the best.

Speaker 4 (00:22):
You watched it, finally, Matt, I've watching it. I think
it's it kicks ass.

Speaker 2 (00:26):
It's so good.

Speaker 4 (00:26):
But obviously a really serious topic.

Speaker 3 (00:29):
We know that some of the pieces have fallen in
the game of chess, that is the US government's prosecution
of the Sackler family. Of course, the top, top, top
members of that family have largely gone, you know, with
its laps on wrists, and that's just unfortunately how these
kinds of things go.

Speaker 2 (00:45):
But is it just them that's right now?

Speaker 3 (00:47):
Of course, Yeah, there's a lot of nuance to this
conversation and a lot of players and moving pieces in
what actually created the opioid epidemic? Was it manufactured?

Speaker 2 (00:58):
You know?

Speaker 4 (00:58):
Was it a conspiracy from the highest levels?

Speaker 1 (01:02):
And now in twenty twenty three, we can once again
look back at this and remember the old adage, if
the punishment for a crime is a fine, then the
ultimate crime is just being poor. From UFOs to psychic
powers and government conspiracies, history is riddled with unexplained events.

(01:22):
You can turn back now or learn the stuff they
don't want you to know.

Speaker 2 (01:39):
Welcome back to the show. My name is Max, my.

Speaker 4 (01:42):
Name is Noel.

Speaker 1 (01:43):
They call me Ben. We are joined with our super
producer Paul Deckett. Most importantly, you are here. You are you,
and that makes this stuff they don't want you to know.
Today's episode deals with some issues that people may find
personally very disturbing. But we are here to shed a
little bit of daylight into a murky world and a

(02:09):
catastrophic occurrence that the US and other countries are experiencing
as we record the episode today, the subjects conspiracy Realist
is drugs, drug use, drug abuse, manufacturing and manufacturing. Oh
that's the most important part. Yes, whether we are talking

(02:29):
legal drugs, illegal, recreational, or purely medicinal, it's no secret.
There's a huge business, a multi billion dollar business. And
each day across this planet of ours, millions of people
depend on some form of drug to either what prolonged
their lives, to combat an ongoing incurable disease or condition,

(02:49):
or to escape their problems, whatever those may be. In
many cases, consumption of recreational drugs leads to injury or death.
And depending on where you're from, this is a question
for everyone. You may have grown up in a school
system with an anti drug program. I think we the
three of us, mentioned it before on the show Dare
Here in the United States.

Speaker 4 (03:11):
Yeah, yeah, yeah, they ought to call it scare because
I have this really distinct memory of being in elementary
school and somebody giving this speech about when they were
addicted to crack cocaine and talking about like, and I
looked in the mirror one day and what I saw
was a skeleton looking back at me. And in my
third grade mind or whatever grade mind, I thought he

(03:31):
meant really like he saw a spooky skeleton looking back
at him in the mirror, and I was like, drugs
are terrifying.

Speaker 2 (03:38):
Yeah. Yeah, the old drug abuse resistance education program it was.
It was rampant in my school. Dare to say No.

Speaker 1 (03:47):
Yes, Dare to keep a kid off drugs, Dare to
give a kid some hope. These are lyrics from the
song They Make You See.

Speaker 4 (03:54):
Now it's just been relegated to a trendy hipster thrift
store shirt. Yeah, you get your hands on one of those,
you're living large.

Speaker 1 (04:01):
Yeah, Yeah, I think it's it's great to have them.
I still have some of my old Dear shirts, and.

Speaker 2 (04:05):
I would say I, I I'm not against this idea
of having drug abuse resistant programs within schools. But there's
there's more to that story, but we can get into
that later.

Speaker 1 (04:18):
Yeah, I'm not against it either in theory. It's I'm
torn because I think in many cases some of those
programs encouraged kids to experiment with drugs.

Speaker 4 (04:29):
Well, they did it throughout my education high school, high
school too, And I remember in high school somebody came
in with this like suitcase with replicas of all the drugs,
and I was like, I want to try that. I
want to try that. I want to try not really,
but it's it just it has this like candy vibe
to it, where everything looks like a fun little thing
you want to check out.

Speaker 1 (04:49):
It's a little weird, and their success remains a matter
of debate today. These sorts of programs. You know, how
many of those how many of those kids in high
schoo would Okay, The joke at a school I attended
briefly was that you could tell all the kids who
won the essay awards for Dare because they were the

(05:12):
biggest potheads by senior year. Wow, every single one. And
maybe that's just that school, right. But today we're talking
about a certain type of drug, one that you may
have seen in that suitcase that Noel had just mentioned
when you were a child, One that previously launched numerous wars,
one that has shaped a lot of human civilization and

(05:35):
experienced the sinister renaissance in the modern age. Today we're
talking about opium, specifically the opioid crisis. So here are
the facts. First, what is opium? What is opium? What
is an opioid? How they how do they measure up?

Speaker 2 (05:52):
Right? Opium is this old substance that's been around for forever.
It's a bitter, brownish, addictive narcotic drug. It consists of
the dried latex that surrounds immature seed capsules in this
this happy little flower plant called an opium poppy.

Speaker 4 (06:10):
It's interesting to me because a lot of marijuana legalization advocates.
One of their arguments is, well, it grows from the ground,
so it's got to be okay. Well, you know, so
do poppies, and so do the coca plants, so kind
of it kind of kills that argument dead.

Speaker 1 (06:24):
Yeah, that's a good point. And also, of course hashtag
not all poppies. The plant is that there's a specific
type of poppy, the opium poppy, that is used to
create this substance, and it.

Speaker 2 (06:39):
Has been cultivated over millennia.

Speaker 4 (06:42):
Yeah.

Speaker 1 (06:42):
Yeah, yeah, it dates way back and people loved it
when they first discovered it because it produces a lower
state of anxiety an increased sense of well being. You
get drowsy, you get a little apathetic, it's tough to concentrate,
and there are physical effects that you will hear people
relay as ways to encounter, ways to tell physically if

(07:06):
someone is under the influence of opium or an opioid.
Like a lat of law enforcement spends time teaching their
officials to diagnose on the fly, which is relatively unscientific.

Speaker 4 (07:17):
I think it causes constriction of the pupils. For example,
they get very tiny.

Speaker 2 (07:23):
Yeah, and there's also a euphoria associated with it when
taken at certain levels with doses.

Speaker 1 (07:29):
Yeah, that's why people chase the dragon, right, So they've
been chasing this dragon or people who use opium and
been chasing it for more than five thousand years. The
first references to growth and use date back to three thousand,
four hundred BCE, when Mesopotamians cultivated the opium poppy. Mesopotamia

(07:50):
is more or less where we would picture Southwest Asia today,
and Samerians referred to it as whole gill the way plant,
which makes sense.

Speaker 2 (08:01):
Yeah.

Speaker 1 (08:03):
They passed it on to the Assyrians. The Assyrians passed
it on to the Egyptians. Greco Romans, of course, were
in the game. They also they saw it as a
both a painkiller and a something to do with bowels.
I can't remember if it was supposed to stop you
up or let you go.

Speaker 4 (08:20):
I think it stops you up. I think that side
effect of opiate addiction is a chronic constipation.

Speaker 1 (08:26):
So they understood its medicinal use in that regard.

Speaker 4 (08:29):
But of course, would you want to do that if
you had like diarrhea, you had some kind of.

Speaker 2 (08:37):
You die from diarrhea.

