15.1 Overdosed: The Worst Drug Epidemic in Human History

[00:00:00] Hey everybody, thanks for joining me today for a solo recording on a topic that is near and dear to my heart Part of my lived experience, something even in the early stages of my psychiatric career that I consider myself to be very well versed in

[00:00:18] The progressively worsening dumpster fire that is the United States drug epidemic Somebody get this guy some help Disclaimer, this podcast is for informational purposes only. The information provided in this podcast and related materials are only to educate

[00:00:43] This information is not intended as a substitute for professional medical advice while I am a medical doctor and many of my guests have extensive medical training and experience

[00:00:48] Nothing stated in this podcast norm materials related to this podcast including recommended websites, text, graphics images or any other materials should be treated as a substitute for professional medical or psychological advice diagnosis for treatment

[00:00:58] All listeners should consult with a medical professional license mental health provider or other healthcare provider if seeking medical advice diagnosis for treatment

[00:01:05] I spend a lot of time talking about our broken healthcare system and there is no one specific issue that epitomizes its dysfunction more than the addiction crisis which has taken the lives of millions of Americans since the late 1990s and affected hundreds of millions more

[00:01:25] You could not grow up in the late 90s or 2000s in Kentucky, Indiana, Ohio, West Virginia, Tennessee, North Carolina and not know somebody afflicted by addiction or a family torn apart by the carnage of their loved ones addictions

[00:01:46] Purdue pharmaceuticals run by the sacchar family who were implicated as a major causative factor in the valium epidemic of the 1970s and 1980s Specifically targeted rural Appalachians with their marketing of the drug oxy cotton What they claimed was a non-addictive opiate, which by the way does not exist

[00:02:13] The opium poppy is the natural plant form of opiates and has been around since the 3000s BC It was recognized as causing potential fatality with improper dosage as far back as the 10th century and was banned by the young zing emperor of the kin dynasty

[00:02:32] In China in the 1700s in part due to its negative impacts on their population In the early 1800s, morphine was isolated from opium as the active pain relieving and respiration depressing ingredient in opium

[00:02:51] Once Purdue managed to get FDA approval for oxy cotton in 1996, which we'll talk about later It didn't take long for the problem of prescription pain pills to spread to the northeast and southwest United States and quickly thereafter A regional epidemic became a national epidemic

[00:03:13] A crackdown on opiate prescribing in the late 2000s co-insided with a widespread increase in the availability of illicit black tar heroin from Mexico in the early 2010s Putting more fuel on the epidemic fire

[00:03:30] And since the mid 2010s fentanyl, a synthetic opiate with a hundred times the potency of natural morphine that is odorless and lightweight, making smuggling much easier has accelerated the flame even further

[00:03:48] Leading to perpetually increasing numbers of drug overdose deaths in the United States nearly year over year for the last 30 years From 1999 to 2020, overdose fatalities have increased by more than 500 percent And probably even more than that

[00:04:11] Today I'll start out by talking about the evolution of mortality with drug overdoses But also discuss some of the other medical and psychiatric consequences of illicit drug use

[00:04:22] Effecting Americans lives and futures as a University of South Florida 10 year study concluded over one third of Florida overdose fatalities were not reported to the federal government

[00:04:37] It's so important to point out that not only are overdose numbers almost assuredly and chronically under reporting the annual numbers of drug overdose fatalities They also do not factor in that this problem is not just limited to overdose deaths

[00:04:57] For people with non fatal overdoses the risk of mortality increases from less than 1% at baseline over a 12 month period To more than 5% fatality rate in the next 12 months

[00:05:13] That's for people who overdosed and did not die from it about half of those people end up dying from an overdose But the other half of that 5% you're talking about deaths related to car accidents Intervenus drug use related infections like HIV which causes AIDS

[00:05:36] Hepatitis C which can lead to an imperative immune system function as well as liver cancer or liver failure Indocarditis which is a heart valve infection that can spread through the circulatory system to anywhere in the body

