The Dollop with Dave Anthony and Gareth Reynolds - 281 - Opium in the US - Part 2

Episode Date: July 10, 2017

Comedians Dave Anthony and Gareth Reynolds examine opium use in the United States of America. SOURCESTOUR DATES REDBUBBLE MERCH

When you're staying at an Airbnb you might be like me wondering could my place be an Airbnb and if it could what could it earn? You could be sitting on an Airbnb and not even know it. That in-law sweet guest house where your parents stay only part-time Airbnb it and make some money the rest of the year whether you could use a little extra money to cover some bills or for something a little more fun. Your home might be worth more than you think. Find out how much at airbnb.ca slash host. You're listening to the dollop. This is a...

Sounds investigative. Buy weekly American History podcast each week. I, homeowner, boy. Basketball hoop. What? Net fitter. That's a thing. Barbecueer. Dave Anthony reads a story from American history to a guy he met on the street. This is hurting now and because we did him in the opposite order this will be quite a dip. Gareth Reynolds who has no idea what the topic is going to be about. That's your name? Gareth Reynolds, yep. I didn't know that. Yeah. That's the lady you named me right there. I always forgot the name. Got beef with her? That is your mother. Yeah. That's why she's

here. Yeah. Yeah, so that we keep the name thing in line. I'm starting to... Yeah. How do you how do you feel with the name Gary? Well I think I think it's quite nice Gareth. I don't really like Gary as much. We actually call him Garfee. Mum. Mother. In my head when you were approaching the microphone I was like I think we're not gonna tap into that but... Well mother got the laugh of the episode. And sometimes we put little in front of it. Alright. Mother. Mother. Have a seat. Have a seat. Have a seat. Have a seat. Sit down now. Sit down. Oh my god. Well. Oh boy. Oh mum. The best. That's a big one. Oh my god. Do you want to look who to do? I'll do one bottle. People say this is funny. Not Gary Gareth.

Dave, okay. Someone or something is tickling people. Is it for fun? And this is not gonna come to tickle you. Okay. You are Queen Fakie of made-up town. All hail Queen Shit of Liesville. A bunch of religious virgins go to mingle. And do what? Pray. Hi, Gary. No. Missy done, my friend. No. No. 1916. Okay. Let's pick up from where we left off last week. Yeah. So part two. Part two of the opioid dollops, right? Yep. Now two professors. And we're not gonna get into the bear-bear gate because I think we're above it. Unlike some people. Well, people, people, particularly one, one German in Australia was very, very upset. Some people were. So I just

posted a commercial from bear. And that's how they say it. It sounds very close. I just didn't know what. Very similar. I just didn't know what. You got thrown off because they did have a bear on their bottle. Well, and I thought. So you got thrown off by that. I thought I really, yeah, I think we're both right. And I appreciate the asshole who said that I was really dumb for it. Yeah, there's always. He can just stop commenting and posting. There's always some great people that come out. Yeah. Two professors at the University of Frankfurt, which is exactly where we are now is like. So heroin has just heroin has been legalized to some extent used on babies. Right. So heroin at this point is still legalized, but it's really

been knocked back by by doctors who have been seeing the progression of addiction and people learning about it. So heroin is not as popular. People are scared of becoming addicted. Right. But but if for a moment there, it was basically like being prescribed like Viagra. Yeah, for a few years, it was everybody was doing it right all the time for everything. Right. But that's kind of Wayne. And now there's push anti drug laws are happening. Right. And I think it's 2024 is when they passed the big overwhelming drug law, which just puts the kibosh on everything. Okay. So in 1916, two professors at the University of Frankfurt in Germany synthesized oxycodone. Oh, I really thought you're going to just say played the synth. Yeah,

they should text us on the road sometime, huh? Yeah, those both of us. This is this one's about the the flock of seagulls. This is craft work. This is a craft work started. This was just a couple of years after the German farce pharmaceutical company, Bayer had stopped mass producing heroin. Yeah, had stopped mass producing heroin because the public was worried about addiction. Okay, oxycodone was created as a solution with the hope it would have the effects of morphine and heroin with less downside, dependence, less dependence. Okay, addiction possibilities, less nodding off during your soups. This comes true as we know. Yes. No, yeah. Oxycodone is a semi synthetic opioid that comes from the poppy plant. So it's semi synthetic.

So in order to get away from the poppy, we just keep finding new ways to split the poppy. Well, they're like, why don't we create something exactly like the poppy that's not the poppy? This I mean, is this a Seinfeld bit? A little bit. Well, you gotta have the poppy. No, no, no. And then Kramer runs in. Oh, I'm hooked on poppies. In 1938, Congress passed the Food, Drug and Cosmetic Act, which is one of your favorites. I've always been a fan of that because of the cosmetic. Yeah. Finally. It gave authority for Sephora to run California. No, that's not right. Okay, what? It gave authority. It was like this is taking a weird little bend. Did you not know that for five years, Sephora ran California? Time to lotion. Everyone. Lotion.

It gave authority to the Food and Drug Administration, the FDA, to oversee the safety of food, cosmetics and drugs. This is a no matter how it goes to begin with, it's terrible. Drugs now needed to be proven safe to be sold. So this is a time when people had faith in the FDA? Yeah, right. Still, nope. Though many opioid medicines already being sold were still allowed to be used by doctors, oxycodone was introduced to the US in 1939 and approved for cancer patients. So now we have oxycodone in 1939. Okay. It was also used for terminally ill patients. So you got cancer, you're dying, you can get some oxycodone. Yeah. But for many years, doctors were hesitant to prescribe opioids to chronic non-cancer pain patients because of the fear of addiction.

Yeah. I mean, basically, so the doctors were being logical. Yes. The doctors are like, well, this sounds really troubling. And the companies are pushing. Companies are companies. Yeah. Although Bear did not, well, we'll see. In 1952, brothers Arthur Raymond and Mortimer. This is adorable. Well, but if you ever have a guy named Mortimer in your family, yeah, you're evil. Ah, man, I really, that is a name to keep in your back pocket. No, you should. There's gonna be either an animal, I'm gonna have a pig named Mortimer is what I'm saying. If you should, if you ever have someone named Mortimer, there should be like just crows flying around them all the time. Oh, I see. I see Mortimer, a little bow ties, thick rim glasses,

and I'm still talking about the pig. Okay. A little graduation cap like they put on owls in the cartoons, remember? Owls, the studious owl. Yeah, he's a good one. So the, the Sackler brothers, that was the name of them, three of them. They bought Purdue Pharma. Oh, boy. All were never a good name to hear dropped in the mix. Nope. All three were psychiatrists. And Arthur was a member of a small New York advertising firm. So it's always a good combination. Terrible. So the psychiatrist and an admin. Totally. What could go wrong? Perfect storm. Yeah. What could go wrong? Oh, I found a number of flaws. Well, I've got a jingle that work around them. He was also a pioneer in medical advertising. Okay. Arthur was behind Valium becoming the

first drug to hit $100 million in revenue. Wow. Killing it. He was also one of the first medical advertisers to develop relationships with doctors. This is so, it is so weird to hear the start. I mean, it really is crazy. You don't know where this is going. Yeah, I kind of do. This model of back scratching with doctors hoping to get paid back in drug sales is now the model for the entire drug marketing industry. So this guy, this guy did it. This guy said this one guy. That was my point to you. And I'll get to this later, but we should kill all that people. But we're going to get to that, but I'll add the thing we're going to get our listeners to do. You subscribe to the Hixian philosophy. If you work in advertising, just kill yourself. Purdue Pharma

introduced MS-Contin. MS-Contin. A time release morphine opioid. They're just having fun. For cancer patients. It's like Dorito flavors. It's morphine with this special time release thing that it has never had before for cancer patients. So it's a capsule now that'll slow, it's a slower release. Because it could be crushed and snorted, which obviously is great for people who enjoy that sort of thing. Yeah, I'm not in the mood to wait around for the time release, kind of looking for one big punch to the gut, if you know what I'm saying. So it started to be abused. Shocking. Though Purdue was not as concerned about that as much as worried that their patent would soon expire. Okay, so they're focused on the right things. Executives anticipated a massive loss

of revenue according to internal company correspondence. Okay. So Purdue needed a new moneymaker. Oh boy. They needed it. In a 1990 memo, the VP of clinical research wrote, quote, MS-Contin may eventually face such serious generic competition that other controlled released opioids must be considered. So really, they just need to diversify because they're going to be copied so clearly. So now they need to create newer. Everyone else is going to come out with their version of MS-Contin and so they got to be like, well, you got to get another kind of opioid going up in this bitch. We'll call it, we'll come up with the crushing snorts. That seems to be a market that we're not legally dipping into.

