their eyes are looking up. almost every community in egypt dreams of looking just a thing needles. for years i had treated patients with heroin addiction with high dose methadone which is the appropriate treatment and so i was thinking well i see how well that works for all these people and they don't tend to overdose on it or have a lot of side effects or have any problems so why wouldn't that be fine for pain patients i do recall individual young man who had a rough go early in life. without paulism was in recovery a number of back surgeries and i was in the middle of a tapering course switched him over to methadone for his other drug to ease his taper and using misguided conversion tables. 3 days after i converted him i

got a call from his wife buddy a doctor and was flabbergasted it's not safe for people who just have chronic pain to give them opioids because they don't have the years of tolerance built up that people with heroin addiction have to really understand the complexity of being that drug is a reflection of. training this was the published data i said there's something wrong here. and that left a. hole in my heart i still remember him very very clearly he had opened up a shop there small business and was really getting conceit and he even gave me his a. 100 day to come already accomplished that information was dribbling in that the opioid miracle pain relievers were killing people is purdue pharma and the other drug companies would have acknowledged the potentially lethal effects of opioids

when these problems are 1st discovered hundreds of thousands of lives could have been saved instead they took steps to suppress negative information within a month received a 3 page letter from produce pharma. basically saying why are you bothering the doctors og this is not a prescribing problem this is a patient misuse problem this is a drug abuse problem patients need to be able to get what they need and then we got a year later got sued in federal court we were all all the medical directors were served in our homes current efforts to stop this overprescribing have been met with much pushback from the pharmaceutical industry they rationalize that the billions of dollars they were making were helping more people than they were whoring they insisted and still insists today that only those who are diverting and misusing the drugs to get high are responsible for the epidemic and not those who are prescribe the drug produced distributed

a follow up video to i got my life back to double down on their claims that oxycontin was a safe non-addictive long term chronic pain relief returning to these patients off to 2 years shows that when pain treatment is successful and stay successful over the last 3 years i've gotten much much stronger is just absolutely a god thing it's just such a different i've been away away. and able it's wonderful however in time even produce own video poster children were succumbing to oxycontin and lethal effect of the 6 featured patients spotlighted in the videos 3 maintained they were still helped by the product 2 were deceased from causes thought to be related to their opioid addiction and non last minute i'm sure i think i said if i was to go to the mailbox once a month and i would find a bottle an oxy i'm constantly on it and i found the needle lauren is among the

lucky survivors i would allow doctors to prescribe me right now into synthetic heroin. in 2010 for do introduce the new tamper resistant oxycontin with a spotlight focused on stopping pill mills in the new tamper. resistant medication easy sources for prescription pain killers began to dry up prescription opioids were expensive on the black market. heroin became a cheaper alternative i can remember this 15 years ago when my patients coming in here for buprenorphine treatment were saying you know heroin is a lot cheaper than most pills and it works better in 2016 the new england journal of medicine published a study that found that 76 percent of those seeking help for her when addiction began by abusing pharmaceutical opioids primarily oxycontin this draws a direct line between produce marketing of oxycontin then the subsequent or when epidemic currently in the united states policy makers were hearing that all of the

problems related to opioids or from so-called drug abusers in that these were wonderful medicines for for pain patients and we recognized this wasn't true one of the 1st people to stand up to the drug companies and lobby for reform was dr andrew . he helped form prop physicians for responsible opioid prescribing their organization is one of the earliest advocates for opioid prescription reform the one federal agency that seemed to understand that overdose deaths in addiction had risen as a consequence of the medical community overprescribing was the c.d.c. you know the f.d.a. gets criticized. the c.d.c. really doesn't i mean the c.d.c. is like you know they care about public health in america at its best and brightest and today had kind of this blue ribbon committee that looked i mean people that had no ties to the pharmaceutical industry no conflicts of interest declare and they

spent a long time reviewing all of their research and when they came back and said it is incredibly damning there's no evidence to support long term use of opioids for chronic pain. what can any drug company say beyond that chronic pain as a.b.c. . one percent of the market what separates the current opioid epidemic from the heroin and crystal meth epidemics of the past is that it affects white middle class and rural communities far more than urban minority poor clicked the early eighty's late sixty's. puce and the negative consequences of the abuse of opiates was primarily limited primarily not exclusively limited to minority populations poor individuals inner city populations. from ny perspective what ended up happening is this current circumstance got a jump start from prescription opioids and as a result of that it impacted the much broader socioeconomic strata in our community

