0:00

Hi, this is Robert here

0:02

with another edition of share intelligence

0:04

where the intelligence comes from my

0:06

guest and no question in

0:08

this case somebody here

0:10

who went to Princeton

0:12

and Harvard Medical School

0:14

and Published 50 scientific

0:17

articles and I'm building

0:19

up his credibility Because

0:21

he's written a really

0:23

important Mercifully short book. I

0:25

want to say as somebody who reads

0:27

books all the time, and

0:30

that is not getting

0:32

the attention I think it deserves. And

0:35

I read his book at

0:37

my producer Josh Shearer's suggestion,

0:40

I'm happy for it, because

0:42

I thought it's about time I thought

0:44

about not only the opioid crisis,

0:46

but thinking about the CDC, where

0:50

Dr. Charles

0:52

LeBaron, I hope I got it right, uh,

0:55

uh, and for

0:57

28 years. And

0:59

his view of

1:01

the official medical

1:03

agency and what it

1:06

does and how it

1:08

sets out guidelines is

1:10

really powerful. But what adds

1:12

force to it is at one point

1:14

where I got really hooked on this

1:16

book, one of the

1:18

requirements at the CDC is you had

1:20

to do some real -life experience out

1:22

there, and he worked in a jail

1:25

prison. And that I found

1:27

is a very moving part of the

1:29

book. And then you worked on

1:31

a Indian reservation, where

1:33

you actually functioned as a

1:35

doctor there, not just as

1:37

the epidemiologist studying these things.

1:39

As you had done, I

1:41

shouldn't say not just, but getting

1:44

into the field. And what

1:46

I found fascinating about this

1:48

book First of all,

1:50

it's a page turner. Usually,

1:52

I think of doctors as people who

1:55

can hardly write a prescription, allegedly.

1:58

And it's very well written. But

2:00

what really makes it so important is

2:02

you really care about the outcome. Not

2:06

the statistics, but the pain,

2:08

the health, does it work,

2:11

don't kill the patient, don't harm the

2:13

patient, and so forth. And I

2:15

don't want to put words in your

2:17

mouth. The title is greed to

2:19

do good. What is

2:22

this subtitle again? Well,

2:25

I wrote it down before. Oh,

2:27

the untold story of

2:29

CDC's disastrous war on

2:31

opiates. And tell me about

2:33

the greed to do good, this

2:35

overview that you bring to it. Well,

2:38

it's a sort of tale of good

2:40

intention going wrong twice. Actually,

2:42

the way the good intentions

2:44

went wrong back in

2:46

the late 90s and early

2:48

2000s was everybody decided

2:50

that nobody should be in

2:52

pain. No one should

2:54

have any pain whatsoever. And

2:56

there were pain scales going around

2:58

and the idea is you could

3:00

walk into a doctor's office and

3:02

you experience any pain. It would

3:04

be basically criminal of the doctor

3:07

not to prescribe something to relieve

3:09

you of your pain. which

3:11

is a little curious because in medicine you're

3:13

supposed to go after the cause of

3:15

the pain rather than the effect. However,

3:17

that was promoted very actively

3:20

by a bunch of folks who

3:22

make money off selling opioids. And

3:25

that story is relatively well

3:28

known that opioids were over -prescribed

3:30

and they were prescribed to the

3:32

point where 80 % of opioids

3:34

were being consumed by the

3:36

US. in a global sense, where

3:38

we only have about 5 %

3:40

of the population. Illegating

3:42

opioids at a rate of

3:44

about 90 % for operations, where

3:46

in Europe, for instance, only

3:48

5 % of people die

3:51

of opioids. And

3:53

the result of this, you

3:55

might call well -intentioned on some

3:57

people's part to reduce the

3:59

number of people who are

4:01

in pain, result in a

4:03

large population of people who

4:05

became in essence,

4:07

legally addicted to

4:09

opioids. Whereupon,

4:12

as you might imagine, the number

4:14

of overdoses also increased in parallel to

4:16

the amount of prescriptions of opioids

4:18

that are going on. And

4:20

people finally scratched their head at CDC and

4:23

said, what are we going to do about this?