So the VP decided to use an old cheap narcotic oxycodone. Oh boy. It controlled pain for up to six hours. They added their patented time release content, the estimated oxycontin time that it would be, you know, work 12 hours. Right. So that's their estimate. I mean, these, I mean, these are that because that's really what they are is they are heroin. It's time release heroin in your body. And now, so again, there's just the legal route to get heroin out. Sales and marketing reps got together in March 1995 to start planning the roll out. Chief executive, quote, oxycontin can cure the vulnerability of the generic threat. And that is why it is so crucial that we devote our fullest efforts now to a successful launch

of oxycontin. That's internal. Yeah. Okay. I was going to say you don't come out with you. That's not your unveiling speech when you're in front of a yacht with champagne. And the reason for this is the people need it because otherwise the generic ones will also be taking money from us. But you could say that at Wall Street when you rang the bell, right? Like that there, they'd be like, yeah. Oh yeah, for sure. Yeah. But the problem is they filmed some of those. Oh, true. Every now and then. So the first patients to use oxycontin were women recuperating from abdominal and gynecological surgery at two hospitals in Puerto Rico in 1989. I mean, this is okay. This feels like the beginning of like an 80s Stallone movie.

More than a third of the women started complaining about pain in the first eight hours and half required more medication before the 12 hour mark came. Okay. So they haven't made a strong enough drug. Well, it's strong, but it's not time. It's not 12 hours. Yeah. The study concluded oxycontin was safe, relieved pain and lasted longer than shorter acting painkillers. Okay. So it's better. It is lasting longer, but not the 12. Right. Okay. And in 1992, submission to the patent office produced said oxycontin controlled pain for 12 hours in approximately 90% of patients. No. What's wrong? How did they get that number? What? They've tested it on how many people? Well, they tested on a few more. So like five people? They did a few tests, but let's just say

none of them. This is like a toothbrush commercial when it's like the three out of five dentists. Kind of like, yeah, it's kind of like that. They kind of making it up a little bit. A little fudgery going on. A little fudgery. So Purdue conducted more clinical trials and study after study. We need more pregnant women. Because I think once you submit for a patent to the FDA, then you still have to do more trials to prove what you're saying is true. Yes. No, the trial process is really, really vigorous to get to market. In study after study, many patients give an oxycontin every 12 hours would ask for more medication before the next scheduled dose. Okay. This is terrible, but honestly, if you're signing up for one of

these clinical drug tests, this is probably the one you want to hit. Yeah. Every 12 hours. Do you want more heroin? Yeah, I'll take a little more. Yeah, I'll take some more, sure. 12 hours later. Yeah, I'll take a little more. Yeah, that's good. I'll take a little more, sure. Are you ever been on morphine? Yeah. Oh, yeah. I love pills. Hi, Mom. I love me pills. Well, I did it in a hospital. I did it as... No, I've definitely been on parkour. They gave me the thing that I would press and I would give it to myself. It would be like ding, ding, ding. And so I just... You're doing jeopardy thumb right now, which I don't know. Well, I had surgery. I was literally just like bing, bing, bing, bing, bing, and the doctor came

and he's like... So the surgery went great. Your husband killed himself from self-morphine. Well, it only allows you to kill yourself. I know, they put a limit on it. So the doctor comes in and he goes, are you in a lot of pain? I was like, no. No, but I want to make sure that I need to see my degree, officer. I like you. We are friends. So... Potent. Very potent. A Tennessee pain specialist testing the drug in 1995 as part of the FDA approval process moved eight of his 15 patients to eight-hour dosing because they were not getting adequate pain relief over the 12 hours. Okay. This led to a letter from Purdue's medical director, quote, the situation concerns me as oxycontin has been developed for 12-hour

dosing. I request that you not use an eight-hour dosing regimen. So his gripe is that this guy, this person is finding the flaw that they already know basically exists, right? And he's just sort of saying like, I'd like it if you weren't reacting how you would react honestly to this situation. He's saying that you should... It should be for 12 hours because that's how they're going to market it. Right. So, okay. So, okay. Fair. This is how most... When the numbers don't work for you, this... I mean, yeah, this is the N-roning of your drugs. It's called future pain relief. Yeah, you save it. Maybe four years down the line, you get another four hours. Yeah. Here's the thing about narcotic painkillers. They work

differently in different people. Some drug companies recommend doctors adjust the frequency with which patients take the drugs depending on the individual's response. Okay. So the... Basically, doctoring. Right. As opposed to... Yes. Instead of just being like, this works 12 hours for everybody. It doesn't work for me. It does. Yeah. But then you... Basically, your doctor would be like, you needed every eight hours. Right. You needed every 10. So not Purdue. Despite the results of the clinical trials, Purdue did not test oxy at more infrequent intervals. So they never tested it. They just said 12 hours. They never did a test for under 12 hours. They never found... They never went like, maybe this would be better at nine hours or eight hours. They just did 12

hours. Well, yeah. I mean, they'd all gotten the 12 tattoo. And they probably... Yeah. And they had all the paperwork painted up. Yeah. They said they had the logo. They're like, then we got it. Then the plane has to lose the 12. And I feel like then we don't even need the plane. Then what are we even doing? Because without the 12... I mean, the 12 looks like the... I mean, it's 12. The answer's 12. No more nine. It's 12. To get FDA approval, Purdue had to demonstrate that oxycontin was safe and effective and that oxycontin lasted 12 hours. It's 12. How many times do we have to go over this? For at least half of patients. So that's the... That's pretty good. That's a fucking low number. Yeah. That's pretty good if you're Purdue. Dr. Curtis Wright led the FDA's medical review of

the drug. Purdue submitted the Puerto Rico study, which showed it showed it lasted for 12 hours. Mmm. The FDA approved the application in 1995. Wow. Right after Dr. Curtis Wright left the FDA and two years later was working for... Don't tell me. Purdue. Yes! How did you know? How did you know that? It's almost exactly like what happened at Enron. That's brutal. That is so crazy. That it? Mom's leaving? Bye, mummy. By the way, really great best intro ever for the show. Yeah. Yeah. Bye. Okay, so... Okay. Is she single? A Pama single. Your mom? Let's not, David. There are lines. I know. For I didn't know people that... I know gentlemen. We're all set over here. Thanks for your help. According to Theodore Cicero, a

neuro pharmacologist at Washington University and a leading researcher on how opioids affect the brain. Quote, oxycontin taken at 12-hour intervals could be the perfect recipe for addiction. Okay. So that's pretty clear. Patients in whom the drug doesn't last 12 hours can suffer both a return of the underlying pain and the beginning stages of withdrawal. That becomes a powerful motivator for people to take more drugs. I mean heroin. I mean more drugs. I mean drug heroin. I mean oxycontin. I mean heroin. I mean legal heroin. I mean time-release heroin at 12 hours. I need some oxys. So by doing the 12-hour window, they're basically creating addicts because the way the medication works, if it comes in at 12 hours, you're in pain

so you need more and then it creates you having withdrawals. It's a fucking... Yeah. So I mean right there. You should... That right... I mean that's not a solution. You're not solving something if you make someone a heroin addict. It's a solution from my bank account, bro. Yeah. Purdue Pharma introduced oxycontin to the world in 1996. They spent 200... I mean we really can boil it down to like six companies that are just ruining everything and Purdue's... Purdue's up there. Purdue's up there. They spent 207 million on the launch and doubled their sales force to 600.

