produce it. if director comey does not have evidence, he should say so. the whole thing is beneath the country. remember we knew that. that's "hardball." thanks for being with us. tonight on "all in" -- >> don't believe those phony numbers. >> day 50 in the trump white house. >> they may have been phony in the past but it's very real now. [ laughter ] >> from phony job numbers to more hiding and lying about collusion with a foreign government. >> no, no -- >> reporter: the person in line to be the national security adviser may need to register as a foreign agent. and that doesn't raise a red flagg. >> it's not a question of raising a red flag, john. >> tonight an "all in" special report. falsehood and facts in the first 50 days of president trump. >> you're saying it's a falsehood and they're giving sean spicer, our press secretary gave alternative facts to that. >> including the massive emerging broken promises of trumpcare. >> saved me care, medicaid, and

social security without cuts. and new questions about whether team trump knew michael flynn was a foreign agent. and an "all in" america investigation. why a single pharmacy in a small west virginia town was shipped nine million pain pills in two years. >> i would love to see the drug companies take responsibility. >> when "all in" starts right now. good evening from new york, i'm chris hayes. on this, the 50th day of the trump administration, the white house is touting what it calls 50 days of action. with the president "achieving results for the american people." that's one way to look at it. we've seen something else in those first 50 days, something that was captured in this extraordinary moment at the white house today after press secretary sean spicer trumpeted a new jobs report showing the jobless rate ticked down to 4.7%. you might recall as a candidate

routinely and repeatedly donald trump didn't put stock in the government's jobs numbers. >> don't believe those phony numbers. when you hear 4.9% and 5% unemployment, the number is probably 28%, 29%, as high as 35%. in fact, i heard recently 42%. >> okay. that's not true but in light of those comments, spicer was asked quite reasonably why would it be that the white house now takes the new job numbers seriously. and spicer's response -- along with the reaction of the journalists in the room -- provided a defining moment to mark this president's first 50 days in office. >> reporter: does the president believe that this jobs report was accurate and a fair way to measure the economy? >> i talked to the president prior to this and he said to quote him very clearly "they may have been phony in the past but it's very real now." >> did you hear that laughter? it wasn't just spicer, it was

the reporters, too, and it was an acknowledgment of what everyone in that room almost certainly -- although certainly not everyone in this country -- has figured out. the white house is full of it. and they know it. and they know the reporters know it and they don't care. you see, not a single thing that emanates from this white house can ever, ever be immediately believed or granted presumptive authority or assumed to be true. not one thing. not what the president says, not what sean spicer says or what officials say on the record or off the record, nothing, no matter how serious or how trivial. you simply cannot take any of it at face value and that is true no matter your politics or whether you support or oppose this president's agenda. this white house has shown over its first 50 days that at the most fundamental level b.s. is part of its dna and it started, of course, even before donald trump took office. think back to the very first thing that donald trump said publicly in the oval office when he met with then president obama during the transition.

>> this was a meeting that was going to last for maybe 10 or 15 minutes and we were just going to get to know each other, we had never met each other. i have great respect. the meeting lasted for almost an hour and a half. >> it's a total trivial thing. how long the meeting was supposed to last, yet trump could not stop himself from lying about it. >> reporter: donald trump mentioned that this was originally supposed to only last 10 to 15 minutes? is that true. why would it go on so much longer than that? >> the president had allotted more time on his schedule for that meeting than just 10 to 15 minutes. >> now fast forward to inauguration day, day one of 50, remember how it rained that day? it started pretty much right when the president started to speak and continued through his speech. it's something anyone who was there could verify with one notable exception. >> god looked down and he said "we're not going to let it rain on your speech." in fact, when i first started i

said, oh, no, first line i got hit by a couple of drops. and i said, oh, this is -- this is too bad. but we'll go right through it. but the truth is that it stopped immediately. it was amazing. and then it became really sunny. then i walked off and it poured right after i left. >> that, too, was just completely made up. just like spicer's claim the crowd at trump's inauguration was the biggest ever. >> this was the largest audience to ever witness an inauguration period, both in person and around the globe. >> no, not true, on the left is a picture of president obama's inauguration in 2009, on the right, that photo with far fewer people, that's president trump's inauguration. and that was just the start. that was day one through four of the trump administration's ceaseless assault on the truth. or, to put it another way -- >> don't be so overly dramatic about it, chuck. you're saying it's a falsehood and they're giving -- sean spicer, our press secretary gave alternative facts.