[00:05:55] Scan and soft tissue infections at the site of injection sexually transmitted infections Namonias and other non-infection related risks like depression suicide homicide domestic violence psychosis Chronic lung disease resulting in respiratory failure alcoholic and other drug related liver disease

[00:06:20] Hypertension or high blood pressure related illnesses chronic kidney disease and other organ failures Throughout this series we will track the evolution of the U.S. drug epidemic from the time of oxycontinous emergence To widespread fentanyl contamination

[00:06:43] But we'll also discuss the non fatal effects on people's health and well-being Let's dive in first and foremost, nobody pays me to do this shit

[00:06:54] I have no disclosures. I don't receive any funding and I don't think with a lot of the things that I'm saying that I will be receiving any pharmaceutical funding anytime soon The reason why I do this is because of people like will

[00:07:12] So I went to high school with will and he was one of the funniest and most light-hearted people I've ever known Now this was supposed to be a very serious Exercise the first couple of students gave very heartfelt responses stating I believe in myself and my abilities

[00:07:37] The next one I believe in my family and the power of community And I believe in God and can do all things through Christo strengthens me Now eventually the baton was passed to will who in classic stoneface fashion and referencing a one hit wonder of the times that

[00:08:02] Probably mostly only the students were aware of Dryly says I believe in a thing called love Now while the priests and the older mentors bought it hook line and sinker gave a somber nod to will

[00:08:22] Who had buried his head in his hands because he was even struggling to keep a straight face While the majority of the rest of us did everything we could to discuss our tears of laughter as tears of empathy We'll always knew how to make people laugh

[00:08:40] Unfortunately in April of 2020 after a long and torches battle with depression and addiction Highlighted by long period of sobriety and being engaged in his recovery A month into COVID will was found dead in his bedroom from an apparent overdose

[00:09:01] It was absolutely devastating to me to his other friends to his family And it's not just will, unfortunately I can't count on both sets of my fingers and toes The number of former classmates who have passed away in the last 15 to 20 years

[00:09:25] Too many parents, too many friends, too many loved ones Are finding their sons, daughters, parents, relatives and more gone in an instant Or having their lives derailed by addiction We've got to turn more focus and attention as a country as a society To rectifying this problem

[00:09:52] Not continuing to put band aids on Our absolutely atrocious addiction care in this country I've got to give a huge shout out and thank you to Will's parents for allowing me to tell a story Trying to raise money and Will's honor It's not easy to do that

[00:10:13] And there's a lot of stigma surrounding addiction But they, as I do, understand the importance of facing that stigma head on Of honoring Will, honoring his memory and so many others memories by pushing for positive change Anyways, this is why I'm here

[00:10:36] Will is the symbol to me of why this matters And I want to make damn sure that his death is not in vain But pushes us towards progress in combating this surging epidemic Okay, so Newsflash Americans are using illicit drugs This 2019 National Survey on drug use and health

[00:11:04] Which represents non-institutionalized US civilians greater than 12 years old shows that 165 million people in the US have used an illicit drug in their lifetime That's 50 to 60 percent and likely even higher if you included institutionalized populations

[00:11:28] More than one out of five Americans have used an illicit drug in the last year And another 13 percent in the last month And all of that only represents illicit use So it doesn't count the millions of Americans who receive dangerous prescriptions or prescription combinations

[00:11:50] From their doctor or provider We're not winning the war on drugs And we've got to be open to changing our approach We've got to stop criminalizing addiction-related behaviors We certainly can't criminalize behaviors under the influence of addiction that are against the law

[00:12:14] But we've got to stop putting people in jail for having drugs And be more sympathetic and try to understand why they are using drugs And how we may be able to help them But first, we need our political candidates to turn more attention and focus

[00:12:35] To how we can combat this epidemic And maybe stop arguing about who has the lower golf handicap Let's start by taking a look at some general trends since the turn of the century So this is a commonly cited graphic