Good. Yeah. They're coming out strong. They're like this is our shit. Purdue was going to sell synthetic opium to the masses. I mean you absolutely need a mascot for this rollout. If you're coming out with synthetic opium, you're like, and me... Synthetic opium bunny Tom. How did the bunny just fall down? Ads and medical journals were not vague about how long it lasted. There was a spotlight illuminating two dosage cups. One marked 8 a.m. and the other marked 8 p.m. Sounds like 12 hours to me.

Quote, remember effective relief just takes two. Two heroin pills. So they're warping a medical necessity around a marketing campaign. Yeah. No, truly. It is... I mean, well, and you don't get the... Like obviously the marketing here for drugs is insane. People from other countries come here and they're like, what is happening? What are your commercials? I feel like I'm in total recall on the train. Like just everything's like, does your back hurt? Well, my back used to hurt.

No, but the best thing is when they do a... Are you on OxyContin? Oh. Then you need the stool softener. I love taking heroin, but it throws my cycle off, if you know what I'm saying. Thank God my doctor recommended shitsilots. Shitsilots. The only pill that covers up the tracks of the heroin you're ingesting because your doctor made you believe bullshit. Are you taking shitsilots so you can't eat all the fiber you want? Well, guess what? Now we're... Do you have headaches from fibercon?

If you have headaches caused by fibercon after shitsilot, after your OxyContin, you need head relief. Do you see ghosts because of all the medication you're taking? Take ghost off. Have you been addicted to ghost off for a few years and you're not able to get, well, hard while you need new dick boom, dick boom, the only thing that's going to get rid of ghost a lot. So, before OxyContin, doctors viewed narcotic painkillers as incredibly addictive. Quite a statement.

Incredibly addictive and reserved for long-term use for cancer patients in the terminal ill. So before 1990, that's pretty much the thought process. Right. So until the mid-90s, we had logic. Yes. Right. And Purdue testing in 1995 demonstrated that 68% of the OxyCodone could be extracted from an OxyContin tablet when crushed. I know. It is so...

Recreational users could crush, sniff, and inject the pill for a high that could last eight hours. So just... So the euphoric effects and potential for abuse were comparable to heroin. So we basically put a rail around it. And still Purdue was looking for cash and a bigger market. A marketing executive at an employee drug debut planning meeting in 1995. An awful title. Quote.

And that's not going to fit on the cake. We do not want a niche OxyContin just for cancer pain. Oh, well, you, I mean, you have to not have something beating in your chest to deliver that. You have to be a psychopath. You really have to just be like, look, I've sucked the devil's dick. It's tasty. Come on, guys. A niche. Yeah, a niche.

Fuck you. Look, we look, the cancer patients we got, guys. Sales reps promoted it on the 12-hour dose. They said it was more effective and less likely to cause addiction. They pitched it to family doctors and general practitioners to treat common conditions like back aches and knee pain. Their hook was the convenience of a twice a day dosing, which was bullshit. Here's who I don't want getting pitches.

Doctors. Right. They don't pitch them. Right. Let's, I think they'll figure, I mean, it's, it's, they shouldn't independently be making decisions on what drugs will work for them. There should be no pitching to doctors. Yeah, there's no pitching.

All right, you're going to love this one. This one's a little bit of heroin, a little bit of opium. Moves into apartment together, okay? The FDA, FDA officials allowed Purdue to state that the time release quote is believed to reduce its potential to be abused. So they put, they allowed them to, to put in their literature quote is believed to reduce, which basically means nothing. Right.

That's like a bag of chips being like, we think it's fat free. Right. But sales reps forgot to mention the believe to reduce part when they talk to the doctors and just presented it as a fact. A 1996 news release for doctors said quote, oxycontin spares patients from anxious clock watching. This, this sounds like it's 1944 from clock watching. This is like 1920.

Yeah. But I mean like the language, it's like, it sounds like a tag that would be on like some kind of hair tonic. A generous bonus system encouraged sales reps to increase sales. Not good. It's just, we are so fucked. You just cannot, these are things you just can't have. You can't have people in government going to work for businesses that they have legislated for

and you can't have people from drug companies getting kickbacks off of selling more drugs. You're not selling, you're not going like door to door selling foods or Tupperware. Well, it's just you're a bonus to sell heroin. Yeah. I mean, honestly, you are, what is the difference? This led to a large number of visits to doctors who made high rates of opioid prescriptions. Yeah. So obviously, if you're a sales rep and you're making money.

It's over, Dave. It's over. It's over. I don't know how much more is left, but it's over. In 2001, the average sales rep salary was $55,000 with a bonus of $71,000. The highest bonuses were $240,000. Purdue paid $40 million in sales incentive bonuses in 2001. It is just.

And spent $200 marketing oxycodone. $200 million? $200 million. Okay. You dropped a mill from there. Window Fisher. Window Fisher? Wendell.

Okay. I was going to say that's a difference. Sorry, you got any fish up there? A Purdue manager in Atlanta wrote in 1996, just 11 months after oxycodone went on sale. Oh boy. Quote, I have concern that some physicians are using oxycodone on an eight-hour schedule rather than a 12-hour schedule. Sales reps were told to visit those doctors and convince them to go back to a 12-hour dosing.

Quote, 100% of the patients in the studies had pain relief on a 12-hour dosing regimen. I don't understand that of all the problems they have, why is that such a huge gripe? Because of the approval process? Because of the marketing. Because the marketing said 12, they don't want to back down from 12. Right. The whole thing is that if.

They can market it to doctors that people have to take fewer pills. But it wasn't working. Soon one in five oxycodone prescriptions were for eight hours or less. Purdue held closed-door meetings to retrain its sales force on the importance of 12-hour dosing. Guys, look, we've got all the stuff printed. We're not changing it to eight. But there's people that after eight, they hurt. Everything hurts, they're pain hurts.

Then they'll take more. But we're not changing the goddamn logo. It's 12. But they can't. What? They can't take more. I don't care if they can't take more. Okay, you know what I care about?

I have a pool in my yard that gives current and I can swim against it. So I'm essentially doing laps in a small pool. And I have a regular pool, but now I have a lap pool. Yes. Hey, I was going to say it's a lap pool, but you were giving a really long description. Oh, I'm sorry that I want to brag about having mother nature in my backyard. Now get out there and sell some goddamn hair oxy pills. So get that sell, people, guys.

Let's just remember who we're doing this for. Who? Me. Lap pool. Lap pool. They were told, quote, managed care plans are beginning to refuse to fill prescriptions and to refocus the clinical, the clinician, back to 12 hours.

Doctors need to be reminded, quote, on every call. One sales manager told her reps, quote, eight hour dosing needs to be nipped in the bud now. It's crazy. But what to do about those people who complain? I mean, they legalized heroin and they're sitting here just barking about 12. I mean, pat yourselves on the back every once in a while. You're making millions of dollars from selling street drugs to people again. So what to do about those people who complain oxy cotton didn't last 12 hours?

Well, Purdue reps told doctors to have new oxy juniors for in between your two oxys. No, increase the strength of the dose rather than taking more pills. Okay, but in some, that sounds like some fire being played with. There's actually no ceiling on the strength oxy cotton. Good. Can be prescribed. Good. Well, that took, actually, I will say I'm genuinely impressed that that took around a year and a half.

I mean, that shows you that they had a year and a half where they were like, well, we don't want to kill them. All right, give them an elephant's dose. So sales reps started throwing oxy cotton goods at doctors. Clocks, pens, shirts, fishing hats, embossed with Q12H, which is what the terminology is for 12-hour dose. That's a cool fishing hat. They were stuffed plush toys. That's my license plate.

When I first got here, I worked at stable centers. I was a suite attendant. You mean you were really good at it or you worked the suite? So much fucking money because pharmaceutical companies would come in and throw a big party and they would write me a $300 tip at the end of the night. And there would just be all these, all this swag. For years, I had all this fucking swag around my apartment. You had oxy, you were walking around, pens, hats.

