Opioid Epidemic： How Big Pharma Created A Public Health Crisis
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Summary
Dr. Chris Johnson is an expert speaker on the opioid crisis, public health advocate, author, and emergency physician. In this episode, Dr. Johnson talks about how he became interested in the topic, how he got started in his research, and why he thinks we should all be talking about it.
Transcript
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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.
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My guest today is Dr. Chris Johnson, who is an expert speaker on the opioid crisis, public health advocate, author, emergency physician.
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And every week we talk about who we want to bring up to interview on what topic.
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This 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.
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It's very painful. But one of the statistics I saw, there's many different things we're going to get into.
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One 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.
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So 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.
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So, Dr. Chris Johnson, thank you so much for making the time for being a guest on Vite Tainment.
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Well, thank you for inviting me. I appreciate it.
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Yeah, I mean, that talk you gave on TEDx, TED Talks, was what you had.
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Obviously, you have a charisma, you have charm, but the statistics I was looking at, I'm like, you've got to be kidding me.
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So would you mind taking a moment and telling the audience your background?
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Obviously, I have it here. You garnered the first Physician Award in 2017.
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You've spoken to FDA advisory committees. You've spoken to a bunch of different groups.
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But give us your history and what got you to be wanting to do more research on this specific topic.
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Well, as you mentioned, my background is emergency medicine, and I'm a practitioner here in the Twin Cities in Minnesota.
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And it might be a little bit unusual that some would find, like, why is an emergency medicine physician talking about this?
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Shouldn't we be talking to a pain physician or should we be talking to addiction physicians?
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And there certainly are experts in that area, too.
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But 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.
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And 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.
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They needed me to give them either, like, Narcan, the antidote.
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Sometimes I'd have to intubate them, put them on a ventilator.
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But 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.
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And they were coming in because they were having breakthrough pain.
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And I was looking around, I was like, why is this happening?
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I don't remember this in my medical school training.
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I don't remember this when I was training as what's called a resident physician, which is an apprentice physician.
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And I tried to invest, like, why is this, has it always been like this?
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Most people are like, they're just like, oh, I guess this is what's happening.
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Or is it just, I've just been unaware and only becoming aware of something that's been going on for years and years.
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And what I found was that it was, in fact, very different.
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That in 1995, the United States was not like this.
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Yes, you still have problems with opioid addiction.
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But the country dramatically changed from 1995 to 2005.
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The prescriptions for opioids massively increased.
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And with the massive increase in the prescriptions, you had all these patients who now became dependent or had chronic pain on chronic opioids.
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And so, my research at that time was mostly to investigate, is this real?
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Mostly to see, like, what I was seeing every day was not corresponding to what I was taught as a physician in training.
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What I did is, when you started talking, I said, okay, these stats, they don't make any sense to be this staggering.
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This is, as recent as 2019, national drug overdose deaths involving any opioids, number of among all ages, gender, 99 to 2019.
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So, we can't say, well, during COVID, people are sitting around there and there are a lot of different pain.
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I mean, this sudden, I mean, this is not a small trend here.
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Some people would say this is even at a faster growth than the S&P 500.
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So, what caused this level of growth in Americans taking opioids?
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If it included the year 2020, that number from 50,000 or just about 50,000 overdose deaths from opioids would be 70,000.
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So, while COVID happened, all right, the opioid epidemic got much worse.
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And so, even that graph, as dramatic as it is, is out of date.
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And if it went back farther from 1999, if it went back to like 1992, there were only about 6,000 deaths per year.
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And about 4,000 were from prescription, another 2,000 from heroin.
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And that had been stable going back into the 80s and even the 70s.
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And then starting in the late 1990s, early 2000s, you saw it go up and up and up.
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And that corresponds to when the treatment for chronic pain changed and we started prescribing opioids for back pain, for headaches, for arthritis.
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And 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.
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And 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.
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And we started to level off the prescribing, but it was too late by then.
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You had already created this population of people who now needed this.
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And as their dependence got worse, as their addiction got worse, then they turned to things like heroin.
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So, that's starting around the 2015, you see the heroin go up.
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And then starting in like 2017, then you have the fentanyl come in.
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And 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.
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And 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.
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That'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.
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And 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.
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So, 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.
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It's coming from the heroin and the illicit fentanyl.
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Yeah, 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.
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And then July 21st, drug distributors and J&J reached $26 billion deal to end opioids lawsuits.
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Are you seeing a major progress being made by both doctors?
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Because you give credit to four reasons why this is taking place, right?
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It wasn't just let's blame the pharmaceutical companies.
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It was four different things that you talked about.
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Are 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?
