186 - The Opioid Crisis with Patrick Radden Keefe
HTML-код
- Опубликовано: 22 май 2024
- Patrick Radden Keefe is an award-winning staff writer at The New Yorker and the bestselling author of Empire of Pain: The Secret History of the Sackler Dynasty. In this episode, Patrick tells the story of the Sackler family and Purdue Pharma - makers of the pain management drug OxyContin, providing the backdrop for the ensuing opioid epidemic and public health crisis. He reveals the implicit and sometimes explicit corruption of all parties involved in the development, approval, and marketing of OxyContin, leading to a cascade of unintended consequences including addiction and death. He explains the unfortunate lack of accountability for the current crisis, as well as what it all means for those with legitimate pain management needs. Finally, he examines the difficult path ahead towards finding a solution.
Show notes page: bit.ly/3dv2HFS
We discuss:
00:00:00 - Intro
00:00:10 - Patrick’s investigation into distribution and use of drugs in our society
00:06:32 - The scale of of the opioid crisis
00:09:19 - The Sackler brothers: family life, career in the pharmaceutical industry, and role in the current crisis
00:17:05 - Purdue Pharma: origins, early years, and move towards pain management drugs
00:27:15 - The development of OxyContin: its conception, marketing, and the controversy around the FDA approval process
00:46:21 - Early reports of OxyContin addiction and unintended consequences and how Purdue Pharma sidestepped responsibility
00:54:35 - The many paths to addiction and abuse of OxyContin and the ensuing downfall of Purdue Pharma
01:06:33 - Peter’s personal experience with OxyContin
01:19:44 - Pain-the “fifth vital sign,” how doctors are trained in pain management, and the influence of money
01:30:17 - Other players that helped facilitate the eventual opioid crisis
01:39:48 - Lack of accountability following the investigation and prosecution of Purdue and the Sackler family
01:54:36 - Legacy of the Sackler family and their disconnect from reality
02:04:12 - Patrick’s views on the regulation and use of pain management drugs
02:07:46 - The difficult path forward
--------
About:
The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 35 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.
Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life).
Learn more: bit.ly/3EzGm5Y
Subscribe to receive exclusive subscriber-only content: bit.ly/3DJhZln
Sign up to receive Peter's email newsletter: bit.ly/3rIphDf
Connect with Peter on:
Facebook: bit.ly/PeterAttiaMDFB
Twitter: bit.ly/PeterAttiaMDTW
Instagram: bit.ly/PeterAttiaMDIG
Subscribe to The Drive:
Apple Podcast: bit.ly/TheDriveApplePodcasts
Overcast: bit.ly/TheDriveOvercast
Spotify: bit.ly/TheDriveSpotify
Google Podcasts: bit.ly/TheDriveGoogle
What amazes me about this crisis is how ordinary citizens have fought to bring justice for the victims of opioid addiction, people need to continue to push for justice in the courts and also continue to shame and track down generations of Sackler's publicly. Sacklers should be treated like Nazis for what they did with Purdue and now MundiPharma.
who are the sacklers? they are a family that went about the pursuit of happiness via the highway publically traded stock and trade intersecting avenue capital gains through the vehicle of pharmaceutical products more specifically the rapidly emerging markets in the multi colored spheres of the semi synthetic patently protected variety rakesin & pwnzor llc raves flyn fkn fandango that is thebeine derivates as it does not have the legal constraints imposed yearly limits allowed to be imported.
to compare them to nazis with a straight face is at best a tired and lazy while also factually incoherent attempt to connect something you dont like with another group of historical actors seen in ill regard....
if this is the case you can simply delete your comment and come back again after doing more research on the topic of discussion.
I normally listen to the podcast, however I just watched your first RUclips interview. Great job on upping the visual game with the virtual interviews! Nice to see people embracing it, yet not being satisfied with one dimensional Zoom recording. You put a lot of thought into everything you produce, and it shows.