4:26

So they slammed the

4:28

door shut on people

4:30

getting legal opioids. Well,

4:33

you can imagine what

4:35

happens if you're opioid addicted

4:37

to legal versions of

4:39

opioids and they slam the

4:42

door shut on that. There

4:45

are a bunch of entrepreneurs

4:47

south of the border who said

4:49

maybe there's a market share

4:51

we can grab here and they

4:54

said we can construct some

4:56

really powerful opioids with some materials

4:58

coming from China and they

5:00

start importing fentanyl and other comparably

5:05

lethal drugs, whereupon,

5:08

as soon as CDC

5:10

had decided to slam the

5:12

door on legal opioids,

5:14

there was an explosion of

5:16

overdoses to the point

5:18

where it quadrupled in about

5:20

seven years, reaching to

5:22

the point where there are

5:24

100 ,000 deaths per year.

5:26

And over the course of the first

5:28

two decades of the 20th century,

5:30

a million people had

5:33

died of overdoses. And

5:36

so again, these were two, in a

5:38

sense, well -meaning but

5:40

misguided interventions. One

5:42

was to reduce the

5:44

amount of pain

5:47

in existence to zero,

5:50

well -intentioned but misguided. And

5:52

the second was, we're going

5:54

to eliminate addiction and

5:56

overdoses by slamming the door

5:59

on safe versions of

6:01

opioids. And in each

6:03

case matters went south and

6:05

here we are Well as you

6:07

point out in your book

6:09

though, it wasn't only and maybe

6:11

with the CDC it was

6:13

agreed to do good But also

6:15

there was agreed to make

6:17

profit by pharmaceutical companies and obviously

6:19

when you get into the

6:21

illegal Even rate of profit perhaps,

6:23

but I want to start

6:25

with the pain because actually

6:28

I found that the book is

6:30

divided into four sections and I

6:32

like that way of treating you

6:34

because you put yourself in the

6:36

position of the patient and the

6:38

first part was about your back

6:40

pain and your illness and so

6:42

forth and it's really compelling because

6:44

you're getting it not from a

6:46

doctor saying suck it up and

6:48

live with it as you know

6:50

you don't want to make the

6:52

cure worse than the illness But

6:54

you experience the pain, you write

6:56

about it very movingly, trying to

6:58

struggle with it, the temptation to

7:00

take more, and so forth. But

7:02

you gained a lot of wisdom about

7:04

it, and having to manage pain. So

7:07

why don't we begin with chapter one, and then we'll

7:09

go through, I mean, section one,

7:11

and then go through the four

7:13

themes of the book. Because I think

7:15

there's, I want to tell people,

7:17

this is like 150, I think 140

7:20

page book, then there's about another

7:22

60 pages of citation, good

7:24

information. It's very solid. But

7:27

I just found it about the

7:29

best way you could spend part of

7:31

an afternoon reading it, you know.

7:33

And on this show, I reviewed books

7:35

and things that take, you know,

7:37

take me up a week or two

7:39

weeks to read. So I was

7:41

grateful for that. But you, as I

7:43

say, you have a real gift,

7:45

I think, with the writing. And

7:48

I haven't read another book I

7:50

saw about you your first year

7:52

at Harvard Medical School, but I'm

7:54

going to get ahold of it

7:56

after we're done here. I'd like

7:58

to know what that was like.

8:00

Also short, also in that zone

8:02

where an afternoon I'll do it

8:04

for you. Yeah, but let's begin

8:06

with the pain because when you

8:08

have pain, you want to manage

8:11

it, whether legally or illegally, you

8:14

know, or including drinking too much or

8:16

whatever. And so it's

8:18

really a good personal

8:20

story there about how to

8:22

deal with it. And

8:25

then what might be the

8:27

role of opiates positively? Well,

8:30

you're absolutely right. I mean, it's

8:32

sad in medical school, and it's absolutely

8:34

true. You learn a lot more

8:36

from your patients than you do from

8:39

your books. But they fail to

8:41

put one additional thing in. You learn

8:43

much more by being a patient.