Speaker 1 (08:40):
Yeah, But regardless though, the the primary appeal of this
substance had has always been the way it makes you feel, right,
uh pooper non poop aside, and the demand for this
increased internationally in early international trade opium play an increasingly

(09:01):
significant role. It it's easy to grow, so people in
the right climate would say, why do I have to
buy this stuff from this shady you know, the shady
Roman or the shady Assyrian or whatever, when I can
just take a poppy and then grow my own and
maybe you know, take care of my supply and then

(09:21):
sell it. So other countries began to grow this industry
and they expanded its availability. The old rule of supply
and demand still played a role here, so opium got
cheaper too as more countries were growing it.

Speaker 2 (09:35):
And it quickly becomes a cash crop for a lot
of places.

Speaker 4 (09:38):
Yes, as it remains so today, places that maybe lacked
other means of making money because of climate or location,
rocky terrain. I think that's part of what makes opium
so appealing to grow is because it's pretty adaptable or
it can grow and not the most ideal of situation circumstances.

Speaker 1 (09:56):
And also it's easy to transport, you know, that's a
big thing. So people began cultivating it all along the
various trade routes through Eurasia which are collectively known today
as the Silk Road. So from the Mediterranean through Asia,
finally to China, opium was growing at this point. Let's

(10:19):
fast forward. That's a very high level look. There's some
excellent history podcast about this growth of opium in ancient
history right to us. If you want to hear them,
we'll send them along. I can safely say that these
are great because we didn't do them, so it's not
us bragging. They're objectively good. But one of the first

(10:42):
and most historically significant conflicts or catastrophes caused directly by opium,
it was a series of conflicts known as the Opium Wars.
The first one occurred in eighteen thirty nine through nineteen
forty two between China and Britain, and the second Opium
War occurred shortly after that in eighteen fifty six to

(11:06):
eighteen sixty. This was sometimes called the Arrow War, and
in that second one, Britain and France teamed up against China.
In each case the Western Powers were victorious, and in
each case the Western Powers were the bad guys.

Speaker 2 (11:23):
Categorically, they're the ones that were They were pushing the
opium trade on back onto China because China was trying
to get away or stop the opium crisis that was
occurring within their country.

Speaker 4 (11:36):
Now, is this one they would have had like these
opium dens or opium clubs or whatever, where people was
recreationally using it and it had become a problem socially
in the country.

Speaker 1 (11:45):
Yeah. There, and in India adjacent to China. What essentially
happen was a trade imbalance. So there was a huge
demand for certain Chinese produced goods, silk, porcelain, stuff like that,
and the West wanted this stuff. It's consumers wanted it.

(12:07):
By consumers at this point for those kinds of goods
I generally mean the really wealthy people, the aristocrats and such.
But the problem was there was no reciprocity. China didn't
want anything that France and Britain were making.

Speaker 2 (12:23):
Yeah, but they did.

Speaker 1 (12:24):
But Britain particularly did control these opium producing regions, and
they knew that they could engage a more successful trade
if they if they had something that the population of
China wanted, even more importantly, if they could create the

(12:45):
demand for something, if they could make people want it.

Speaker 2 (12:48):
And can we just go back and just say they
were controlling those regions through colonial means, yes, through capturing
regions that were resource rich or in this case poppy rich.

Speaker 1 (12:59):
Right, the East India Company and one of the most
one of the first globally successful corporations and definitely one
of the most brutal. So the addiction rate amongst the
Chinese population soared. They said, look, we're banning all opium,
don't bring it in. Britain started smuggling it through the

(13:23):
areas they controlled in India, and then they decided to
fight dirty. Ultimately, when they were victorious, what they got
were trade concessions and some subjugation, but they didn't They
did not succeed in colonizing China. It's too big and
not as not as vulnerable in a lot of ways

(13:45):
the other nations were. They also had no interest in
the spread of Western religion.

Speaker 2 (13:50):
There you go, and I mean that's a huge deal.
You got indoctrinate as you move forward and colonize. And
we have made two videos on this subject. They're available
on YouTube and our website. One of them is called
have Countries really fought Wars over Opium? And the second
one is do the Opium Wars continue today? And they're
highly informative videos and they pull on a lot of

(14:12):
stuff that other our colleagues have done on the opium
wards in the past.

Speaker 1 (14:17):
Right, like stuff you missed in history class. Stuff you
should know all hits, all classics. Hey, Matt, do those questions?
Do those videos still hold up? Would you say they're
still relevant in twenty eighteen?

Speaker 2 (14:28):
Yeah, definitely. Well, and these are historical accounts of the
opium wars, so the first one is at least and
the second one really has to do with kind of
what we're talking about today.

Speaker 1 (14:39):
Ah, I see, yeah, And speaking of today, what is
the legal status of opium? Right? This thing that launched
so many wars like an evil hellen of Troy. Today,
opium is considered illegal in most countries, including, oddly enough,
the countries where tons and tons literal tons of it

(14:59):
are produced each year, such as Afghanistan. It's still illegal there.

Speaker 2 (15:04):
And again you're talking about substance that can fund anything
else in the country because there is so much money
to be made and not a lot of other resources
to be produced.

Speaker 1 (15:14):
Yeah, yeah, that's I mean, that is a crucial point here,
I think.

Speaker 2 (15:21):
So.

Speaker 1 (15:21):
In the US, most opiates and synthetic opioids are considered
scheduled to narcotics by the DEEA Drug Enforcement Administration, and
because of this, they have to be prescribed by a physician.
They are highly regulated currently. Of all the opiates, opiate
or opioid being something derived from actual opium. Of all

(15:42):
of those things, heroin is the only one that is
Schedule one, which means the US government Uncle SAM considers
it that it has a high potential for abuse with little,
relatively little real medicinal value. Like to the US, this
is just a drug that does damage.

Speaker 2 (16:02):
Just when it's heroin, and it's so fascinating, which is interesting.
Take half a step and then you've got all the
other drugs we're going to be talking about today.

Speaker 1 (16:11):
And of the estimated global opium production, almost half of
it is legally produced for processing into these medicines that
you just mentioned, Matt. Any country can do this. Any
country in the world can apply to the UN. They've
got a thing called the Commission on Narcotic Drugs to cultivate, produce,
and trade opium legally because of this convention signed in

(16:35):
nineteen sixty one, the UN Single Convention on Narcotics Drugs,
and they'll have some supervision from another UN body. But
as of two thousand and one, there were eighteen countries
that do this legally, including countries you might expect like
Turkey or India who had historically produced opium. I'm not

(16:58):
doing a stereotype just based on historical But then other
countries like Australia and the United Kingdom also fall under this,
so they're also producing opium. I just want to be
clear about that. So that's opium. But we're going toward opioids.
What exactly is an opioid?

Speaker 4 (17:18):
Yeah, opioids. It's kind of like this overarching umbrella term,
but it's used to describe substances that tick at least
three of the opium receptors in the brain that interact
with them. It's a class of drug that includes illegal,
the illegal narcotic heroin, but it also includes synthetic opioids

(17:39):
like fentanyl and other pain medications that can be obtained
legally with the prescription, like oxycodone. We've got some brand
names here, which is OxyContin, hydrocodone, or vicodin, codeine, morphine,
and tons of more. So, Okay, a little more on
the way the US and the DEA schedules drugs. There's

(18:00):
a system in place. Opioids vary from Schedule one. We
talked about earlier heroin being the only one that is
considered that meaning it has no medicinal use whatsoever and
high potential for abuse, and it goes to Schedule five
and depending on it, it's all depending on this perceived
medical usefulness, abuse potential, safety, drug dependence profile, which sounds

(18:22):
like a very high level way of saying.

