8.6 Problems: Extra: Falling Life Expectancy

[00:00:00] This extra segment is actually the first thing I ever recorded with the help of my friend

[00:00:07] and audio engineer Rob Goodnight. Dr. Beckman and I later recorded together without Rob,

[00:00:14] but this segment really didn't seem to fit with any other series. It is at times very

[00:00:21] crude, brash with a significant amount of cursing. So if you're easily offended maybe

[00:00:28] you should skip over this segment. We talk about a lot of the same issues, but in addition

[00:00:33] talk about how United States life expectancy is falling. Part of that is due to the opioid

[00:00:39] epidemic and the influx of fentanyl. But we also discuss polypharmacy. We discuss the psychosis

[00:00:48] inducing combination of amphetamines and benzodiazepines and then talk about other forms of over-treatment

[00:00:56] which leads to a conversation about Christopher Dunnch, the neurosurgeon featured in a

[00:01:02] Wondery podcast and later a TV show called Dr. Death. I hope you enjoyed this episode and if

[00:01:10] you really enjoy it more than the other episodes let me know. Reach out at Renegade Psych

[00:01:16] on all social media platforms or email us at RenegadeSych at gmail.com

[00:01:24] Somebody get this guy some help!

[00:01:35] United States number one per capita healthcare spending per year $12,318. Germany spends about

[00:01:48] $7,300 per person per second the world average of quote unquote wealthy countries. 5,800.

[00:01:59] So we spend 12 grand plus a year on healthcare twice the average of other wealthy countries

[00:02:05] more than 5,000 per person more than second place you would think that life expectancy in the United

[00:02:12] States is pretty high. We live on average four years shorter lives than the top dogs like

[00:02:18] Sweden, Switzerland, Japan and Germany. Shorter lives compared to the Czech Republic. The Czech

[00:02:25] Republic spends about 2,000 per person on healthcare. There's gotta be something like skewing it.

[00:02:31] The opioid epidemic calls us to actually see a decrease in life expectancy for the first time

[00:02:38] since the HIV AIDS crisis from the early 90s. That is such an obvious and huge example of how

[00:02:45] our healthcare system is failing us. We have a healthcare system that allowed itself to be overly

[00:02:51] influenced by big business interests to the absurd detriment of our society's health as a whole.

[00:02:59] I'm not gonna say it's on any one entity but marketing of drugs is a crazy concept.

[00:03:07] It's something that doesn't happen anywhere else in the world. The FDA,

[00:03:12] fucking drug addicts allowed Purdue pharmaceutical to

[00:03:18] market that oxy cotton was not an addictive substance or that it led to addiction in less than

[00:03:25] 1% of people. This pharmaceutical company was allowed to market a very addictive substance

[00:03:34] that everybody fucking knew was addictive since ancient times. The Chinese were using opium

[00:03:41] back in the middle ages and they knew this shit is addictive. And there was just this whole

[00:03:46] perception growing up, oh you know I'm just stealing some pills from my dad's medicine cabinet.

[00:03:51] A doctor gave him to him. You don't group it with like street drugs but it is exactly that.

[00:03:58] Since Jimmy Carter and Reagan they've really been hammering home on the war on drugs

[00:04:03] and then in a sleuth-type fashion we have this other drug oxy cotton just kind of weasel its way

[00:04:11] into the more acceptable path to getting people addicted to it. Back in 1999,

[00:04:21] this is all drug overdoses. We're talking about less than 20,000 by 2010 we're pushing up towards 40,000

[00:04:32] by 2016 we've escalated above 60,000 and by 2020 92,000. 2021 and 22 estimates are well over 100,000.

[00:04:47] Holy shit. That's why our life expectancy is dropping. We've got young fucking people dying left

[00:04:54] and right. Sqeeing that number up a bit. Yeah. Annual deaths from alcohol drugs and suicide in the

[00:05:00] United States. In 1999 about 60,000 in 2020, 187,000. It started with prescription drugs.