>> the alternative facts are used to discuss relatively trivial matters like the size of donald trump's win. >> people came out and voted like they've never seen before so that's the way it goes. i guess it was the biggest electoral college win since ronald reagan. >> not true. they're also deployed for more serious issues like the absurd claim that anti-trump protesters are being paid. >> do you sense that there's an organized pushback and people are being paid to protest? >> oh, absolutely. protesting has become a profession now. they have every right to do that, don't get me wrong. but i think we need to call it what it is. it's not these organic uprises we've seen through the last several decades. the tea party was a very organic movement. this has become a very paid astroturf type movement. >> alternative facts are even used to again up anti-immigrant sentiment with lies about refugees and references to terror attacks that never happened. >> you look at what's happening last night in sweden, sweden,

who would believe this? sweden? >> two iraqis came here to this country, were radicalized and were the master minds behind the bowling green massacre. >> there was no bowling green massacre. now, we can't possibly go through all the examples. the huffington post counted what it said were 100 lies from the trump team in the first 36 days, but the lesson of these first 50 days is clear -- the white house, the office of the president, has become an unreliable narrator. a source of information that you just cannot trust. and it matters when a president falsely claims that millions are voting illegally, throwing the integrity of the entire electoral system into question and when an administration misleads the public about contact with russia and when, without evidence, the president of the united states accuses his predecessor of illegally wiretapping him sending capitol hill on what by all accounts is an absolutely wild goose change. today white house officials told the a.p. the president got that claim from breitbart news which had written up a rant from a right wing radio host.

and they placed that breitbart piece in trump's daily reading pile, the official said, and the president was off there's a good chance that happened but it's hard to say because that claim itself comes from a white house official and as these 50 days have shown, that means none of us should take it at vase fall. joining me now, joy reid, host of msnbc's "a.m. joy." joy, the wiretapping was the most extreme version of this. thousands of hours in newsrooms, around all of our political media complex have been devoted to getting to the bottom of this tweeted claim when it was obviously just, for lack of a better word, b.s. from an article he read. >> as you were going through that opening and litany it occurred to me that it was a show within a show.

the first show has an audience of 62 million people. he's putting on performance for them and he wants to look good to them. so he'll say i'm going to build a big beautiful wall, they're not going to pay for it. i never said mexico would pay for it but you'll love it, it will be beautiful. then you have this other show happening where donald trump's staff, his team, sean spicer, these guys who work for him, are putting on a show for him. >> that's exactly right. >> he is not entertained. i don't know if they know what he'll do and he'll get angry if sean spicer doesn't come out and say that was the biggest inaugural crowd ever, he's on thin ice. so they have to perform. and it seems part of the performance has been to feed the paranoia of the president who says "why are my numbers so low? why don't people believe me." they slip the breitbart articles and they say it isn't you, it's obama, obama is wiretapping you. they keep him paranoid in part to entertain, mollify and calm and soothe him.

that's terrifying. >> it means, john, that first of all the things -- the information that goes into the president is unreliable, as joy is pointing out, that's part of the problem. the information that comes out of the president is unreliable to the point where, the credible of the office will matter at some point when there's -- the president needs to say something about the north korean weapons program or some international crisis or just speak with some sort of level of trust to the american people about an outbreak of a disease or natural disaster, there's no reason at this point to trust anything that is said. >> absolutely not. and it's -- he's really put the presidency and the ship of state, if you will, on unchartered route. we don't know where this can lead because as joy said there's theater going on here. the way people looked at the presidency was during watergate. after my testimony people made the oddest comment, they said

"we enjoyed your show." and i didn't understand it. but a lot of people see this sort of thing as pure theater. so while we've had this before, we've never had it as compressed, we've never had the underlying falsehoods that are building. there's going to be a time he needs the credibility and he has none. >> you mentioned his supporters, one of the things that can get frost the tumult and these crises is that actually his approval has been quite stable. you know, tracking poll over the last month, trump at 43% a month ago, 42% today. and he got 46% of the vote. so he is not popular. voted in by a minority of people but it's not like he's going down. they're still there and part of what this president is doing is asserting the primary right to describe reality over and above