Like it was just fucking all over the place, Pfizer and yeah. This is, I mean, and this is in the grace period where you were like, well, they're not that evil. Yeah, sure. I'll wear a pill hat. There were stuffed plush toys, music CDs with songs like... What are the plush toys? Music CDs. Music CDs.

Songs like Get in the Swing with OxyContin. Who, who are the bands? I would not get that. Who? Aerosmith. Oh my God. No. This was unprecedented for a schedule to opioid.

The company brought doctors to all paid dinner seminars and flew them to weekend junkets at resort hotels. Well, they're putting the junk in junket. There they were encouraged to prescribe OxyContin and even promote it to their fellow doctors back home. What is this? What are these as blood being drank at these? It's like a colt. I mean, honestly, are they wearing cloaks?

Hey, go back and get your other doctors to, you know, do the same thing, right? Are you headed to Amway? This is Amway, but for heroin. Ah, yeah. I mean, I guess it's not so bad. Do you like the trip, right? The shrimp's delicious. Yeah.

My wife and I were saying, we haven't eaten like this since, I don't know when. So put all your guys on OxyContin. I mean, you know, morally, it's reprehensible. But again, yeah, but look at the shrimp. I know. And all the stuffed toys. Yeah. Oh, you guys want to throw a party?

I'll kill them. All right, there we go. I'm having fun. Let's kill one guy. Yeah, let's get one guy. Yeah, that's what I'm saying. Yeah. Nice pen, too.

Thank you. Thank you. That's gonna last a long time. And this fishing hat that says QH-1200, it makes sense. You know how long that, the ink in that pen lasts? How long? 12 hours. Get on up there.

Hey. Oh, man. Yeah, we're going to kill some people here. And the FDA does not have enough manpower to oversee promotional materials. The FDA, so in 2002, there were 34 FDA staff members who had to review 34,000 pieces of promotional material. So 10,000 a pop.

It's not like it matters. But in that circumstance, what they're basically doing is they're overseeing the marketing, sort of? Yeah, they have to make sure everything is on the up and up. They've done a horrible job of doing that. Well, when they've stopped, right? 39 guys for 34,000, like they're doing a lot of shit. And it's not just, it's videos, it's everything.

They got to look at all kinds of shit. But it's not like it matters anyway. Regulations require that all promotional materials for prescription drugs be submitted to the FDA for review, but it is not required that the materials be approved by the FDA before they are used. It's literally pointless. It is literally pointless.

They literally made it pointless. Cool. So it's a hoop. Yeah. In 1998, Purdue didn't even bother to submit to the FDA. They just- So it's getting a little lax. Hey, we got another one. For them, what are they going to say? Well, look at the last.

We did that before. Bullshit. Last 12 hours, trust me. They just distributed 15,000 copies of an OxyContin video to doctors. Though in 2001, Purdue did submit a second version of the video to the FDA. So three years later, the FDA did not-

Well, we finished our final cut. The FDA did not review it until October 2002. So it's been out for four years now. The FDA then concluded the video minimized the risks from OxyContin and made unsubstantiated claims. So it's been out for four years. And then they finally were like- And then they finally say, no, it's not okay.

That's not okay. That's not good. No. Sorry. Anything happened in those four years? Sorry, we took so long. By 1999, non-cancer related pain made up 86% of the opioid market.

Good. Good. Purdue's, this is 10 years later, they've completely obliterated everything that was- Completely taken over. Yeah. They ubered the pills. Purdue's promotion led to an increase

in OxyContin prescriptions from 670,000 in 1997 to 6.2 million in 2002. So that's more. If you- Moving units. Moving some units. Good God. There is very little evidence that opioids work

for long-term pain, but Purdue still promoted it to primary care physicians to use it liberally. That really, I mean, that's the thing. We're just not prepared for total bullshit. Like, we, like total bullshit works. Assaultive bullshit eventually wins. Yeah, it does win. In 2003, half of all physicians prescribing OxyContin

were primary care physicians. Good Lord. Primary care physicians are not the ones you want prescribing something like OxyContin. Honestly, what, how, what? Obviously. They have a limited amount of time with patients for evaluation and follow-ups

and often are not sufficiently trained in pain management and addiction issues. I mean, at least you used to have to, like, drive and go to a shady place and wait around to get heroin. Like, it was harder to get heroin. It was harder to get heroin. You feel fine if a doctor's like, well, you should try heroin.

Might be right for you. My back feels weird. Have you tried heroin? So I haven't been able to go to the bathroom since you put me on the heroin. Oh, have you taken, we'll try shits a lot. Okay. Hey, this flower is great,

but I have horrid headaches. Which, headaches? I forgot the next medicine we do. The head and ghosts. Fiberol? Fiberol. Fibercon. I think ghosts, ghosts away is the last one.

I don't know, I mean. This is quite a run. I think it's okay to not recall it. Um, so was this a problem? No. Purdue trained their sales reps to tell primary care doctors that the risk of addiction was, quote, less than 1%.

Yeah, we went to the, uh, because we said so company. And they told us that. Yeah, sealed approval because we said so. They would cite one study. Unfortunately, there are many studies that say the addiction rate is anywhere from zero to 50%. Purdue just picked the one study they liked.

Some people are saying that some of these studies are useless. Doctors took courses to fulfill education requirements for their medical license renewals, paid for by a company that wanted them to prescribe opioid pills. I mean, it just, it's in the blood. Organizations that write treatment guidelines then started endorsing opioids for chronic pain.

Many of the people writing the guidelines were financially tied to the drug makers. And there were regulations that were problematic. So Purdue took a Trojan horse approach and infiltrated regulatory agencies and academic medicine in order to convince doctors that prescribing more opioids was evidence-based medicine. So you said, up until now, pain was treated differently.

And they didn't believe that this is how you treated pain. And so they, so Purdue went to the governing bodies and got in there and then had all the literature changed and had all the recommendations changed. We're not. We're good. We're good people. It's not. I mean, we're good people. Suicide bombers and markets.

Purdue Pharma joined forces with the Joint Commission. The Joint Commission is an organization that accredits hospitals. And Purdue gave tons of teaching material to the Joint Commission, telling them they needed to make doctors treat pain more aggressively. The Joint Commission agreed.

They started telling doctors that opioids aren't addictive as long as they're treating patients for pain. So this is the body that tells doctors what to do. It's, again, I mean, it's like the water's ruined. It's over. Me and Aaron had a Joint Commission right before the show. This led doctors to no longer saying no to patients who wanted more drugs.

This is the opposite of what happened to Bear with heroin. Heron was scuttled because doctors saw it leading to addiction. Right. So if you are, if you're a company, let's just step back for a minute and hypothesize that you're a company and you're putting on a new product that is heroin-like. And you saw in the past that the thing that cut off

all revenue for another company was doctors becoming aware. It's almost like they saw that history and swooped in. And annihilated it. There's no bottom to evil. So you can't keep racing. It worked in ways Purdue executives had not dreamed of. Oxycontin revenues crushed MC Contin revenues. At first, the highest...

MC Contin, they'll put out a couple other good albums. Yeah, yeah, they're almost done. But even their last album was not. Really? Well, I mean, it's just because five milligram died. At first, the highest... At first, the highest dose of Oxycontin made was 40 milligrams, but soon the FDA approved 80 milligram version.

By the way, 40, super high, right? Look, yes. I mean, like any, like if I think of any of the pills that I hear about, the 40 isn't really attached to them. No, that's a crazy amount of fake heroin. 40. So then they went to 80. Then they went to 80.

And they, you know, they had a higher one, but they eventually got rid of it. But it was like 120 or even higher. Sales went from 44 million in 1996 to a 2000, 2000, 2001, 2002 combined sales of nearly 3 billion. Oh my God. Over 14 million prescriptions. By 2002, Oxycontin combined for 68% of Oxycodone sales.

Sales would keep climbing until 2010, when they leveled off at a sweet 3 billion a year. Oh my God. Did somebody mention opium coupons? I don't think so. Yeah. How about some opium coupons? Purdue began a patient starter coupon for Oxycontin. It gave patients a free prescription

for a seven to 30 day supply of Oxycontin. Anyone? Well, anyone, the doctor. Anyone that went in with that. Have you ever gone into a doctor's office and they give you the little prescription packet for something? Yeah. That's what they were doing, but with Oxycontin.