8:45

that you do from either of those

8:47

other factors. And

8:49

pain is a particularly

8:51

enlightening event. This has

8:53

been well known throughout

8:55

spiritual history as well,

8:57

the distress educates. And

9:00

in my case, I had,

9:02

well, I think most

9:04

people were considered to be

9:06

majorly pain. I had

9:08

staphylococcal meningitis. it claps a

9:10

bunch of vertebrae and

9:12

on top of that I

9:14

got shingles which is

9:16

a ulcerative condition of the

9:18

of the skin over

9:20

about half of my torso

9:22

and it's all simultaneous

9:24

and it is remarkable when

9:26

you're in the level

9:28

of pain which I experience

9:30

how fundamental that experience seems

9:32

to be in many

9:34

ways. Fundamental to your understanding

9:36

of yourself, your understanding

9:39

of The world around

9:41

you, you develop a very

9:43

interesting view of how the

9:45

universe operates when you're in

9:47

excruciating pains. It sounds metaphysical,

9:49

and it is metaphysical, but

9:52

believe me, it has a

9:54

trivial aspect in that you

9:56

realize that a pill can

9:58

make a go away. But

10:01

someone won't give you that

10:03

pill, even though it's there. And

10:06

you develop a remarkable view of

10:08

human nature. When

10:10

that happens and in effect what

10:12

happened to me and happens

10:14

to many people who are in

10:17

really severe pain is there

10:19

the CDC had developed a bunch

10:21

of rules associated with who

10:23

was allowed and who was not

10:25

allowed To get pain medications

10:27

and it was remarkably instructive for

10:29

me and that was what

10:31

motivated me to write the book

10:33

about how Pain

10:36

is really a pretty extreme

10:38

event when it's As strong

10:40

as what I had as

10:42

pretty extreme view that you

10:44

develop of other human beings

10:46

if that the remedy is

10:48

withheld from me So but

10:51

you also there was a

10:53

serious illness and I think

10:55

you have a statistic in

10:57

there that there was a

10:59

50 % death rate of Yeah,

11:02

about the right. I survived that. I

11:06

ultimately ended up

11:08

on a level of

11:10

narcotics, which would

11:12

over time create about 50

11:14

% risk of ongoing need

11:16

for narcotics, and I

11:18

used to get off those.

11:21

So I kind of

11:23

had luck. I had

11:25

luck, I survived physically, and I had

11:27

luck in that I survived the

11:29

adverse events of the medication. So,

11:32

um, one of the

11:34

things I mentioned in there is it's good

11:36

to have good luck. Now,

11:38

good luck in the sense

11:40

that I got medical care.

11:42

Other people don't have access

11:44

to medical care. I good

11:46

luck and I come from

11:49

a good sociologics, in which

11:51

I have the support of

11:53

economic and personal, and I

11:55

had probably good accidental biologics

11:57

in that I never got

11:59

high. off this stuff. I

12:01

never felt euphoria. I never

12:03

felt anything. As far as

12:05

I concerned, it was a

12:07

medication to relieve pain. I

12:10

never felt any of the other events,

12:13

psychological events that are

12:15

associated with ongoing

12:17

news. So let

12:19

me go from that to

12:21

the second part of your

12:23

book, the capacity for fanaticism.

12:25

How does that relate? So

12:27

here you are from being

12:29

the patient, and now

12:31

you're describing your experience of

12:33

being at the central health

12:35

organization that revered most of

12:37

the time, at least

12:39

before the pandemic, and now

12:41

Donald Trump, but still it

12:44

was revered. And what did

12:46

you mean by that, the

12:48

capacity for fanaticism? Well,

12:50

I allowed myself to

12:52

draw the analogy. between

12:56

what I had done

12:58

at CDC and what CDC

13:00

was trying to do

13:02

with opioids. At

13:04

CDC, things are very different

13:06

right now. A different program would

13:09

be required to examine what's

13:11

going on at CDC. But we're

13:13

serious folks at CDC. And

13:15

we like to get rid of pathogens.