any other interlocutor or source. that's a key part of what this white house wants to do. >> he's still the star of "the apprentice," it's still his show. the thing that's disturbing is the way he stays at 42% is because among everyone else he's got a terrible underwater approval rating but among republicans he's higher than ronald reagan, 88%. how is he doing that? because his show for them is bread and circuses. what's the most cynical thing he's done so star in to say i have to ban people from these seven muslim countries, it's urgent. then when he gets rejected by the courts, the second version of this ban can wait because he's getting lauded by the press and so while he is being applauded, it's not so urgent. it can wait now. >> literally the day they put it out he said we had to rush to put it out. >> had to do it quick. >> the 2.0 was going to come out the day after his speech to congress and we heard from reporting it was delayed a day

so he could soak up the adulation. >> and the other part in's cynical and frightening is that the bread and circuses for his base includes the persecution of should be universally accessed by women. you could believe we should scrap medicaid or have medicare for all. whatever your political beliefs the basic facts of the matter about the world and the white house choosing to misrepresent them constantly is just a central defining feature of our politics. >> he seems to be an empty

vessel into which he's allowing others to pour thoughts and a program if you will. he came with very little conviction. he's been on all sides of most issues as we knew from the campaign and now it seems he'll play to at least part of the hard right, part of the middle right. he's all over the lot. he has no real philosophy or core beliefs so this is another problem where his credibility will hurt him. where i have no idea what it's like in private meets with the man or private telephones, if people accept him, but based on what he's saying publicly, there is no public credibility in what he's doing. >> finally joy i want to talk about this story. roger stone who is a trump confidante he had exchanges with guccifer 2.0, one of the early dnc hackers, said they were innocuous. the reason i think this relates

to what we're talking about here is there's a swirling sense of -- set of suspicions about possible collusions with the russians, et cetera, which may prove to be nothing or prove to be something massive. but right now the problem is any denial just can't be viewed by anyone credibility. >> because you already made the central point. you can't believe anything they say, except you might be able to leave a couple things roger stone has said to lots of reporters, that he had a back channel to wikileaks. the occom's razor explanation is that russia decided to attack our elections and more than one person in trump world knew about it. if this person, roger stone who has been a trump consigliere since the '80s, if he says he had a back channel, he might want to believe that. >> the question is what can you believe? joy reid and john dean, thank you both, appreciate it. up next, 50 days of facts continues. nbc news has confirmed donald trump brought a paid agent of a foreign agents to top secret intelligence meetings.

more questions about what mike flynn was up to. we are back in just two minutes.

new developments on former national security adviser michael flynn appear to show the white house once again caught in a lie. this week flynn registered retroactively with the justice department as a foreign agent for lobbying, and i quote here, "it could be construed to have been work for turkey." this was 234 exchange for $530,000. it happened while flynn was a top adviser for the trump campaign. here's white house press secretary sean spicer being asked about the matter yesterday. >> was the president aware that lieutenant general michael flynn was acting as a foreign act when he appointed him to be the national security adviser? >> i don't believe that that was known. >> i don't believe that was known. to reiterate, he said he did not know about flynn's work as a

foreign agent which, frankly, seems incredibly unlikely. here's why. on november 18 of last year, congressman elijah cummings sent a letter to vice president mike pence stating "lieutenant general flynn's general counsel and principal confirmed they are hired by a foreign company to lobby for turkish interest." that letter came less than a week after a pair of news stories detailing the fact flynn's company was lobbying for a firm with ties to the turkish government. today the a.p. reports the trump transition team knew before inauguration day that flynn might have to register as a foreign agent. among those told of flynn's lobbying work was don mcgahn, trump's campaign lawyer who served in the transition and later became white house counsel. today sean spicer continued to insist the president had no knowledge of flynn's lobbying and it didn't concern the transition team. >> reporter: can you say the president was informed at all about this arrangement? >> no. >> reporter: to register as a foreign agent? >> no. >> reporter: how did that not raise a red flag.