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Or are they kind of looking the other way from your experience?
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My 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.
00:09:36.500
And it's oftentimes seven years, sometimes 10 years that they are making these, you know, these restitution payments.
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OK, 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.
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So it's really just, yes, the number sounds big and you might say, well, it's better than nothing.
00:10:02.960
I mean, no executives went to jail and none are going to jail.
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You know, and the Sacklers, the ones who own Purdue Pharma, they just got a bankruptcy settlement and said earlier this month.
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And they are immune to civil litigation for imperptuity now.
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And they get to keep over their many billions they've made.
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So fines seems to be what pharmaceutical companies do and is seen as the cost of doing business.
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And it's a good business decision if you're a pharmaceutical company or if you're a board or a shareholder.
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They're not really approved for what you say they're using, but we're making a lot of money.
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Eventually, someone will impose a fee, but it'll be far less than what we've made.
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And what I want to point out to you and some of your viewers is that this is not the first time that has happened.
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Other drugs have had similarly been marketed off-label, and I'm referring to a drug called Neurontin here.
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Neurontin was marketed by Pfizer as a drug for seizure disorder if the other medicines weren't controlling it.
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But then it got off-label marketed for everything from headaches to ADHD.
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And because of that, it got so over-prescribed and made billions.
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And they had to pay fines subsequently as well, several hundred million dollars.
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But if you're paying 700 million dollars on a drug, you made billions per year.
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The only people that get harmed are the patients.
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Under this agreement, the country's three distributors would make payments of $21 billion over 18 years.
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Johnson & Johnson would pay $5 billion over nine years.
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But can you go back to the perpetuity, which means there is no lack of accountability.
00:12:02.460
Can you unpack what that means when they say it's in perpetuity?
00:12:06.940
So if something happens, if you can unpack that for the rest of us.
00:12:10.420
What that means is that according to, all right, and I am not a, I can't, I can't claim to be a bankruptcy legal expert.
00:12:18.640
But according to the stories I've read about the bankruptcy filing in the state of New York for Purdue Pharma,
00:12:24.780
the Sacklers have been absolved of wrongdoing, and they may not be held accountable for any future civil litigation
00:12:32.320
due to the harm of their product that they caused through exposing them even irresponsibly.
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And remember that Purdue Pharma had to pay, had to pay hundreds of millions back in like 2007
00:12:44.140
for irresponsible marketing of their product, even then.
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So this is, there's nothing new about the irresponsible marketing they've, and they,
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Are these politicians who are helping them do that?
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Who allows these contracts to be written in a way where they're protected?
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Is it, it has to do with the, how the bankruptcy laws are written and they are written true by politicians,
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but the, but remember that politicians are writing these laws that are often made,
00:13:15.380
put together by the lobbyists that represent the corporate business interests.
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So they make the laws very favorable to the business interests.
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And so that, and then you, then you can, now you've got the law in the books and you're like,
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Hey, we'd like to do something, but this, you know, we can't because here's how it's written now.
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And I'm like, eh, just, just out of curiosity, wasn't the vaccine also written the same way
00:13:35.460
as well in perpetuity that if something were to happen, there can't be a level of accountability
00:13:47.600
I saw that where there's a similar accountability where, you know, if something were to happen,
00:13:53.780
say something, there's a reaction, they can't be held accountable either.
00:13:56.640
It, it protects them, but I want to go to this one site that gives stats on what else
00:14:03.840
Um, here's a mass.gov, uh, four out of five people who use heroin began by misusing prescription
00:14:13.740
Uh, similar ones you're talking about, oxycontin, Vicodin, fueling commonly disprescribed pain
00:14:20.300
One in 14 reports they've misused or abused a prescription drug.
00:14:24.000
At least once I was asking my peers here right now, before we setting up the camera, I said,
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how many of you guys have lost a friend to opioids?
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One of them was a teenager because she just got her hands on it.
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I said, was it from the doctor or somebody else?
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One of her friends gave it to, she thought it was something else.
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Two out of, two out of three teens abusing prescription meds say they get them from family
00:14:46.320
So I'll give you one story of a friend of mine.
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Best friend of mine, when I was in LA going to Glendale high school.
00:14:54.000
He, uh, uh, you know, started taking Vicodin and he was getting this Vicodin from a dentist
00:15:02.540
that was selling it to him and it was selling it for whatever the price was.
00:15:06.120
He started off with one, you know, he's having pain.
00:15:10.800
It got to a point where it's taking 10, 20 a day Vicodin.
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Obviously we ended up losing them, uh, uh, years ago.
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And I took him to rehab and it wasn't a good situation.