13:18

And in my case, we

13:21

basically got rid of measles.

13:23

In the United States, you'll note

13:25

that measles is making a

13:27

resurgence under the current regime. And

13:30

we had previously gotten rid of

13:32

smallpox. We'd worked on a bunch

13:35

of other things. We're serious folks

13:37

about when we regard a pathogen

13:39

as preying upon the public and

13:41

we want to get rid of

13:43

it. Where the

13:45

problem becomes is when

13:47

you apply the pathogen

13:49

notion to a medication

13:52

like opioids. And

13:54

to some extent, if

13:56

you take that lens and

13:58

view opioids as if

14:00

they were an infectious agent,

14:02

there's some seductiveness to

14:04

it because they basically are

14:06

imported. In effect, it

14:08

becomes a communicable disease. If

14:10

other people are taking opioids, you

14:13

tend to do so. But

14:15

if you regard them as

14:17

an infectious disease that you

14:19

need to eradicate, No

14:22

one ever needed a

14:25

little bit of smallpox to

14:27

get along in life

14:29

No one ever needed a

14:31

little bit of measles

14:33

to survive but opioids are

14:36

an essential medication for

14:38

survival in many ways and

14:40

the extent to which

14:42

we applied the same degree

14:45

of seriousness of purpose In

14:48

a sense, the

14:50

capacity for fanaticism

14:53

to opiate created

14:55

the problem of

14:57

illegalization being normalized

14:59

and then overdoses

15:02

being the consequences.

15:06

But when you say fanaticism,

15:08

I mean, yeah, they

15:10

really messed up a lot

15:12

of people's lives. experienced

15:15

some of that by my witness

15:17

when you worked in the prison,

15:19

right? One example of a

15:21

young man, he went in there

15:23

20 -something for a pocket full of

15:25

what they said was a lot of

15:28

drugs, and he's going to be

15:30

there till he's in his early 50s.

15:33

And, you know, just a sort

15:35

of carelessness of the way

15:37

we mix up that which we

15:39

should ban, and if we

15:41

do ban it, how to ban

15:43

it, and whose choice it

15:45

is, I mean, it's a very

15:47

powerful eyewitness in your book,

15:49

and sort of a madness to

15:51

it. I

15:54

don't know, I don't want to again put ideas

15:56

or words in your mouth, but that's what has

15:58

struck me as a reader. You

16:00

know, it's kind of what's going on, and

16:02

you know, and it was

16:05

racially based too. I think the,

16:07

one prison you were in, there was

16:09

like 80 % people were African Americans.

16:12

Exactly right. Yeah, the

16:14

one claim I'll make for my

16:16

book, you know, is said in

16:18

medicine that you're either an inch

16:20

deep and a mile wide, or

16:22

you're a mile deep and an

16:25

inch wide, you're either a hyper

16:27

specialist or a hyper generalist. In

16:29

my case for this book, I

16:31

will make the claim for uniqueness

16:33

in that I had a variety

16:36

of experiences which at least to

16:38

my knowledge no one else has

16:40

published. I have

16:42

had extreme pain that required opioids

16:44

for long periods of time. I've

16:47

treated populations in Appalachia

16:49

where the highest rates of

16:51

addiction and overdose are

16:53

present. I've worked in the

16:55

prison system where so

16:57

many people have been incarcerated.