[00:05:13] Yep. And it really started with pulling the rug on them and making it so oxy cotton is really

[00:05:22] hard to get. So now what do I do? I'm going to heroin and now I'm fucking doing fentanyl.

[00:05:28] It's absolutely absurd how 1996 oxy cotton gets FDA approved and people start using it for

[00:05:35] chronic pain way over diagnosed. From 1996 to about 2007 when we were in high school,

[00:05:42] that started to be introduced to oxy cotton at a party knowing people that use it and you know

[00:05:48] shit like that. And then the government's like, oh shit we fucking created a monster here.

[00:05:54] We'll put all these regulations in. Who do you think was the patient population who the doctors

[00:05:59] cut off? It wasn't the 50 and 60 year old veterans who had long standing injuries.

[00:06:05] So all the young kids they even had the little what they call them like people drive down to Florida

[00:06:10] just to see pain doctors. Hillbilly pilgrimage is there was this big black market for opiates within

[00:06:17] younger people is 65 year old person's not necessarily going to have the same

[00:06:23] whiliness to figure out where to get opiates off the street whereas a 25 year old doesn't give a

[00:06:29] fuck so a lot of those people ended up converting to heroin users. Do you think pain pills are

[00:06:36] still being over prescribed? Everything in our country is being over prescribed. You had prescription

[00:06:42] opiates and then you had heroin pop onto the scene Mexican cartels really common deered that

[00:06:48] market the people who started making black tar heroin that became so popular they were actually

[00:06:55] a bunch of sons of sugar cane farmers in the Mexican state of not your writ and they were just like

[00:07:01] we don't want to work the fields from sun up to sundown and like barely scrape by making a living.

[00:07:08] Hey we could plant this opium and we could make a lot of money off of it so they're taking over

[00:07:15] that heroin market in the mid 2010s like 2014-15 and then within a couple of years fentanyl

[00:07:23] it's odorless it is super fucking potent very easy to transport the amount of

[00:07:31] respiratory compromise slowing of your breathing that it causes is just astronomical compared to

[00:07:37] even oxy cotton. So that took hold and you keep seeing the drug overdose deaths rising

[00:07:44] and now we're in this kind of fourth wave of ovid and the advent of people using pill presses.

[00:07:54] There's only a certain percent of the population that's going to go for going and getting fentanyl

[00:08:01] or heroin and injecting it even if you've gotten addicted person that might be the line that

[00:08:07] they're not willing to cross. What people do now what drug dealers do is they get pill presses

[00:08:12] you know pill presses. Oh yeah they got the same little marks on them as regular percusset. Yep

[00:08:18] so they get the pill press and then they get the molds that are widely available online.

[00:08:23] Historically not been any big penalties even if the government finds you with a pill press

[00:08:29] and with molds that look exactly like a Xanax exactly like oxy cotton or a vikadin or an aderol

[00:08:37] they maybe put a little bit of aderol in there they put a little bit of vikadin and then they put

[00:08:41] a bunch of aspirin or Tylenol or baby laxative and then they throw a little bit of fentanyl in there.

[00:08:49] So you've got all of these fentanyl lace pills I mean a buddy of mine bought a Xanax online one Xanax

[00:08:59] did one Xanax died because it had fentanyl in it. Benzos by themselves don't sew anybody's breathing

[00:09:07] like Xanax clonopin adevane valium it's one of the reasons we started using them over what are

[00:09:13] called barbiturates like phenobarbital if you've ever heard of that people used to die all the time

[00:09:19] from barbiturate overdose including Marilyn Monroe fucking Dorothy Judy Garland Jimmy Hendrix but

[00:09:26] they switched over to Benzos and Benzos you can take a bunch of them you just pass out and black out

[00:09:32] wake up but not when you mix them with something that slows breathing like opiates now like 50%

[00:09:38] of the opiate deaths have they been so also involved with them these pill presses and these fake

[00:09:45] pills everywhere are just a smorgasbord of random shit you don't know what you're getting.