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I remember one time we're at a, uh, uh, restaurant and he steps out right after we were done with
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And I'm trying to get this guy to kind of trying to figure out a way to change.
00:15:28.040
He goes to his car, pulls into his car and I sneak up on him to see where he's at.
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Cause I knew when he would roll his, uh, when he would talk and I see, he pulls in to take
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I've never heard anybody beg for anything in my life to give to them.
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I've never heard anyone be this week to beg, to say, please give it to me.
00:15:51.600
Can you unpack the level of how addictive these opioids are when somebody starts?
00:15:57.880
So walk me through what the process is and where it goes next.
00:16:01.800
So, Hey, typically it's a doctor gives it to them.
00:16:07.900
Well, what I would, I would, I want to maybe back up on just a little bit here.
00:16:13.440
What it, what is certainly true is that, um, three out of four people who, who three to
00:16:21.040
That's about roughly like who move on to heroin began, uh, their use of opiates with a prescription.
00:16:27.560
And, uh, and I w I, I would also like maybe quantify or push back a little bit on misuse.
00:16:34.700
Um, what happens with opioids is that these are pharma pharmaceutical, these molecules mimic the
00:16:47.820
But our brains are built for physiologic doses, small ones.
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And then we're getting pharmaceutical doses, big ones.
00:17:00.780
The brain doesn't want to feel elation and euphoria all the time.
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It pushes back almost immediately and says, this is not normal.
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And what we know is that very quickly, when you start exposing yourself to opioids is your
00:17:13.540
brain starts to change and it stops responding to them.
00:17:16.760
And it actually develops these processes called opponent processes where they don't work so
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And there was a very important study done in 2016 by the Kaiser foundation and the Washington
00:17:26.680
post that shows people who are exposed to opioids report becoming dependent or addicted
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So it's not so much that they are misusing them.
00:17:37.900
What they're finding is that they are being told they work for pain and then very quickly
00:17:42.680
find out, well, one isn't working for pain anymore.
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And what homeostasis means in medicine biology is that the body wants stability.
00:18:00.260
So these medicines are not working like they were supposed to because the body is pushing
00:18:06.300
And so that's what happens when a person, again, like your friends, starts it out for tooth
00:18:16.280
Your own reward system gets hijacked by these chemicals such that now you make almost no
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Your endorphins, your natural opioids stop getting made.
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And so now when you are without them, your brain says, I feel awful.
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And so that might've led to that episode where your friend is begging because they were in
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pure misery because the molecule that everyone sort of almost takes for granted, you've got
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a regular amount of it keeping you feeling normal, that feeling of normal is gone.
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And that's how dangerous and how destructive they can be that in as little as two months,
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you can change the brain enough to become dependent.
00:19:00.580
Would you say the closest thing to, if we were to make a reference, not closest thing to how
00:19:06.420
addictive it is, but is it kind of like when a bodybuilder or somebody does steroids and
00:19:12.000
their testosterone, they're no longer producing testosterone naturally and they stay on it for
00:19:18.120
Let's just say they cycle, they go six months, 12 months and the body, when they get off of
00:19:24.180
The body doesn't know how to produce testosterone.
0.98
00:19:26.220
Would that be a similar way to look at where your body forgot how to produce that testosterone?
0.94
00:19:32.580
I think that's actually, that's a very good sort of analogy.
00:19:36.420
You might say that sort of a bodybuilder, let's say a male bodybuilder in particular,
00:19:40.780
you know, the sort of, now I'm not a, I like fitness.
00:19:46.000
I do fitness, but I'm not a bodybuilder and I, and I've never done testosterone, but since
00:19:51.020
your testicles make testosterone, what bodybuilders find is that the more they get testosterone
0.99
00:19:55.180
through a shot, you know, from out, from their environment, the testicles shrink.
0.98
00:20:03.920
Why would I bother making all my own testosterone?
00:20:09.480
And so, yes, that is exactly the same mechanism.
00:20:18.580
Who is the most powerful person that is bringing this up and wanting to do something about it?
00:20:27.460
If you were to name a couple of people, when I mean powerful, I mean, somebody that can
00:20:30.980
really move, you know, that can do something about it.
00:20:34.840
I mean, we've, we've, we've got, you know, we've had, you know, the government, governor
00:20:46.440
of Minnesota put together this pain pill problem summit back in 2015.
00:20:52.340
The state of Minnesota is actually involved in a, in a very important effort to bring a
00:20:59.760
I work for the department of human services, opioid prescribing work group, and we're actually
00:21:03.720
now reviewing prescriptions by doctors all over the state and giving them feedback for
00:21:10.820
I mean, even I'm getting feedback, like I never knew how much I was prescribing relative
00:21:17.540
Now I get a report card every year that shows how many am I prescribing?