>> you already got your question, john. we're doing one question -- >> reporter: this is an important point. >> no, it's not. >> reporter: you have an attorney calling the transition saying that -- >> no, no -- >> reporter: the person in line to be the national security adviser may need to register as a foreign agent. that doesn't raise a red flag. >> it's not a question of raising a red flag, john, it's a question of whether or not they gave them the advice they're supposed to. it's not up to them to make decisions as to what you need to do or not do. >> the transition officials were not overly concerned by his relationship -- >> it's not a question of overly concerned, glenn, did they provide him the avenue they were supposed to, did they tell him to seek counsel? and they did and that's what's supposed to happen. that's it, plain and simple. >> joining me now, matthew rosenberg who covers intelligence and national security for the "new york times." matthew, it strikes me as fairly unusual that an individual in classified briefings giving to the nominee of a major party as lieutenant general flynn was would be at the same moment they

are receiving what is essentially some of the most classified information of the u.s. government acting as a foreign agent for a foreign government. >> i don't know where to start with this whole flynn episode. throughout the summer he is on the campaign trail presenting himself as the honest angry general who has the clean up this corrupt washington national security establishment that can't protect america and when he's criticized for being overly partisan -- and he did this in an interview with me in october -- he said they're out there using their former titles to do that. i can't do that. i'm not making money because i'm so honest and because i want to help this country. he said on october 16 when he was halfway through making a half million dollars, he said "i would love to be making some money. i wish i could stop what i'm doing" i don't know where to start with that. >> this is the other point that is key, this is a retroactive registration, he is not telling anyone at the time while he's doing this.

presumably, you know, i don't know what's in the presidential daily briefing or what the briefing is being presented to the nominee of donald trump but there might be information there that would be useful if you're angling to promote the interests of the turkish government. >> and he may be seeing this information and he's advise ago candidate through the lens of what his commitments are elsewhere. this is a classic conflict of interest situation so yes, well before the election he was donald trump's top national security adviser and to not disclose this it seems part of a pattern where, you know, the white house says no, no, no, no, no and then they are forced to admit something and they say not much here and then it gets worse and worse and worse. >> a crucial point here, there's a form called the fs-86 that people have to fill out going through the clearance process and one of the sheets asked these questions, whether you've been the representative of a

foreign government or foreign agent, presumably he had to file that during the transition, everyone does the sf-86s. either he lied on it or the white house saw and new at the time because it was on the form and they were fine with it. >> we're confident he told the white house, his lawyer told the white house about this arrangement and wondered whether it would be a problem during the transition. he would have had the security clears clearance as the former director of the intelligence agency, but it's not clear what he told the defense intelligence agency about his relationship. we should note that in september he filed an lda, a lobby form you file if you represent a foreign company or non-government organization but i've spoken to lawyers about this and the way it works is that once the thinnest connection to a foreign government shows up, that means low-level official shows up at a single meeting you have to do the registration he did today which is a much higher level to say you're a foreign agent. so if you're filing something in

september but you know you're a foreign agent not filing that form, that looks -- there's something there, that looks like a possible attempt at to deceive. >> that's an excellent point. this is an individual who wrote an op-ed saying the u.s. should extradite the chief i do midwest i can political enemy of the president, a man by the name of fetulla gullen, he knew for whom he was working. >> absolutely. that op-ed was in the hill and the hill today or yesterday has to append a note on to that op-ed saying neither general flynn nor his representatives disclosed this information when the essay was submitted. so not only was he making a case for them, he was not saying he was being paid to do so. >> matthew rosenberg, thanks for joining us. >> thank you.

still to come, candidate donald trump promised no cuts to medicaid. president donald trump is now supporting a plan that would gut medicaid. the jaw-dropping betrayal on a promise that will devastate millions ahead.

the gop lawyer in a hearing on the bill. >> so when we look at those health benefits, whether it's mental health care or potentially for other health conditions, that is no longer

essentially covered or required to be covered by this version of this text, is that not correct? >> the text before us does remove the application of the central health benefits for the alternative benefit plans in medicaid. >> sorry, does what? i apologize, i just didn't get it. >> i'm sorry, sir, i genuinely didn't hear what you said. it does what? >> it does remove the application of the central health benefits on the alternative benefit plan. >> does remove them? >> correct. >> including mental health. >> yes. >> thank you. >> congressman joe kennedy joins me to talk about trumpcare next.