Right. So, and coupon. It's a fucking coupon for heroin. It's a heroin coupon. But by the way, in the last one we talked about, they were sending heroin in the mail and that had to stop. Yeah. And this is eliminating a trip to the mailbox,

which by the way, with some of these dosages, sounds like it might not even be an option anymore. That is cool, because the mail come to me now. But if you have a 30 day supply, you're hooked. I don't know how long it takes to get hooked on Oxycontin, but there's plenty of people that get hooked in 30 fucking days. Well, yeah. The program ended in 2001, but then around 34,000 coupons

had been redeemed. Redeemed. And strangely, Those are hard to cut too, because you're all piled out. Oh, dude, the worst. You're just cutting through your thumb like, Hey, guys, see the toxicity. Here's a free one.

And strangely, rates of addiction and overdose shot up. Really, from what? I don't know. News coverage focused on Appalachia and New England and made Oxycontin well known. It became known as Hillbilly heroin. Peru's response was to send reps to Virginia, Maine, and elsewhere to defend the drug.

They blamed misuse of Oxycontin and insisted their pill was a godsend for pain sufferers. If used the way it was supposed to be, the way it didn't work. Right. The 12th. Look, I don't know how many times we're going to have to go over this. Over and over. The number is 12, guys.

12. The number is 12. All right. I mean, somebody was saying eight. I mean, no. Okay. You're way up base. The number is 12.

We had a lot of meetings. Yeah. We had a lot of meetings. We got a plane with a 12 on it. We got a bunch of mugs with the number fucking 12. The number is 12. That's a plushie 12. The number is 12.

Plushie 12. Somebody tried telling 12 the turtle that he's not going to work anymore. What does my hat say? 12 the turtle. 12. It's 12. Maybe nine.

Produced Senior Medical Director, David J. Haddix. A lot of these people say, well, I was taking the medicine like my doctor told me to. And then they start taking them more and more and more. I don't see where that's my problem. Yeah. No. Where did they get that idea?

God, Jesus Christ. Yeah. No. Yeah. The guy who planted the seed is like, I don't know where that tree came from. The U.S. Justice Department launched a criminal investigation. Into the completely corrupt corruption of this situation.

Yeah, all of it. They're looking into particularly the marketing and that shit. Right. Produced marketing of Oxycontin had already changed the practice of medicine. Other drug companies started marketing their narcotic painkillers for routine injuries. Everybody's getting on board. Oh. And Purdue compiled data on doctors to figure out which ones would prescribe the most.

That is not something they should have accessed. I mean, hey, who's working the best corner? Yeah. Honestly, you are. That is who is working the best corner fucking 100%. They detailed the prescribing patterns of doctors nationwide. With a doctor's profile, they could identify the highest and lowest prescribers of particular drugs.

So it's a list of best to worst doctors, essentially. For them. And they're going from the bottom down. Yeah. Purdue would then target doctors who were the highest prescribers for opioids in the country. Oh, cool. The data did not look at whether or not the doctors were just indiscriminately prescribing. So they would push the drug on doctors who were just pill pushers.

They found the weak ones. They found all the Dr. Roberts and they just threw pills. They found the guys who need money, right? Is the guy who's got the house maybe got a divorce or two and now he's fucking hurting. And so he's in money trouble. He's hurting. I got a pill. He could take the last 12 hours.

Oh, yeah. Allegedly. One of the things they used was a video. It's the one the FDA eventually said was misleading. Okay. The video is about one Dr. Alan Spanos who is a pain specialist in North Carolina and a paid speaker for Purdue Pharma. I don't think he should be allowed to be both.

Why? It also talks to seven of his patients. Okay. They share their oxycontin success stories. It was made in 1998 and sent out through 2002. In the video, Dr. Spanos urged doctors to consider prescribing opioids more often. Good. Well, he is a pain specialist.

Who's paid by the company that's asking him to make the video? We got to double up on this stuff. Gentlemen, we're doctors. Come on, guys. Is your patient drooling? No. Let's go more. Higher.

Can he open his eyes? Is he an eye opener? I think he's dead. Well, you overdid it. You did. That's your fault. What we call that is losing a client. Okay.

Oh, yeah. And terrible for the family, but that's called losing a client. Okay. Juice him up to a certain point, but don't overjuice. Juice him up. Okay. He said that oxy was less addictive and less likely to be abused than other drugs. Sure.

He said opioids, quote, don't wear out. What? He said opioids, quote, don't wear out. Does he talk? What? He's just saying whatever he wants to say at this point. Has he had contact with a person who doesn't work in the company lately? He's literally a guy who's just like,

give me more money. What do you want me to say? I'll say anything for more money. That means patients wouldn't need stronger doses over time, which is insanely false. People actually develop tolerance over time. Okay. Right. Exactly.

So that the point of that is obviously that you're saying like, you know, this is it. This is the end of the road. You're not going to get more addicted to this. Right. Right. Spannus also downplayed the risk of sedation and doctors concerns that patients on narcotics seem, quote, sleepy and vague.

That's called working, gentlemen. And look stoned all the time. Yeah. That's called working, gentlemen. Quote, nothing could be further from the truth. He said the sedation would wear off after a couple of weeks. Good Lord. They'll be fine once they come out of the heroin circle.

Other doctors try it. Could you imagine being a doctor and hearing a guy say that after a couple of weeks, there'll be less fucking nodding out? It is the problem with what, you know, with being desensitized, because it's happening now in the news where we know like we've just been hit with so much that the crazy is now normal. And it's the same thing with anything like with this. Now the crazy shit is now normal.

And now you're like, well, I mean, I guess I could be throwing more pills at my patients. Sure. Yeah. I mean, I do like that luxury. No. If you look at our overall society, the pattern of lying is insane. Yeah. And so everything starts to work for people.

Yep. So other doctors tried to counter Spannos' narrative. Deborah Grady, a professional of medicine at the University of California, said, quote, enough opioids can make you sleepy to the point of dead. That's pretty sleepy. That's a dead. We'd all agree that that's real sleepy. That's what happened.

Too sleepy. That's what happened to one of the seven of Dr. Spannos patients in the video. Johnny had back pain and was prescribed oxycontin. Sounds like a Bon Jovi lyric. Right? Johnny had back pain. Go on. I'm retiring.

So he was prescribed oxycontin by Spannos. He became addicted to it and frequently dozed off. His wife. During the video. I think we should cut that part. That seems like it's incriminating. His wife. I don't even remember life before that.

Hello. Pills of dust was the difference between the home. Have you ever talked to someone who nods off? It's really insane. No, I've seen it. There might be someone in my family who would not often come to. Got a case of the sleepies. You're like sitting at a table and he's falling asleep.

He had a bagel and he had a tomato on it. He fell asleep in the tomato and then he comes to and starts talking when we've moved on three minutes down the conversation. My guess is the conversation was starting to become about when the guy put his head in a bagel. And he was like, we're not talking sports anymore. What do you mean, someone put a bagel inside their brain? Oh, good Lord. So Johnny has back pain.

He gets the oxycontin, becomes addicted. He's dozing off a lot. His wife spoke of one incident at a restaurant quote. He had a hamburger, but instead of biting the hamburger, he would actually be biting his hand. I mean, it's so, it's like that's obviously, like you're just to laugh at a man eating his hand for dinner. What's a hamburger?

Oh, Dave. Oh boy. But it is terrible. It's absolutely terrible because you are brought up to trust doctors and to trust these things and to trust that whatever you're getting is going to be okay. And then you're at a dinner and your wife's like, you haven't eaten anything except for your hand. And but now imagine you're the wife and your husband had back pain and now you're looking at this guy eating his hand.

Like that. How bad was the back? There's two hells going on. Yeah, absolutely. So Johnny U was continuing using Oxycontin and morphine in 1999. He appeared in a second Purdue video quote. Never a drowsy moment around here. Johnny said his voice slurred and his eyes heavy.