16:59

We have the highest

17:02

rate of incarceration in the

17:04

world. And

17:06

so I, in a sense,

17:08

know the situation from a great

17:10

deal of breadth. I

17:12

don't claim to know the situation

17:14

from the same degree of depth

17:16

that a opioid treatment specialist would,

17:19

but I have the sense that

17:21

I know the situation from a

17:23

breadth. And what you're

17:25

bringing out is the other aspect

17:27

of what's happened with opioids, which

17:29

is basically the notion that if

17:31

you make a war on supply, If

17:35

you go after the supply,

17:37

the demand will go away. Well,

17:40

the difficulty is there's no evidence that

17:42

that's been the case. And

17:44

our war on supply is

17:47

basically a war on poor

17:49

people because we're not arresting

17:51

the people in Purdue, the

17:54

Sacklers. The Sacklers have a wing

17:56

of the Metropolitan Museum. They don't

17:58

have a, they're not in a

18:00

wing of the federal pan. But

18:03

the people who are trying to

18:05

sell a couple grams of something,

18:07

they end up with a mandatory

18:09

minimum. And one of the

18:11

things that that was an experience

18:13

working in the federal penitentiary, that

18:16

was remarkable to see

18:18

how many lives were being

18:20

ruined by the supply

18:22

side aspect of the thing.

18:24

Yeah, we get El Chapo once in

18:26

a while, or we get the

18:28

Sacklers to give up a billion dollars

18:30

or something. but the real

18:33

casualties are the people at the

18:35

bottom who end up going in in

18:37

their 20s not coming out until

18:39

their 50s because they had a pocket

18:41

full of some stuff they were

18:43

trying to sell. You

18:45

know it's interesting because

18:48

that's an issue right now

18:50

with the Trump administration

18:52

between the United States and

18:54

China over fentanyl and

18:56

so forth. It's a big

18:58

issue with Mexico and

19:00

it's dominating the

19:02

whole discussion, you

19:04

know, I mean,

19:07

maybe we should talk a little bit about

19:09

that. Well, it is

19:11

interesting because that's one aspect that I

19:13

haven't had too much to deal with.

19:15

So I can't speak to it. I

19:17

haven't been a law enforcement officer. I

19:19

may have had all these other hats,

19:21

but I haven't arrested people at the

19:23

border. But it's an

19:25

enormously futile to run

19:27

around. and say that

19:29

we're going to impose what,

19:31

you know, 80 % tariffs on

19:33

Mexico, bringing in cars, and that's

19:35

somehow going to reduce the

19:37

fentanyl that's coming in. There's

19:40

no evidence that would be the

19:42

case. And so

19:45

far, all our efforts at

19:47

preventing fentanyl from coming in

19:49

across the border have been

19:51

largely futile because the demand

19:53

is very, very strong here.

19:56

And all you need

19:58

to get across the

20:00

border is something equivalent

20:03

of a 12 -pack of

20:05

beer of an even

20:07

more potent opioid than

20:09

fentanyl, that's carfentanyl. If

20:12

you bring in basically the equivalent

20:14

of a 12 -pack of beer

20:16

in a false bottom of an

20:18

18 -wheeler, that's enough to

20:20

overdose every man, woman, and child

20:22

in the United States. So

20:25

it is basically impossible to

20:27

prevent drugs coming in, where

20:29

you can prevent the drugs

20:31

coming in, is cease to

20:33

have the demand, the level

20:35

that we have. And we're

20:38

willing to spend billions, particularly

20:40

in tariffs, on

20:42

creating obstacles to the supply,

20:44

which cannot be done. You're

20:46

taking basically a paperclip to

20:49

a rising tide. And

20:51

we don't spend a sense

20:53

on the treatments and other

20:55

things are necessary to reduce

20:57

the demand So why you

20:59

know again speaking from your

21:01

experience in I miss a

21:03

long time 28 years to

21:06

be at the CDC And

21:08

you had you know you

21:10

were honored there you you're

21:12

not some angry,

21:14

dissonant or something. You know,

21:16

you're a great success story. I mean,

21:18

you know, we grew up in the Bronx,

21:20

not far from each other. You

21:23

know, you

21:25

got into the special gifted high

21:27

school, you got into Princeton, you

21:29

got to Harvard, you got the

21:31

credentials, you published in the papers. And

21:33

what I loved about your book,

21:36

I got to keep pushing this book,

21:38

because I really just think it's

21:40

a terrific. book, you know,

21:42

and agreed to do good. The

21:44

untold story of the

21:46

CDC's disastrous war on opiates.