[00:09:51] That's almost like terroristic you know you're not even trying to create something that has a

[00:09:55] similar effect that's just like you're trying to kill people. So coming about 2014 2015 all the

[00:10:03] sudden we have a spike in the amount of cocaine and opiate overdoses and then you had this huge jump

[00:10:10] from 2017-18 and on because fentanyl is in everything it just started coming in in troves 20,000

[00:10:19] people in 2020 died of cocaine related overdose. You know you're the guy selling the fentanyl

[00:10:25] cocaine. Business has got to die down for you pretty quick. The amount of fentanyl that it takes

[00:10:32] to kill somebody is crazy low take the tip of your pen and dab it into sugar that's the amount

[00:10:40] of fentanyl that can kill a person. That's crazy and these guys are mixing in the big batches all it

[00:10:45] takes is one little crumb to be out of place and you're killing people yeah you may get a portion of

[00:10:52] pressed oxy-cotton or pressed adorol that didn't actually have any fentanyl in it or you might get

[00:10:58] another one that had two or three little crumbs of fentanyl in it. You just don't fucking know.

[00:11:05] Car fentanyl is just a it's elephant tranquilizer and if you're fucking doing car fentanyl you're dead.

[00:11:10] 50 or 100 times stronger than fentanyl. There's like one grain in that little test tube that will

[00:11:15] kill you. That's probably my biggest passion is just growing up in the drug overdose fucking

[00:11:22] capital of the world. Appalachians surrounding regions and not knowing in high school what was going on

[00:11:30] and not understanding in college like oh you know it's just a party drug it's not a big deal it's

[00:11:36] you know kind of like equivalent to smoking weed right like just trying to have a good time.

[00:11:42] It goes back to the marketing that the FDA like it's just example a pill for my dad's pill cabinet

[00:11:49] right it's a big deal yeah lawless to sleep there and then you see the after effects

[00:11:55] like you see your friends go to rehab at best right then we started having friends that died

[00:12:02] yeah or commit suicide because they're in the throes of addiction and that's their only way out.

[00:12:08] Yeah it's sad to see man because I mean we're just kids you know I could see how it all happened

[00:12:14] for a lot of people. I'm lucky I never really liked it but for those that did

[00:12:19] I didn't think there were some like scumbag or anything like oh that's your thing whatever

[00:12:24] it's not that big of a deal it's just not my thing. That was the craziest thing for me was you know

[00:12:29] I graduated high school in 2007 and at that point I couldn't tell you what Oxy Cotton was.

[00:12:36] I went to college away from home to himself Carolina and I remember on Christmas break

[00:12:44] that first time coming back to Louisville and holy shit everybody was snorting Oxy Cotton.

[00:12:53] I considered myself very lucky that I didn't have any source of income or like the money that I

[00:13:00] made was waiting tables or you know doing odd jobs and I had a undergraduate curriculum to maintain

[00:13:07] but some kids who had money available to them so much of that money just went down the drain

[00:13:14] for Oxy Cotton. I do those things like 40 80 bucks a pill. They used to make an 80 milligram pill.

[00:13:20] 80 milligrams of Oxy Cotton is absurd you know they used to make 160 milligram pill and they had

[00:13:26] to take it off the market why do you think maybe because people were fucking dying from it.

[00:13:30] I think I would die if I took an 80. Yes oh you would almost assuredly I think most people

[00:13:38] would die if they just took an 80 out of the blue. Your brain is not used to that type of effect on

[00:13:43] your opioid receptors it ends up causing a downstream effect causing this enzyme to basically tell

[00:13:51] your brain that you don't need to breathe. I never realized that before that there's actually like

[00:13:58] an enzyme in your brain that something's communicating with that will just shut your reading down.