What? In 2008, he fell asleep while driving, flipped his truck and instantly died, which is a pretty common way these people died. There's a lot of traffic accidents. Doctors also had an interesting switch during this period. 100 years ago, the medical community thought that pain made patients stronger. It was largely held belief that pain had a physiologic benefit to the individual

and certainly some spiritual benefits. So they think pain actually makes you stronger. Like long-term pain you can eventually overcome. Like pain isn't eternal, but when you give someone Oxycontin, you're saying this is going to be here forever. Right. But the way they used to look at it is it's going to make you stronger, you're going to battle through it,

and you're going to come out through the side and you're going to be a better person. Well, I mean, they believed a lot of crazy shit 100 years ago, but it is true that if you take antibiotics a lot, your body creates a resistance to antibiotics, and if you take them less, when you do take them, they're more effective. Unfortunately, we've overtaken them, and now we're almost out. Anyway, keep going. Don't worry about it.

But as prescription painkillers became more available, patients became less willing to endure pain. Right. Because they're spoiled. Yes, and suddenly doctors began to feel that pain was something they had to eliminate at all costs. It is crazy the goal to remove pain. But this was also an orchestrated effort by Purdue

to make doctors and people switch it. They're also telling people you shouldn't be in pain. Right, right. Yeah. No, they're fighting a war on pain. Yeah. Doctors just prescribing it more and more, often because it was wearing off and because people were getting addicted.

Now Purdue officials worry that if OxyContin wasn't seen as a 12-hour drug, insurance companies and hospitals will stop paying hundreds of dollars a bottle. Well, they're the real victims. Dr. Lawrence Robbins started prescribing OxyContin at his Chicago migraine clinic shortly after it hit the market. 70 to 80 percent of his patients reported it lasted just four, five, six, seven hours. So Robbins started telling people to take it more frequently, but insurance carriers began to refuse to cover the pharmacy bill for more than two pills a day.

So, I mean, you're creating junkies who don't have money. That's, yes, exactly what you're doing. In 2007, the U.S. Justice Department's case against Purdue finally went to court. Prosecutors found a, quote, corporate culture that allowed this product to be misbranded with the intent to defraud and mislead. Purdue was ordered to pay around $600 million in fines. That was 2007. Purdue had already made well over $7 billion. Well, it's simple, it's paying for parking.

It worked, yeah. Three executives of Purdue Pharma, its president, its top lawyer and former medical director, pled guilty as individuals to misbranding, which is a criminal misdemeanor. They agreed to pay $34.5 million in fines and were sentenced to three years probation and 400 hours of community service, not one day of prison time for destroying tons of lives and killing people. Of course. Purdue put out a statement, quote, nearly six years-

Community service. Yeah. I mean, it ain't J. Walker. Nearly six years and longer ago, some employees made or told other employees to make certain statements about OxyContin to some healthcare professionals that were inconsistent with the FDA approved prescribing information for OxyContin and the express warnings it contained about risks associated with the medicine. The statement has also violated written company policies requiring adherence to the

prescribing information. We accept responsibility for those past misstatements and regret that they were made. Well, I think I believe them. That's something. That sounds pretty from the heart. Oh, wait. In a separate quote. Huh?

There's no one close. In a separate statement. No, they had a good one. Of the executives, Purdue said, quote, neither engaged in nor tolerated the misconduct at issue in this investigation. To the contrary, they took steps to prevent any misstatements in the marketing or promotion of OxyContin and to correct any statements of which they became aware, even though they just played guilty and they just said the opposite in the other.

But you know what is maybe the scariest part is that I feel like they believe it. And I feel like these people, when they do cite their bullshit, they're surrounded by others or spew it all the time, that it becomes like a different language and they actually do start to not feel any culpability. And that's even more dangerous. I think you're giving them too much credit. I think they're fucking monsters and they don't give a shit. I bet they're monsters, but I bet I'm saying they're monsters on such a level that they

are, you know, able to lie and think that they do do well. I think I, yeah. Like George, yeah, I don't know what to say anymore. So after the settlement, three years later, Purdue pulled the original OxyContin from the market and introduced an abuse resistant form that makes it harder to crush, snort or inject. So what doesn't come up here is that the patent was running out. So the patent wasn't going to, the patent was going to come up in 2013. So they just came up with a new form, right?

As the patent was about to end. So now the patent on Oxy 2.0 is good till 2025 and the FDA rewarded Purdue with a patent extension for a drug that injured and killed millions because they came up with a way to stop people from crushing and snorting it. Oh my God. Oh, and 25% of users claim they figured out how to defeat the deterrent. Yeah, of course. Always.

It's like a rock in a river. It's going to get around here. I mean, if people want to put it in them quickly, they will find ways. That's why you can't be giving people heroin. Yeah. The original, so the patent expired in 2013. So that's when generics would kick in as we learned from their last NRX cotton thing. But the FDA banned generic versions of the original Oxy cotton.

Well, we're retiring it. And required drug makers to develop abuse resistant versions. So now. But isn't the, but go ahead. Okay. So the abuse resistant form of Oxy cotton. Isn't abuse resistant. Did cause, no, but it did cause a big drop in abuse.

Okay. Because not everybody figured it out. Well, I mean, just posted. But at that point, there's tons of addicts. Right. Right. So what about those guys? Right.

So they're already addicted. Right. Turns out heroin has almost the exact same chemical structure and effect on the body as Oxy cotton and heroin is cheaper and not that hard to get. And it's heroin. It's also heroin. So while the abuse of Oxy cotton went down overdose deaths from heroin more than doubled. Right.

Because if the people who switched from Oxy cotton to heroin are now using heroin, which they're injecting, which is super dangerous. So they're going from taking a specific amount to now hitting the streets and getting they've they don't know if a batch is super potent, super weak. So now they're going into a whole new fucking ball game and they're dying all over the place. Yeah. Because I mean, it is because you can't like you're already you got addicted to opioids. And this is because these motherfuckers made everybody addicted and then came up with a

a pill that was harder to crush so they could keep their fucking patent. I have I have a couple friends of mine who because it's huge. It's so abused in the Midwest as well. And there are a couple of friends of mine who have died from it. And there are a couple of people who have gone on to heroin. And I remember I mean, just so clearly when it was starting. I mean, people had it and would just be snorting it. And you watch the experience of someone snort Oxy cotton.

It's really bizarre because it literally is it is heroin. They drop back. They pass out. It's not fun. It's not like a party drug, but people would be like, yeah, let's do Oxy. And then all pass out. And then we'll all nap together. We'll do some Oxy.

They'll all nap and then we'll wake up and not know what's up. Have tummy aches. Do more, but it's it is. I mean, it's just, you know, you the idea that that you don't feel complicit. If you've put opioids into somebody's body and then they're doing heroin, you're like, man, poor choice. Yeah, you made a bad choice there. Weird call.

So many of the people are young 18, 19, 20, 21. Purdue has been sued hundreds of times over how it marketed Oxy cotton. Most never get to a jury. Purdue gets suits dismissed using precedent, which shields drug companies from liability when their products are prescribed by doctors. I mean, that's a shield they don't deserve. That's fucking insane. So they're untouchable.

They're untouchable. Some lawsuits were settled confidentially and the evidence was sealed to protect trade secrets. These sealed materials include internal memos to members of the Sackler family, FDA correspondents, testimony from executives, and sales reps reports. One case that got further the most was a 2004 case in Appalachia. The West Virginia attorney accused Purdue of deceptive marketing, including the 12 hour claim. I mean, we are right.

Show me one piece of evidence that says the 12 doesn't work. Good. I mean, look at the plane. Look at the house. It's 12. It's 12. I mean, look at the pens. Was there gonna be a plushie?

The whole thing's 12 and anyone who's saying different doesn't understand. It's a plushie. It's 12. Why is there a plushie here? Hey, look at the balloon. It's a one and a two. Your Honor, I'd like to bring in an exhibit adorable, Your Honor. Exhibit one is a pillow.

Yeah, exhibit B. We're going to go number letters. Exhibit B, all these mugs. I'm sorry. I thought I saw ghosts. Hey, you'll have to excuse my friend. He wasn't going to the toilet a lot because of the opioid. So now he's on Ghost Be Gone.