Speaker 1 (18:25):
Addictability, right, yeah, yeah, yeah, which is different from abuse potential.
Abuse potential is how likely would someone go overboard to
chase a particular effect to the fuzzies, And dependency is
how likely would somebody have to be normal with it?

Speaker 4 (18:41):
And dependency and the argument or discussion surrounding that is
a huge part of today's story, which we'll get more
into in a bit. And heroin remains completely illegal to distribute, purchase,
or use outside of any kind of medical research, where
I don't know what that would look like.

Speaker 1 (19:00):
Medical research in this sense would mean that a board
like clinical researchers or groups of doctors, often through a
university or government sponsored treatment center, will be able to
access opium or create heroin from it for the purpose

(19:22):
of creating maybe a new opioid, for the purpose of
learning more about how heroin itself affects users and it's.

Speaker 2 (19:31):
Kind of similar to the like testing some of the
hallucinogen's right now, sure, see how they affect people with
either post traumatic stress disorder or something.

Speaker 1 (19:41):
That's like MDMA R.

Speaker 4 (19:43):
Yes.

Speaker 1 (19:44):
Yes, And speaking of users, we would say one of
the most important parts of this story, let's learn a
little bit more about usage statistics for opium and opioids.
After a word from our sponsors, Okay, everyone, this is
the point where we dive into some numbers which are

(20:08):
fascinating and damning.

Speaker 2 (20:11):
I would say, yeah, and important, and please try do
your best not to gloss over and soak these in.
There are a lot of numbers in this section we're
coming on too, but they are highly important.

Speaker 1 (20:20):
So we dug up some relatively recent numbers. Just going
back a few years, the International Narcotics Control Board reported
that in twenty fifteen, ninety nine point seven percent of
the world's hydrocodone, known by its brand name vicodin, was
consumed in the US alone. Zero point three percent of

(20:45):
the world's vicodin is consumed outside of the US.

Speaker 4 (20:48):
It's insane.

Speaker 2 (20:49):
Do you think that has anything to do with our
ability within this country to promote drugs through advertising?

Speaker 1 (20:55):
Yeah, that's true. Yeah, we've mentioned it before, we should
mention it again. Will you break that down for anyone
who didn't hear this in earlier episodes? And is it
from the States.

Speaker 2 (21:04):
In a lot of places outside of our grand little
experiment here you are, you're not allowed. It is illegal
to market prescription drugs to people, to try and sell
it as a product to purchase or to use.

Speaker 4 (21:17):
Wait, so you're not allowed to have a happy housewife
dancing blissfully across the playground to her child waiting on
the swing sets.

Speaker 2 (21:24):
Yes, no matter how many precautions you put at the
end of your ad, you cannot show it in many places.

Speaker 4 (21:28):
With neon green grass and perfectly as your blue skies.

Speaker 1 (21:32):
And very very vague. It's only allowed in New Zealand.
In the US, bonkers.

Speaker 4 (21:40):
And I was even gonna bring up, like, what's that conversation,
like where you decide we're gonna call it vicadin? Is
there any etymology in the names of these drugs ever
at all? I've always wondered the case by case.

Speaker 1 (21:51):
Yeah, it's similar to so, because this is private industry,
there's the marketing decision really comes down to conversation between
the CEOs the pr firms and maybe the people who
actually made the drug.

Speaker 4 (22:07):
But I don't think the FDA would have any any
way in potential.

Speaker 2 (22:10):
Because there because these groups present it to the FDA.

Speaker 1 (22:14):
Right, yeah, and the FDA often is a series. They
will have some guidelines about this. But the FDA in
theory on paper and the FDA in practice are two
very very different organizations, unfortunately for most residents of this country.
But yeah, it's it's true. It's a case by case thing,
so they'll have there will be some policy conventions. There's

(22:37):
not a law, but there will be policy conventions such
as you can't name this.

Speaker 4 (22:44):
Cansecure havy fun fund pills.

Speaker 1 (22:46):
Right right, right, But I would argue that things like
Lyrica are pushing the line on that.

Speaker 4 (22:52):
It sounds nice, yes right wow, just saying it out
loud makes me have a warm, fuzzy feeling.

Speaker 1 (22:57):
Right, So it's it does go down to marketing. If
you are listening to this and you are you have
participated the naming of a drug, we would love to
hear your process.

Speaker 2 (23:07):
Absolutely, yeah, Tyland, all get at us right.

Speaker 1 (23:11):
Exceedrin's a good one because he's had the root of
excel in there. That's an excellent. So throughout twenty sixteen,
regardless of what the names for these drugs were, there
were more than sixty three thousand, six hundred overdose deaths
in the US. Of those, sixty three thousand, six hundred
forty two, two hundred and forty nine involved an opioid,

(23:33):
that's sixty six percent. That's over sixty six percent, and
that if we want to math it out a little bit,
that equates to an average of one hundred and fifteen
overdose deaths just from opioids every single day in twenty sixteen.

Speaker 4 (23:48):
Do we have a statistic as to whether there were
street opioids or prescription opioids, and I would love to
see a breakdown of that. Probably hard to.

Speaker 1 (23:57):
Tell, well, yeah, because they gather that information, they assess
cause of death, and sometimes it might be difficult to
figure out how that got in their system. So I bet,
I bet you if we drill down enough we can
we can find something there, or we can find a
good guess. But that statistic is just some sort of opioid,
But still it's they're dead.

Speaker 4 (24:19):
But given the prescription rate and the numbers, it sure
feels like a big chunk of those are probably legally
obtained and prescribed or sold by someone who legally obtained
and prescribed them to someone who maybe shouldn't have had.

Speaker 1 (24:34):
Them from what they call pill mills pill mills.

Speaker 4 (24:38):
Considering those numbers, we said at the top of the
show about how many people in this country rely on
prescription medication.

Speaker 1 (24:44):
Yeah, and we do have stats on the number of
opioid prescriptions in nineteen ninety two. This is troubling. It
goes to your question about how we can ascertain which
particular type of opioid people were trying, like street or prescription.
Nineteen ninety two, there were one hundred and twelve million
prescriptions written for some sort of opioid. By twenty twelve,

(25:07):
that had peaked to two hundred and eighty two million.
I'm sorry what, Yeah, per year, not per day. Well overdoubled. Yeah,
well overdoubled. The good news is it began to decline
after that by but not by that much. Two hundred
something million is the new normal. Now in twenty sixteen,
the number had fallen to two hundred and thirty six million,

(25:28):
so it's still more than doubled.

Speaker 2 (25:32):
My gosh.

Speaker 4 (25:33):
Yeah, and surely it's not a product of some kind
of massive population boom, right. You know, we definitely obviously
know that our population is growing, but certainly not by
that kind of number.

Speaker 2 (25:43):
And all you're asking about a number that you could
point to to how many prescription deaths there have been.
So from nineteen ninety nine up until twenty fifteen, there
were roughly an estimated one hundred and eighty three thousand
deaths from prescription overdoses opiate overdose, which.

Speaker 1 (26:02):
Means that's what the average of ninety one overdose.

Speaker 2 (26:07):
Deaths per day since ninety nine.

