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The methadone industrial complex killed the cure · Cultural Wars | America Out Loud News

• 0:08
  We've learned anything from these past couple of years.
• 0:12
  My problems that personal medical freedom and liberty are in prices.
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  American pulse brings together the top experts in health care related fields to keep you up being ahead.
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  Eastern.
• 0:39
  I'm Dr.
• 0:39
  Wolverbach here to Unpack Meth Innovations and give you actual insights into the world of medicine and health.
• 0:45
  I'm honored today to have with us Percy Menzies.
• 0:48
  He is in St.
• 0:50
  Louis Pharmacologist and the head of assisted recovery center, I believe.
• 0:56
  But he'll tell us a little bit more about his career, his bona fides, his interests, and uh how we possibly overlap in our views of addiction.
• 1:04
  So thank you so much for being with us, uh Percy Menzies.
• 1:08
  Thank you, Randy, for inviting me.
• 1:11
  I believe that this was uh really uh it was fate that brought me into this field.
• 1:18
  I came as an immigrant from India and started working for a pharmaceutical company whose claim to fame was developing a range of medications from the opium poppy.
• 1:30
  Obviously, the first medications were developed as super heavy-duty pain medications like oxycodone, hydrocodone.
• 1:37
  Okay, and in the quest to develop a non-addicting medication, they discovered this drug naloxone or narcan.
• 1:46
  And little did we know at that time that the discovery of Narcan would usher in the birth of a new class of opioids, it's almost an oxymoron, it's an opioid, but has no opioid-like effects.
• 2:02
  So that was the product, that was a product they developed, and later on they developed a longer acting form of narcan or naloxone called naltrexone.
• 2:12
  I came into this field, you know, because of my background in pharmacy and I was an instructor in pharmacology, I was very intrigued by the interplay of the opiate receptors, the endorphins were just recently discovered how these interplay in really in helping patients in helping the body mediate pain and pleasure, and also when that goes awry, how addictions you know explode.
• 2:39
  And here I am given the task to start promoting these medications and and educate the medical community about what these drugs are.
• 2:49
  So I really believe it was fate that brought me into this field, and I also realized later on how in C how very outdated the field was that there was very little concern, unlike other medical fields like cardiology or neurology, which which really lives on um with a frontier mentality.
• 3:14
  Here we were very much in a very archaic system archaic mentality, archaic situation.
• 3:20
  So there was no enthusiasm for these medications.
• 3:24
  I mean, I would have we were expecting that there will be the medical community will just you know will embrace us with open arms, tell us more about these medications.
• 3:34
  Instead of that, we face this uh bursts of hostility and rejection saying that you are threatening our livelihood.
• 3:44
  So that's how I got into this field, and this year is the 25th anniversary of my clinic, and I this was my after 18 years in pharmaceutical sales and management.
• 3:55
  I followed my calling to determine to change the field that we have we understand the neurobiology of the neurobiology of addictions, we know how drugs work.
• 4:07
  Why still in this uh in the state that we lose over a hundred thousand people to alcohol?
• 4:15
  Well, the most recent figures is 180, 178,000, and we lost about 80,000 people to opiate addiction, and we think we are doing good.
• 4:29
  So there's a lot of things there.
• 4:30
  So when you talk about the fact that that um naloxone hasn't been adopted medically, obviously there are some uses for it.
• 4:38
  Um you are well, then I always get confused with naltrexone and naloxone.
• 4:43
  First of all, you can maybe describe for us the difference between those two, how they came about, which one was first, and which one is used in your um as a resource for addiction, how they are used.
• 4:54
  But you know, we we hear about you know, Narcan being out there, and we we hear about kind of recovery kits that uh police and schools and so forth are gonna have on board uh to help reverse opiate uh uh overdose and so forth.
• 5:07
  Um, so there are some ways in which it's used, and obviously, Suboxone um is a formulation to treat, you know, as it were, uh, to treat narcotic addiction, opioid addiction, and has um an element, obviously, in the name Suboxone and naloxone and so forth.
• 5:23
  Um, so maybe go over those things.
• 5:25
  And obviously, you know, there are some uses from what I understand in alcoholism as well.
• 5:29
  So there's kind of a lot of uh things, you know, balls in the air there.
• 5:32
  I don't I don't want you to juggle them all simultaneously, but maybe pick a one or two and see if we can you know help uh hone the argument a little bit for our listeners.
• 5:40
  Absolutely.
• 5:41
  So naloxone was discovered rather accidentally, and rather than in an attempt to develop a non-addicting opioid, but what they found was this was a powerful medication that would reverse the effects of opioid.
• 5:55
  So obviously, this was a new tool that in case somebody had overdosed.
• 5:59
  Now we had a we had a very powerful and a very effective medication that would reverse an overdose and give this patient uh you know a fighting chance to get well and get into treatment.
• 6:11
  Now, most people uh do not remember this, but naltrix and naloxone was approved in 1973.
• 6:20
  Okay, it's it is so, but at that time the reaction was intense skepticism.
• 6:26
  So, how can you have a non-addicting drug?
• 6:28
  Because prior to the development of naloxone, every new opioid that came into, which is supposed to be safe and non-addicting, turned out to be just the opposite.
• 6:39
  You saw that with the dilodid, we saw that with pentazocene.
• 6:42
  Remember Tolwin.
• 6:44
  All these drugs were supposed to be non-addicting in a matter of months, they became street drugs.
• 6:50
  So there was this skepticism that naloxone will take the same path, and that was not the case.
• 6:56
  But by the time naloxone was introduced, the opiate addiction had pretty much ended in the US.
• 7:03
  The Vietnam War had ended, the you know, the the USS had successfully Nixon has successfully shut down the the narcotic, they are the heroin labs in France.
• 7:15
  So if you look at the figures around 1973, 74, there were only about four to five thousand overdose deaths, and heroin was pretty much restricted to some of the inner city communities.
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  But what people don't realize that then the naloxone has a has three major limitations.
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  One is obviously it can only be given after an overdose.
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  Secondly, it can only be given by a person other than the patient.
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  You cannot self-administer it.
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  And third, it only lasts for about 30 minutes.
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  But the pharmacology of Naltrex of naloxone gave hope to the federal government that we can develop a longer acting form of uh naloxone that would really be a protection that would be a prophylactic medication, because they realized the president Nixon realized that methadone was not for the long term.