saved me care, medicaid, and social security without cuts. have to do it. get rid of the fraud, get rid of the waste and abuse but safe it. people have been paying in for years and now many of these candidates want to cut it. >> candidate donald trump's promise on the day he announced his run for president, no cuts to social security, medicare, medicaid. but in the american health care act, trumpcare, there are, guess what? cuts to medicaid, not just cuts to medicaid, big cuts to medicaid, house speaker paul ryan went on conservative hugh hewitt's radio show today to brag about the scale of the cuts to medicaid framing them as enormous historic cuts. >> we're talking about hundreds of billions a year throughout the country. this is -- this is so much

bigger by orders of magnitude than welfare reform because let me describe exactly what this bill does for conservatives. this is why i'm so excited about it and this is why i think people need to see the for rest for the trees. we are defederalizing is an entitlement, block granting it back to the states and capping its growth rate. that's never been done before. >> when hewitt asked ryan about the possibility of the congressional budget office coming out with a number that 15 million people will lose insurance under the gop health care bill, speaker ryan responded with this. >> you're never going to win a coverage beauty contest. our goal is not to show a piece of paper that says we're mandating great things for americans. >> joining me now, congressman joe kennedy iii of massachusetts. you're shaking your head. what do you think about that line from paul ryan? >> it's not who we are as a nation, health care at its most basic is about taking care of

those among us in their time of need. that's what health care is, that's what health care does and why so many of us are so upset is we have what is really a massive tax cut to the wealthy on the backs of hardworking families that are working paycheck to paycheck and costing 15 people their health care. all in the name of health care reform it's outrageous and not who we are as a country. >> i want to focus on that exchange you had. one of the things folks have underappreciated is what paul ryan boasted about. this is a huge cut for medicaid and what it does is delays them and caps them so over time they get more and more severe. so in the early years people don't recognize but the folks that need it most, say mental health addiction treatment, folks in west virginia where 30% of the folks are on medicaid, they are going to take it on the nose. >> absolutely. we tried to expose this in our

hearing over the course of those 27 nearly 30 hours we were in that room together and it was clear that, one, most of my republican colleagues didn't understand what the bill did and, two, that for those that are in need, for families that are working paycheck to paycheck who have operated under the have the value we have as a country that in your time of need we'll care for each other. they'll take it on the chin. if you look at the technicalities of it, it rescinds these essential benefits for folks on medicaid is preserving them for everybody else and tries to pass off a huge tax cut literally on their backs so for folks looking for maternal care, mental health care, opioid addiction care, basic wellness and prevention services, all of those are at risk and our colleagues try to say well, there's additional funding set aside that might be able to cover it.

one, the funding isn't anywhere close to covering it and, two the whole point behind the affordable care act was making sure everyone across the country got the care they needed when they needed it. this bill blows a whole in that value that we have as a country and that's why it's so insulting to those of us trying to expand on those efforts and make sure we strengthen the affordable care act and build upon the values that we've built. but what speaker paul ryan has said -- we didn't hear that rhetoric last night during the course of nearly 30 hours together in the room. >> congressman joe kennedy, appreciate your time tonight, thank you very much. >> thank you. still to come, why did one tiny pharmacy in a small west virginia town get shipped over nine million painkillers over just two years? an "all in" special investigation coming up. you don't want to miss it. plus an amazing television

debut in tonights thing 1 thing 2 starting after this break.

thing 1 tonight, each night this show and others like it bring guests on from various remote locations in cities around the country, live locations or studio setups with cityscapes or other scenes behind them. you've probably seen guests sitting in front of this same pretend bookcase on every cable tv show going back ten years. some guests even have cameras set up in their homes, which is really convenient if you want to talk crime any time. or if you need a north korean expert right away, like the bbc did recently. >> what does this mean for the region? >> my apologies. north -- sorry. um -- north korea -- south korea's policy choices on north korea have been severely limited -- >> the door close does it. that video is thing 2 in 60 seconds.

today a political science professor based in south korea

appeared as a guest on bbc via skype from his house. robert e. kelly was on to talk about the impeachment of a south korean president which almost everyone involved in that segment would agree is a pretty serious story. >> no, i would argue this is a triumph of democracy, scandals happen all the time, the question is how do we deal with the scandals. >> what will it mean for the wider region? i think one of your children has just walked in. shifting sands in the region? do you think relations with the north may change? >> i would be the surprised if they do. the -- pardon me. my apologies. >> what does this mean for the region? >> my apologies. north -- sorry. north korea -- south korea's policy choices on north korea have been severely limited in the last six months to a year because of north korea's behavior, most recently the use

of vx gas in the airport in malaysia that indicates north korea doesn't follow global norms.