Speaker 1 (26:10):
And as a result, to put this in perspective, this
means we have we have a lot of folks who
listen to this show while they're driving. Yeah, so this
might be good news for you. You are more likely
to die of an opioid overdose than a car crash. Yeah,
so you're safer in your car at least.

Speaker 2 (26:32):
Man, you know, driving and work today. Four cars ahead
of me, some dude was trying to get off at
the fourteenth Street exit coming south on eighty five. This
is for all you Atlanta listeners. And as he's trying
to get over, he's trying to do it, you know,
right at the end, right before there's the guardrail and
every one of those and he couldn't make it. So
he like swung his car back to the left, made

(26:52):
another car get out of the way of him, and
ran into a truck just a couple of cars ahead
of me.

Speaker 4 (26:58):
And so even a in Atlanta traffic, you're safer in
your car. You are taking prescription opius.

Speaker 2 (27:04):
Yes, in a crazy place like this.

Speaker 1 (27:07):
Statistically speaking at least, right, but yeah, that's that's a
sobering point. And as of twenty eighteen, more than two
million American residents have become either dependent on, or have
abused prescription pain pills and street drugs. So luckily at
least that's the total for the illegal trade as well

(27:29):
as the quote unquote legal one. And we have to
ask ourselves, at what point does this become an epidemic.
Most would argue that having this many people addicted to
some derivative of opium or a similar narcotic means we're
already in a crisis. But if that doesn't tip the scale,
if two million is not enough, then what does move

(27:49):
the needle? More deaths, a higher rate of addiction. Is
it a crisis when it's five million people? Is it
not a crisis until it's ten million.

Speaker 2 (27:58):
Yeah, who decides that?

Speaker 1 (28:01):
Well, I think recently the current president did declare that
there was a crisis.

Speaker 2 (28:07):
Right Well, there have been cries to call it a
crisis for a long time, and the news, the media
has been calling it a crisis for years and years.

Speaker 4 (28:18):
But didn't he stop just short of there being really
any real action behind it? Like I think declaring a
state of emergency or something allows some kind of federal
money to kick in to help mitigate a problem. And
I think his declaration stopped just short of anything real happening.
It was more of a symbolic gesture than anything.

Speaker 2 (28:38):
Well, yeah, it's a question of do we use tax
money to actually combat it or do we say, yes,
it's a crisis and let's get more private institutions working
on it.

Speaker 1 (28:46):
And right now that fight is going state by state,
and it leads us to another question, how did this
all happen? What caused this? It's sort of like that
trope in film and televis where you get to a
freeze frame and someone you hear a voiceover say, you're
probably wondering how I got here? That's our question? What

(29:07):
brought us here? Here's where it gets crazy. According to
numerous critics, policy researchers, government officials, medical experts, and more,
the cause of the current opioid epidemic isn't solely the
fault of say, like some illegal drug cartel over the

(29:32):
border or in the Golden Triangle somewhere. It's not street
level dealers like Pooky in the wire. Instead, they argue
the blame for the present crisis falls squarely at the
feet of the pharmaceutical industry, the lobbyist it employees, and
the government officials with whom these lobbyists interact. I mean,
if we take a closer look, nearly seventy five percent

(29:54):
of people who are receiving treatment for heroin addiction didn't
just start doing heroin. They didn't wait up one day
and say, you know what, carpe dum. They began their
addiction by being prescribed opioid painkillers.

Speaker 4 (30:11):
Yeah, typically for.

Speaker 1 (30:12):
A painkilling thing, right. And these are often people who
don't have a history of drug abuse.

Speaker 2 (30:17):
Yeah, And many times it has to do with being
prescribed a certain amount of opioid, so over a threshold
of days. I think the safe threshold is like seven
or something around that, and many of these begin when
you get like two weeks three weeks worth of prescription painkillers.

Speaker 1 (30:36):
Yeah, and the weird thing is that this statistic that
seventy five I think the number may have increased to
eighty percent now that the vast majority of people are
in treatment for heroin addiction in the US started heroin
after they could no longer get legal opioid prescriptions. This

(30:58):
is absolutolutely a well known fact, but it still has
yet to stop the rise in opioid prescriptions for pain relief.
That over the past ten years, the number of prescriptions
handed out has risen by three hundred percent.

Speaker 4 (31:15):
Well, get this. There's an article from the Washington Post
from twenty fifteen, so not incredibly up to date, but
still The headline is why a bag of heroin costs
less than a pack of cigarettes, And it has a
map for the entire country showing about how much a
bag of heroin costs. And by bag, we're saying that's
that's about a dose. Maybe it's two doses, I'm not sure,

(31:36):
point being it's between seven and ten dollars for an
amount of heroin that could potentially kill you. It would
be enough to completely put you put your button, the dirt,
you know what I mean.

Speaker 1 (31:51):
But how much does that how much does a heavy
heroin user use per day? Surely more than water two doses, absolutelysolutely.

Speaker 4 (32:00):
And here's the thing too, I just looked up OxyContin
pill price and it says when legally sold, a ten
milligram tab of oxycotton is about a buck twenty five,
and an eighty milligram tablet will cost six dollars. When
illegally sold on the street, it can cost between ten
dollars and eighty dollars for one pill, depending on the dose,

(32:22):
So it's usually about a dollar a milligram, So an
eighty milligram oxy content is about eighty dollars.

Speaker 1 (32:29):
And a tab is just a pill a pill, Okay.

Speaker 4 (32:32):
So you can see maybe if you can't get it
legally prescribed and you're relying on those pill mills or
buying it illegally from someone who does have the prescription,
which is certainly how a lot of this stuff gets
into circulation, you could see the attraction of buying those
seven dollars bags of heroin if you're really addicted to
that particular you know, buzz yeah.

Speaker 1 (32:55):
And then people would say, well, I'm not. I'm doing
this as a stopgap, right, and I'm not going to
shoot it up. I'm not going to take it intravenously.
I'm not going to insulfate or whatever. I'm just going
to maybe smoke it or snort it. Yeah yeah, right,
maybe get to snorting it, but never shooting it. So
one of the big There's some demographics that fall into

(33:16):
this too that we would be remiss if we didn't mention.
We'll get to them by the end of the episode,
but for now we can say that opiate manufacturers know
how much money is at stake. They've spent more than
eight hundred and eighty million over the past ten years
just to not to make new drugs, but just to

(33:37):
keep control over the making and distribution of these substances.

Speaker 2 (33:44):
Yeah, we almost said products, but it just makes you
want to bomb it a little bit, right, It's true.

Speaker 1 (33:49):
And this money, where did this massive amount of cash
come from? Where do we get this number? It comes
from their lobbying and campaign contributions. And this has been
used in large settlements with anyone looking to challenge what
is commonly called big pharma. I know, when you hear

(34:09):
that phrase makes it easy to dismiss this as some
looney tunes conspiracy theory. But there is a huge industry,
it's real. Call it big pharma and call it whatever
you want. It's not going to stop them.

Speaker 2 (34:21):
Yeah. A small group of very profitable companies.

Speaker 4 (34:25):
Yeah, very powerful, and they have, you know, a lot
of money for lobbyists to wield legislative influence and make
sure that that pill money keeps on a flowing.

Speaker 1 (34:37):
Yeah. In the nineteen nineties, pharmaceutical companies reassured the medical community, doctors, researchers, hospitals,
medical institutions that patients would not become addicted to prescription
opioid pain relievers. This is different from heroin. This is
a morphine, right, or opium. This is FDA proved this.