• 8:13
  It was a stop gap medication to be used only for a relatively short time, but one thing led to the other, once the genie got out of the bottle, it became so entrenched, and they said, okay, we are now finally coming, if we are developing a medication that is non-addicting, can be used in it, but can be prescribed in a physician's office, and we can finally replace methadone because we know historically that no chronic condition can be successfully treated with an addicting drug.
• 8:46
  Not one chronic condition has been treated that way.
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  So methadone was really the outlier.
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  And naltrexone was supposed to be the answer, and never in the history of medicine do we have two drugs at the opposite ends, methadone and naltrexol.
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  And that's where the clash occurred.
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  That's where Armageddon occurred.
• 9:10
  And when they introduced naltrexone, the methadone clinics needlessly saw this as an existential threat to them.
• 9:19
  They should have embraced it, you know, with open arms and say, hey, we are we have a new tool.
• 9:24
  We can start, we can stabilize patients on methadone, slowly taper them off, and then put them on a non-addicting drug for long-term use.
• 9:33
  And this would also allow methadone clinics to close down because giving a medication a clinic setting is extremely in extremely inconvenient.
• 9:44
  And I think on in some ways, demeaning.
• 9:46
  Can you ask?
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  Can you expect can you imagine expecting a patient to stand in line every morning to take the meds?
• 9:52
  So that was the goal.
• 9:54
  But I did not realize you know how much of a threat it was that they saw this as a threat.
• 10:00
  To them and they killed Naltrexone.
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  But what bothered me even more was they said, let's keep Naltrexum for the well-to-do people, the physicians, the pharmacies, the business executives, the airline pilots.
• 10:13
  And that treatment segregation still remains today, till today.
• 10:21
  Well, there's a lot there.
• 10:22
  I mean, first of all, um, Nixon did a lot to bring about the methadone clinics.
• 10:27
  And I I'm be curious to see, and I have not read this yet, where he uh presented it as a short-term solution.
• 10:35
  Um, and I you know it sounds like you're better informed on this.
• 10:38
  Obviously, I've written on the topic, and and I I know you've read my my work, uh, it's in Brownstone and elsewhere about the you know, methadones being central to the opiate uh epidemic, the opioid epidemic uh that you know had we we consider you know all uh from oxycontin and fentanyl.
• 10:58
  We have recency bias, and we don't really look at the fact that there was essentially, as you kind of hint at um 19 early 1970s, really you know, close to zero uh opiate death going on.
• 11:10
  There, there was uh what I there was a period of what's called now the classic era of narcotic control that somewhat overlap with the prohibition era of alcohol, but it actually preceded and post seated, uh, you know, went on after uh prohibition came and went, but for sure, you know, it was there briefly prohibition, but you know, from the 1910s, really the you know, more in the 20s uh until the 1970s, basically, and or late 1960s, there was essentially zero uh opioid death in the US.
• 11:41
  Now you can never say zero zero um fully, you know, there's always gonna be a couple here and there, but as you mentioned, uh, even into the 60s was isolated in uh high crime, um, usually, you know, blackslash you know, uh Latino areas of New York City, Chicago, and whatnot, uh, a few places, you know, on the Texas uh Mexican border and LA and whatnot.
• 12:02
  Um, but for the you know, for decades, for pretty pretty much half a century, uh, we had gone from the scourge of of opium, um, and the morphine was supposed to be the cure for that.
• 12:12
  So, you know, as you brings up your point about you know, treating a chronic illness with a you know a chronic medication.
• 12:19
  Um, you know, this is everyone's been going uh you know, with one different type of opioid to treat another different opioid.
• 12:25
  And I I've mentioned to you previously that we we don't do that with alcohol.
• 12:28
  If you're an alcoholic, um, and you you know have a I don't know, a fifth of um bourbon every day.
• 12:35
  Uh we don't you know treat you with this nice clear, you know, water like liquid we call vodka.
• 12:40
  We don't do that, we don't do the hair of the dog um for alcoholism, we don't do it for any other addiction, we don't do it for you know, uh Brett Favre, Tiger Woods sex addiction.
• 12:50
  We don't give them a prescription for a call girl uh three times a week.
• 12:53
  Um, you know, we don't have uh junkets to Las Vegas for our gamblers, you know, every month or something like that to kind of wean them off their addiction.
• 13:01
  We tell them to stop, and that's that.
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  You know, we we kind of have this, you know, abstinence aspect for obesity.
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  There was that TV show the biggest loser, and nobody didn't lose weight.
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  I mean, there was one who who was the biggest winner by being the biggest loser of weight, but everybody there, they could say they have an you know obesity uh you know, uh disease or whatever, but the fact of the matter is that not eating, they all lose weight.
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  So there's kind of a unilateral way to get away from things, which is to get away from things.
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  And um, you know, so anyway, so the we did have this kind of long um pause.
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  Uh we didn't know it was a pause at the time of zero opioid death because it was treated with uh different kind of mental paradigm as well as legal and social and whatnot.
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  There, and you know, right now, by diseaseifying, by medicalizing uh addiction, we have created this um lack of agency, lack of personal responsibility in the issue, and at the same time created kind of a cash cow.
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  And I I know you're from India, and uh in India, the the cows are sacred.
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  Um, and so we have our own type of sacred cow here.
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  Once you start an industry such as the methadone, um, you know, they don't want to be uh, you know, they don't want to go away.
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  And this is a uh a problem with all bureaucracy.
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  Ronald Reagan um brought it up uh, you know, really succinctly.
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  I'm not gonna be able to duplicate it.
• 14:20
  Um, but you know, he I think he compared it to zombies, you know, zombies are easy to kill, you know, they're gonna continue on life long after the youths and whatever, but they're but they're nothing compared to the bureaucracy.
• 14:30
  Once you build something up, it's going to be there searching and hunting for its own food for long after your you know initial intention has been worn out or disappeared.
• 14:39
  So then the Nixon point is interesting to me.
• 14:41
  Um, I'd like to read more about that because I, you know, I'm not happy that he fell sway to the concept that all the returning Vietnam veterans who had opioid addiction because there were plentiful opiates in Southeast Asia, um, you know, in the kind of opium uh triangle down there of Indochina, um, that they were going to be perennial narcotic addicts, therefore they needed perennial methadone, so forth.