I was a Paramedic who's coverage area included the Creedmoor facility. The facility is massive. It has quite a few buildings (in excess or 50 buildings). I certainly have gotten lost a handful of times in there, and many of those buildings have long been shut down. But the bulk of the facility is still active today.
“The surgeon operated on the wrong side”😲
I’m glad you survived all this lunacy
🙏💪
I share Attia’s weariness to pain relief.
I had a large cyst surgically removed, and it took two weeks for the pain to finally go away.
But I wasn’t taking any strong pain relief prescriptions. I took something with the same potency as Ibuprofen, but nothing more.
I don’t know… i just didn’t want it.
But my medical friend was horrified to see that I was in a really painful state, and I was crouching all the time. So she made me take the pill in front of her. I’m glad I did because the pain did get too much.
I just watched this video. As a practicing RN in the mid-2000's, we were almost 'forced' to ask about pain; it was called the 4th vital sign. Patients were asked before surgery what their
acceptable pain level was; many stated a '2' out of 10.
To Peter: One of your very best interviews, ever.
Such a fascinating conversation!! Thank you Peter & Patrick
Great convo. Watching dope sick now, will grab this book
Such an excellent, in depth discussion of the US opioid crisis of addiction. 🙏🏻
Im here after watching Painkiller.
Fascinating and disturbing discussion. Thank you for posting. Prayers for all those impacted by the opiate scourge.
Importantly, I believe in human resilience and second chances. I remain optimistic.
IMO, you hit upon something very relevant, we do not all have addictive personalities. In my 20's I experimented with recreational drugs. Luckily I had had some natural highs that were more compelling than the drug highs. Consequently feeling good naturally became my focus. Perhaps the downside was that I became anti-pharmaceutical and do not trust prescription drugs and the myriad number of side effects.
We live in a predatory environment. It’s not just the entities mentioned but other institutions as well. Some people are able to precisely see it, many many others just are generally angry, they know something is off. Others lose hope. Bottom line is, it’s not sustainable. Things will therefore change, but at what amount of disruption?
Its really discouraging to see so many professional folk with a total lack of scruples .
Peter, as a subscriber to your premium service I have a suggestion. It would be great to have a private Discord server for subscribers where we can hang out and discuss various health related topics under different channels. You wouldn't even have to be active, it would just be nice to have a place where members can interact and share knowledge
That's actually a great idea
So interesting and depressive. Thank you!
I think not enough attention has benn directed at each person's "addictability": people get addicted because they cover up/escape emotional pain.
The same exposure to addictive sunstances creates different levels of addiction in different people. That needs to be addressed in order to rrduce future addiction.
Dependence vs Addiction.
Thank you both for making this possible for everyone to view.
The crack down on oxy after everyone was addicted caused people to get on to fent, a perc went from a dollar or two the the street to over 20$ for an original non-pressed one. They just made the problem worse!!!
Great podcast Dr. Attia, thank you.
Thanks you, Mr. Attia!
And this is for a drug that big pharma clearly DID have liability for and were eventually sued for billions. Imagine what they would do for a drug if they were completely immune to liability.I’m sure you could count on it being safe and effective hmmmm.
Thank you for this!
Opioids have been studied for a long time. How the hell could a doctor not know the ramifications of over-prescribing this drug?
They know what high potency opioids do regardless of extended release formulation.
Exactly. Oxycodone was first made in Germany in 1916 from thebaine, euphoric alkaloid of opium.
Sackler "invented" SR version and prescribing docs didnt know its addictive even though its made from opium?, everyone playing dumb. They knew but they loved making money on repeat custies.
Lets just blame Sacklers and let docs off the hook
This was an amazing interview. Very informative. I didn't understand what was it about the other company, that people went to jail? Was it also some pharmaceutical company, or similar drugs?
Very interesting program👍 some of the content made me think about tamiflu, 😶
Thank you. I am a student or Sackler school of medicine
Thank you for talking about this subject. This people should be in jail... No doubt in my mind about that.