(35:01):
We have specifically made this to mitigate or ameliorate some
of those concerns about the possibility of addiction. And then
healthcare providers began to prescribe them at these drugs rather
at greater rates. And when they say they persuaded them
and reassured them that that's where money comes into play.
It's a little bit of a euphemistic thing.

Speaker 4 (35:22):
Well, you know our mousepads, right, Yeah.

Speaker 2 (35:26):
I think we just have to say right here at
the top that there are a lot of people everywhere
on this planet that are in constant pain that just
kind of live in some kind of pain. Yes, sure
that exists, and it subsists, and the invention of these
products what is and was kind of this amazing miracle

(35:51):
thing for people who are just constantly in pain. You mean,
I could take a pill and I don't hurt always.

Speaker 1 (35:57):
Right, It's not a cure, but it's a it's not
it lessens the curse. Yeah, chronic and curable pain.

Speaker 2 (36:04):
It almost the idea of it at least gives the
lives back to people who are taking it.

Speaker 1 (36:10):
Right, That's powerful.

Speaker 2 (36:12):
So you can see you can kind of see here
where a lot of it is mental from the manufacturers
to the end user of I'm doing something good or
this is helping me, this is giving me my life back. Yeah,
I just want to throw that.

Speaker 1 (36:28):
In that that's a brilliant point. In the nineteen nineties,
everyone wanted to believe these statements, yes, by the pharmaceutical companies,
and perhaps you know what, you know what, man, perhaps
they believed it too. Yeah, let's just look, maybe they
did either way, whether they were purposely being deceptive or
whether they honestly just somehow didn't do even the most

(36:54):
cursory research on this stuff. Whatever happened, it led to
the misuse of these medications and eventually became clear that
they were highly addictive, and anyone who said otherwise was
either lying or cartoonishly wrong. And first, it is valid

(37:14):
for defenders of these companies to say you cannot blame
drug companies for legally selling something the FDA approved, But
the problem with that is pharmaceutical companies didn't just sell
these opioids. They also brutally suppressed legislation that would have
limited addiction among patients, including, for instance, a bill in

(37:36):
Tennessee that was designed to reduce the number of newborns
who were born addicted to opiates. For some reason, the
drug companies heavily lobbied to kill that bill and successfully.
In New Mexico, there was another proposed bill that was
supposed to limit the initial prescription of opioids for acute
pain to your PA point MATT to seven days to

(37:58):
a week, and that make addiction less likely and produce
fewer leftover.

Speaker 2 (38:03):
Pills, which is such a idea a.

Speaker 1 (38:05):
Big problem, but that legislation got killed as well. And
let's be even more fair here, they didn't just kill
certain bills or proposals. You don't want to make it
sound like that they were instrumental. In fact, this might
surprise some people in supporting several key pieces of legislation
related to opioids. They were huge fans of a bill

(38:30):
in Maine that required insurers to cover the company's abuse
deterrent painkillers. Do you like that phrase abuse deterrence?

Speaker 2 (38:39):
Right? Wait, what are what are these abuse deterrent painkillers?
This is a special version.

Speaker 1 (38:45):
Well, the idea is that they aren't there, you're less
likely to get addicted again. That's how they were sold.

Speaker 4 (38:53):
Things like time release kind of like stuff like that,
because I know that like early on you would always
read that with oxy content, for example, you could crush
them up and snort them like we were talking about.
And we found out that the that the companies knew
that was being done, that there was that kind of abuse.
But then later there were versions of them that you

(39:13):
could not do that with. They had some special coding
that you could not break or it would fundamentally change
the nature of the drug, and it prevented you from
doing this is that the kind of stuff you're talking about.

Speaker 1 (39:24):
Yeah, those would be a couple of examples. And I
don't know if there's anything that's industry wide with that,
because again, these are all private companies, but it would
be stuff like time release, for instance, or something that
coding you mentioned is fascinating everyone to read more about that.
But I'm glad you're bringing up specific examples because we'll

(39:45):
get to some specific examples of instances wherein these pharmaceutical
companies became let's say, controversial. Sure, after a word from
our sponsors. All right, twenty seventeen.

Speaker 2 (40:06):
Day, I am there. Let's see what's going on.

Speaker 1 (40:08):
It's it's it's about a year ago.

Speaker 4 (40:10):
Oh, oh, you're right, Okay, much much the same.

Speaker 1 (40:14):
What's going on?

Speaker 4 (40:16):
First? We love? What what season of Game of Thrones
are we on at that point?

Speaker 3 (40:20):
Right?

Speaker 1 (40:20):
Right? Is it?

Speaker 4 (40:21):
We're still wrapping up the last one?

Speaker 2 (40:23):
Right?

Speaker 1 (40:23):
I think so? Yeah? And you know, the four of
us are all still devastatingly handsome, h reasonably witty.

Speaker 4 (40:33):
Man, you devil, I'm a sly one.

Speaker 2 (40:36):
Right.

Speaker 1 (40:37):
And there's also a senator named Claire mccaskell, Democrat out
of Missouri, who releases a report about an Arizona based
drug maker named in ciss I n s y S. Yes,
they make an opioid called Subsis s U b s ys.

(40:59):
It contains and in this senator's support again this twenty seventeen,
there are a ton of internal documents from the company,
from Insists itself describing how it works to get over
these barriers called prior authorizations. Subsists the drug is meant

(41:19):
for one thing, and one thing alone, for cancer related pain.
If you want to get it for anything else, you
have to get prior authorization from your doctor. So it
turns out internally Insists had a whole department within the
company just for doing this, just forgetting these prior authorizations.

Speaker 2 (41:42):
And it was not above board.

Speaker 1 (41:44):
No, no, no. The employees in this department would call
pharmacy benefit managers, who are in charge of these prior authorizations.

Speaker 2 (41:53):
You've got to love the terms.

Speaker 1 (41:54):
Yeah, and they would pretend they were with a doctor's
office to get the sign off for Subsists to be
prescribed to a patient who did not have cancer.

Speaker 2 (42:08):
Wow.

Speaker 1 (42:09):
So my question is is that not fraud?

Speaker 2 (42:13):
I think it is. I would argue that it was
like it like.

Speaker 1 (42:16):
The definition of fraud it's illegal for us to call
a pharmacy and pretend to be a doctor's office.

Speaker 2 (42:22):
Yeah, m all right, is it all right? We see
you in sis.

Speaker 1 (42:29):
And then there's there's another example, which is one that
I think really stood out to all of us. This
company is one of the most well known cases of
we're going to be alliterative pharmaceutical perfidy.

Speaker 2 (42:41):
Oh wait, word of the day, perfety. What does it mean?

Speaker 1 (42:46):
It's deceitful, untrustworthy, treacherous, duplicitous, perfidy.

Speaker 2 (42:51):
You're word of the day.

Speaker 1 (42:52):
Okay, thank you, Matt So. Purdue Pharma is a company
that aggressively marketed oxy cotton and they made it. They
made it, and that's the brand name for Is it
hydrocodone or is that vicotin?

Speaker 4 (43:10):
I think it's oxy codone.

Speaker 1 (43:12):
Isn't it oxy codone? I think yes, you were correct.
Thank you. Oxy Conton, marketed by Purdue, was claimed to
be one of those things that was going to be
less addictive, right than a heroin and have all same
great benefits, same great taste, far fewer calories, very American

(43:32):
in the marketing, right, but they also claimed The company
claimed that they were unaware of the growing abuse of
oxy contin, which I think is also called in some
some parts of Appalachia at least is called hillbilly heroin.