• 15:07
  People actually, you know, when they came back from Vietnam had a very low rate of addiction.
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  You know, the the only real indicator of of post-Vietnam continued opiate addiction was pre-vietnam mental you know issues and drug use.
• 15:21
  Now, the people who were otherwise you know reasonably healthy um and just went over there and had you know, they they had uh a tough time over there.
• 15:29
  They went for hookers and and blow, whatever, stop the hookers, stop the blow, stop the drugs when they came here because it was a different society and they reintegrated to this society.
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  So humans are somewhat mimetic chameleon aspects, and they can kind of take on addiction, they can take off an addiction and so forth, you know, given the proper circumstances, incentives, and and again, I'm sorry to kind of monopolize here, but you know, the the incentive issue was very much changed um in the 70s and beyond.
• 15:58
  So we have medicalized, diseasified this, we've taken away responsibility, and we've made a huge huge industry for opius in particular to sustain them and maintain them when we physicians, we the medical community, we you know, in this kind of I don't know, methadone industrial complex, you know, not me personally, because I'm kind of a different breed.
• 16:18
  I I wouldn't rather not make money on the back of somebody's addiction if it's not the best thing for that person.
• 16:24
  You know, I wouldn't want to extend somebody's case.
• 16:26
  Let's say I was doing chemotherapy for cancer.
• 16:28
  I wouldn't want person to have cancer longer, so I could, you know, be the oncologist longer.
• 16:33
  I want to cure that person.
• 16:34
  I want to get that person away from me.
• 16:35
  I I can, you know, a car mechanic that you know somehow sabotaged your car so you come back is not a good car mechanic.
• 16:41
  That's an antithetical to the mission.
• 16:43
  Anyway, so enough about me.
• 16:45
  I'm just uh the lot there for you to uh chew over.
• 16:48
  I don't know if you have any thoughts about anything I said.
• 16:49
  Yeah, you know, most people don't uh don't remember this, but the Nixon's war on drug had three distinct aspects to it, had three prongs to it.
• 16:59
  The first prong was interdiction.
• 17:02
  Now, the interdiction occurred one with the Vietnam War ended, so there were no more uh you know, GIs getting addicted to heroin.
• 17:11
  More importantly, he stopped the flow of heroin coming into the US, which is coming through France, and the French Secret Service was involved with these labs.
• 17:21
  And you know, you see we all remember the thriller called the French connection.
• 17:26
  The interdiction worked extremely well.
• 17:28
  That's the reason they know almost all the experts said that finally we have ended the heroin epidemic.
• 17:34
  The second prong was treatment.
• 17:37
  Now, his uh drugs are Dr.
• 17:40
  Robert DuPont convinced him that we know we need methadone for a short time because we need to, you know, the the die, the diehard heroin addicts or the people coming in back from Vietnam, they will need something.
• 17:53
  So that right now the only the drug we have is methadone.
• 17:57
  Now they knew the limitations of it because the studies were done in a very half-hazard manner.
• 18:02
  The way it was it was introduced was very questionable.
• 18:07
  But you know, Nixon opened Methadone Clinics not because he was a bleeding heart liberal, he had a disdain for blacks and hippies.
• 18:14
  So this was a nice way to, you know, offer them this medication, and he also created the DEA.
• 18:20
  And the DEA said, hey, methane is a very dangerous drug, it's good it could be get diverted.
• 18:26
  So they insisted that we that that it'd be restricted and restricted to a clinic setting.
• 18:32
  Well, that's a fascinating thought.
• 18:34
  And we're gonna have to hear more about this just as soon as we come back from our break.
• 18:39
  We're gonna return with Percy Menzies.
• 18:41
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• 21:07
  So welcome back for our second segment.
• 21:09
  We are here with pharmacologist Percy Menzies discussing addiction.
• 21:13
  And we last left off speaking about methadone.
• 21:17
  And I'd like to hear more a little bit about the creation of methadone as a treatment.
• 21:22
  I think we're back in the Nixon era, 1971 or so, when possibly Richard Nixon was fed a bait and switch in the creation of the methadone industrial complex and treatment, thinking it was only going to be short term.
• 21:37
  The third thing was called he created an agency because what do you call it?
• 21:44
  Uh I don't remember that the exobody stands for special action office for drug abuse prevention.
• 21:52
  He created an office and they were given the task of developing two new medications, a long-acting form of methadone called called lamb.
• 22:01
  And the other medication was naltrixone.
• 22:03
  Both these medications were developed with great success.
• 22:07
  But unfortunately, sadly, the methadone clinic saw this as a threat, and both were killed.
• 22:14
  So this is the sad part of it.
• 22:15
  So we all equipped to denounce the war on drugs, but it had certain positive aspects.
• 22:23
  And once methadone, once the lamb L-A-A-L-A-A-M and Naltrixone were rejected, all research into newer medications came to a heart.
• 22:35
  And that's the sad part of it.
• 22:36
  And for a 20-year period, everything seemed to be nice going well until opiates were reintroduced for chronic pain.
• 22:44
  You know about the whole story about it.
• 22:46
  And then of course, all these things happened that they came up with another buprenorphine was another challenge that we're almost um a topic for a full hour of discussion.
• 22:59
  Why they introduced buprenorphine the way it was introduced, it just became fuel to the bonfire.
• 23:06
  Because huge opiate substitution medications are less effective when the supply is not controlled.
• 23:14
  For the first time in history, we had not found a way to control the supply till the supply is growing and becoming more potent.
• 23:22
  So we had prescription opioids followed by heroin from from Mexico, then Camp Fentanyl, now violinitizines.
• 23:30
  And the biggest problem is that people are not staying on methadone, they're not staying on pupinorph because they have too many temptations to use street drugs.
• 23:40
  Yeah, I think I think there's another layer to that.
• 23:44
  I I agree with, you know, I mean, you're more knowledgeable about a lot of the history than I am.
• 23:49
  But um, one additional aspect is the street price.
• 23:53
  You know, uh there was this thing called government cheese.
• 23:57
  I don't know if you ever saw it.
• 23:58
  Uh I actually have seen it.