[00:14:04] Whether you are on an addictive drug or not polypharmacy is a ridiculous problem in the United

[00:14:12] States putting people on multiple medications or too many meds. Working as a psychiatrist it is

[00:14:19] absolute travesty some of the medication regimens people are on for medications that really don't

[00:14:25] work very well and you see so much of the Adiroles annex combo you got to get jazzed up in the

[00:14:31] morning chill out at night. How could you be a fucking regular person when they want to

[00:14:36] make rats psychotic because they're trying to study things like schizophrenia or mania in bipolar

[00:14:43] disorder they give rats a combination of amphetamines and benzos and I know people personally not

[00:14:54] just the professional definitely seeing people professionally but I know people who have been on

[00:15:01] that combination of prescription Adirole prescription X that lose their fucking mind they come up with

[00:15:09] these crazy delusions that they have a really hard time of letting go. Probably one of the biggest

[00:15:15] ones for amphetamines especially is that somebody's following me there after me the quote unquote

[00:15:24] in I mean I've had conversations with patients where I'm very straightforward with them and I'm like

[00:15:29] hey man I'm not trying to be disrespectful but you don't have a dollar to your name.

[00:15:35] It's like they're not coming for you you don't have what the people want.

[00:15:38] These delusions go pretty deep sometimes I've had people who are in town from Atlanta because

[00:15:45] they're running away from those people the black SUV is following me I'm like there's black

[00:15:51] SUVs no matter where you're at in the country and they're not following you.

[00:15:55] There's also mild like you see people on that shit that are like oh my friends are talking shit

[00:16:00] about me. Yep blah blah. My spouse is cheating on me. Fating issues that don't exist. Psychiatrist

[00:16:08] and family docs just answering a problem with another medication because it's easy. It's so much easier

[00:16:16] if you come in to see your family doctor oh I've got this headache I haven't been feeling good

[00:16:22] and man this guy's really drowning on about this headache and he's you know 30 years old he's fine

[00:16:29] just take this medicine. The doctor wants the answer to be this medication let me go over these

[00:16:35] quick side effects and prescribe it and let's get you out and move on to the next person.

[00:16:39] What does the patient want to? Hey I don't feel good you're smart tell me what to do

[00:16:46] take this medicine okay that's easy enough and then it'll feel better with something like

[00:16:52] Tylenol that's okay that's not a big deal but when it's annex right maybe you need to unpack

[00:16:58] some other things you got going on instead think about how we treat diabetes in this country

[00:17:03] don't get me wrong there are good doctors here absolutely there are good doctors

[00:17:10] but there's a lot of shitty ones and they mean be shitty for different reasons they may be shitty

[00:17:15] because all they care about is making as much money as they can yes doctors are incentivized in

[00:17:22] a lot of professional or occupational roles to see more patients generate more revenue

[00:17:30] and get bigger bonuses because of that that is absolutely true the hospital certainly would much

[00:17:37] rather you see 100 patients for five minutes a patient as opposed to seeing 20 patients

[00:17:44] for 30 minutes per patient because when they build that insurance company the more time that

[00:17:51] you've spent with that patient the less money they're going to be able to recoup so the doctor wants

[00:17:57] to be able to prescribe something the patient wants to be able to just take something your 350 pounds

[00:18:03] and 30 years old you don't yet have diabetes but you're really moving towards that why don't we

[00:18:11] just get you started on this anti diabetes medicine because you're going to have it instead of hey

[00:18:18] let's sit here and talk about why you're overweight or I don't have time to talk to you about it

[00:18:24] but what I can do is find a good referral source for somebody that can help you work on that part

[00:18:30] of the problem and prescribing exercise prescribing diet writing that shit on a prescription pad

[00:18:38] and saying hey this is what I want you to do if this fails then we can consider medication

[00:18:45] but it shouldn't just be the first and only option the treatment instant gratification like there's

[00:18:52] going to be a deeper way to work out some right and it's fucking easy right yeah it is easy who

[00:18:59] is incentivized by that model big business interests you're getting people in and out you're

[00:19:05] getting pharmaceutical companies their money you can be talking about just medications or you can

[00:19:12] expand it to different imaging modalities and the increase in the number of tests and procedures

[00:19:21] that are done maybe you find something that is totally asymptomatic but then we got to follow