Speaker 4 (43:50):
It is right, and I spoiled a little bit of
this earlier, but let's get into some details here.

Speaker 1 (43:55):
So it turns out that a copy of a confidential
Justice Toon Apartment report surfaced, and it shows that federal
prosecutors investigating Purdue found that Purdue knew about quote significant
abuse of this drug, in particular in the first few
years after they introduced it in nineteen ninety six, and

(44:16):
then they covered it up. They were aware that people
would do insane things to satisfy oxy cotton. They saw
that pills were being sold illegally and then crushed and
snorted or cut with other stuff, you know, and that
they would be stolen from pharmacies, sometimes in violent robberies.

Speaker 4 (44:35):
Yeah, like drugstore cowboy style if you've ever seen that
Gus van Zam movie.

Speaker 1 (44:39):
And then they would some doctors were being charged with
just selling prescriptions. Just come into my pill mill where
the address changes every few years, give me fifty bucks,
tell me what you want.

Speaker 2 (44:50):
It's despicable, and guess what they did. They went on
ahead they pushed forward and they said, no, no, no
oxy cotton. Guys, this is less own to addiction then
other prescription opioids. It's the better choice for you and
your family and then family.

Speaker 1 (45:08):
Yeah, exactly. And today Purdue maintains that it had absolutely
no knowledge of the abuse potential until two thousand, again
despite internal memos from the higher ups, multiple memos and
conversations that clearly contradict this.

Speaker 2 (45:25):
Can we go ahead and just talk about the Sackler family, Yeah.

Speaker 1 (45:30):
Lay it on the meat.

Speaker 2 (45:30):
This is just really fast.

Speaker 1 (45:31):
So the Sackler family, ultimately they're the owners of Purdue.

Speaker 2 (45:35):
Yeah, there's there are about twenty individuals that share the
wealth of this one family that owns Purdue, and it's
it's fascinating. I think they have a net income or
a net family worth of around thirteen billion dollars right now,
at least that's according to Forbes.

Speaker 1 (45:54):
They're eating pillion dollars.

Speaker 4 (45:56):
The you would say that, I love that. Yeah.

Speaker 2 (46:00):
Yes, they bought this this drug manufacturer a long time
ago in nineteen fifty two, the one that was just
kind of around.

Speaker 4 (46:07):
It's fledgling, young upstock drug manufacturyarium.

Speaker 2 (46:14):
And they were making things again. According to Forbes like
uh ear wax remover and laxative.

Speaker 4 (46:20):
Tonics, no doubt.

Speaker 2 (46:21):
Yes, you know. Thing well, I mean it's nineteen fifty two.
They're making they're making prescription drugs and stuff like that
to cocaine and.

Speaker 1 (46:28):
I'm sure mother's little helper, right but.

Speaker 2 (46:32):
Yeah, But apparently they didn't have really much going on,
as you know, a way of bringing money into the
company until they made this drug oxycont and in nineteen
ninety five that's when they officially were making it or
like made it, and from that point on that was
the thing. I mean, it's literally the cash cow or
the heroin that they came upon.

Speaker 4 (46:53):
More like oxy Koching.

Speaker 1 (46:55):
I mean, there we go, yes, yes, worth it.

Speaker 2 (46:59):
Yeah, but they're the number nineteen most wealthy family in
the world right now.

Speaker 1 (47:04):
Insane and they made that money. They made the bulk
of it off of this particular.

Speaker 4 (47:11):
Product.

Speaker 2 (47:12):
Yeah. Oh I'm sorry, number nineteen in America.

Speaker 1 (47:15):
Oh okay, world, there we go. You know, it's still
kudos to you Sacklers.

Speaker 4 (47:22):
If you want to dig a little deeper into that,
there's an article in The New Yorker with a fabulous
headline it's the family that built an Empire of Pain.
The Sackler dynasty's ruthless marketing of painkillers has generated billions
of dollars and millions of addicts.

Speaker 1 (47:37):
That's a great title and surprisingly accurate. Let's look at
those distribution statistics. Between twenty seven and twenty sixteen, the
most widely prescribed opioid was Actually it was an oxycodone,
not this time. No, it's hydrocodon vicated, which you might
remember from some of EM and M's earlier lyrics.

Speaker 4 (47:56):
Yeah, and you know movies from the eighties.

Speaker 2 (47:59):
Yes, or you know, just any of your relatives or
friends who have been prescribed it. Yeah.

Speaker 1 (48:05):
In twenty sixteen, six point two billion hydrocodone pills were
distributed across this nation. Six point two billion oxycodones. Not
even the OxyContin. Rather, it is not even the second
most prevalent. The second most prevalent is another version of oxycodone, percocet.
That that topped out at five billion tablets or pills

(48:31):
distributed in the US.

Speaker 2 (48:32):
Oh my god.

Speaker 1 (48:34):
People have been taking notice, you know, not just not
just us, not just a couple of reporters here and there,
but the government too. In two thousand and six, after
a four year investigation, the Justice Department and the prosecutors
recommended that three top executives at Purdue be indicted on

(48:55):
felony charges, including conspiracy to defraud the Unite Kid States.
And this would have resulted in prison time if these
people have been convicted.

Speaker 2 (49:07):
This okay, so it just go ahead. That reminds me
of maybe the market crash of two thousand and seven,
two thousand and eight. Yeah, where all the guys in
charge were supposed to get indicted and and charged and
they'd be in trouble.

Speaker 3 (49:20):
Mm hmmm.

Speaker 1 (49:20):
Yeah, I'm glad it reminds you of that.

Speaker 2 (49:22):
So I'm hopefully just just like that situation, all those
guys went to prison, right, oh boy?

Speaker 1 (49:28):
Yeah, okay, So what happened was officials in the George W. H.
Bush administration did not support this prosecutorial move.

Speaker 2 (49:39):
Oh.

Speaker 1 (49:40):
Instead, they settled the case in two thousand and seven.
And we have a quote from a New York Times
article on this debacle.

Speaker 2 (49:49):
Some would call it Prdue Pharma pleaded guilty to a
felony charge of misbranding and oxyconton while marketing the drug
by misrepresenting, among other things, it's risk of addiction and
potential to be abused. So there were three executives, the
company's chief executive, Michael Friedman, it's top medical officer, doctor
Paul D. Goldenheim, and mister Udell, a gentleman who died

(50:10):
in twenty thirteen. All of these guys pleaded guilty to
misdemeanor misbranding. Yeah, and it solely held them liable as
purdues Purdue pharmas responsible executives and did not accuse them
of any wrongdoing.

Speaker 1 (50:26):
And the company had to pay.

Speaker 2 (50:28):
Oh.

Speaker 1 (50:29):
Along with the executives paid six hundred and thirty four
point five million dollars in fines, and although they did
not go to jail, they were required to perform get
this community service.

Speaker 2 (50:42):
No member.

Speaker 1 (50:43):
By the way, the prosecutors did not accuse any Sackler
family members of wrongdoing.

Speaker 4 (50:49):
Let's just remember that, you know, six hundred and thirty
four mill seems like a ton of cash, but this
family is worth upwards of thirteen bill.

Speaker 2 (50:57):
Well and at the time the breaking in about one
point six billion dollars a year with their farm industry.

Speaker 1 (51:05):
So it's like with banking regulation, is that just the
cost of doing business at this point?