00:21:23.280
Um, so that's a very powerful effort that is being led by the state of Minnesota.
00:21:28.240
I don't know if it's being done in other states.
00:21:31.060
Um, you know, I, I, I can't say that I know anyone who's really bringing the medical industry
00:21:38.600
It's sort of, you know, or, or to, to, to control it.
00:21:41.300
It's sort of being left on its own to try and regulate itself and, and self-regulation
00:21:45.000
doesn't have a great track record, uh, in this country, whether it's medicine or banking.
00:21:50.180
Um, you know, part of, part of the problem, part of the problem is that if you'll look
00:21:57.100
up at the top five lobbying contributors in this, in this country, it's the American
00:22:02.340
Medical Association, the American Hospital Association, and pharma are in the top five
00:22:08.760
And as a consequence, some of the changes that we might want to see to make medicine more,
00:22:14.200
more, uh, responsible, such as, um, let's interrupt the financial relationships between
00:22:21.680
Let's stop having, you know, uh, just regular fee for service payment that just encourages
00:22:28.780
These things that might, um, reduce the, the sort of business incentive just to keep the
00:22:36.920
None of that is really happening as far as I can tell.
00:22:42.640
We have multiple senators and Congress, people who know friends that know family have had problems,
00:22:46.820
but in terms of changing the overall marketplace, I can't say that I've seen anything.
00:22:51.880
Why, why do you think, I mean, look, I'm looking at right now, Johnson and Johnson, they've said
00:22:54.900
they, uh, suspended supporting any political donations in 2021.
00:22:58.420
But if I go and look at their 2019 and 2020, 2019, they gave lobbyists, uh, uh, 5.83 million
00:23:09.180
At the top is Biden, $370,000 second is Trump 106.
00:23:14.900
So they gave four times more to Biden than Trump.
00:23:17.060
Then it's DNC services core, democratic senatorial, Republican senatorial.
00:23:29.240
If we were to say which side politically they're supporting.
00:23:35.740
And I would say this, like, if you look at the, I mean, remember that, that top five
00:23:40.000
list, you know, you, uh, uh, including those, that goes back year after year, whoever is
00:23:44.480
in power, I'm aware of this, they give to both sides.
00:23:50.180
They have an incentive to make sure that whoever, I wonder who they give to more because of why
00:23:54.800
I wonder if they give right more, if they give left more, I don't know if you've ever
00:23:58.660
investigated this because I think there has to be a reason why nobody in power is bringing
00:24:05.720
I mean, look, we can sit there and, uh, when there's a presidential, uh, uh, person that's
00:24:11.320
running, say governor's running, they typically campaign around something.
00:24:22.040
You got oil, you got immigration, you got wall, you got drugs, you got fight against drugs.
00:24:28.760
You got, how come we're not, if we're talking 70,000, right?
00:24:32.400
You're saying 70,000 in 2020 statistics came out that out of the 660 something thousand
00:24:37.960
people, this was public info out of 661,000 people that died from COVID 5% died with COVID
00:24:46.660
So 5% of 660, you're talking about 33,000 people died as a leading cause being COVID.
00:24:53.640
You're talking 70,000 died last year, leading cause in opioids.
00:25:00.300
How come I don't see it on CNN, Fox, MSNBC wise is, are they afraid of bringing it up or
00:25:05.440
is everybody kind of like hush hush because they're giving us money for campaigns and commercials?
00:25:09.400
Well, there, I mean, I mean, some have been doing documentaries on this.
00:25:15.620
I forget if it was CNN or MSNBC, but understand that when you have privately fund campaigns
00:25:20.960
that are routinely in the millions, tens of millions, maybe hundreds of millions, these
00:25:28.180
They mean, whether you're right or whether you're left, you are often getting corporate
00:25:32.840
donations or corporate interest group donations.
00:25:36.400
And when you, when you take someone's money, it's very difficult to tell them no, or to
00:25:45.580
And these major donors give to both sides so that whoever ends up in power, they don't
00:25:52.480
mess, they don't mess with those, the healthcare system, which right now is very lucrative.
00:25:57.220
And as you probably know, the United States healthcare industry is over $3 trillion a year
00:26:05.200
That's the fifth largest economy in the, in the world, just the, just healthcare.
00:26:09.240
And what you also might know is that we live about the same number of years as they do in
00:26:20.700
So it's not like the, the, the patient in the United States is actually getting a good
00:26:26.360
So we have a very expensive system that is not giving us life expectancy in return.
00:26:31.800
And we have a political system that is often dependent on private donations.