• 24:00
  Um there were these huge uh rectangular prisms, you know, like a foot, two feet long, um, that were handed out in poor neighborhoods, um, and it was an entire box of American cheese and unsliced and so forth or and and um it was brought to to you know, food pantries and whatnot, it was called government cheese.
• 24:21
  And the idea was um, you know, that was going to help with hunger.
• 24:26
  But as we've seen with, you know, when whenever the food shipments wind up in, you know, in Gaza, um, somebody takes over.
• 24:33
  It doesn't wind up to the populace the way you think.
• 24:35
  All these great ideas wind up getting diverted, you know, and diversion is frankly one of the arms of the DEA um is diversion because that's what happens.
• 24:45
  So the mere fact that that's such a prominent word points to the fungibility, i.e., the changeability, interchangeability, the currency aspect.
• 24:53
  You know, I I could be wealthy coming from Mexico with, you know, I don't know how many I would need to be wealthy, maybe 100 million pesos.
• 25:00
  Okay, they wouldn't stay pesos for long if I wound up here.
• 25:04
  I would take them to the bank, I'd convert them to, I don't know, whatever Bitcoin or dollars or something like that, and go to Europe and turn them into euros.
• 25:11
  All these things are interchangeable.
• 25:13
  And on an opiate basis, uh, what we did was we brought a lot of Mexican pesos um of methadone into the equation.
• 25:20
  And then we brought a lot of, I don't know, euros of I'm just making this up.
• 25:24
  That's not not, you know, uh from those regions per se.
• 25:28
  Um, but I suppose you could say we've brought a lot of renminbi of fentanyl.
• 25:32
  We've brought a lot of, you know, uh of pesos and uh bolivarece, uh Venezuelan, whatever, of different drugs into our country, and they wind up increasing the supply, and that changes the external market price of these you know illegal illicit drugs.
• 25:49
  And so part of my article, which really, you know, uh I mean, I think it should be a book at some point.
• 25:54
  If I can sit down and spend the time, maybe I'll write it with you.
• 25:57
  But um, the the you know, the the external marketplace one once you pour a lot of methadone, which is you know free, you know.
• 26:04
  I I personally don't even know like you know, I I've read who makes it and what, and we don't really hear about where the methanone is created and from what and whatnot, but some place is being made.
• 26:13
  And and what you're in St.
• 26:16
  Louis by a company called Malincro, the only methadone.
• 26:20
  Yeah, I know they make a lot of drug.
• 26:22
  They make a lot of the oxy oxy uh codone as well.
• 26:26
  So I actually literally do know that because I wrote an article on Purdue, uh, which is somewhat counterintuitive.
• 26:31
  I I actually spare Purdue from my um from my scorn because I think they were just the best student in the class amongst all the pharmaceutical companies, and they made um not only oxycontin one, but oxycontin two.
• 26:42
  And both cases were you know abuse deterrent formulas, which worked.
• 26:46
  And an oxycontin was not the method or the modality of of narcotic abuse or death and whatnot.
• 26:52
  And so they were the best student in the class, and they got the wealthiest, you know, like Elon Musk or Jeff Bezos, you know, they made they made the most money because they were most you know inventive and whatnot, and they also had the biggest pockets, so they were first one killed.
• 27:03
  The way the EU goes after Elon Musk every time he sneezes because they they can and they want to and one and they probably go after Jeff Bezos, too, and they go after Microsoft whenever they can, because those are the ones with the money, like Willie Sutton's paradigm about banks.
• 27:16
  Um, so you know, there's a lot uh there, but you know, the the fact of the matter is that this increase of government cheese methadone and government cheese suboxone doesn't sober people up.
• 27:29
  You know, we don't have an alcohol abuse problem growing.
• 27:34
  We have one.
• 27:34
  We have a baseline alcohol abuse problem for whatever it is, and we can talk about whether you know how much of it's a problem, all that kind of stuff.
• 27:40
  But alcohol's been around for a while, it's legal, bartenders sell it.
• 27:43
  So it's basically an unregulated marketplace.
• 27:46
  You can go to liquor stores, we call them package stores here.
• 27:48
  Uh, you can go to the bar, you can go, you know, a party, uh, you can, you know, whatever.
• 27:53
  There's a lot of booze around, and it's an issue for the people who overdose on it, clearly, and people who ruin their lives with alcohol, whatnot.
• 27:59
  But for a lot of people, they don't.
• 28:00
  They're using it socially, they go to bars, they have a go to watch a Super Bowl game, they get a few drinks, they go home, they're happy.
• 28:05
  People mate and date based on alcohol.
• 28:08
  You know, a lot of people would not meet and greet uh their spouse and whatnot.
• 28:11
  If they didn't kind of break the ice with a uh shot, you know, whatever, a glass or something like that.
• 28:16
  Uh, I think the Red Sox in their uh first victory 2004, they admitted, you know, to having a shot of uh whiskey before the games, it loosened them up, limber them up.
• 28:25
  So there's some usage for kind of like this, you know, relaxation phase that people go through.
• 28:30
  And clearly the uh opiates have you know mimic our own you know pleasure system, they're called endorphins when with within in us and morphines when they're without you know outside us, um, uh opiates and so forth.
• 28:42
  So clearly there's there's kind of a biological benefit to some of these things to a certain extent.
• 28:46
  Um, but but once the market gets flooded with this government cheese, if you put government cheese in a lot of places, what happens is it gets diverted and stores take it and they sell it and it changes the marketplace of cheese.
• 28:57
  It lowers the price of cheese elsewhere because the people who sell real cheese or you know, I don't know, public, I mean, uh private market cheese, uh all of a sudden have this huge influx of a government product, and it distorts the marketplace.
• 29:09
  And I think the same thing happens with with methadone and with suboxone, and moreover, when when addicts go into treatment, they don't get sober.
• 29:16
  So their baseline need if the methadone clinic is closed or they go on a trip to you know from Boston St.
• 29:21
  Louis or vice versa, they can't get in the clinic, they wind up shopping for stuff and and they have a need that is never addressed because they never hit sobriety.
• 29:29
  And so I think there's a real fault of the system because in fact, you know, the system as it is, the methadone industrial complexes I've labeled it, you know, makes money by keeping the patient.
• 29:40
  Starbucks doesn't want people to stop drinking coffee, you know.