Speaker 2 (51:09):
I mean, it's a huge cost. It's like over one
third of your your cost of doing business.

Speaker 1 (51:14):
But still, but those payments are negotiable too. It's essentially
a layaway payment plan or they can they can appeal
that and see what they did make a settlement. Yes,
that's the problem. So they are on the hook some
how to pay it. But once that stuff gets out
of the news, you would be surprised how amenable both

(51:35):
parties can be behind the scenes.

Speaker 4 (51:37):
And yet, Ben, if I get a parking ticket, I
gotta pay that thing in full. Yeah, or any kind
of moving violation or misdemean whatever it might be. Like,
I've been the court only for parking and traffic stuff,
but you have to pay it before you leave unless
you give some kind of crazy mitigating circumstances.

Speaker 2 (51:58):
You know your your local government appreciates it's your business.

Speaker 4 (52:00):
Well, yeah, that's how it feels. But it's so crazy
to me thinking about the back room scenarios that would
go into scheduling payments for an astronomical amount like this
when the company can totally afford it. I don't know,
it's just rubs me the wrong way.

Speaker 2 (52:16):
Sacklers.

Speaker 1 (52:18):
And there's a pretty interesting anecdote that I think you
found though, about protest with Purdue and the Sacklers.

Speaker 4 (52:27):
Yeah, I think we've talked about this on another episode previously,
but I think this is a really nice way to
tie this thing up. Earlier this year, an art gallery
owner in Connecticut got arrested after he placed an enormous
sculpture of a heroin spoon. You might have seen this
in movies. So you take a spoon and you bend
it backwards on top of itself so that you can

(52:49):
take the powdered heroin. You place it in the spoon,
and you light a match or a lighter or a candle,
and it boils it up or burn. You put water
in it and it becomes an inject double substance as
opposed to a powder and this notion of being addicted,
it's kind of an icon of addiction to heroin, very specifically.
So this gallery owner placed an enormous sculpture of one

(53:12):
of these heroin spoons right outside in the walkway of
the home office of Purdue Pharma in Stanford, Connecticut. And Yeah,
the owner of the gallery was named Fernando Luis Alvarez,
and he collaborated with a Boston based artist named Dominique
Esposito to commission this piece, and he has a great

(53:32):
quote here, Ben if you shouldn't mind.

Speaker 1 (53:35):
He told Time magazine, the justice department in the country
has to start putting some of these people behind bars
because they go on and make a lot of money
and then they pay a fine and so be it
as just not the way it should be. And he
got charged by the police, I.

Speaker 4 (53:51):
Think, yeah, for obstruction of free passage. It wasn't even
in traffic, it was a footpath, and also for infering
with the police after he refused to remove the sculpture,
and it sounds like he's going to be charged, you know,
whatever goes along with those misdemeanor violations, and also the
cost of removing it because it looks like it was
like bolted down to the concrete. So he's probably gonna

(54:15):
have to pay some fees to patch up the sidewalk
where he put it in. And removal of this thing
would be no joke because it's it's about ten and
a half feet long, and they had to, you know,
the city government I guess or law enforcement had to
remove it and also store it. So you know, this
guy's going to get pretty hefty fine for that. Whatever
they assess.

Speaker 1 (54:36):
However, we are a pretty resourceful team conspiracy realists. If
you're listening to this, you happen to be in the
area and you practice law, why not accept his payment
that gigantic sculpture, get the guy out of out of court,
and then plant it back. I love there is. We're

(54:56):
going a little bit long on today's episode because, first
because this is incredibly important and it doesn't matter what
your personal beliefs are. The numbers are real and they
have no opinion. There's something else we wanted to mention
that we were talking about with our super producer Paul,
who bought up a great point. This is obviously not

(55:17):
only is it not the first opium crisis in the world,
it's not the first drug crisis in the US. In
the eighties, there was the crack cocaine epidemic, and the
government handled it in a very different way. They didn't
they didn't say, let's sort of soft foot around on

(55:37):
a federal level holding pharmaceutical companies responsible. Right because all
the powerful legislation for this stuff, we should say, is
coming state by state, and we can tell you a
little bit more about that later. But what they did
instead in the War on drugs was add things like
mandatory sentencing, add things like three strike laws for stuff

(56:00):
relatively innocuous like possession, not even with intent to destroy,
for the end user, for the end user, not the supplier,
someone who was addicted to smoking crack is probably not
also pressuring lobbyists right to let the market cocaine more effectively.

(56:22):
So one of the huge differences here that you can
also see in various news articles such as MPRS why
is the opioid epidemic overwhelmingly white? Some of the really
i would say revelatory media research in this thing is
tracing it to the demographic of the end user. Right,

(56:44):
because crack cocaine's user base was portrayed as predominantly people
of color, and the opioid epidemic is portrayed predominantly as
white people.

Speaker 2 (56:56):
It's a really I mean, it's an unfortunate point. And
just see you can see how it's shaped the entire
both of the entire processes. One thing we do have
to point out here is that the crack cocaine epidemic
is illegal substance, solely pedaled illegally, right, there's no legal
prescription version of cocaine or crack cocaine now, and in

(57:19):
this case, I think it's kind of the same point
you're making, Ben. In this case, you've got somehow the
same illegal substance change just enough that it can become
a product that can be sold legally.

Speaker 4 (57:31):
Yeah, I think they that takeaway here is the money.

Speaker 1 (57:34):
Yeah. Well, there's also there's also an interesting thing in
this article that is profoundly disturbing, and it goes back
into stereotypes. Medical professionals have patients based on what they
perceive the patient's identity to be. There's a drug abuse
expert in this interview on NPR named doctor Andrew Koalagny

(57:57):
apologies if I'm mispronouncing your name, doctor, and Colodeney notes
that one thing he's seeing is that doctors tend to
prescribe is a quote here, doctors tend to prescribe narcotics
more cautiously to their non white patients because it seems
that doctors themselves have stereotypes about addiction. So really, yeah,

(58:22):
so that that sort of racially based or motivated attitude
on the part of the medical professional may be playing
a role too.

Speaker 2 (58:32):
Geez.

Speaker 4 (58:32):
There's an interesting analog or with something that's going on
in the news right now. Matt. You mentioned the difference
between or one of the differences in the way that
the government handled it is the fact that heroin and opiates,
there's a legal version of it that you can be prescribed.
No analog exists for crack cocaine or cocaine what have.

Speaker 2 (58:49):
You, since they took it out of cocaine.

Speaker 4 (58:51):
So they took you out of coca cola. And you know,
Mommy's little helpers or whatever. Right, And I've talked about
this before, and it's just interesting because it really is
an ongoing story. There is what's what's kind of built
as an herbal supplement called kratom. It's a it's a
crowned up leaf from a tree that's indigenous to like
Malaysia or some somewhere Thailand. That's that's correct, And it

(59:11):
has been on the DEA's watch list for a long
time now because it has supposedly analog analogous sensations and
effects to opioids, and a lot of people take it,
and there's a whole you know, it's it's it's a
billion dollar industry and there's all like an organization that
is like the advocate for this substance, and people say

(59:32):
how they take it to get off of prescription painkillers
or to treat some of the things that prescription pills
would be, you know, prescribed for and what have you.
And then of course there is also a people take
it for anxiety, what have you. But there's also potential
for abuse. But the latest is that the DEA is
finally really cracking down on it, and it looks like

(59:53):
they may make it federally illegal sooner rather than later.