00:26:35.980
And so when they make their, whichever side gets the money, they don't mess with this system.
00:26:43.400
I think it was a John McCain who called for campaign finance reform as well.
00:26:47.680
Sort of getting the money out of campaigns would then make candidates more responsive to
00:26:51.820
the needs of a population as opposed to the needs of corporate imperatives.
00:26:56.520
So, so how much deeper are you going with this?
00:26:59.400
I'm curious because are you, are you going surface level where it's like, look, here's
00:27:06.600
Let's have somebody else go and figure out a way to address this.
00:27:09.380
Are you somebody that's saying, here's what's going on?
00:27:11.960
And you're making the phone call and you're setting up the meetings to present this to the
00:27:27.520
I would, I would say that in my role for the Minnesota department of human services and,
00:27:32.900
and, and, and, and being part of that effort, as far as our legislation to bring better prescribing,
00:27:38.780
um, I am taking that to as high as I can on that level.
00:27:44.300
Now, do I have the ear of, you know, literate leaders and decision makers here?
00:27:53.000
Um, I make it a point to attend the conferences.
00:27:56.880
And when I see people from the DEA come and speak, uh, uh, and I, and I have meetings
00:28:01.180
occasionally with people like, you know, represented Vanjie Craig, believe me, I believe me,
00:28:06.400
I try, um, but, but I, I, I can't say that I have the ear of the, of those kinds of decision
00:28:14.740
makers, though I am open to any and all anyone who will listen, I will speak to.
00:28:21.360
I mean, I just think if so, uh, it's fair to say these numbers are not fake, right?
00:28:25.540
So, I mean, if the government's given us the stats, you're looking at 70,000 people.
00:28:32.380
So if we go from 10 to 70,000 and everybody has a story there, so it's a, it's a, it's
00:28:40.840
And we all know what happens when a person gets heroin.
00:28:43.540
I had a person that told me it's tougher to get off of Vicodin than it is to get off of
00:28:48.060
You know, it's always been heroin is what's tougher to get off of.
00:28:51.180
Historically, it's always been heroin is tough to get off of instead of Vicodin.
00:28:54.620
Uh, how hard is it for somebody once, once they're in too deep to get off of the addiction
00:29:05.520
Um, I guess I don't have the stats on how long it would take this opioid versus that
00:29:12.860
Um, we do have treatment for opioid addiction, which, uh, I talk about, um, uh, I mean, I
00:29:19.500
don't know if I could get into it much in my Ted talk.
00:29:23.420
Um, but the, but medical assisted therapy, that's the methadone, that's the buprenorphine.
00:29:28.200
Um, we know that those treatments are available for people who have opioid dependence, opioid
00:29:33.660
Um, but understand that, um, it doesn't get, it doesn't make things whole again.
00:29:38.980
They, they don't get rid of the change neural pathways.
00:29:41.800
They reduce the cravings so that the people aren't miserable, but the, but the physiologic
00:29:46.960
and the neuro neurophysiologic changes of addiction persist.
00:29:49.980
Um, the study that I quote often to people who are trying to get off those drugs is that
00:29:54.440
methadone and buprenorphine reduce your risk by about a third to a half in the first year.
00:30:04.180
You're the risk of overdose is still very high.
00:30:07.540
Um, and if you look at all cause mortality, not just overdose deaths, but all cause mortality,
00:30:13.060
the risk of death, if you develop use disorder, even getting treatment is about one in five
00:30:17.920
and 10 years, one in five and 10 years, because people who have developed addiction also develop
00:30:31.480
So addiction is not just overdose, all the dangerous life things that happen to you when
00:30:36.100
you're in the midst of addiction happened to you at a higher rate too.
00:30:39.100
Um, I want to go back at least one thing to say about like getting the ear of decision makers.
00:30:44.260
Um, what I would, what I would also say to you, and I think I sent you the, the, the, uh, the information
00:30:52.120
is that even the American medical association is compromised by relationships with the pharmaceutical
00:31:00.420
industry at their board of trustees meeting in 2019.
00:31:04.140
And I brought up their meeting minutes and I sent them along the American medical association.
00:31:08.920
The loudest voice of doctors is partners with Mallinckrodt.
00:31:16.760
Um, so when I, you try to have, you know, you, you try to have a loud voice and reach
00:31:22.760
our politicians and decision makers, understand there's nothing I'm going to do.
00:31:25.840
That's going to have a louder voice than the president of the AMA, but the AMA is compromised
00:31:30.280
by relationships with pharma, which makes the independent voice of protest difficult to
00:31:41.240
Uh, I don't think the CDC is compromised by financial conflicts of interest the way
00:31:46.400
the AMA is, but I, I don't, um, I, I can't say I've looked at their meeting minutes.