• 29:43
  Um, I mean, whatever the industry is, they don't want you to stop doing whether, you know, I'm not saying you know, you're addicted to airlines, but they have frequent flyer miles, so you come back, use that same airline, Starbucks.
• 29:51
  You know, they they they have coffee, it's addictive, it's easy.
• 29:54
  You know, there are a lot of models for this.
• 29:55
  Cigarette companies, you know, they have to have a warning on it, but the product is addictive.
• 29:58
  And I think the same thing holds.
• 30:00
  Holds true for narcotics in this world, but it's just not as obviously commercial as Starbucks.
• 30:06
  Right.
• 30:06
  You know, with you know, with methadone, um, and also this whole thing is based on because there's such a stigma to that.
• 30:13
  And you know, when you talk about let's not use stigmatized language and so on, then that makes sense.
• 30:18
  But people overlook the fact that once you are you have when you're dealing with a stigmatized disorder, you are completely open and vulnerable to exploitation by you know, by special interest group.
• 30:31
  For instance, telling a patient with the with the opioid with an opioid disorder, you now have an you have an incurable disease, you need methadone, like a like a diabetic patient needs insulin, it is completely irresponsible.
• 30:45
  Why is it that you know when the methane clinics they're not they're not being they're not started using uh buprenorphine, naltrexone, lamb, you know, if you're running uh you're a cardiologist, you will use a whole range of medications to treat.
• 30:59
  You don't say, I'm sorry, I only treat I only use digitalis here, or I only use comed in here.
• 31:05
  You use the whole range of medication.
• 31:07
  Why is it that the methylone clinics only use one medication?
• 31:11
  And the way it is offered is even more is even more troubling.
• 31:17
  You've had the same price of whatever dose you're given.
• 31:20
  So if you're uh you're taking a 20 milligram dose or you're taking a 200 milligram dose, you pay the same price.
• 31:27
  That is that is completely illogical.
• 31:31
  So there's a perverse incentive to keep them on a higher and higher dose.
• 31:35
  And because these opioids will cause uh you know build up tolerance, they have to take a higher and higher dose, but that just puts the patient from the frying pan into the fire.
• 31:46
  So these are the questions I always ask.
• 31:49
  Why is it that you know we have we have not changed these kind of things?
• 31:53
  Now, methadone clinics were supposed to really be for a short time.
• 31:57
  Now, yes, methadone is very helpful for many patients, don't get me wrong, but it cannot be the only medication.
• 32:05
  And even physicians who claim to be experts on that, they are they they barely understand the difference between an agonist, an agonist antagonist like buprenorphine and an and an antagonist like niltrexone and so on.
• 32:19
  Many of them don't even know why naloxone was added to the formulation of suboxone or bufinorphin.
• 32:25
  They think that you know it's safe by so if they added naloxone to make it safer.
• 32:30
  So those are the kind there's so much misinformation that goes on, and the victims unfortunately ran the other patients.
• 32:37
  Yeah.
• 32:38
  So just to go over again, a few maybe uh ground strokes here.
• 32:42
  Um the naloxone, my understanding is it was added to suboxone so that it would not be injectable.
• 32:49
  Yeah, that would not divert it.
• 32:51
  It's not really a therapeutic dose, it's a very small dose of naloxone.
• 32:55
  But I also want to talk about kind of the the base derivation of you know, when you you call it an opiate antagonist, is it an opiate itself, naloxone and naltrexone?
• 33:04
  And what is you know, would you how do you get naltrexin from naloxone?
• 33:08
  What's the original core product from which all of these things generated, whether it's methadone, um buprenorphine, whatnot?
• 33:14
  Are they you know synthetic opiates?
• 33:16
  Um, are they do they come from the poppy, the opium, whatever?
• 33:19
  And is naloxone or naltrexone itself uh in any way give you a high if you were like baseline sober to begin with.
• 33:26
  You know, if I you know sit sat here today as a sober individual, which I am, frankly, um, and I took naloxone pure or naltrexone pure, would I experience anything on a uh you know kind of mental basis?
• 33:39
  Good question.
• 33:40
  There are drugs, you know, the the most valuable plant for humankind for human beings is opium, and the opium poppy or the opium, which is we derive from the opium poppy, is an extremely valuable substance.
• 33:55
  Now, the two naturally occurring substances in opium are morphine and codeine, but the most valuable what is called for chemically we call alkaloid is a non-effect is a non-active alkaloid called Thibae.
• 34:09
  And Thebane is the starting material for about 12 different medications, starting from oxycodone, hydrocodone, hydromorphone, all these are derived from Thebane.
• 34:19
  Also, by modifying the structure of Thebane, we can change it into a naloxone and naltrexone.
• 34:28
  And I really take issue that the federal government should never have called naloxone and naltrexone, opiate antagonists, opioids.
• 34:37
  It's a it's a misnomer.
• 34:38
  It's called like an opioid and opioid because it is derived from opium, they call it an opioid.
• 34:44
  But that but the pharmacology is exactly the opposite.
• 34:48
  And being a pure antagonist, it has zero zero agonist properties.
• 34:53
  It will not give you a high, it will not give you any kind of uh opioid like opioid like uh effects on it, except if it reverses.
• 35:03
  That's why we do not even know what is the overdose limit of naloxone and naltrexone.
• 35:09
  Almost every drug has what is called lethal dose uh, you know, of uh fratertous um dose, you do not know what the dose is.
• 35:21
  If they are such safe medications, but they're also can be relentless.
• 35:25
  If you are actively using opioids and they give you naloxone, it will reverse the effects.
• 35:31
  So I described, you know, we have been very fortunate and we are not utilizing them very effectively.
• 35:37
  It's very rare in medicine that the first opiate antagonist, naloxone, is will reverse the effects of every known opioid under the sun if given in time.
• 35:49
  It is rare, and naltrexone will prevent every known opioid from activating the opiate receptor.
• 35:57
  You take one pill of naltrexone for a 24-hour period, no opioid can enter your brain.
• 36:04
  You can bind with their opiate receptor.
• 36:07
  So a side question, um, we'll get to the difference between naloxone and naltrexone and how one's derived from another pharmacopharmacologically, but um there are as we mentioned previously the endorphins, uh, which are your own pleasure molecules, and obviously, you know, we are guided by those things.
• 36:24
  That basically it's our reward system, you know.