[00:19:27] that up and figure out why there's that tiny little lesion on your MRI but again is not causing any

[00:19:34] problems in a worst-case scenario somebody goes in and tries to do something about it or maybe they

[00:19:41] give you some sort of medication to reduce the size of that lesion or God forbid they go in and do

[00:19:48] a surgery on something that has no business having a surgery done on like for example all of the

[00:19:54] back surgeries I can't tell you especially working in mental health I've got to have seen a much

[00:20:02] higher proportion of patients who have gotten back surgeries pain is a really complex thing when

[00:20:10] you look at parts of the brain that light up when somebody is having a physical pain versus an

[00:20:15] emotional pain there's a lot of overlap I see people with a lot of emotional pain that's like my job

[00:20:22] and on a very anecdotal level they seem to be getting a lot more of these procedures on their

[00:20:28] spine in hopes that it will reduce pain but I couldn't tell you one person who said oh my pain

[00:20:35] went away some people say oh at a milder maybe even modest benefit but most people are still in

[00:20:43] a bunch of pain no always yeah I work in construction almost every guy that does concrete or floors

[00:20:51] has fucked up backs in their addicted pain pills yeah if had surgeries and it doesn't you ever

[00:20:57] heard of anybody getting I remember Tom Cruise saying that he got one that fixed something literally

[00:21:03] might be the only person I've ever heard say that a back surgery fixed something in Tom Cruise probably

[00:21:09] has a pretty fucking good back surgeon like spine surgeon did you ever see uh doctor death

[00:21:15] wondering did a podcast on this neurosurgeon well this guy went through his whole training

[00:21:21] did great on all the tests on paper he was one of those people that get all kinds of interviews

[00:21:28] all kinds of offers this guy's name is Christopher Dunnch he goes into neurosurgery and within his

[00:21:34] residency just highlights of research here research there started a company and you know he's

[00:21:41] going to do great things and really really charismatic guy and many years later they find out that

[00:21:49] well throughout his residency he really didn't do very many spine surgeries so he didn't practice

[00:21:56] his craft he didn't know what he was doing but he portrayed this very confident outward persona

[00:22:04] and of course as a neurosurgeon with a stellar record everything on paper looked great

[00:22:11] as a resident you're always have an attending physician there with you when you're doing these

[00:22:16] procedures so you know they can clean you up or whatever well they looked at the number of

[00:22:22] procedures this guy had done versus other residents like 20% if that he had done way less than the

[00:22:29] mandated number of procedures that ACGME organization is supposed to kind of track so this guy comes

[00:22:37] out of residency and they decide well I know he didn't meet the requirements but he's such a good

[00:22:44] resident and does all this research the other thing is if you're a residency program and you

[00:22:50] have to tell people on the other end who are just starting and interviewing with you that

[00:22:56] ex number of people didn't graduate from the program huge red flag on your residency program because

[00:23:04] the medical students have already been down this road of did I do well enough on the entry's exam

[00:23:08] to get into medical school did I pass all my medical school tests did I pass my three national

[00:23:15] exams that you have to pass in order to keep going so when they get to that residency they're like

[00:23:21] you damn well better be graduating me from residency at the end of this yeah and then I'll pass

[00:23:27] that last test and be a full on certified psychiatrist or family doctor etc etc so Christopher

[00:23:37] Dunch he comes out of somewhere in Tennessee they're like oh fuck it we'll graduate him

[00:23:42] he starts working in hospitals every hospital he works at bad outcomes follow this guy around

[00:23:49] classic narcissist can't admit that any of this could be his fault doesn't have the recognition or

[00:23:54] the morality seemingly to say hey I don't know what I'm doing I might need a little lecture help

[00:24:01] and he ends up killing people like left and right this guy did I think 30 or 40 total procedures

[00:24:07] over like a several year career we'd be at one hospital and they'd realize hey this guy's

[00:24:14] fucking people up like we're gonna have a lawsuit coming our way so he would get not fired

[00:24:20] because then they would have to admit to the wrongdoing which would put them at risk for litigation

