yet with much pushback from the pharmaceutical industry they rationalized that the billions of dollars they were making were helping more people than they were hoarding 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 for do distributed a follow up video to i got my life back that doubled 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 it stays successful over the last 3 years i've gotten much much stronger is just absolutely a godsend it's just such a difference i've been away away. and 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 maintain they were

still helped by the product 2 were deceased from causes thought to be related to their opioid addiction and non last minute other things said if i was decoding mailbox once a month and i would find a bottle an oxy i'm constantly on it and i found the need to lower and is among the lucky survivors i will allow doctors to prescribe me x. right now it's a synthetic heroin. in 2010 to 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 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. 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 there were an 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 arisen 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 the next great middle class in rural communities far more than urban minority poor compared to 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 perspectives what ended up happening is this current circumstance got a jump start from a. 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 the risk of addiction and ease of abuse they were fined over $635000000.00 the biggest pharmaceutical settlement in 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 were polled mills 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 investigators local officials and the men.

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 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 a 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 scopic gallbladder removal calls the stock to me 15 pills should be

enough we're worried 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 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. can 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 was. as we exercise use our systems normally we can create our own 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 and aleve it's a 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. 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.

in the troubled 19 seventies a group of. street. that was coordinated. population . were forced to flee their homes. these attacks was a p.r. you see the police actually took part in the attacks so instead of preventing they

were active participants in the streets in belfast. more than a 100 innocent civilians were. seniors and we found out more. about the extent. to which the solution was unfolding some of those cases. would lead to be named. to the very top i think if the phones. there was. the go ahead. so what we've got to do is identify the threats that we have it's crazy. let it be an arms race. dramatic development only. exist. we'll be successful. to sit down.

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 people who believe that their opiate prescription is 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. out of 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 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. from some of these pain patients who are opioids. perceived threats and it's it's often a threat. wanting to cause bodily harm so that. maybe 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 and so cut off from their long term supplies of opiates which are not appropriate for them to be. but i imagine we'll be seeing those people coming to our addiction treatment program that begins to happen as states but more restrictions in place for physicians people want to blame big pharma and then 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 of invested $40000000.00 in icy hot before they 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 cure 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 in some of the faculty here at the central institute are working very hard on the pain we need to treat pain is very important to treat i've been studying the. courage of studies in england we close up that we found the gene which we call code that. 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. research.

the. cells to actually valid. response has worked on the animals so we decided to shoot from animals as well as. expression and produce an expression and i think the really promising aspect of our study then is that these. are a target for treating pain better so we could inhibit their activity. and actually improve the clinical efficacy of get rid of some of these problematic tolerance addiction exaggerated 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 its receptor you can see if it's really nicely and i was told into that binding 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 are in this binding pocket and then can we use this kind of knowledge to develop better drugs that act these receptors are 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 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 manmade epidemic in modern medical history. we still have reversed it and we've known about it for more than 10 years so we're are where are these teachers that taught us to do these things why are they all very helping to reverse this during the making of this documentary we saw to interview representatives from purdue in the form of suitable industry and those doctors who advocated for sure all your. own would appear on. this is a common problem experienced by most journalists covering opioid up and i would

love to talk to anyone from the sackler family because 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 get 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 and very high opinion of the family. he didn't want his name used because he's like if look i stand by them 100 percent but if i give you my name then like i'll be just pillory 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 what addiction

epidemic produce. as a purse shoot financial profit and the fact that they didn't 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 of 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 are going 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 more could eventually narrowing. as one door closes another opens produce private company owners international from monday for money 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 in foreign countries for credit 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. 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 opioids addiction and

overdose deaths was in many ways caused by. i buy green eat oh i think inform 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 government 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 code 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. probably. summer. long. hooper joey you know they have so being you. just. so.

they take you. through. life with fashion. style with things that might be seen as weakness in this masculine world but they still demonstrate incredible strength. to choose. so what we've got to do is identify the threats that we have it's crazy going for them to let it be an arms race is all off and spearing dramatic development only closely i'm going to resist i don't see how that strategy will be successful very critical time time to sit down and talk.

the world is driven by shaped by our own personal those with. no dares thinks. we dare to ask. one else chose seemed wrong but old quotes just don't hold. me to the old belief yet to shape our disdain to become agitated and engaged with equals betrayal. when so many find themselves worlds apart when you

choose to look for common ground. is your media a reflection of reality. in a world transformed. what will make you feel safe. isolation community. are you going the right way or are you being that. direct. what is true what is faith. in the world corrupted you need to descend. to join us in the depths. or a maybe in the shallows. and

german clinic treating the gravely ill russian opposition activist alexei navalny says it's found traces of a substance that affects the nervous system the spot russian doctor saying they could find no toxins and his blood. a weekend of huge rallies peacefully but it was 2 weeks after the disputed election based with tens of thousands calling for him to quit president lukashenko thanks to riot police for their support. that was simple. and. someone to the russian foreign ministry in moscow off to vienna said it's expelling a russian.