So Perdue made a bunch of attempts to get this lawsuit dismissed and they kept failing. Perdue then made a motion for summary judgment. To make this argument, Perdue reached out to UberGrate. Oh, God. What the? Well, this is super friends. Future attorney general under Obama, Eric Holder. Oh, God.

Eric Holder argued that West Virginia prosecutors didn't have sufficient evidence to warrant a trial. Well, the judge ruled there was enough evidence. Okay. So just so we're, if we're keeping score. Yeah. Eric Holder let the banks off after they destroyed our economy. Well, to be fair, I mean, they were fined of $20,000. Argued in favor of Uber not having any background checks.

And now is arguing in favor of OxyContin. I'm sorry, Dave. This still falls on Bush's doorstep. I think there's a way. Obama great Eric Holder, fucking monster. His decision meant OxyContin's duration would be aired at trial. Sealed evidence would be out for everyone to see. So Perdue quickly settled for $10 million.

Well, the evidence was on a time release. $10 million. I mean, it's just, were they, like, did one of them laugh and then just like open a wallet? It was just like, throw it in the judge's face. Hey, here's some cab fare, bitch. Oh, I'm sorry. That is, I didn't realize I could be held in contempt. Morris lawsuits against Perdue rolled in.

In January, 2017, Everett Washington filed a first of its kind lawsuit, alleging the drugmaker, quote, supplied OxyContin to obviously suspicious physicians and pharmacies ultimately failing to prevent the illegal diversion of OxyContin into the black market. The suit states that the heroin crisis is directly due to Perdue's wrongful conduct. Good. Quote, we believe the flooding of the city with OxyContin caused the crisis. Our capacity to respond has been overwhelmed and Perdue should pay for the harm they caused. But the truth is that in a situation like this, the problem is that they, I mean,

they have so much money that they can just make it as impossible and as costly as it could possibly be. That's cool. That's capitalism. That's how it works. Oh, sorry. I didn't realize. I do like capitalism. I remember knowing that I like it. This all started with a sham clinic in Los Angeles. It was set up in 2008. An Armenian mobster, leased in an office space near MacArthur Park, which is not a great area. They hired an elderly doctor and gave the clinic the name Lake Medical. Hello.

The doctor, Eleanor Santiago, started prescribing OxyContin. And lots of it. And one week in September, she prescribed 1,500 pills. Oh, my God. In October, she prescribed 11,000 pills. Oh, my God. In December, she prescribed 73,000 pills. She's just like the person in the Guinness book who can just hold their breath longer and breaks it.

I don't even know how you write that much. Yeah, honestly, that is nonstop. You're definitely writing it once and just purring them out. Oh, hold on. Let me just give you a 40. There you go. A sales manager went to look at what was going on. I like what I see. So the Purdue persons like this seems, she sent an email to Purdue's compliance director, sales manager, quote, the line was out the door with people who looked like gang members. I feel very certain this is an organized drug ring. Shouldn't the DA be contacted about this?

Yeah, under federal law, they're required to. Sure. Let me guess. Yeah. They don't. They didn't. Of course. Oh, except the federal government has not accused Purdue of any wrongdoing in the case. Oh, good. Well, I mean, then, well, you can trust the government, so they're right.

Or of any other suspected drug operations anywhere in the US. Sure. They haven't done anything now that I recollect. In a statement, Purdue said the company had, quote, at all times complied with the law, which might be the problem. Yeah. The truth is that they found, I mean, they kind of found ways around the laws. Quote, it would be irresponsible to direct every single anecdotal and often unconfirmed claim of potential misprescribing. Yeah. I mean, that's going to take a long time.

I wouldn't want to be the guy collecting those numbers. So here's how they get away with it. Purdue is required to monitor and report suspicious orders to the DEA. Okay. That seems like a problematic step. But Purdue found a nice middleman from a Purdue lawyer, quote, Purdue does not ship prescription products directly to pharmacies. It sells only to authorized wholesalers who maintain their own monitoring programs. So they're basically like, how can we monitor? They're monitoring.

Well, we're not supposed to monitor because we give it to a warehouse that does it. Right. Who, I wonder who owns that? More than 200,000 people have died from overdoses involving opioid painkillers. But it's weird with all the data that, remember the data they were collecting on doctors? Yeah. About who prescribes the most? Yeah. The batting average.

It's weird they can't see who's overprescribing with that. Strange. Because it's literally data that finds out who's overprescribing. Yeah, but. But they can't figure out who's overprescribing. Yeah. But who has the data? They have the data. Okay. Yeah. But who, yeah, exactly. So, you know, exactly.

Okay. Yeah. This is a good talk. Okay. Yeah. Because they, yeah. Yep. Yeah. Is this a good time to mention how much money pharmaceutical companies have spent on lobbying? Let me ask you this. Is this a good time for me to flip this fucking table? $880 million as of 2016.

That's eight times more money than the gun lobby. It's 200 times the amount of groups advocating for stricter opium prescription rules. Good. Most of the funding is done through the pain care forum or the PCF. PCF was founded by a lobbyist for a company called Purdue Pharma. Anyway, back to the clinic. Turns out Dr. Santiago. A lot of punches coming my way.

Turns out Dr. Santiago was drowning in debt when she took the job at the clinic. Okay. So that's why she was making it rain with pills. We're back to that weird. Oh, you mean where, yeah, that thing where you incentivize via money? Where you incentivize crime by putting people in, right. The 80 milligram pills she was giving out were usually for patients with severe chronic pain who had built up a tolerance. They were called 80s on the street and they are the most in demand.

Well, normally if they're called 80s on the street, it's being used legitimately. Yeah. They went for 80 bucks each. This was when pills could be crushed and shot, it started. The number of pills Santiago was prescribing was described as, quote, jaw dropping. Yeah. And by the way, a lot of patients' jaws continued to drop over the coming months. Some doctors go to their entire careers without prescribing 180. And she was like, one. Thousands.

Hold my beer. When the sales reps went to check it out, the building looked abandoned. Inside, hallways were filled with trash and lined with men who, quote, look like they just got out of LA County jail. So the clinic is just a fucking old school crack house like thing. It's just ridiculous. A couple months later, a Purdue security committee met to discuss the clinic. Instead of reporting it to the DEA, they put the doctor on a list of possible

reckless doctors. Big list, big list. Possible. Possible. We're seeing a little, some red flaggery, but we're not really willing to call it crazy. 73,000. We're still on the... We're not sure. We believe a truck flipped. In 2013, there were 1,800 doctors on the list. Eight percent were reported to law authorities. The medical clinic was getting homeless people from Skid Row, paying them 25 bucks to get

prescriptions filled. The pills were then brought to a middleman who packaged them for sale. And they made the way across the country. Well, this doesn't sound shady. East Hollywood's white fence gang trafficked them to Chicago. The Crips brought them to the Inland Empire. One pharmacist in Encino reported someone was shuttling in homeless people in vans to fill prescriptions. Oh my God. How long until these people are giving doctors the drugs?

It sounds like there might be a... I mean, how far away are we from the doctor needing to score some 80s for his clinic? Pharmacists all over LA started complaining to Purdue. Purdue just wouldn't respond. Sorry, we're busy. I got a thing with a guy. Yeah, we're doing things with guys. So, we do things with guys. Pharmacists just started denying the prescriptions on their own.

But the ones that kept selling, Purdue decided to, quote, continue to watch the situation. That's cool. They're just going to ump it. Purdue never shut off the supply to any pharmacist. And the pharmacists kept selling because they were making money. Right. In the end, it was a state team of federal state and law enforcement who shut down the clinic. It was closed in 2010, a year and a half in business.

Well, that's... I mean, they caught it quick. Purdue still had still not shared any information with the government at that point. Good. After, one Purdue executive wrote, quote, it really takes the G a long time to catch up with these jokers. Can we get his name in homeless sending stuff? This is right around when Purdue switched to the new tamper resistant formula and people

addicted switched to heroin. In December, 2011, Purdue emailed the DEA the names of local LA doctors it believed were misprescribing Oxycontin, Santiago... These ones were really obeying orders. Santiago, who was now in jail, was on the list. But that is also so messed up. No, now they're acting like they're doing the right thing when they've waited too long. It's so sacrificial.

