00:00:00.000America has only 4.4% of world's population, only 4.4%, yet 31% of all opioid deaths that we have around the world is from U.S.
00:00:30.000My guest today is Dr. Chris Johnson, who is an expert speaker on the opioid crisis, public health advocate, author, emergency physician.
00:00:45.240And every week we talk about who we want to bring up to interview on what topic.
00:00:50.060This opioid topic came up, you know, oxycodone, and many of us have either had direct experience with it or an indirect experience with it, a loss of a loved one.
00:00:59.100It's very painful. But one of the statistics I saw, there's many different things we're going to get into.
00:01:04.640One of the statistics I saw him talk about was the fact that America has only 4.4% of world's population, only 4.4%, yet 31% of all opioid deaths that we have around the world is from U.S.
00:01:20.220So we want to find out why is U.S. This is not a statistic we want to be leading in, and he's the expert in this area.
00:01:26.340So, Dr. Chris Johnson, thank you so much for making the time for being a guest on Vite Tainment.
00:01:30.480Well, thank you for inviting me. I appreciate it.
00:01:32.680Yeah, I mean, that talk you gave on TEDx, TED Talks, was what you had.
00:01:38.280Obviously, you have a charisma, you have charm, but the statistics I was looking at, I'm like, you've got to be kidding me.
00:01:43.560So would you mind taking a moment and telling the audience your background?
00:01:47.500Obviously, I have it here. You garnered the first Physician Award in 2017.
00:01:51.340You've spoken to FDA advisory committees. You've spoken to a bunch of different groups.
00:01:57.320But give us your history and what got you to be wanting to do more research on this specific topic.
00:02:03.760Well, as you mentioned, my background is emergency medicine, and I'm a practitioner here in the Twin Cities in Minnesota.
00:02:11.420And it might be a little bit unusual that some would find, like, why is an emergency medicine physician talking about this?
00:02:18.940Shouldn't we be talking to a pain physician or should we be talking to addiction physicians?
00:02:23.160And there certainly are experts in that area, too.
00:02:25.880But what got me motivated to learn more about this was my own clinical practice in the early to mid-2000s, where I was going to work every day.
00:02:38.360And I found that I really couldn't get through a shift without seeing a patient who was either having some sort of pain exacerbation or complication from opioids, maybe someone overdosing.
00:02:55.580They needed me to give them either, like, Narcan, the antidote.
00:02:58.820Sometimes I'd have to intubate them, put them on a ventilator.
00:03:01.140But actually, more often than not, it was someone on high-dose opioids, such as OxyContin, plus Percocet, another opioid, a short-acting for a breakthrough.
00:03:10.840And they were coming in because they were having breakthrough pain.
00:04:13.620But the country dramatically changed from 1995 to 2005.
00:04:18.440The prescriptions for opioids massively increased.
00:04:23.220And with the massive increase in the prescriptions, you had all these patients who now became dependent or had chronic pain on chronic opioids.
00:04:32.920And they were having problems with it.
00:04:34.840And so, my research at that time was mostly to investigate, is this real?
00:06:32.720And if it went back farther from 1999, if it went back to like 1992, there were only about 6,000 deaths per year.
00:06:41.120And about 4,000 were from prescription, another 2,000 from heroin.
00:06:45.320And that had been stable going back into the 80s and even the 70s.
00:06:48.940And then starting in the late 1990s, early 2000s, you saw it go up and up and up.
00:06:54.000And that corresponds to when the treatment for chronic pain changed and we started prescribing opioids for back pain, for headaches, for arthritis.
00:07:02.520And we exposed this massive new group in the patient population to opioids and caused a great many to become dependent or addicted at that time.
00:07:15.140And then as we started to realize in the 2010s, around 2010, 2015, that prescriptions were the root cause of this increase in dependence and addiction and death.
00:07:29.420And we started to level off the prescribing, but it was too late by then.
00:07:34.040You had already created this population of people who now needed this.
00:07:38.620And as their dependence got worse, as their addiction got worse, then they turned to things like heroin.
00:07:43.760So, that's starting around the 2015, you see the heroin go up.
00:07:47.720And then starting in like 2017, then you have the fentanyl come in.
00:07:54.200And when you have this population that's dependent and now they are getting fentanyl from China and other places that have learned to manufacture this stuff and they ship it.
00:08:05.860And then people who are selling on the, not the medical market, but the extra legal market to these patients who have become dependent from what we did.
00:08:16.080That's where you have this explosion and overdose deaths because when they go outside the regular medical marketplace, you don't know what's in it.
00:08:24.900And that's when you get people might find, they may think they're buying oxycodone pills, but they're actually oxycodone pills and there's fentanyl in there.
00:08:34.040So, that's why you have that dramatic increase even in the last five to eight years of deaths is because that's where it's coming from.
00:08:41.400It's coming from the heroin and the illicit fentanyl.
00:08:43.420Yeah, so how come, how come we're not, I mean, look, I saw the J&J lawsuit that took place, I think, started in 2019, 2020, October 13th.
00:08:55.640And then July 21st, drug distributors and J&J reached $26 billion deal to end opioids lawsuits.
00:09:02.020Are you seeing a major progress being made by both doctors?
00:09:08.400Because you give credit to four reasons why this is taking place, right?
00:09:12.400It wasn't just let's blame the pharmaceutical companies.
00:09:15.100It was four different things that you talked about.
00:09:16.960Are you seeing this being an issue that the folks at the top from the politics or whoever holds them accountable is bringing this up more?
00:09:24.500Or are they kind of looking the other way from your experience?
00:09:27.280My experience is that these settlements that you're talking about, and if you look closely at the settlements, you'll see that how many years that they're paid out over.
00:09:36.500And it's oftentimes seven years, sometimes 10 years that they are making these, you know, these restitution payments.
00:09:44.200OK, but understand that they've made billions and billions on their on their drugs, and they will continue to sell and make billions while they're making these payments.
00:09:54.260So it's really just, yes, the number sounds big and you might say, well, it's better than nothing.