21:49

And, you know, there's one book

21:51

you read about this. This

21:53

is the one. And because there's

21:55

a humanity to it, you

21:57

know, you're not preaching, you're not

22:00

You know, like Robert Kennedy now,

22:02

he's got the answers and everything.

22:04

He knows it should be this

22:06

way. And then Donald Trump

22:08

shows it should be another way.

22:10

You just got open eyes there.

22:12

You're doing what, you know, any

22:14

honest observers should do. And you

22:16

say, hey, this is not working.

22:18

Or these people are, you know,

22:20

and the CDC, you talk about

22:22

how they drew up their guidelines

22:24

and that it wasn't really good

22:26

science. I think that's chapter

22:28

three, isn't it? Right?

22:31

Yeah. Chapter, part three is

22:33

about poor, poor science. right.

22:37

Not any work. And it's

22:39

not fact driven. How

22:41

does that happen? Well, it's

22:43

interesting how it would happen. What

22:45

happens is there isn't impatience in

22:47

public health when you see a

22:49

rising tide of overdoses. You

22:52

tend to say, I can't just sit here.

22:54

I have to do something. And

22:56

there's a danger to just

22:58

doing something. Because in

23:00

the case of public

23:02

health, yes, sometimes

23:05

you have to respond on

23:07

plausibility alone. And the plausibility

23:09

here is, you know, the

23:11

drug companies promoted these drugs

23:13

and people are taking them

23:16

like crazy. We got cut

23:18

off this promotion of drugs

23:20

by drug companies. Sounds good. Now,

23:23

basically what you'd say the motivation

23:25

is. The difficulty is that demand

23:27

has been created. And the

23:29

addiction is a very, very

23:31

powerful demand. It's very hard to

23:33

erase it merely by edict. And

23:36

the evidence that merely

23:38

now just telling doctors they

23:40

can't prescribe opioids is

23:42

going to correct the problem.

23:44

All it did is

23:46

displace it into the illegal

23:48

system where the demand

23:50

became much more dangerous. There's

23:54

no dishonor to operating quickly

23:56

on plausibility without too much

23:59

data because sometimes you have

24:01

to react. Where

24:03

the difficulty is is when

24:05

things are ambiguous in the

24:07

data, it's your is your

24:09

obligation to constantly query the

24:11

outcome. Am I doing good

24:13

or am I doing harm? Now

24:15

there is greed to do good

24:17

in the sense that people want to

24:19

do something right on a plausibility

24:21

basis. Drug companies are

24:24

really addicting everybody we got to

24:26

stop them. However,

24:28

you need to examine the consequences

24:30

of your own behavior. Did

24:33

this have any effect that

24:35

was beneficial? And

24:37

when you get a

24:39

doubling of overdoses after

24:42

your intervention is applied, it

24:44

behooves you to say, you know, are

24:47

we doing more harm than good? And

24:49

what should we be doing? And

24:51

that was not done. And then

24:53

this comes back, Robert, to what

24:55

you're talking about the capacity for

24:57

fanaticism, the characteristic of fanaticism in

24:59

contrast to what you would call

25:01

ethical medicine is, yeah, this was

25:03

a good medication. I did it

25:05

as best I could. But the

25:08

patient got worse. I got to

25:10

reconsider my strategy. And

25:12

unfortunately, for basically six or

25:14

seven years, while the overdose

25:16

rate kept going up to

25:18

the point where it is

25:21

ultimately going to kill a

25:23

million people in a decade,

25:25

nothing was done to back

25:27

off. And it

25:29

just became, in

25:31

essence, a fanatical activity

25:33

rather than a

25:35

medical activity. And

25:38

as you predict in your

25:40

book, another million will

25:42

die in the next

25:44

period. I mean, it's not

25:46

getting better. Well, it's

25:48

interesting how that thing

25:50

recently, for reasons which

25:52

aren't clear, and I

25:55

would love to think

25:57

it represents CDC backed

25:59

off slightly on its

26:01

medication recommendations about a

26:03

year and a half

26:05

ago. And thereafter, the

26:08

rate of overdoses has

26:10

gone down somewhat, about

26:12

20 % down. And you

26:14

can't believe how much

26:16

celebration there's been over that.