• 36:26
  Uh if you watch uh on whatever sport you watch, whether from cricket to baseball to football to hockey or you know, whatever every sport has some kind of scoring system, tennis and whatnot.
• 36:37
  And so people have a totally different appearance when they've won versus when they've lost.
• 36:42
  And the people who win, uh, you know, they understand the score and they've worked really hard, and it's a culmination, and it's uh you know, it's not the same thing, but it's this in a sense, orgasmic um joy.
• 36:56
  If they they have just an incredible pleasure, and the person who could be have have worked out just as much on the other side of the field is miserable, they're in tears, they're weeping.
• 37:04
  So if you watch super all the end of the super, they all pretty much exerted themselves equally on the field, you know, by position, you know, you know, the the one offense line reverses the other teams, you know, not much different as far as the the calories they burn, uh their exertion, their size, all that kind of stuff.
• 37:20
  You know, you could probably interchange them, and the result of the game wouldn't have been that different.
• 37:24
  But one guy's miserable, the other guy's happy because something happened, and so that's a reward system.
• 37:28
  You know, it's not beyond exercise.
• 37:30
  Obviously, there's you know, we get um these kind of orgasmic units, the endorphins from proper exercise.
• 37:37
  You know, we we have the runners high, so forth.
• 37:39
  So, but they all everybody on the field had the runners high.
• 37:42
  The guy playing tennis, running around pretty much 98, 99% as much as his opponent has exactly exactly the same runners high.
• 37:49
  And in the end, one guy's miserable, the other guy's happy.
• 37:52
  Because in addition, there's this satisfaction, accomplishment high.
• 37:56
  And so we get even higher based on following the tracking system, the reward system that is either providential uh by design, applied, uh, social, however, you want to call it learned, doesn't really matter to me.
• 38:10
  I think pretty much across the board, every animal has this reward system, and they don't go to school, uh, then some of them don't have parenting.
• 38:16
  A lot of fish don't never you know, see their parents, they don't know what it what it is to be, whatever they are, and yet they have to, you know, go and succeed and learn how to hide, learn how to mate, they have to do all kinds of things along their fish uh or avian or mammalian pathways, whatever it is, we all kind of have a reward-based system.
• 38:33
  So given that, so here's the question, um, which is um, you know, if you have this thing that's an opioid blocker, you know, are you going to be blunted?
• 38:43
  You know, and not that it's the same thing, but I was reading a uh hearing today of somebody who went through the transsexual pathway, and um he, I don't know, so he or she, whatever, I don't, I'm not sure that this person knew whether he or she anyway, miserable because unable to achieve orgasm because the the proper pieces had been taken away and an unpropitious um uh prepuberal point, which is yeah, tough tongue twister to say, um, and not as twisted as what happened to them.
• 39:09
  Anyway, so you know, do you blunt if you take if you law let's say I don't know, you're out of 15 years old, somehow you want to prevent uh you know heroin or something like that, or 20, and you start taking the naloxone uh on a regular basis, are you gonna be preventing the natural kind of uh pathway towards you know these uh endorphins, which are you know similar to the exogenous endorphins, which are morphines and opium and heroin, all that kind of stuff.
• 39:37
  It's a good point.
• 39:38
  And this is this I get I get asked this question over and over again.
• 39:42
  So when you block the opioid receptors, the endorphin system, okay, what the body does because the pleasure system is so is so vital to to the well being that they have redundant systems, so there are other systems called the endorphins called the encaffelin system become.
• 40:00
  Active.
• 40:00
  Now, in response to the opiate block of the blockage, the body will develop new opiate receptors.
• 40:08
  So, and that they get the pleasure back.
• 40:11
  So, I describe naltrexone as a medication that restores the endorphinic homeostasis.
• 40:18
  Now, on the other hand, if you're if you're constantly, if you're on a on an opioid of an agonist drug with this chronic, you know, with his oxycodone or methadone, your body's endorphin system gets suppressed.
• 40:30
  The only way you can feel quote unquote normal is by taking methadone.
• 40:35
  So people don't realize that that's why an opiate um agonists are notorious for suppressing the gonadotropins in men, the follicular stimulating hormone in women.
• 40:46
  That's so most drug addicts, even methadone patients, they have very low sperm count, they have low testosterone levels because opiates are notorious for suppressing gonadotropids, and many of them are asexual.
• 41:01
  Again, we're gonna have to take a break, but you are leaving us with some very stimulating and interesting thoughts.
• 41:06
  So we're going to talk a little bit more about methadone, the bait and switch that created the methadone industrial complex, initially given to us as a short-term treatment and has turned into an industry during which time the opioid epidemic really took off.
• 41:24
  So stick around with us for our third and final segment with pharmacologist and addiction treater, Percy Menzies.
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• 43:17
  Welcome back to our third and final segment.
• 43:19
  I'm Dr.
• 43:19
  Landabach here at Impact Myths, explore innovations and give you actual insights into the world of medicine and health.
• 43:25
  Firstly, we're familiar with Kane and Abel and Jekyll and Hyde.
• 43:29
  It seems like methadone and naltrexone come from different sides of the same family.
• 43:34
  Tell us a little bit more about Naltrexone, please.
• 43:37
  The drugs like Naltrexone will restore the homeostasis.
• 43:41
  Now you enjoy a meal, enjoy companionship, you enjoy exercise, becomes more meaningful.
• 43:49
  So this is the this was the kind of um misinformation that was uh you know that was perpetrated saying that this is this is an opiate blocker, it makes you into a zombie.
• 44:00
  It's just the opposite.
• 44:01
  There are physicians who go back to to doing surgery to do that.
• 44:05
  If you're a physician, you cannot go back and practice medi practice medicine if you're on methadone.
• 44:11
  But naltrexone is a perfectly effective drug and has no none of these effects.
• 44:18
  So all these are the very important to understand that, but there are special interest groups who had made it into almost like a cottage industry to slander and malign these drugs, saying you need you know, you uh you heard me say earlier, methadone is like like uh insulin, which is nonsense.
• 44:37
  There is no comparison whatsoever.
• 44:40
  No, that's true.
• 44:41
  You know, Vincent Dole and uh Nicewander, uh I don't know if they were a couple, I think were they a couple.
• 44:48
  They they got married later on.
• 44:50
  Yeah, fair enough.