They've already killed a bunch of people. Yeah. They've literally killed them. No, and then they're like, you're right, these doctors, they really, where do they get this? The DEA called it, quote, old news. Because fake news wasn't around yet. Purdue officials did not go to authorities until years later when the drug ring was out of business and the leaders under indictment had had 1.1 million pills go through the clinic.

Oh my God. Almost all were 80 doses. In places like Everett, the jail was overflowing. We'd like to buy you some dollar sign wallpaper for the office. In places like Everett, the jail was overflowing with addicts. The detox facility is set to double in size. The city now spends a fortune clearing its streets in parks of needles and plastic bags. Addicts, burglarized homes, picked pockets, stole identities, robbed businesses, and

prostituted themselves. Oxycontin attracted people with no criminal records from stable homes, shops, and families. After Purdue introduced the heart to crush pill, many of them moved on to heroin. Dealers who had been selling heroin to the same small group of drug users for years suddenly had a booming new clientele. I don't know what's going on, but things are terrific. It's great. Yeah.

As one dealer from Everett said, quote, upper and middle class children. Today heroin addiction is such a crisis in the county that more than 40 residents fatally overdose each year. The suit against Purdue aims to not only recoup costs, but help Everett finance its fight with opioid addiction in the future. From 1999 to 2010, the sale of prescription painkillers quadrupled. And from 1999 to 2010, the number of overdose deaths from prescription painkillers also nearly quadrupled.

The U.S. accounts for 5% of the world's population. The statistic is always horrible when it starts like that. The U.S. accounts for 5% of the world's population, but about 99% of oxycodone use. Many years later, Dr. Spanos, who made the video, now says he was trying to explain that some patients could take opioids and not turn into, quote, classic drug addicts. He now regrets if any doctor's got the wrong message. Oh, I mean, honestly, that's what I mean. It's like you convince yourself, boy, I mean, I don't know why

they went haywire with this shit. I don't know where they got it from. Oh, yeah, me, but why'd they do it? Oh, I told them to, but how come it's bad? Oh, I knew before. I'm out of questions. Of the seven patients in the videos, two are dead and were active opioid abusers when they died. Another became addicted, suffered greatly, and quit after realizing she was headed for an overdose.

She like lost everything. Three patients still say the drug helped them cope with their pain and improve the quality of life. And when I read up on descriptions on all those people, they're still using the drug. They use it every day. They use it constantly, but they don't call themselves addicted. A seventh declined to answer questions. Now Spano says, I'm only answering statements. Now Spano says, quote, I would hope that what was conveyed in the video is that there are patients

in whom tolerance doesn't happen. And he also says it remains unknown how many patients will, quote, have a stellar response from taking opioids instead of the 1% Spanos touted in the video. Studies now show that upwards of 50% of patients taking opioids long term for a medical condition begin to show signs and symptoms of addiction. Today, Purdue's owners, the Sackler family, has a fortune of around $14 billion, which is shared by about 20 family members. It ranks among the top 20 in the United States between two alcohol dynasties,

the beer making Bush family and the Brown family, which owns a majority stake, the producer of Jack Daniels and Finlandia Vodka. The Purdue's are richer than American dynasties, the Melons and Rockefellers. The family name adorns a wing of the Metropolitan Museum of Art and several galleries in the British Museum. So what now? Well, what now? By 2016, there were nine fentanyl manufacturers in the United States.

Fentanyl has been called an opioid on steroids. Well, we don't want a steroid. It is so powerful that two milligrams, which is smaller than a P, can be a fatal dose. Okay. So I mean, we're going big for the sequel. Fentanyl can come in pastures, lozenges, tablets, lozenges, and liquid. In 2011, only 3% of overdoses were due to fentanyl alone. In 2015, no, there were 9,580 deaths from a synthetic opioid other than methadone.

Those are mostly fentanyl. That's three times as many deaths in 2013. In 2016, fentanyl caused 27% of overdose deaths when combined with other drugs. It was 70%. Meanwhile, heroin-related deaths plummeted from 28% to 3%. Within just five years, heroin and fentanyl have traded places. So we went from, I mean, it really just is the shell game. Once the OxyCotin wasn't enough and there was some legislation that came around that,

that's when you switched to heroin. And now that you actually have a legal option, again, you're able to drop heroin because they've made better heroin legal. I mean, it really just is so, you know, I mean, it's just, there are 19 different things that are going on in our world now, where you're just like, why does it have to be totally fucked? Why do all the big institutions are totally fucked? So fentanyl is, like you hear about drugs are just scary.

Fentanyl is terrifying because if you touch it, you can die. Oh, I'm sorry, what? It's like a ring? So I listen, so postal people, anybody, if it's not a package, there was a cop and he had done a bust, a fentanyl bust somewhere, and he was walking out of the police station and like his sergeant said, hey, you got a little smudge on your thing thinking it was dust or something. He touched his uniform.

He hit the little white spot. He woke up four days later in the hospital in the ICU. It's fucking gnarly. How, how, how are they, how are they making drugs that you can't touch? Because- But you're supposed to put in. Because all we give a shit about is companies making money. Nobody gives a fuck.

And people sit here and say, the parties aren't different. Really? Because they're fucking killing people. They're literally killing human beings, both of them together. They're both doing it. Yes, on some shit they're worse, but both parties are fucking murdering our citizens. Honestly, at some point in the last, like, five or ten years, the Democrats have made more money off of pharmaceuticals.

They make shit loads of money off of- That's their, that's their, their, their weaponry. That's their- No, the Democrats jam as far as pharmaceutical companies, and these deaths are on their fucking necks. Well. Guess what? Capitalism for healthcare ain't fucking working.

If you go to single-payer, then just keep chalking up death. Because it's not, it's not just people getting sick and dying. This is part of it. And also think about, like, the, what, I mean, the moment that we're in right now, where you're, we're arguing about healthcare and what it should be. And because of the way the system has worked, you now have all these opiate addicts, and now, potentially, there will be no care for them to figure out what,

how to handle their issues or what. It's a fucking, it's a remarkable, if they roll this shit back, all of these people, there are, there's gonna be so many deaths, it's gonna be astounding from, from drugs. This is, this is, more people are dying from this than AIDS. than AIDS when AIDS was at its fucking peak. These are hundreds of thousands of people are fucking dying. Cops now carry around that Narcon thing that can revive people instantly.

They just care, that's how fucked up our society is. They just carry around a drug to make people come back to life. It's true. It is, it is, it's like, you know, that it is crazy that they're like, we have a huge opioid overdosing problem. What are we gonna do? We're gonna make a gun that'll bring people out of comas. That'll do, that'll do it.

It's, it's, I didn't know it was this bad when I said I remember this. It's super fucked up, and the reason it's happening is because of our government is corrupt to the fucking core, and that's why people, hundreds of thousands of people are dying. Because there's no way this shit should be legal, should be getting prescribed the way it is, if you don't be going to terminal people and people with cancer, nobody else should be fucking taking this shit. And fentanyl is insane.

I mean, and how old is fentanyl? It's, it's pretty recent. I mean, they really started pushing it as a late. Yeah, I mean, you know, yeah, they, they are, it's just more sophisticated than what part one was. They've just figured out, I mean, yeah, it truly, it all ends and begins with the idea that all of our politicians are totally corrupted. Totally corrupt, totally paid for.

And so they're all totally corrupted, 90% of them are totally corrupted. They're never going to do things that, I mean, they genuinely now look at the way to win is to have the most money, and if you got to shake a few shady hands to get money for your campaign to keep going, that's okay. But then it completely ruins what you're intentionally, what your initial effect That's fine, but you're killing us. You want to go get a sandwich? Yeah, let's do it, man.

I don't fucking love meat. I mean, that, it really is just, oh my god. Ah, we signed fentanyl. Damn it.