26:18

And of course, I

26:21

celebrate people not dying like

26:23

anybody else. But

26:25

what that means instead of

26:27

100 ,000 doses, 100 ,000

26:29

overdoses a year, we

26:31

have 87 ,000. That's

26:34

good. I'm glad I went down.

26:36

That means in order to kill

26:38

off another million people, we'll do

26:40

it in 12 years instead of

26:42

in 10. That

26:44

isn't just the kind of

26:46

success you'd usually break

26:49

out the champagne for Well,

26:51

you know, it's interesting

26:53

this idea of the physician

26:55

do no harm and

26:57

and being you know Having

26:59

your book has great

27:02

modesty to its essential style.

27:04

You don't claim you

27:06

are a well -educated doctor

27:08

obviously of great experience, but

27:10

you don't claim you're the

27:12

expert on every aspect, you don't claim

27:15

you have the answer. And

27:17

there's a great sense of

27:19

humility, which I really loved

27:21

coming from a highly trained

27:23

experience professional, no more so

27:25

than in the fourth section

27:28

when you talk about Native

27:30

American. And I was just thinking

27:32

of the, and work on

27:34

a reservation, I was just thinking, when

27:36

we were growing up in the Bronx, And

27:39

even though there had been

27:42

strong native cultures here before

27:44

colonization in New York and

27:46

so forth, people forget the

27:48

Bronx of our time was

27:50

also thought to be a

27:52

place of farms and even

27:55

some agriculture. But

27:57

nonetheless, there was absolutely

27:59

no sense of self

28:02

-criticism of the whole

28:04

American expansionist adventure. that

28:06

we represented enlightenment, we

28:09

represented white America, represented

28:11

civilization, and so forth. And

28:14

that last section of your book, why

28:16

don't you talk about it, your work

28:18

there, because it really was quite an

28:20

enlightening to me as a reader. Well,

28:23

it's enlightened me to me

28:25

as a physician. Basically, their call

28:27

went out to members of

28:29

the US Public Health Service, of

28:31

which I was a member.

28:33

Hey, we got a crisis going

28:36

on up in this particular...

28:38

They don't like calling a reservation

28:40

because it wasn't technically a

28:42

reservation. It was an area that

28:44

had Indian Health Service, however,

28:46

a hospital there. So I went

28:48

up and the place was

28:50

in total chaos. quite

28:52

correctly, a crisis, but was

28:55

an ongoing crisis. And

28:57

in that crisis, opioids

28:59

were being distributed right,

29:01

left, and center because there

29:03

was no coordination whatsoever. And

29:06

the interesting thing for me, having

29:08

worked there for about 20 years periodically,

29:11

is the tribe took

29:13

over ultimately. And

29:16

things improved

29:18

so much. when

29:20

the tribe was running it

29:23

then when we the Indian health

29:25

service were running it and

29:27

It's kind of remarkable now some

29:29

of some of that arose

29:31

from a in a sense an

29:33

ambiguous situation They opened the

29:36

casino which there have been a

29:38

lot of debate as to

29:40

whether they should have a casino

29:42

there, but they got a

29:44

casino a casino basically As someone

29:46

says a casino is a

29:49

tax on the mathematically

29:51

challenged. Basically

29:53

what it is, is you've got

29:55

a whole bunch of white people

29:57

coming in spending their money irrationally

29:59

and giving the tribe a whole

30:01

bunch of cash. And

30:03

then the question is, was the casino

30:05

cash going to do with it?