• 44:51
  Anyway, um, you know, I don't know if they personally started, but at Rockefeller University, uh similar researchers, and and I think their third partner, I can't remember her name.
• 45:01
  Um Mary Jean Kreft.
• 45:05
  Yes, how do you spell that?
• 45:08
  Yeah, um, you know, they they use that that insulin analogy endlessly, and it's it's and then it just carried on for years.
• 45:14
  You just hear this over and over again.
• 45:16
  This, you know, our opiate usage is disease.
• 45:18
  This is basically just like uh you would never take insulin away from a type one diabetic, et cetera.
• 45:23
  You know, the analogy I I make in my book and whatnot is you know, if Joe and Fred um get arrested in I don't know, Istanbul or something like that.
• 45:32
  It was that movie I can't remember.
• 45:33
  Um Midnight, uh Midnight Express.
• 45:37
  Um, let you know, they get arrested, they're put in jail because they're you know, whatever, shady and they're they're in the drug trade or whatever, and they get put in jail to Americans.
• 45:45
  It's not a happy place.
• 45:46
  They take away all the you know, the authorities take away all their needles.
• 45:49
  And turns out Joe also happens to be a type one diabetic, and Fred isn't.
• 45:55
  You know, they both have their heroin needles, and they take away all the needles, and Joe's like, oh no, no, I need some of those needles for my insulin.
• 46:01
  Like, no, no, no, no, you're lying, you want needles, blah blah blah.
• 46:04
  So they lock them both away.
• 46:05
  So in my thought experiments, this isn't the movie.
• 46:07
  This is my thought experiment, you know, Joe uh passes away in two weeks because he doesn't have any insulin and he doesn't make any, and he has you know a true genuine need for a needle in the form of insulin.
• 46:19
  Um he's dead.
• 46:20
  You know, two weeks later, Fred, you know, he gets over the sadness or whatever, you know, he actually looks a lot better than when he got pulled in because he got away from the drugs, he's not scavenging, he's not you know ruining his life, he's not avoiding you know proper nutrients, etc.
• 46:33
  In the pursuit of this one, you know, orgasmic stimulation um by injection.
• 46:38
  So it's kind of a misattribution of the endorphin pathway, it's a disrespect.
• 46:42
  I I also made this short video when it was actually hard to make videos.
• 46:46
  Now you can make one in the blink of an eye.
• 46:48
  Um, but I I made this kind of cartoony kind of video like 20 years ago or more when I was treating people, and I call it um uh porno or the prom.
• 46:58
  Um, I mean, I'm not that wasn't really the title, but basically that was the essence of this show, which is you can do porno or the prom.
• 47:06
  Let's say you're a high school um I don't know, 16, 17-year-old, whatever, and the prom's coming up, and you're a guy.
• 47:12
  Um, you could ask somebody, but it's you know, that's a lot of tension, you know.
• 47:15
  You're you're nervous, you don't want to be rejected.
• 47:17
  Uh you maybe you're awkward, you got a few uh zits or something like that, and you're like, oh my god, I can't do this.
• 47:23
  Now, if you actually want to guarantee the orgasm, you'd be much better off to just do porno.
• 47:30
  You know, you sit at home and you can have as many orgasms as as your your muscles will tolerate, and you can have them over and over again, endlessly, you know, or you could do the prom, which is no guarantee of of an orgasm, you know, especially traditionally, you know, and some you know, cultures and places right now, um, you know, probably a Mormon uh prom is not gonna guarantee anything like that.
• 47:54
  Um, and so but there's a lot more work again, like the football, the tennis players, all this work, and you go to the prom, but which you know, if you go into the day after the prom, who's happier?
• 48:04
  The guy who did the porno, you know, with with I don't know, 100 uh orgasms, or the guy who did the prom with maybe zero to one orgasms.
• 48:13
  Who's happier?
• 48:14
  Well, clearly the guy went to the prom.
• 48:16
  You know, why is that?
• 48:17
  It's because you know, we we really you know need to have this this kind of accomplishment scaffolding, this lattice, this ladder from which to work our lives.
• 48:27
  And again, that's why the whole system is engineered that way.
• 48:29
  And I think we have done a grave disservice to addicts, you know, by mislabeling them as diabetics essentially, you know, as equally necessary and conjoined uh to their supposed drug and whatnot, when one is an actual therapeutic drug and the other is is a replacement for the lattice work, the framework and scaffolding of accomplishment and joy, which is the prom, not the porno.
• 48:54
  And I think that the the you know, this kind of constant giving them what they supposedly you know have need medically is is kind of a pornoization, it's an infantilization, it's a a coddling, it's it's a zookeeping of the patient, which benefits maybe Malencrot and a few you know pharmaceutical makers and the clinics, and secondarily, kind of the you know, maybe say I hate to use this word, but lazier aspects of the people themselves who just want the drug, and so you can make them happy.
• 49:23
  You know, I'm not saying every zoo animal is unhappy.
• 49:26
  We go to the St.
• 49:27
  Louis Zoo or the Boston Zoo, yeah, but you know, they don't know they're unhappy.
• 49:31
  You know, they're in a zoo, but I I literally, as you were speaking, uh, I'm staring out my window here, and I I I'm not joking.
• 49:37
  I saw a raven or a crow, I always have a trouble telling apart, but a big black bird, we'll call him a crow.
• 49:43
  Um, he was holding a uh uh a mouse in his jaws.
• 49:47
  He's sitting on the roof of my neighbor's house there.
• 49:50
  I've never seen this in my whole life.
• 49:51
  Um, but he's not in a zoo, he had to work he or she, this this bird had to work to get that that treat.
• 50:00
  You know, and I don't know.
• 50:01
  I can't, I'm not a uh a Raven psych psychotherapist.
• 50:03
  I I can't tell if if the raven was satisfied, but I imagine it's a lot of work, they're very low payoff.
• 50:10
  Maybe every few days you you get a reward, but that's got to be satisfying.
• 50:13
  And and then you've accomplished it.
• 50:15
  So what so there's kind of the zoo keep kept way of living, which is the methadone model, and then there's the kind of free form open model.
• 50:23
  Now, the the if the raven were in a zoo, he would have no idea that that there's any other way but you know, having some guy bring around your dose for the day of food, you know.
• 50:32
  And I think this is what we've done.