particularly individuals who have access to health care middle class for the most part white families in 2007 produce foreman 3 of its executives pled guilty in federal court to charges of misleading the public about oxycontin their risk of addiction and ease of abuse they were fined over $635000000.00 the biggest pharmaceutical settlement and us history now that may sound like a lot it is a lot but if you look at the damage that's been done particularly since then in terms of the number of people that are taking. not only oxy cotton but many types of opioids for conditions that really have there's no value for these drugs. today the opioid epidemic commands national attention there are now dozens of court cases against purdue and other pharmaceutical companies for their collusion to

promote drugs they knew were dangerous for turning a blind eye to the sale of opioids to doctors and clinics that we're told will and for the destruction of states and communities ravaged by the up at them. i'm not sure i'm enough of a medical expert to say what steps need to be taken at this point. but you know what what's very clear is that unless you have. public health experts regulators criminal investigators local officials and the medical community working together. in some kind of established program the problem will never get solved the one thing that we have to do is slowly and surely. the. prescriptions we need to get the doctors are now strongly encouraged to cautiously prescribe for both chronic pain and acute pain this will lessen the

chance of surplus pills being diverted in the buz surgeons or dartmouth hitchcock medical center in lebanon new hampshire recently published guidelines to reduce the number of excess opioid pills prescribed for acute pain what we found was that only about a quarter of the opioid pills that were being prescribed were taken by the patients so it was clear that we were over prescribing these opioids and so we came up with the guidelines and said ok for a partial mastectomy 5 pills should be enough to satisfy 80 percent of the patients for lack of scopic gallbladder removal calls the stock to me 15 pills should be enough to worry and say well did a whole bunch of patients come back for refills what we're really taking care of their pain ok and the answer that was we were taking care of their pain because less than one percent of the patients ended up needing an opioid we felt some doctors question the use of opioids at all and feel they were more effective non-addictive options even for acute pain when we think about treating patients in

pain we should understand what the ability of the body is to respond to those things themselves. we hear and orphans and we stimulate those. activity and exercise. oftentimes when somebody is in pain we tell them not to move that's the bad it that's bad it was. as we exercise use our systems normally we can create our own and orphans and pain control that's number one and. number 2 is to go to over the counter medications for example there are lots of good studies that show that the combination of taking acetaminophen which is tylenol. and ibuprofen which comes in multiple forms like advil and motor and in aleve but the combination of those medications together actually is much more effective than opioids for taking care of acute pain we can use.

activity we can talk about comedy reading there's things to divert people from pain if we sit home all day in pain we will guarantee you you will have pain if you try to be active you won't necessary get rid of it but you'll learn to deal with it better on the other hand there are those patient there is no alternative but to use narcotics i can count those on one hand in any one. it's very rare. no shots. actually felt. well it's true i

know those 2. points your thirst for action. there was a period of school at the uni polar you know period. after the end of the cold war where the u.s. and nato countries and other people sort of once would russia to become what they described as a normal country what they meant by normal was a country that was democratic by western standards not was capitalists now it was a member all the us led international rules graced the water established. i think a lot of people saw that as sort of criminal and 2nd class status in the us system and i think it's pretty clear that russia in particular has been pushing back on that.

there was a. chance to do crack when i was a little kid. he was like oh. so you know like what i needed when i was a baby boy i had a bad childhood. there's always been single mothers and african american community service and slavery. i think it's more of a teenagers having kids in you can expect a 14 or 15 year old 1st voted out for him there and he said check out. the last place on. my car and breaking down i was unable to get to work on time so they let me get my paycheck that i bring home. early enough to pay my.

doctors are getting the message that certain uses of opioids are not appropriate for example long term chronic use there are lots of educational programs out there there are. d.n.a. enforcement activities out there. in fact some doctors are now complaining that it's so hard to write a narcotic prescription that they don't even bother to talk to people who are chronic pain patients and i get e-mails from these people who believe that their opiate prescription isn't working for them. they are very scared of the discussions going on they're scared that their doctors not be able to prescribe it the federal government's going to take away their pellets and that are allowing them to have a quality of life that they don't believe is possible about the drugs there are a lot of patients that are. going to have pain acute pain and chronic pain that

aren't attics that need to be treated properly with pain medication that does work for some people so i don't think we should throw the baby with the bathwater for about 10 to 12000000 americans who have been put on long term opioids. many of whom may never be able to come on and who many of whom are convinced that the opioids are helping them they're desperate to maintain their supply and the idea of folks out there telling other doctors that these aren't safe and effective that they don't work well long term they rightly believe that it could make it harder for them to continue to access opioids and so. from some of these pain patients who are on opioids. first of threats and it's it's often a threat of. wanting to cause bodily harm so that. there.