>> we will stop the drugs from pouring into the country and poisoning our youth and we will expand treatment for those who have become so badly addicted. we will soon begin the construction of a great, great wall along our southern border. we are removing gang members, drug dealers, and criminals that threaten our communities and prey on our very innocent citizens. >> the president tells a specific story about the origins of the drug epidemic that's ravaging this country. it's a very real crisis. look how the number of overdose deaths from opioids shot up from 2000 to 2015. more americans now die from drug overdoses than they do from car crashes. but a wall on the southern border isn't going to solve the problem.

to show you why, we travel to a small town in west virginia that's at the heart of the epidemic. our special investigation coming up next.

this monday we're airing another edition of all in america, bernie sanders in trump country. we're headed to mcdowell county, west virginia. like many parts of the usa lot of them poor, rural, largely white, west virginia has been ravaged by a flood of opioids, highly addicted drugs that range from heroin to legal painkillers like vicodin or oxycontin. the state has the highest rate

of overdose deaths in the entire country by a long shot. the president of the united states has promised to put an end to the crisis but when he talks about where it came from, he's got it all wrong. we went to west virginia to investigate. this is kermit, west virginia, population just under 400. and this was the save-rite pharmacy in kermit, where at least nine million opioid painkillers were shipped in just two years. nine million. that's the equivalent of over 22,000 pills for every person in town. people came from all over the region to get drugs in kermit. >> a lot of traffic from different states where people are getting and getting their prescription filled because they heard this was an easy place to get it fill sod this is where they came to. >> those drugs didn't come over the boarder from mexico. they were manufactured by american firms, prescribed by

american doctors and sent to pharmacies by american drug wholesalers or distributors. some of the nation's biggest companies. >> you have those rogue doctors prescribing incredible numbers of opioids. you have the pharmacies dispensing large numbers of oxycontin and hydrocodone and then you have the drug wholesalers which are shipping from the manufacturers to the pharmacies. >> tommy priest has lived in kermit his whole life. he served on the town council for 17 years. he's now chief of the volunteer fire department. >> it was a great life growing up here in a small town. everybody knows everybody. >> prescription painkillers transformed kermit. >> my generation, the kids wasn't out playing no more. they wasn't doing nothing. i guess they was afraid to come out. >> there was some robberies, there were some people that were robbed, what have you, not a

safe place to be at the time when this was going on. >> at the fire department, tommy priest found himself responding to more and more overdoses. many times he and his men would arrive too late. >> it's a terrible feeling when you go in and you know you can't revive somebody and help them. it is, it's a bad feeling. >> in 2005, his younger brother got a prescription for several large doses of oxycontin. >> they fill it no questions asked, they fill it for him. and two days later we get a phone call, my brother's laying in a trailer down here in wayne county dead, he od'd on the oxycontins. and i've never heard of anybody giving anybody four 80 mill oxycontins a day. that was a big loss to lose my brother. me and him was close.

>> no state has lost more of its people to drug overdoses than west virginia. law enforcement has cracked down on pharmacies around the state, including the one in kermit that received nine million pills in two years. its owner was fined and sent to prison. but in west virginia, until recently, the distributors that supplied those pharmacies with millions of painkillers have largely escaped consequence. >> every drug they distribute to is to a licensed pharmacy and every prescription the pharmacy fills is from a license doctored so they say hold on a minute, we're just the middleman. >> according to an investigation by the charleston gazette mail, drug wholesalers shipped 780 million oxycodone and hydrocodone pills to west virginia between 2007 and 2012. during that period, over 1700 west virginians fatally

overdosed on the same two drugs. under west virginia law, distributors are legally required to report pharmacy orders that seem suspicious. >> the quantities of the opioids were increasing dramatically. they were shipped from the wholesalers to the pharmacies. that should have sent signals to the distributors. >> west virginia sued the distributors for failing to raise red flags about the number of painkillers flowing into the state. during the previous 12 years, the state received just two suspicious order reports. in the years since the lawsuit was filed, that number shot up to more than 7, 200. the state settled with two of the biggest distributors which said they would pay $36 million. neither admitted to wrongdoing. now the town of kermit is following the state's example, suing five drug distributors for damages. >> if we don't get anything out of this suit monetary maybe we

can get the fire started and keep it going where it grows bigger and we can get over people involved in it. other towns. >> that fire appears to be spreading. mcdowell county was shipped 26 million painkillers over a six-year period. it has the highest rate of fatal drug overdoses in the nation. in the county seat of welch 80 miles from kermit, mayor reba hoeniger just filed her own lawsuit. >> i'm here to file this. >> she wants to hold the wholesalers accountable for their role in the opioid epidemic that has devastated west virginia. >> i would love to see the drug companies take responsibility for the number of drugs that they send into our city and our county.