• 50:33
  We've zookeept uh a lot of our patient coderie at the benefit of you know, I mean, they're they're alive in there, but uh at you know, benefit to the to the zoo, which gets its funding from other means.
• 50:46
  You're exactly right.
• 50:47
  I mean, there's some people would need that, but the way we have maintained this dominance of the methadone clinics, and the sad part of it is that any new medication, and I say this bluntly there's no way in the world we can end the opiate epidemic with just methadone and bupinorphen.
• 51:05
  So you cannot do that.
• 51:07
  Naltrexone has completely been uh maligned and slandered that it even if 10 or 20 percent of the patients benefit from naltrix and we should offer them, not one of them hardly even people who are who are supposed to be members of ASAM do not know the history of Naltrix or barely talk about it.
• 51:26
  They just keep talking about oh, it may turns you into a zombie, you know, if you're on Naltrix and you stop taking Naltrix and you could overdose and die because it increases your uh your vulnerability to an overdose, all sorts of things.
• 51:39
  So we have gone with the but yet the number of people that have died is shocking that in the last 20 years, or a million people have died from an opiate overdose.
• 51:50
  And if if that was the case that they needed insulin, what happened to the GIs that came from Vietnam who are addicted to heroin?
• 51:57
  Less than five percent continued using heroin, others were able to go on with their life and lead a very normal life without having to go to a methadone clinic or any kind of treatment.
• 52:08
  So the body is an amazing body's amazingly resilient to for to cure and get well if you give them an opportunity, but by putting them on a replacement medication, you're doing a great disservice to them as the only alternative.
• 52:23
  Yeah, and so Michael Knowles uh points out the the similarity in the root word of libertine and liberty.
• 52:30
  Um, and he's a podcast guy.
• 52:32
  I listen to Daily Wire.
• 52:33
  Um, but I think we we've done the same thing here.
• 52:36
  We've um taken the libertine, which is the people running out and doing drugs or whatever, and having this kind of like kind of crazy phase, which I think is part of youth or young adulthood to a certain extent, a lot of trial and error and so forth, and kind of reinforce the error phase, you know, the trial and error, trial and error.
• 52:54
  And people will learn from that if you give them the right pathway and the and the right, frankly, rewards as well as punishments.
• 53:00
  The the thing about the you know, classic era of narcotic control is there were punishments, and we've taken away kind of the blame game uh for a lot of things, and and you know, shockingly, we shouldn't be shocked, but we get more of it.
• 53:12
  You know, I have an article uh called um I can't remember the name, but it's basically on the on the concept of mental health parity, P A R I T Y.
• 53:22
  Yes, and I seen that uh and and what happened is that uh in the 2000s and beyond, well, I started in the 90s, but 2008 it got uh institutionalized.
• 53:32
  Um, that that you know, any kind of mental, you know, mental strain was was figured the same as an ankle sprain.
• 53:40
  So you you could see an ankle sprain, you know, a lot of forensic things.
• 53:44
  I mean, you can tell if somebody's got a glial glioblastoma or hepatoma, whatever, but you can't always tell if they've got I don't know, you you fill in the blank ADHD, um, Asperger, whatever, a lot of things, anxiety, so forth, and and what has happened, addiction, um, you know, sexual dysmorphia, all these things have grown enormously when the payment pathway is unfettered and completely open.
• 54:06
  And I see you know, a lot of these things have been hidden from view, and but also abused, and not just drugs get abused.
• 54:12
  I mean, we've seen this huge fraud epidemic, um, ancillary to the opioid epidemic.
• 54:19
  It's been uh talked about um in a lot of different ways, but I don't think it's been talked about enough and uncovered enough that when money is there, people will flock to it.
• 54:27
  So we see all these hospices in LA.
• 54:29
  Uh, we see you know, autism, you know, clinics and whatnot in Minnesota Minneapolis, I'm sure they're everywhere pervasive.
• 54:37
  But I think that the methadone concept, you know, clearly if it outlived the original directive, has been there as a what has become an institution.
• 54:45
  We have you know, addictionology now is a field of practice, and and nobody can do this but that person, whatever.
• 54:50
  Um, and and you're shun, you know, my own practice was you know, pretty much shut down because I espouse something different.
• 54:57
  That addiction is not a disease, it's it's it's an addiction.
• 55:00
  There's a word for it, you know, addiction.
• 55:02
  You can if you want a different word for it, maybe it's like a trauma.
• 55:05
  You know, you can hurt yourself breaking a hip.
• 55:07
  You know, if I god forbid, you know, fall while I'm playing tennis or whatever, you know, I may never be the same.
• 55:13
  I might even, you know, die if you know the wrong injury, you fall off of whatever, but that's not a disease having fall.
• 55:19
  That's a trauma.
• 55:20
  And and uh theoretically, if I survive it, you know, I learn from it.
• 55:24
  It's like, you know what?
• 55:24
  I shouldn't play on the tennis courts when it's wet, you know, I shouldn't stick my finger in the socket.
• 55:29
  You know, we learn from our injuries and whatnot.
• 55:31
  But what has happened again for my zookeeper analogy is that people are kept their buffered and and and kind of mattressed and and cushioned and um you know, bowling guardrailed away from you know getting any better.
• 55:43
  If you always had the guardrails in the bowling alley, you would never probably well, maybe you would, but it would take you a lot longer to learn how to throw a good ball when there's no punishment for you know hitting the sides and whatnot.
• 55:53
  And so I think we've we've done a grave disservice.
• 55:56
  Um anyway, we're we're kind of rounding out our hour together, and I'd like to give you an opportunity to talk about your own treatment pathways and also you know, Vivitrol, which is something I used to put on as a cap to as I was tapering people away from all drugs using Suboxone down to zero, you know, complete sobriety, checking for all drugs and whatnot.
• 56:13
  And then a lot of people wanted something else.
• 56:15
  They wanted a you know, I don't know, kind of a teddy bear or whatever to kind of carry with them a talisman of the the program.
• 56:22
  And I I used to, you know, either do vivitrol or you know, naltrexone as a medication because it was cheaper as a generic if they paid cash and whatnot.
• 56:30
  That's all for today.
• 56:31
  Remember, every myth has a solution and every truth has the power to transform your health.
• 56:35
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• 56:38
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• 56:41
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• 56:43
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