30:08

And remarkably enough, the tribe, which is

30:10

very different from the rest of

30:12

us, Yeah, they said, okay,

30:14

should we distribute it and everybody gets

30:16

close basically several thousand. They said, no,

30:18

we'll invest it. We'll invest it in

30:20

the schools and we'll invest it in

30:22

this case in the hospital. And

30:25

they built a very,

30:27

very nice hospital and

30:29

they built up very

30:31

good systems that reduced

30:33

the amount of really

30:35

bad opioid prescription to

30:37

very little. What

30:39

was the difficulty? The difficulty

30:41

was that they were able to do

30:43

that, but they, like the rest

30:45

of the United States, did

30:48

not invest, because it's

30:50

very expensive, in

30:52

decreasing already existing

30:54

demand, the addiction

30:56

level that was

30:58

in the population. And

31:01

needless to say, there was a gigantic enterprise

31:06

surrounding the reservation, this

31:08

Appalachian, where there was

31:10

plenty of illegal opioids

31:12

coming in. So

31:14

they were able to clean

31:16

up the act in the

31:18

hospital, but they couldn't clean

31:20

up the United States' act

31:22

in what was going on

31:25

outside of them. And

31:27

in a sense, it represents the

31:29

triumph and the... tragedy of the

31:31

whole situation that they couldn't cure

31:33

us. They could cure themselves, but

31:36

they cured and cured the rest

31:38

of us. I'm

31:41

going to conclude this,

31:43

but the book, let me

31:45

say it again, agreed

31:48

to do

31:51

good. Wow, that's so

31:53

much of US policy since we

31:55

were kids in the Bronx, agreed

31:58

to do good.

32:00

meddling, well, the

32:02

untold story, CDC's disastrous

32:04

war on opiates. And

32:07

what I think makes this

32:09

book really a great model, and

32:11

I hope we can do

32:13

a little bit to improve sales,

32:16

I really should be

32:18

read, is that

32:20

you abandoned the pretense

32:22

of the arrogant

32:25

professional. And you are actually

32:27

looking there and say, wait a minute, I'm

32:29

here as a doctor in this prison, or

32:31

I'm here working on this reservation, or I'm

32:33

here in this bureaucracy. And

32:35

how is it affecting ordinary people?

32:38

How is it really working out?

32:40

And my model in journalism

32:42

is I always want to know

32:44

who's getting screwed and who's

32:47

doing the screwing. And you're very

32:49

agnostic about it. I mean,

32:51

the book just has a certain

32:53

really Wonderful honesty to it.

32:55

You don't claim you know everything You

32:57

don't claim you have all the answers, but

32:59

you sure have a good bull detector

33:02

You know you you know what this is

33:04

not working You know why are these

33:06

young people being locked up in this prison?

33:08

Who was it doing any good because

33:10

he had the wrong stuff in his pocket

33:12

that was somebody else was that they

33:14

were selling you know What's to be gained

33:17

by keeping him here? I don't

33:19

know that stuck with me as an image You

33:21

know, I mean, just always going

33:23

to be there another 20 years.

33:25

He hopes his girlfriend will still

33:27

love him when he comes out.

33:29

I mean, it's so poignant, this

33:31

description. So anyway, I want

33:33

to recommend the book. Get

33:35

it. Hopefully it's some

33:37

independent stores, but you can get it on Amazon.

33:40

Agreed to do good. Dr. Charles

33:42

Lev Barone. That's a very fancy name

33:44

there, but he's a guy from the

33:47

Bronx like I am. So I'm I

33:49

want to help them out here. And

33:52

well, that's it for this edition of

33:54

Sheer Intelligence. See you next week. But

33:56

I want to thanks to Joshua Sheer,

33:58

our producer, who got me to read

34:00

this book. I didn't even know it

34:03

was out. I think it's terrific. And

34:06

Diego Ramos, writes the

34:08

introduction and our managing at

34:10

Sheer Post. Max Jones

34:12

who does the video, which seems to

34:14

get more people to watch these

34:17

things than just the audio alone. And

34:19

I want to

34:21

say thanks to Integrity

34:23

Media, founded by

34:26

a very good criminal

34:28

lawyer in Chicago

34:30

and Len Greenwell, Len

34:33

Goodman, for providing some funding

34:35

for this and the JKW

34:37

Foundation in of Gene Stein,

34:39

very independent writer for helping

34:42

out as well. See you

34:44

next week with another edition

34:46

of Sure Intelligence.