[00:12:54] Showing the drastic 500 plus percent increase in drug involved overdose deaths from 1999 to 2021 Prior to 2000 there were less than 20,000 overdose deaths annually With things like the HIV and AIDS crisis, motor vehicle accidents, suicides and homicides or gun violence Outpacing overdose deaths for decades upon decades

[00:13:24] And as you can see, a slow burn increase in prescription related overdose deaths Primarily, opiate pain pills first oxy cotton followed by several replacements of oxy cotton An increase in these prescription related overdose deaths in the late 1990s into the 2000s Consistently and steadily increased until about 2014-2015

[00:13:54] That no burst onto the scene leading to the highest drug overdose death rates in our world today And from what I can tell in the history of the world Now, this problem is so bad that it is affecting our actual life expectancy numbers

[00:14:14] Between 1950 coming out of World War II and 2015 Excluding 1993 when we lost 0.1 year of life expectancy related to homicides in HIV There were no decreases in life expectancy But in 2015, we saw another dip of 0.1 years related to overdose deaths

[00:14:40] And in 2020, with the combination of COVID and a massive surge in overdose deaths Our life expectancy dropped by 1.8 years Think about that We had a 70-year period of consistent increases in life expectancy And then in one year, we dropped almost two years of life expectancy

[00:15:09] Now you may think or say that this is mostly related to COVID But it's not just isolated to the COVID pandemic Of the 350,000 COVID-related deaths That's an official CDC number In 2020 in the United States 93% were in people over the age of 50 And 75% in people over the age of 65

[00:15:38] On the flip side of the 100,000 plus overdose deaths And I will argue that it is higher than that 90% occurred in people younger than 65 With the average age younger than 40 Not every death counts the same in terms of its impact on life expectancy This crisis is killing young people

[00:16:05] Of every community, of every ethnicity, of every socioeconomic background This is killing young people with their entire lives ahead of them So to go back to a common theme of the podcast All of this is happening, this drop in life expectancy

[00:16:27] Despite us Americans spending drastically more money than any other nation Per person on healthcare The Japanese and the Swiss are pushing towards average life expectancy around 85 years Australia, which has similar rates of obesity and smoking Are living until about the age of 84 The United Kingdom and Germany, about 82

[00:16:58] And here's us Americans With an average life expectancy around 78 or 79 years old Ranking consistently outside of the top 50 in the world Despite spending double per person Compared to just the next highest healthcare spender Now, no offense to check Republicans Or antigones in barbeutans, Croatians or homonies

[00:17:29] But with our resources in this so-called developed nation We should not have the same life expectancies As those four mentioned countries This problem shows majorly in our top 10 leading causes of death by age group Where you'll see unintentional injuries, which include overdoses Killing about 167,000 people in 2008

[00:18:01] And it reported greater than 200,000 in 2020 With more than half of those due to direct reported fatal overdoses And if you break down the unintentional injury deaths Between the ages of 15 to 44 The most likely reason for your death as an American Is from a drug overdose or suicide

[00:18:34] The other top causes of unintentional injury death Likely have an addiction subset to them as well With motor vehicle accidents Likely with some impaired drivers An unintentional falls From bad medication combinations Suicides and homicides And adverse effects of medications all in the top 10

[00:18:58] This is not to mention heart, liver, kidney, brain damage, disease Or other chronic medical conditions Exacirbated by illicit drug use So in 2020 unintentional injuries were the number four cause of death But again these are killing a much younger population

[00:19:24] Than all the other causes of death you see on there Covent cancer heart disease Cerrorobascular disease or strokes COPD Some of these other deaths also could be related to addictions Or exacerbated by addictions It's also really important to consider a stat called yol Years of life lost

[00:19:52] With an average years of life lost In an overdose between 30 and 45 years We're talking about over 3 to 4.5 million years of life lost annually In the United States To just fatal overdoses And well over 1 million dead Directly from a document reported overdose since 2000 It's so bad here