>> i'm joined by dr. ana lemke, chief of addiction medicine at stamford university, author of drug dealer m.d., how doctors were duped, patients got hooked and why it's so heart to stop. if you look at any of the data, that chart we showed about opioid overdoses, there's something crazy. >> what happened? in 1980 doctors were reluctant to prescribe opioids for pain because they were concerned about patients getting addicted. in 1908, there was a huge shift in medicine -- 1980 -- and doctors started prescribing opioids for pain conditions. and the major driver was the pharmaceutical industry. but in order to understand how this happened it's necessary to realize the pharmaceutical industry used a trojan horse like approach to infiltrate what i call big medicine.

basically the pharmaceutical industry behind the scenes launched a covert operation in essence to influence academia, to influence the fda, the federation of state medical boards, watchdog organizations that are supposed to keep an eye on how doctors practice. and the pharmaceutical industry ended up perpetrating one of the greatest myths in modern medical history which is if a patient is prescribed an opioid for a pain condition they won't get addicted. now we know that's not true. >> so you have big pharma, the distributors who are wholesalers, the targets of the lawsuit. you have doctors doing prescribing, huge amounts of pain pills flowing into the american populace. my question for you is in places that have seen a lot of economic devastation how much is this a story about the specific nature of opioids or economic desperation leading to addiction?

>> it's a great question. karl marx said religion is the opium of the masses and i think we've reached a new era where essentially opium has become the religion of the masses. we have so wrenched our social fabric, we have communities that are devastated by unemployment, devastated by multigenerational trauma and these are communities in which people are particularly vulnerable to becoming addicted and when you add to that poor access to quality health care and you have doctors who are prescribing opioids because it's all they have at their disposal to target pain, they don't have access to other resources, you have a perfect setup for addiction. >> one of the things that is so horrifying about those numbers on overdoses addiction is one thing then you have people dying from addiction. there's one story people tell that the kind of restraints on pain pills that lowered the prescriptions, started monitoring it, that people then moved to heroin and more dangerously fentanyl which is

synthetic and that moved from prescription pills to things in the black market is part of what's driving the overdose epidemic. >> certainly it's true that many individuals begin with pain pills and then transition to heroin but it's not clear this transition is because they can no longer get the opioid they need from the doctor. what's more likely happening is that in the general populace people are exposed to opioids through a doctor's prescription or a friend's prescription or a family member's prescription and hence get a taste for opioids and then quickly transition to heroin because it's cheaper. in other words, the crackdown on excessive opioid prescribing is not driving the increase in heroin use, it's simply that we have created a nation of people who are addicted to opioids. >> how do we solve it? >> well, one of the ways we have found to be most effective looking at communities around the country is when many different stakeholders within

the community come together. for example, volunteer firefighters, the criminal justice system, the school system, the medical community, when all of those different factors and people from different stakeholders come together and try to rebuild their community from the inside, including getting affordable and immediate access for patients who have become addicted, then we see better results. >> dr. anna lemke, thank you for joining me. >> you're welcome. >> we'll be airing our "all in" america special on monday. and in 11 days my new book "a colony in a nation" comes out. you can pre-order it now. check out our facebook page for details on the book tour because spots are filling up and i hope to see you out there. that's "all in" for this evening. the rachel maddow show starts right now. good evening, rachel. >> thanks, my friend, have a great weekend. >> you, too. thanks to you at home for joining us for the next hour. happy friday. so the wheels are coming off a little bit. if the wheels are not yet off

you are starting to hear the start of lug nuts stripping their threads and pinging across lanes of traffic while the wheels start to wobble. there's a bit of a freakout in washington and we're seeing it on two big stories developing tonight. why is it always friday night? one of these two stories tonight, developing tonight that shows this freakout, one of them is about the administration itself, the other one breaking tonight appears to be about the prospect of investigation into the administration. but we'll start at the beginning. we'll start with the first one tonight that concerns michael flynn. never before in the history of our country has a national security adviser been fired after 24 days in office. michael flynn made that history, he didn't make it to the end of his fourth week in office but he made it to the history books. when he was fired there were things about it that didn't make sense that still don't make sense and are starting to become untenable.