00:31:51.700
I mean, if you, I can pull it up right now who funds CDC and you'd be shocked by who funds,
00:31:59.320
So, so, so you, you don't trust them because you think they're compromised by big pharma.
00:32:04.640
I would say that, you know, when you see that on, they have something called a corporate round
00:32:08.260
table and Teva is there, Mallinckrodt's there, pharma is there, all these pharmaceutical companies
00:32:14.160
Um, that is why you've never actually seen the AMA, the American Medical Association come
00:32:20.320
out with a statement, you know, say as early as 2010 saying, you know, in, in looking at
00:32:25.660
the, at the, at the record, we do not see that opioids are providing the benefit of long
00:32:32.200
Um, we make a statement that no, no physician should start further patients on these medications,
00:32:40.100
They've never said that not in 2010, not in 2015, not in 2020.
00:32:45.720
If you look at what the statements of medical organizations typically do is they, they, they
00:32:52.920
There, that means they would like to do their best to solve it, but in a way of solving it,
00:32:57.360
that still allows them to sell more healthcare.
00:32:59.960
Um, so you've never heard, had them call out, you know, the science on, on the pain medicine
00:33:10.340
Um, and in that sense, I do not think they're, they're, uh, uh, their voice is uncompromised.
00:33:15.840
They, they, they are protecting their financial relationships.
00:33:20.660
You talk about Pfizer, uh, you know, all the main ones, Gates foundation.
00:33:25.540
I think even J and J, a lot of these guys are also backing those guys up.
00:33:28.760
You know, what, what makes it difficult when someone like you comes up and you're sharing
00:33:33.260
these things, uh, the, the tough part becomes, who do you trust?
00:33:38.400
Do you sit there and trust these independent organizations that are supposed to do what's
00:33:45.820
They're being funded by these big corporations that can, like you said, if somebody gives you
00:33:52.840
It's not a lot of statesmen left around nowadays.
00:33:56.460
And let me be loyal to them because if I don't get reelected, how am I going to get this money
00:34:07.100
Oh, and I don't even, maybe I said it in my Ted talk too, but like there's lots of studies
00:34:12.120
showing that it doesn't take much to change a doctor's prescribing, you know, about a $20
00:34:17.820
Um, I think there was a journal, the American medical study, yeah, $20 for a lunch is all
00:34:24.680
Um, and in 2019, the journal of the medical association published a study.
00:34:29.100
These guys looked county by county where, where, where, where there was more frequent
00:34:37.000
There was increased opioid prescribing and increased opioid death.
00:34:44.000
Because I've, I've been able to practice medicine my entire career without, without accepting
00:34:47.700
any gifts, you know, in the securities industry, but I would, but I would, I would, I would
00:34:52.880
say that it's, it's, you want, you, there are good people in medicine.
00:34:59.360
There are ethical people in medicine, but what I say, and when I give my talks, I try to remind
00:35:04.160
it's very often what you have are good people in systems where they're, they have bad incentives.
00:35:09.760
They have incentives not to do the right thing point.
00:35:15.460
So the compensation structure is set up in a way where they're tempted to do the wrong
00:35:22.100
That's a scary thought, you know, this is, we saw that in Wells Fargo.
00:35:28.800
I mean, yeah, of course, with the credit card, I totally get the whole, I don't know
00:35:32.540
It was a ludicrous amount, but you know, one thing they did in the financial industry, again,
00:35:35.880
I'm giving you this stuff that maybe, you know, you, you, if you're in this world, you
00:35:41.260
If I'm securities licensed, you know, what my limit is for gifts.
00:35:46.060
I can't give you, I can't get you a gift more than a hundred dollars per year.
00:36:00.020
Now I know the sales part is kind of taken out, but you are dealing with someone's health
00:36:05.500
So should there be an incentive to get the, I don't know.
00:36:09.400
I think it's a different story when I'm dealing with investments versus someone's health.
00:36:13.360
I don't know if I'm comfortable for the doctor to get a gift by a pharmaceutical salesman.
00:36:18.660
Well, there, I mean, there are limits to gifts, but, but understand that there's, it's,
00:36:23.600
it's a very sneaky history about what then compromise, a gift.
00:36:27.820
And you can start to have, you can bend the rules.
00:36:30.560
So say you're not giving this doctor a gift, you're paying them to teach.
00:36:37.160
And all of a sudden these paid speaking gigs constitute teaching.
00:36:43.120
They're not gifts, but for there for a couple thousand dollars.