Thank you for this great work
It’s only one thing that I would say about Curtis Wright. There is no soft corruption or hard corruption. This is corruption
Regarding the web of factors..
Producers (Pharma) -> Distributors (Mckesson) -> Retail (Walgreens) -> FDA/DEA -> Regulators -> Providers (Doctors) -> Patients
I recommend the Econtalk episode with Sam Quinones.. where they discuss the corruption in the Producer/Distributor buckets.
BTW, thoughts on the documentary series Dopesick?
Trust Science? Trust government? Trust the AMA?
Exactly!!!
Safe AND Effective!
You need to elect an Opioid Tsar. 😂
I have a very good understanding of addiction. I speculate the reason you didn't get severely psychologically addicted to oxycontin because you have a good handle on pain/pleasure in your life.
You workout, studied and became a doctor etc, so you can deal with pain.
Really bad addicts can't even do simple things like brush their teeth or make their bed.
Why are The Drive episodes on Spotify significantly shorter?
I've just noticed that! I wonder which parts are missing? It looks like half an hour shorter?
I always have to laugh at how ignorant doctors are of basically every facet of opiate addiction. What's not funny is all the suffering caused by these evil drug manufacturers and how doctors and society in general consider them 'legitimate" professionals and humans for that matter. Ugh. "I had to go to a pain expert"said Attia, to learn that I had to get off the Oxy's, always makes me laugh. Really? u could have asked ANY run of the mill junky how to. I'm sure he doesn't know about Iboga and a million other tricks. This is ALL about money. As usual.
This is just another example of why we should end the monetary system entirely and permanently.
Not to usher in some kind of utopia.
To change the incentive to change the behavior that results.
Which is the only way to change behavior, really.
Disincentives don't work. All they do is incentivize people to get around the disincentives.
End money and adopt a natural resource based economy instead.
Before it's too late.
Thank goodness for kratom and massage therapy school or I would have taken my life.
There's life after being a lab rat, people.
The "opiate crisis" by the statistics does not involve much pure heroin. If we subtract out the IV users and those who use multiple substances (a sure way to OD), the numbers are incredibly low! It is, almost purely, a fentanyl and Benzo (with some booze added in) crisis. Many of the compounds are synthetics - that is, analogs.
I have maintained, for many years, that if light opiates were quasi-legal we'd cut the deaths in 1/2 in the first year. But the government and society does not seem interested.
I think if you look carefully at the stats you will see 20% or fewer of them being pure opiates - pharma or heroin only with no other adulterants in it. If you subtract out the really rabid addicts (IV anything!), it's even smaller.
For all these intelligent literate people why are there so many. Uuuuuuummmmms in the convo.? So annoying
Another podcast that, although interesting, has literally nothing to do with the stated focus of the podcast, which is health and longevity. Previosuly, it was the lessons from 9/11Sure, you can argue that this is related to health and longevity in the sense that, if you OD on opiates, you die. But the vast, vast, VAST majority of people that are into the anti-ageing movement are not addicted to oxycodone, methadone or morphine, I fail to see the relevance of this podcast.
Your fallacy is to think only of your own lived experience. To assert that a public health crises is only "tangentially" related to health and longevity is rather simplicial and more than a little narcissistic. Perhaps you or someone dear to you will soon experience a life altering diagnosis of which the primary symptom is chronic pain. Knowledge of the current best and worst practices in pain management science will immediately be of utility then I'm sure.
I'm sorry but this is just an outrageously silly criticism to level. You seem to be ignoring the first of the two central focuses of this podcast -- HEALTH and longevity. This would obviously fall squarely under the "health" category in terms of subject matter. If you can't see the supremely relevant, timely and even urgent connective tissue between a podcast exploring human health and one of the most explosive, costly and tragic HEALTH crises our nation has ever faced...don't know what to tell you. As far as the way you seem to be determining the relevance of a conversation by whether or not you have personally experienced the subject matter being discussed...yikes.