may be i have a different feeling about opioids and i was injured that that type of threat i do worry in some ways that now perhaps the pendulum. swinging so far the other way that we're going to see a lot of people and so it's cut off from their long term supplies of opiates which are not appropriate for them to be on. but i imagine we'll be seeing those people coming to our addiction treatment programs as that begins to happen as states but more restrictions in place for physicians people want to blame big pharma and say they're greedy they're terrible now but the problem is that big pharma is the engine for medical innovation in this country they develop drugs they are willing to invest millions in invested $40000000.00 before they've made a dime from it. so if we if we say let's you know what's make all of our drug companies nonprofits like we're not going to have a lot of innovative drugs that are going to

a carrot cancer or things like that so it's a problem and the rest of the world is counting on american drug companies to come up with cures chronic pain is truly a life altering problem for millions of people 'd. search for safe non-addictive solutions for pain really we can probably produce better drugs in terms of alleviating pain without the addictive component and some of the faculty here at the similar institute are working very hard on the. we need to treat pain is very important to treat i've been studying the system since the microchip studies in england we cloned that we found a gene which we call coded. we can block the information in the brain and we don't quite know what that will do i think what's needed is a drugs which don't. necessarily all 'd. drugs which work at over substance but don't reach the reward system there is some process in the playing field in developing new drugs the focus of our study is really to investigate the role that

the immune system actually plays and so that's. a new angle. in research regard to the. cells to actually valid. response is worth on the animals so we decided to shoot from animals as well as. an expression and then produce an expression and i think the really promising aspect of our study then is that these clues are a target for treating pain better so we could inhibit the activity. and it actually improves the clinical because it's get rid of some of these problematic effects like tolerance addiction exaggerated and i came to stanford to understand how proteins these very fascinating molecules work at the most basic level i'm an instructor in the department of molecular and cellular physiology where we study very basic aspects of biology and the work that we've been doing lately is to

understand how. they bind to their receptors and function these models provide is really remarkable ways of developing new drugs and what i'll do next is put up a. drug like morphine here in orange inside its receptor you can see if it's really nicely and i was told and that i can i can kind of cut away and you can see how well those little balls are sitting inside that receptor because what we can do now is to say well this is the receptor binding poket what other drugs in the pocket and then can we use this kind of knowledge to develop better drugs that act these receptors and not addictive opioid would be a medication that targets the new opioid perceptor. turns it on provides pain relief but doesn't trigger the rewarding pathways in the brain that cause tolerance for cause addiction you know with these other drugs that target different systems likely also are coming down the pike actually see either a complete turn to drugs that are actually used to treat pain or we can actually

apply these drugs to improve the clinical profile of our heads so. it's could still be administered but if we shut down the signaling that occurs at the same. time then we can eliminate these problems of tolerance addiction as i said earlier the system better because as well despite all the attention focused on the opioids to make the crisis continues to grow. according to the c.d.c. . 2016 there were over 62000 deaths due to overdue this is the worst made up its. in modern medical history. we still have reversed it and we've known about it for more than 10 years show where are where are these teachers that taught us to do these things why are they all fair helping to reverse this during the making of this documentary we saw to interview representatives from purdue in the form of suitable interest here on. this is

a common problem experienced by most journalists covering all preorder picked up i would love to talk to anyone from the sackler family because they you know they're smart people and this is a complicated problem but i want to hear what they say about it you know it's a family company and there is a sense that i got from talking to people that are associated with it that they feel that they've been mistreated by the media by the government by politicians. and that they feel attacked you know i was interviewing someone who has a very high opinion of the company and very high opinion of the family i mean he didn't want his name used because he's like if look i stand by the 100 percent but if i give you my name then like i'll be just pilloried you know people look askance at me all the internet people trolling me. and so i feel like they have this you know they would say it's a well grounded cynicism about the media and about just you know coverage of their drug i believe that. in terms of the blame for opioid addiction

epidemic produced forum was pursuit of financial profit and the fact that they did . and care about an epidemic of addiction and overdose deaths that they were fuelling. the fact that the food and drug administration failed to properly regulate the claims that produce was making the failure of the medical establishment. and the fact that it took money from purdue and other opioid makers and promoted aggressive use state medical boards that failed to regulate the way in which doctors prescribing and even encouraged aggressive prescribing there's a lot of blame to go around the question is is who is guilty or who should feel guilty i don't know that anybody feels too guilty i kind of wish a few more people did feel a little more guilty despite public outcry pharmaceutical companies find new and