Speaker 1 (59:57):
I meaned it, schedule it.

Speaker 4 (59:59):
Make it one.

Speaker 1 (01:00:01):
Wow.

Speaker 4 (01:00:01):
Can you know how many deaths have been attributed to
this substance?

Speaker 1 (01:00:04):
Roughly zero thirty thirty And.

Speaker 4 (01:00:07):
I don't know the details about that, But how many
deaths did we say we're attributed to prescription painkillers?

Speaker 1 (01:00:12):
Thousands?

Speaker 4 (01:00:13):
So why is the attitude so different? Why is this
substance on the chopping block, and yet the others that
we have massive amounts of data that show it is
in fact deadly are not. I think it comes down
to Big Pharma is pissed that this legal substance that
you can buy in head shops and online or what
have you is potentially taking away taking money out of

(01:00:36):
their pocket.

Speaker 1 (01:00:37):
Yeah, I want to. I think that's a fantastic point.
I want to go back, though, make sure we don't
miss the point with what this doctor was saying about
the way we handle these epidemics. And I think they
tie in because in the doctor Kladney was saying that
in this epidemic where we do see these legal analogs,

(01:01:02):
he's saying, we're hearing from policymakers, even conservative politicians, when
they talk about the crisis, they begin by saying, we
cannot arrest our way out of this. We can see
that people who are addicted can access effective treatment. We
did not hear that during the crack cocaine epidemic. It's
good that we're hearing it now, but it's too bad
we didn't hear it then. And if kretom is a

(01:01:25):
possible way to help people in need, then it seems
just objectively, it seems pretty counterintuitive to remove that from
the conversation.

Speaker 4 (01:01:34):
Absolutely, I didn't mean to derail the racial tones to
this comparison. I think that is absolutely accurate. I think
this is almost It just really goes to show that
there is not only that bias in place in this discussion,
but also that whole lining of the pockets. Absolutely element
I think there is hand in hand.

Speaker 2 (01:01:55):
Yeah, well here's the thing. Does cretum then do you
get kreatum clinics like method own clinics and are addicted
to said there's potential for abuse.

Speaker 4 (01:02:04):
That's here's what the DEA has to say about this.
One of their big beefs is that it's being supposedly
marketed for those things that I mentioned earlier, withdrawal from opiates,
treating things that would require a more professional medical opinion,
et cetera. Supposedly, they say it's being marketed that way.
So it says, quote, the FDA knows people are using

(01:02:24):
Creative to treat conditions like pain, anxiety, and depression, which
are serious medical conditions that require proper diagnosis and oversight
from a licensed health care provider. We also know that
the substance is being actively marketed and distributed for these purposes. Importantly,
evidence shows that creative has similar effects to narcotics like
opioids and carry similar risks of abuse, addiction, and in
some cases death. But then you have people that use

(01:02:45):
it and talk about it very openly that a part
of these organizations that say it's just not the same
that they were able to use it because as a
similar effect to narcotics, but that they it literally allowed
them to kind of integrate back into society in a
way that is weren't able to do with the narcotics
that they were on, the heavy doses of narcotics.

Speaker 1 (01:03:04):
So MDMA and PTSD.

Speaker 2 (01:03:08):
Yeah, what we need is a prescription version that we
can sell for eighty dollars a tablet and then it's
good to go.

Speaker 1 (01:03:17):
No cures, only treatments, you.

Speaker 2 (01:03:20):
Know, I know, we're wrapping up. We're going way too long. Sure,
we didn't even really get into the fentanyl thing that's
happening right now as part of the crisis. Like the
reason why so many people are dying right now today
while we're recording this because the heroin supply that is
illegal that people are getting rather than the prescription drugs,
is laced with this thing that's deadly in very very

(01:03:41):
very small doses.

Speaker 1 (01:03:43):
Yeah, can you tell us a little bit about that.

Speaker 2 (01:03:44):
Well, it's just a fact fentanyl is a drug that's
being laced within supplies of heroin coming into the United States,
and it maybe it's a whole different episode for another
show where we talk about like why is that happening?
Is it just to save cost on the manufacturer's side.

Speaker 1 (01:04:02):
How does heroin get into the States?

Speaker 2 (01:04:04):
Yes? Well, yeah, and and what is the difference between
fentanyl and all this stuff? And who would just who
would be putting it in there?

Speaker 4 (01:04:12):
There's a there's a photo in this article from statnews
dot com. The headline is why fentanyl is deadlier than
heroin in a single photo, and it's these two inch
tall vials. On the left is heroin and it has
about a centimeter of powder in the bottom of it,
and then the next to it is fentanyl. And it
just looks like residue, Like there's like maybe ten grains

(01:04:34):
that you can see. Wow, it looks like the leftovers
in like a salt shaker.

Speaker 1 (01:04:38):
And that's an equivalent dose.

Speaker 2 (01:04:39):
Yeah, oh my god, Yeah, terrified. That's terrified.

Speaker 1 (01:04:43):
So maybe that is a future episode for us. Today,
we want to thank you for thank you for taking
this strange journey with us. It's only the beginning of
something that has been ongoing for you know, not just
since maybe since the nineteen nineties here in the States,
but ongoing for thousands of years in terms of our

(01:05:07):
species struggle with opium So, in short answer for today's question, yes,
the opium epidemic in the US is at least partially
the result of an active and very successful conspiracy on
the part of pharmaceutical companies, some of them, not all
of them, to twist the law or circumvent it entirely

(01:05:27):
and push these painkillers on innocent patience. To biggest factors
in this are private partnerships with politicians, with holding or
suppressing of important information, and nowadays twenty eighteen, multiple companies
claim they are in fact combating the crisis they or
companies like them, did play a role in creating. None

(01:05:48):
of these companies to date have acknowledged that they played
this role, even when internal memos show that they consciously
did so. It's pretty easy to see how critics don't
trust these statements. Currently, the attorney's general of forty one
different US states, inspired by aggressive legislation from Ohio, are
joining forces to investigate these companies. The ultimate goal of

(01:06:11):
these lawsuits is to force the manufacturers to change their
marketing tactics offer better warnings as to how addictive these
things can be. So far, all of these cases have
been civil and not criminal, and gosh, we have war
as a final As a final word, we want to
hear from you. What are the consequences for these companies,

(01:06:32):
What should they be? How can societies and grips of
these epidemics hope to combat them. The answers have a
wide range of approach and plausibility, but one thing is
for sure. At the rate people are overdosing here, at
least in our neck of the global woods, are projected
five hundred thousand Americans could dive from opioid misuse in

(01:06:52):
the next ten years. If you are one of the
millions of Americans struggling within an addiction to opioid drugs,
please reach out directly to one of the many free
treatment centers in your area. There are numbers you can call.
We guarantee you are worth it, and your time is
worth it. The time of your loved ones is worth

(01:07:13):
it as well. We'd also like to hear your story,
and we promise we won't share it unless you give
us the oka to do so.

Speaker 2 (01:07:20):
And that's the end of this classic episode. If you
have any thoughts or questions about this episode, you can
get into contact with us in a number of different ways.
One of the best is to give us a call.
Our number is one eight three three STDWYTK. If you
don't want to do that, you can send us a
good old fashioned email.

Speaker 1 (01:07:40):
We are conspiracy at iHeartRadio dot com.

Speaker 2 (01:07:44):
Stuff they don't want you to know. Is a production
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