Studying, discussing and learning about the history and dimensions of various subjects - particularly and ESPECIALLY those which aren't part of our day to day lives or the communities we come from - is fundamentally crucial if you want to be an informed, well rounded, generally intelligent adult capable of empathy.
You must be into anti aging. Take a deeper look.
@@Penrose707 I hadn't read this stupid reply before. Nothing of what he discusses here is related to the tipic of health and longevity enough to be relevaant. It is pseud-sicne. Or the scientific evidence that this will boost longevity is dubious at best and probably just a case of "just so story."I never said that chronic pain is not included as a *symptom* that is related to diseases that affect longeivty, like for instance, intense pain in the abdomen region indicating pancreatic cancer., or shooting pains up the left arm indicating the symptoms of a cancer. But is pain the *cause* of a disease that affect longevity? No. Shut up, dummy. Ihate when people that are less intelligent than me try to talk to me as if they were in a position of intellectual superiority.
@@harrisonquery9810 Wow, so many sentences to say absolutely nothing. The opioid crisi has nothing to do with *my* longevity. It doesn't matter to me, because I am not addicted to opioids. Does thiis mean that I do not care about adicts? NO. I have volunteered to treat meth addicts. but the point is that this is not a topic to be discussed in *this* podcast. The point of this podcast is to figure out advanced ways/methods/mnall molecules that might prolong the lifespan of people that are *already* healthy. Telling people that using opioids chronically is bad for your health is such low hanging fruit that even children understand this. The opioid crisis is not relevant here because:
1. This podcast is for anti-ageing people that are already healthy and want to improve their healthspans and lifespans even more. Anti-ageing people tend to be the most extreme health freaks imaginalbe. The odds that someone that is a lot into anti-ageing will be an opioid addict is very, very low.
2. The opioid crisis is a "crisis" not necessarily because everyone is using it, but because opioids are such destructive and powerful drugsa thst any number above a few hundred addicts per city is considered a crisis. Let's say that rhere are millions of opioid addicts. Their share of the total population is still very, very low.
This topic has *no* relevance here. This topic is much more adequate for a general medicine board than one focused on anti-aging.
The opioid cris obviouslyt matters, but this sis a topic more fitting for:
1. Channels of general medicine.
2. Channels related to public health policies.
3. Channels focused on drug dependency and harms deduction.
4. Channels dedicated to the development of effective medications to treat addiction.
Does this topic mattter in a channel where at least 99.9999% of the subscribers are not opioid addicts? NO. If you are an opioid addict, you have much biger fish to fry than to be concerned about whether nicotinamide riboside or nicotinamide mononucleotide are more orally bioavailable, or how to suppress the loos of bone and mass caused by intermittant use of rapamycin, which can lead to insulin resistence. Or whether the inhibition of the electron transport chain of mitochondria caused by metformin, although improving insulin sensitivity, might accelerate neurodegeneration via caspase-6 mediated brain inflammation caused by metformin's excessive activation of AMPKA. Even if you happen to be the 0.00001% oxycontin addict that is watching this video, you are not going to profit from anything that Attia said here, because this is a discussion focused more on social effects and future prospects for treatment rather than things that addicts can do now, like go to an actual channel specialized in psychiatry and ask the psychiatrists there for efective medications or clinics where they can seek treatment. The discussion that Attia has here has NO direct relevance in helping someone that is addicted now.
Why is it that stupid people like you debate me on the internet? You try to make some grandstanding posturing as if you have some great wisdom and that I am limited in my scope, and then I procede to completely destroy you and embarrass you with your own flawed logic. How does it feel to make a post with such preachy and condescending tone and then get owned by me? The fact that 4 people agreed with you mean nothing, as argumentum ad populum is one of the classic logical falalcies. It just means that we are a general dysgenic trend and that stupid people are priliferating. It's Darwin in action. The dumb shall inherit the World.
Patrick! You need a speaking coach! Reach out to me, I can help you!
Gawd! Man! Quit saying. ‘Um over and over and over again…..it’s astoundingly annoying!