[00:20:22] That according to the World Drug Report from 2021 Put out by the United Nations Office on drugs and crime And not including alcohol or tobacco related deaths The US claims one out of five world overdose deaths 20% of the world's overdose deaths Despite only having 4.2% of the world's population

[00:20:49] Overdoses which I would argue are actually the third leading cause of death in the United States Are not even in the top 10 causes of death globally And while not the most important aspect to me The cost of the epidemic on our society is absolutely financially draining

[00:21:11] Yeah, you see that number up there That's not one million dollars That's one trillion dollars As of 2017 Who knows how high that cost is now? This is a very interesting study from 2018 Out of Columbia University and featured in Jamasich High-Eatory, a major psychiatric medical journal

[00:21:41] Regarding 75,000 adult Medicaid patients During their first year After a non-fatal opioid overdose What it reveals Is that there were 5,200 deaths Out of this 75,000 Compared to an expected number of deaths in the general population of 215 That's nearly a 25 times increased risk of death For this population

[00:22:17] With 50% of those deaths related to substance use or subsequent overdose But another 13% related to circulatory system failure 6% related to respiratory failure 6% to infections 4% to suicides 4% to GI system issues Or stomach issues or colon issues 10% to cancers 2% to cirrhosis or liver disease There is so much more

[00:22:54] To this problem than just overdose fatalities Now depression and suicide Are difficult to measure outcomes associated with prescription pills And IV or intravenous drug use Some overdoses are surely intentional While some suicides in drug use are also inevitably linked to that person's drug use

[00:23:20] This study shows that suicidal thoughts, intentions and attempts Are all increased among drug or alcohol dependent persons With 6 times the risk of suicide attempt 4 times the risk of serious suicidal thoughts and plans And people who use drugs Have a 10 to 14 times higher risk of death by suicide

[00:23:48] But again, this is an ancient statistic As of 2012 And I don't think the numbers have improved to any significant degree And are likely even worse in 2024 This September 2017 study showed the rates of opioid involvement In fatal car accidents Increased more than 7 fold in 6 combined states

[00:24:17] California, Rhode Island, West Virginia, Illinois and New Hampshire Between 1995 and 2015 And oftentimes Fatal car accidents may not be reported as drug related If there's no toxicology screen Or if they're located in an area where there's a lot of stigma attached to reporting it as drug overdose

[00:24:44] Which is exactly what it is The driver would not have been swirving Or lost control due to notting off When they have an opiate or a depressant in their system Now, there's a lot more to come in this series Hopefully, I've stressed the fatality part of this epidemic

[00:25:07] And the likely under reported nature of drug overdose related deaths Which I will continue to do throughout the series Based on adding up all the related deaths Not categorized as being caused by an actual overdose I would estimate the overall number of annual drug overdose deaths

[00:25:27] And related deaths is pushing beyond 200,000 That's not even counting alcohol or tobacco related deaths Which jumps that number up considerably further In the remaining episodes of the series I'll discuss the evolution of the epidemic From prescription pain pills to heroin, to fentanyl contaminating

[00:25:52] Pretty much the entirety of the drug supply Discuss complications of IV or intravenous drug use As well as other non-fatal, medical and psychiatric consequences Of non-intervenous drug use It's a heavy as fuck subject But it is so damn important to talk about

[00:26:18] Hopefully you'll join me again next week For the next episode in the series Hope you enjoyed Thanks again for watching and or listening If you're passionate about the subjects that I discuss on the channel Do me a favor and like, comment, subscribe

[00:26:39] Do whatever you can to make your voice heard That these are problems that must be addressed in our society If you have any questions, comments or concerns I want to hear them Feel free to reach out on social media Or email us at RenegadeSyke at gmail.com

[00:27:00] And if you'd like to be a guest of the show Or you have a connection to some money that you think would be a good guest Let us know Thanks again for listening