[00:24:28] but they also when that dot goes to the next hospital and says hey I would like privileges to do

[00:24:34] surgery at your hospital in Dallas they may even call the old hospital administrators

[00:24:39] but they're not gonna say that he's botching surgeries yeah they don't want the fucking

[00:24:44] bottom of the bed you're the bad press eventually there were enough people that reached out to

[00:24:50] the Texas medical board and we're like hey this fucking guy is killing people or he's leaving

[00:24:56] people paralyzed he is snipping harder he is doing these procedures that he obviously has no

[00:25:02] idea what he's doing because others will come in and do a second operation to revise it and are like

[00:25:08] what the fuck did he put in this person's back there this is not the accepted way to do the procedure

[00:25:15] and all these clips, screws and plates they're in the totally wrong position this guy looks super

[00:25:22] incompetent covering it up because the hospital doesn't want to come back on them

[00:25:27] and so just perpetuates that is the hospital administrative side of things patient care

[00:25:34] is not the top priority at that point it's all about bottom line how much money do we make this

[00:25:40] quarter yeah they're fucking business yeah absolutely I'm not saying that that's how every hospital

[00:25:48] or every clinic or every business interest runs but you can imagine that there's kind of a

[00:25:56] self-selection process there because if those hospitals that are employing the Christopher Dunches

[00:26:04] well he obviously doesn't know when to even recommend surgery much less does he know how to do the

[00:26:10] surgery they are just wanting more surgeries more procedures they want to put in things like

[00:26:17] vagus nerve stimulators which are just something that attaches onto what's called your vagus nerve which

[00:26:24] is connected to basically everything in your body and it just kind of shocks it as a way

[00:26:29] to combat a bunch of different conditions I call it a sham treatment and I'm sure there's some

[00:26:35] VNS people out there that argue with that and there probably is some utility but it doesn't need

[00:26:41] to be this thing that's put in all kinds of people it just doesn't have the proven efficacy and utility

[00:26:50] that as a medical society were taught to use evidence-based medicine not marketing based medicine

[00:26:58] we've got a system where we diagnose conditions way more than anybody else in the world we

[00:27:05] should do the things that from a common sense and an evidence-based perspective makes sense

[00:27:11] and work and constantly evaluate and re-evaluate those things with data with outcomes

[00:27:18] in a perfect world there wouldn't be any financial incentive it would be because it's the right

[00:27:26] fucking thing to do or even just from an intellectual standpoint we want to know more about what works

[00:27:32] and what doesn't at the end of the day is in the end of life who really gives a fuck how much

[00:27:39] money any particular entity makes 10,000 years ago before you have the common currency people are

[00:27:47] living their lives based on what should I do as opposed to how can I figure out how to cheat the

[00:27:54] system to make as much money as possible to have as much of this thing money that is so important

[00:28:01] even though by itself in an apocalyptic situation it's got zero relevance that is how our health

[00:28:08] care system runs we diagnose everybody with all kinds of conditions we treat them with primarily

[00:28:15] medications or other procedures and we just don't use common sense it's too financially driven

[00:28:23] it's not driven by this desire anymore to help people get better to help people understand their health

[00:28:35] somebody get this guy some help

[00:28:44] thanks for listening for more social media content check us out on all social media platforms

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[00:29:09] disclaimer this podcast is for informational purposes only the information provided in this

[00:29:12] podcast and related materials are meant only to educate this information is not intended as a

[00:29:16] substitute for professional medical advice while i am a medical doctor and many of my guests have

[00:29:19] extensive medical training and experience nothing stated in this podcast nor materials related to

[00:29:22] this podcast including recommended websites text graphics images or any other materials should be

[00:29:27] treated as a substitute for professional medical or psychological advice diagnosis or treatment

[00:29:31] all listeners should consult with a medical professional licensed mental health provider

[00:29:34] or other healthcare provider if seeking medical advice diagnosis or treatment or put more simply

[00:29:38] you need help like this guy call your own doctor