dr. compton has already presented. i spent 10 years as a prescriber because i came to government. 5 years in my solo private practice. and 5 years as medical director of an opiate treatment program for western psychiatric clinic pittsburgh. i maintain my private practice over that time. i can tell you the single most therapeutic thing i did for anybody was provide respectful medical treatment. whether that included medication or just listening and advice in coronation of ancillary services. it almost did not matter which. obviously medication was an important part. of going to spend a lot of what i talk about todahyy on that. a word about the pictures i'm showing you. one day i asked everybody i saw if they could give me their permission to take a picture. this was for me to use these photos to teach medical students about bias and disparity in health care. this is far less than half the people i saw on that date. of the people they gave me permission, i removed the children and adults that could not fully consent. it

dr. compton reviewed the point. i won't go into a lot of detail except to talk about the difficulty that we in those we interact with can we in understanding how you give an opiate to in opiate addict. that is intuitive, that where you expect it to be going. as dr. compton laid out for you, if you get on the right dose. take method of -- take methadone. it is a full agonist. the more you take, the more affected has.if you get on the right dose , it controls your withdrawal so you can stay engaged in treatment and function. but it also feels up your receptors -- fills up your receptors. it keeps them on an even plane so that you are not being driven to use. but also, your receptors are full. so if you relapse and use something, there is no place for them to go. there is no receptor for that to bind to to you -- to reward you for that slip up. you can go okay, that did not pan out, and move on with your recovery instead of the whole bottom out of the top. it's not just about getting the dose in the right range and sat