00:36:46.140
And you might remember the case of Insys Pharmaceuticals, that is I-N-S-Y-S.
00:36:53.180
And they were found to have a sham teaching or speaking program where the people on the,
00:37:01.060
And they got paid to give these quote unquote talks often with only their office staff and
00:37:07.140
So while there are gifts and there, there is the Physician Payment Sunshine Act where
00:37:15.020
You can sort of get around this and say like, okay, we're, we're, this is technically teaching
00:37:19.520
or this is some other service that is not a gift, but it's, you know, we compensate for
00:37:25.080
You know, you have, you have, you know, this is also true in the device industry where you
00:37:27.900
will have orthopedic surgeons on the boards of, of device companies with a new artificial
00:37:32.940
hip and then that surgeon puts in that particular hip.
00:37:36.920
So you, you have it when, when there is, you can have these conflicts of interest in a number
00:37:41.380
of ways that circum circumnavigates the definition of a gift, but I, yeah, that's an ongoing issue.
00:37:49.740
I mean, if, if this is what you study and this is what you talk about and there still isn't
00:37:55.040
anybody in power that is willing to talk about this and bring it up, I've never heard
00:38:00.040
I've never heard anybody get up and as a politician, a governor, a president, a candidate
00:38:18.200
Well, on a, on a individual level or individual patient level.
00:38:22.520
I would want anyone who watches this talk, watches you, watches anyone.
00:38:31.860
We've done, we now have, we should have done the study 25 years ago and we didn't, but
00:38:37.280
We've done a blinded trial to see, do opioids work after a year?
00:38:41.840
And they don't that, that was the space trial S P A C E.
0.88
00:38:46.660
So for someone, you know, who's got back pain, joint pain, understand that they should not
00:38:52.220
be taking opioids with the intention of ongoing treatment and therefore they can protect themselves.
00:38:57.540
I would also let them know that don't even take it for two months or even one month, your
00:39:01.280
risk of becoming dependent goes, is extremely, goes up to like one third.
00:39:05.680
So if you're going to take these medicines, say for like, you've got a, you know, a broken
00:39:14.380
You can take them then, but you, with the goal of being off of them quickly, you take
00:39:22.040
What we also need to do in the immediate term here is, is find a, you know, compassionate
00:39:29.840
treatment for those who probably, you know, through no fault of their own, started these
00:39:35.140
We're told they weren't nearly as dangerous as we thought and became dependent and now
00:39:39.500
we're addicted and now they are using, we need to find ways to get them the treatment
00:39:44.100
Not, you know, not because it's going to cure them, but we were trying to minimize the risk
00:39:49.320
of damage and give them as long and happy life as possible.
00:39:51.700
And that's through things like addiction services, addiction treatment, medical assisted
00:39:57.040
Those are the things we can do on an individual level and we can do as a, as a, as on a medical
00:40:03.420
I still want to reform a political system that caters to the business interests of medicine.
00:40:11.100
I was hoping for like congressional, I was, I was ready to go, I'll go to Congress and
00:40:15.160
talk to them like they did for the mortgage backed securities crisis.
00:40:20.800
They have not had those hearings on the opioid crisis.
00:40:29.700
What's the process for you to get enough signatures?
00:40:31.860
What's the process for you to get enough people to say, because listen, 70,000 people died in
00:40:40.360
That's 70,000 people's brother, sister, cousin, daughter, son, mom, dad, best friend.
00:40:53.400
If that's a stat, how many signatures do you need to get on the congressional to be able to
00:40:58.520
Because when I watch your TED talks, you know, what's the first thing I asked myself?
00:41:09.540
How the hell does this thing only have 40, 45,000 views is not going to make an impact.
00:41:13.440
So what do you need to do to get in front of congressional to get enough people's
00:41:16.900
attentions to say, hey, we kind of want to see what the Congress wants to do about this?
00:41:20.400
I have had relationships with Congress members, you know, Klobuchar.
00:41:31.980
I've spoken with Angie Craig and given talks about this.
00:41:37.140
I don't have, I can't say I have the voice to sort of just call their office and say,
00:41:53.400
I think you've got to play a little bit of offense, maybe go buy a sales book and make
00:41:58.480
the phone call, send the emails, because I think this is that important of a thing that
00:42:01.700
if you've done research on it, you have way more credibility than a guy like me to go and
00:42:06.100
I just have pain in my heart because the person I lost, I love dearly.
00:42:12.960
I lost that person because of this bullshit and it should never happen.
0.97
00:42:15.920
So, uh, I, I don't have your kind of influence, uh, uh, in regards, I don't have the doctor
0.99
00:42:24.220
I think I would encourage, I'm a nobody to encourage you to do this.