creative ways to market their heroin builds. what's in the parts lauren and we do have pounder we can employ from there and it looks to be very opioid centric including painkillers marketed to children the food and drug administration announced about a month ago that they were determining that oxycontin is safe and effective for children 11 and up which is very disturbing most of the companies that now operate in these bases in this space have gone dark. it's not the big names that you and i would recognize like pfizer or johnson and johnson pfizer does have a little bit but not a lot. is actually these small very focused companies the focus on pain and then not names in the household names they don't have to worry as much about the sort of reputational damage as forces in our nation strengthen against the over prescribing

of opioids from a suitable company see their us market eventually narrowing as one door closes another opens produce private company own. there's international from monday for mine has already begun the same kind of marketing campaign in latin american asia the middle east and africa. nations where chronic pain is high and people haven't the money or access to medical treatment communities ill equipped to handle an opioid epidemic los angeles times reporter harriet ryan was the 1st to break the story interviewed someone who is going around the world training physicians a foreign country is for to do for teaching them how to use oxycontin he admitted he doesn't use it as a practice citizen think it's a. as big pharma broadens its horizons our nation continues to struggle in the aftermath of their deceit. and it wasn't until february of 2017 after

much had been exposed about the overprescribing of opioids that a new doctor at the clinic noticed 70 year old linda g.n.r. he had a serious opioid addiction he discontinued her high dose prescriptions causing linda to experience a painful withdrawal process get nauseous you might throw up and get diarrhea there's a whole array of stuff you feel pretty miserable for people like myself need some relief from the chronic pain. and it doesn't take 150 milligrams of the whole to do that today life is better but that doesn't make up for the decades of endangerment and loss of quality of life linda innocently experienced by trusting her doctors would do her no harm this film quite a journey one i don't want to go through it again. happy with how things are now. i think it's fair to say that this epidemic of opioid addiction and

overdose deaths was in many ways caused by by greed so i think an informed public is critical to resolving this. problem. people need to understand that these drugs are very potent very dangerous. very addictive the opioid epidemic can only be contained if it is attacked from multiple fronts start with an informed nation regulatory agencies that placed public welfare above special interests health care and pharmaceutical industries governed by providing each an oath to help the sick and to do no harm. the battle continues. pleasure to have this opportunity to speak with you all about the opioid addiction epidemic i'm going to just jump right in i'll start off by saying i have no financial relationship with pharmaceutical companies and i think you'll understand if you

hear my talk why no pharmaceutical companies that want to relationship with me. i'm going to start off by saying something very obvious or something that should be obvious but unfortunately is not obvious when we talk about drugs like oxy co don't which isn't oxycontin or hydrocodone which is invited and we're talking about drugs that come from opium to to make oxycodone and hydrocodone you start with opium and the effects that hydrocodone and oxy co don't produce in the brain are indistinguishable from the effects produced by heroin if you give an experienced heroin user oxy called onan heroin to administer like a blind taste test in fact they did a study like this at columbia. the heroin user can't tell which is which and if you ask them which they like a little bit better they actually rate the oxycodone higher than the heroin so when

we talk about opioid painkillers we are essentially talking about heroin pelz. drew on friday oh oh oh oh it gets crazy oh. we've been a real good shots few begin murders controls all life. but sometimes our last community young people are deciding if they want to not like their parents not like them liberals. always drug school again you always have problems but you're not going to focus and walk is the most ubiquitous going out there most police departments use it almost overstayers in the school that they could get their hands on communism 20 rallies.

through it teach nice kids about racism about police brutality taking cried of them they are these kids are a part of history. some control from middle class to who most of the night most of our very hard working people who want to get ahead that either have some some health issues or have some of it out of strict about luck the whole time jule moon to always pay for a place to live and missing just a month's rent can get you a victim to gunpoint if anything bad happens to any thing that just throws your budget off slightly. you better catch up real quick or you're going to have a judgment of possession against you and get addicted to anyone that's homeless is history like garbage people look at you like a monster or someone bad or you chose to be there most of the time it's not the case see how it is to be paul in the world's richest country.

so just. police chief quits as another african-american police. protesters in seattle occupy 6 blocks of the city center declaring it. has been. protesting creasing militarization of the u.s. police this question.