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 really do recall individual young man who had a rough go early in life had some problem with alcoholism was in alcohol recovery had 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 didn't really understand the complexity of doing that drug is a reflection on. guys much 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 a small business and was really getting on conceit. he even gave me his a. 100 day. any accomplish that information was dribbling in that the opioid miracle pain relievers were killing people is produced pharma and the other drug companies would have acknowledged a 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 purdue pharma basically saying why are you bothering the doctors 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 rationalized 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 forced bribed the drug producer 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 godsend it's just such a different i've been away a wait. and able is wonderful however in time even produce

own video poster children were succumbing to oxycontin lethal effect of the 6 featured patients spotlighted in the videos 3 maintain they were still helped by the product 2 were deceased from causes thought to be related to their opioid addiction and non linesmen another i think said if i was decoding mailbox once a month and i would find a bottle an oxy i'm constantly on it and found the needle lauren is among the lucky survivors i would allow doctors to prescribe me x. right now it's a synthetic heroin. in 2010 for do introduced a 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 cheap alternative i can remember this 15 years ago. in my patients coming in here

for buprenorphine treatment we're 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 and the subsequent care one epidemic currently in the united states policymakers were hearing that all of the problems related to opioids or from so-called drug abusers and 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 what they came back and said 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 is 87 percent of the market what separates the current opioid epidemic from the heroin and crystal meth epidemics of the past is there that affects white middle class in rural communities far more than urban minority poor click. the early eighty's late

sixty's. the 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 employer socioeconomic strata in our community particularly individuals who have access to health care middle class for the most part white families in 2007 produced 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 u.s.

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 epidemic. 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 it unless you have. public health

experts regulators criminal investigator 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 i'm surely. the. prescriptions we need to get them doctors are no 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 a guideline and said ok for

a partial mastectomy 5 pills should be enough to satisfy 80 percent of the patients for lack of stopping 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 the pain crying 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 have endorphins and we stimulate those with activity and exercise. oftentimes when somebody is in pain we tell them not to move that's the bad it that's bad it but. as we exercise use our systems no.

we can create our own pain control that's number one and. number 2 is to go with. medications for example there are lots of good studies that show that the combination of taking acetaminophen which is tylenol. ibuprofen which comes in multiple forms like. in the leaves but the combination of those medications together actually is much more effective than opioids for taking care of acute pain. heat activity we can talk about comedy. there's things to divert people from pain if we sit home in pain. 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. on one hand. it's

a very. let's say. thank you for. destroying. pretty. pretty good. history you know yet

sport so to book is just beautiful day to get the word for it but. these are the stories of men who can't imagine life without fashion without a sense of style without things that might be seen as weakness in this masculine world but they still demonstrate incredible strength of spirit to live as they choose. to call them to let's have a group of us of us get. points for the. same wrong. all just all. get to shape out of disdain become educated and engagement equal betrayal.

when so many find themselves worlds apart. chance to look for common ground. 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. that 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 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. these

pain patients who are opioids. perceived threats and it's often a threat. wanting to cause bodily harm so that. they're like. i have a different feeling about opioids and i was injured 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 at science 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 put 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 and 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 are 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 central institute are working very hard on the piping we need to treat pain is very important to treat i've been studying the. 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 in chronic pain and so that's. a new line of. research. the. cells to actually valid. response is work 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 better so we could inhibit the activity. and actually improve the clinical. 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 because what i'll do next is put up a. drug like morphine here in orange and inside it's receptor you can see if it's really nicely and i was alluding to that. i can i can kind of cut away and you can see how well those little balls are fitting inside that receptor because what we can do now is to say well this is the receptor binding poket what other drugs. 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 a 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. are coming down the pike actually see either a complete turn over the drugs that are actually used to treat pain or we can actually apply these drugs to improve the clinical profile of our people it's. true it's could still be administered but if we shut down the signaling that occurs at the same. time then we're going to eliminate these problems of tolerance addiction as i said earlier the system better because as well despite all the helping to reverse this during the making of this documentary resort to interview representatives from purdue in the form of sudoku industry and those doctors who advocated for shabelle your no one would appear on camera. this is a common problem experienced by most journalists covering people preordered but 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 and you know i was interviewing someone who has a very high opinion of the company had very high opinion of the family. 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 ben 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 as pursuit of financial profit and the fact that they

didn't care about an epidemic of addiction and overdose deaths that they were fueling. the fact that the food and drug administration failed to properly regulate the claims that produced was making the failure of the medical establishment. and the fact that it took money from purdue and other opioid makers and promoted progressive. you this 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 power and data 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 cases in the 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 they're 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 owners international from munda form 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 somebody here. it's going around the world training physicians a foreign country is for 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 who 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 like go do it again don't you 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 green so i think an informed public is critical to resolving this problem. people need to understand that these drugs

are very potent very dangerous on very addictive the opioid epidemic can only be contained if it is attacked from multiple fronts start with an information regulatory agencies that placed public welfare above special interests health care and pharmaceutical in. stres governed by. 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 code. 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 her alone.

in the troubled 19 seventies a group of killers rampage through parts of northern ireland that was coordinated loyalist attacks particular population. were forced to flee their homes to put these attacks was a p.r. you see the police actually took part in the attacks so instead of preventing it they were active participants in the burning of the streets in belfast at the take more than a 100 innocent civilians women. as the review can seniors and we found out more i was surprised about the extent to which the pollution was involved in some of those places the killers would lead to be named. i think it went

to the very very top i think it is. the water where. you. give the go ahead. so what we've got to do is identify the threats that we have it's crazy confrontation let it be an arms race in. very dramatic development only personally i'm going to resist i don't see it. will be successful very critical time to sit down and talk. make no certainly no borders to nationalities. has emerged. we took

a back seat. to. judge a. commentary crisis with this system things. we can do better we should be. everyone is contributing way but we also know that this crisis will not go on forever the challenges created with the response has been so many good people are helping us. it makes us feel very proud that we are in it together. anti-government rallies with almost 800000 paper on the streets and by the russian capital passed peacefully after weeks of violence from both law enforcement and protesters present look at express his gratitude to the military and riot police

for maintaining a war that. was simple. we have to this morning mainstream media pointing the finger at russian authorities after the country's problem an opposition activist alexina valmy falls into a coma russian doctors who initially treated him say no toxic agent has been detected in his blood. 12 o'clock we've received results from 2 loves one into.