00:42:28.640
You have your own family, things that you're doing.
00:42:30.120
I would encourage you to, uh, play a little bit more offense to bring this up.
00:42:34.720
By the way, have you reached out to both sides of the aisle?
00:42:36.880
It sounds like it's only Democrats you're reaching out to.
00:42:39.980
Oh, but those are the ones in Minnesota that are local.
00:42:43.660
Maybe reach out to the other side, maybe somebody on the other side, maybe reach out to if McCain
00:42:48.040
was talking about this, maybe reach out to his daughter, maybe reach out to, I think
00:42:52.000
if you play the laws of numbers and say, can you watch this?
00:42:57.720
I think someone's going to say, yes, I'm just saying, if this is, I, I, I am not, I
00:43:08.180
I don't, all I know is my, we're like, this is what I'm seeing.
00:43:14.180
I think that I don't, I don't have, I can't say that I have the, I haven't been trained
00:43:20.480
on the skillset to get that message out there more effectively.
00:43:23.640
And I am open to any and all in terms of how does one, how does one go about promotion
00:43:35.200
You got, you got something you're talking about that if 70 million died just last year, 70,000
00:43:42.260
My policy 70,000 died last year, 50,000 a year before.
00:43:45.640
Let's say it's 400,000 people in the last eight years.
00:43:49.780
Let's just put that number, give or take, right?
00:43:51.920
400,000, the individual that dies, how many people do they have that love them?
00:44:03.940
You got millions of people that are interested in this kind of being heard by the people at
00:44:08.980
And if I ask you a question, I say, who's the most powerful person that's talking about
00:44:14.480
10 seconds, you were stuttering because you couldn't think of somebody.
00:44:17.740
I think there's millions of people that would like to see this be more of an important subject
00:44:24.420
Maybe team up with somebody that's a good marketer, good on social media, good on the
00:44:28.440
emails, good on contact and good in sales and see if that person can help you get in
00:44:33.500
But I think you're, I mean, we're doing our part.
00:44:36.080
Your message is going to be out there and God knows how many people are going to reach out
00:44:38.580
to you because they're going to say, I heard the message.
00:44:41.240
But on top of that, I think there'd be other people that you can play offense with to get
00:44:47.240
Well, I'm all for increasing the urgency behind this.
00:44:51.880
Obviously, I mean, COVID has, you know, almost 700,000, okay, in the last year and a half.
00:44:58.060
So, I mean, it has basically, you know, it has taken the public health spotlight, obviously.
00:45:05.200
But that's why I can't say, do I know what drugs are, who's working on this right now?
00:45:08.780
Because all the public health resources right now have been dedicated to COVID.
00:45:11.920
You may not understandably so, but there's this other urgent need that hasn't gone away.
00:45:17.360
And I'm absolutely prepared to do all the work that I need to do.
00:45:23.720
I mean, listen, the world can handle, America can handle multiple different crises at the
00:45:31.160
I think if you went into a lecture hall and you asked them to raise their hand, who do
00:45:41.500
That's why I think this needs to get to the next level.
00:45:46.760
Anyways, by the way, if somebody wants to get a hold of you, how can they find you?
00:45:55.080
If it's a website, you can tell us, but we're also going to put it in the description.
00:46:08.400
I don't know if you put a Gmail email on there or is that sort of, there's rules about that.
00:46:12.480
Are they going to be able to find you, contact you through your website if they want to send
00:46:21.680
You can find me on LinkedIn as well, Dr. Chris.
00:46:28.040
We're going to put all of it below because if anybody is watching this and you were directly
00:46:32.360
affected by this and you can have an impact where he can get in front of Congress and give
00:46:44.500
Dr. Chris Johnson, thank you for making the time and being willing to take the questions I just threw
00:46:49.800
your way and addressing them to the best of your abilities.
00:46:52.760
I think you have a message that needs to be heard.
00:46:54.560
And I think a lot of people are hoping this thing gets heard by the right people.
00:46:58.600
Thank you for making the time for being a guest on Byte Taman.
00:47:07.720
Just out of curiosity, do you have anybody close to your friend or family that also got
00:47:11.680
addicted to opioids that you lost because they couldn't stop using them?
00:47:15.820
I'm actually curious to hear your stories and also thoughts on what he had to say.
00:47:19.980
And if you know somebody on a way to get him in front of those guys, let's figure out a
00:47:26.360
But if you enjoyed this interview, I did an interview also with Dr. Jason Fong where
00:47:31.680
He has a treatment for obesity, cancer, diabetes.
00:47:38.280
If you've never watched this, you'll get a different angle from what he has to say.