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We have this massive supply of the synthetic fentanyl.
We have this massive supply of the synthetic fentanyl.
It seems to be manufactured mostly in China.
This is not only the worst drug crisis in American history, but it's quite possibly the worst drug crisis in world history.
The standard playbook just is not working.
You know, the DEA, everyone, they want to stop deaths.
They really believe in their mission.
It's just not cost-effective by any stretch of the imagination.
And nothing annoys me more than people thinking that these are free markets.
These are not free markets.
There's no denying that the methadone industry is um just a giant cash cow.
These companies, they do this unethical stuff, and then they get caught, and then they pay the fine, and it's just part of the cost of doing business.
The whole war on drugs, which I think we both agree has failed miserably. What's the answer?
How do How do we stop this? Well, hello everyone.
It's Jim O'Shaughnessy with yet another Infinite Loops.
Today's guest, I I said to him off air that literally I could read all of his accomplishments, but that would occupy about 30 minutes of the podcast.
So, I'm only going to try to hit the highlights.
My guest is Ben Westhoff, the best-selling investigative journalist and publisher of the incredible and incredibly disturbing book, Fentanyl, Inc.
How rogue chemists are creating the deadliest wave of the opioid epidemic.
You've advised virtually everybody that governs this type of stuff.
You've won the 2023 Norman Zinberg Memorial Lecture Awardee from Harvard Medical.
Uh Wow, you're also working on a full-length uh, documentary called Antagonist, which I want to talk about a lot uh, about a drug that blocks the effects of opioids and how many people are trying to suppress that information, which I find evil. Welcome, Ben.
Well, thanks Tim for having me.
It really is an honor and a pleasure to be here.
So, if you if you don't mind, uh, a lot of people are really not aware of just how bad this epidemic is.
So, if you wouldn't mind for our listeners and viewers giving an overview of the opioid crisis, because a lot of people just look at headlines, but the numbers here are are really staggering.
I don't think most people realize that this is not only the worst drug crisis in American history, but it's quite probably the worst drug crisis in world history.
I mean, only you know, 10 years ago we were just seeing a fraction of the deaths we are now, and now it's over 110 thousand Americans likely dying in 2023, just under that in 2022, and the vast majority are coming from synthetic opioids like fentanyl.
Let's talk a little bit about the difference between plant-based medicines and synthetic, because you make a big deal about that rightly.
Um, that the differences are really staggering.
And they can contribute uh, in many cases unknowingly to somebody dying because they they got the dose completely wrong.
Well, for most of human history, there were only a handful of drugs that people used to get high, and they all Some from plants.
Some came from animals like uh certain toad venoms or like by licking a toad, you can have hallucinogenic properties if you have the right toad.
But, it's only in recent years that there's been this explosion of synthetic chemicals.
And um now more than a hundred new new drugs come out every year.
And a lot of them are sort of analogs for plant- based drugs, right?
So, we have um we have fentanyl, which is the synthetic version of heroin, which comes from the opium poppy.
We have uh marijuana, you know, that is natural plant and and now we have synthetic marijuana.
Which is actually it's it's sold as K2 and spice, you may have heard of it.
But, it's not a plant at all.
It's just a chemical that is sprayed onto plant matter and makes people lose their minds.
And so, basically the rule of thumb with all these new drugs is the old version, you know, may have been addictive, may have had its issues, but the new new versions like fentanyl are much much worse.
So, you know, the the obvious question because again, as I was going through, I mean, this is like as as you mentioned, this could be the worst drug epidemic in the world history.
Like, it's big it's bigger than the number of deaths uh that were caused by uh the AIDS crisis, for example.
Uh and and there was a really chilling note where it was the average American is now more statistically likely to die from an overdose than from a car accident.
How How did How did this thing I mean give us some more context around this.
Yeah, it it it really is the thing nobody saw coming.
In fact, even the DEA as recently as 2015 put out their their threats report, you know, the the things to worry about.
And basically what they said about fentanyl was nothing to see here, you know, fentanyl is too powerful.
You know, addicted users don't want it because they know it could so easily kill them.
Um, but they could not have been more wrong about that.
And it was only a year later that fentanyl surpassed heroin, it surpassed pain pills like OxyContin.
And it's, you know, it is a little bit counterintuitive because what's different about this drug epidemic is that it's not demand-driven.
You know, like usually a drug becomes popular because people want it, you know, people want cocaine, people want heroin, whatever.
But fentanyl is supply-driven because it's so much cheaper and it's so much more powerful that traffickers and dealers cut it into other drugs because of its cost savings.
You know, not only does it save them money because it's so much cheaper, but users think they're getting a more powerful drug.
They are getting a more powerful drug.
And eventually that has come all the way full circle.
And now users, you know, who may have been subsisting on heroin, they may have been addicted to heroin for decades, now they've tried fentanyl and it's so much power so much more powerful that they can never go back to heroin.
And so so now all of a sudden the users are asking for fentanyl itself.
And this has been kind of a startling turn of events.
So this brings in all sorts of other variables, right?
So, we have this massive supply of the synthetic fentanyl.
It seems to be manufactured mostly in China, correct me if I'm wrong about that, available fairly widely over the dark web.
Can Can Can you talk Can you talk about both of those issues?
The The Why is Why is China over manufacturing this synthetic drug?
And and like what's going on?
Righty, well, I actually went undercover into some Chinese drug operations, you know, a number of years back for my reporting for Fentanyl Inc.
And at the time, this is 2018, um these variations on fentanyl were still legal.
So, fentanyl had been banned in China a long time ago, but all these chemists had to do was just tweak the molecule a little bit, and they would have what's known as an analog.
And so, an analog of fentanyl, you may have heard of things like carfentanil, um which is like a an elephant tranquilizer, basically.
But, these these fentanyl analogs were still, you know, just as deadly as fentanyl, if not more so, but they were legal in China.
And so, I went to the labs that were operating in this kind of gray area, and they were selling to, you know, Western customers where where these were banned, but they were smuggling them through customs.
Um what's changed is that now China actually has banned all of these fentanyl analogs.
But, what they haven't banned is the fentanyl precursors.
And the precursors are the most important chemical ingredients used to make fentanyl.
And so once you have these fentanyl precursors, you're about 90% of the way towards having finished fentanyl.
And so what these Chinese companies do is they sell them to Mexican cartels.
And the cartels finish the fentanyl and send it north across the border.
And this is really at the heart of this whole drug epidemic in the United States because China sells these precursors so cheaply that the profit margin for the Mexican cartels is just absolutely astronomical.
And they can still sell these drugs on the streets in the US at rock-bottom prices like $5 for a a dose of fentanyl.
So it just seems to me there are so many kind of like breakdowns here.
Um I how how have we become so in the United States?
How have we become so ineffective at interdiction and or uh the variety of things.
We're going to talk about the the failed war on drugs later.
But like but why are we seemingly just not addressing this?
Well, you know, I don't think we were ever that good at interdiction before, you know, stopping drugs from getting into this country.
But now it's just all of a sudden much, much harder.
Because if we couldn't stop 50 lb of heroin from getting into the country before, now the equivalent of that is 1 lb of fentanyl, and so we're not going to be able to stop that.
Um my friend had, you know, this quote that he said, "We We can't even stop drugs from getting into prisons, so how are we going to stop them from getting into a whole country?" Yeah, I saw that quote. I loved it, too.
If we can't stop fentanyl from getting into a solitary confinement cell in a federal prison, how in God's name are we going to stop it from being at a festival, a street festival, and or anywhere else where people seeking these drugs are uh going to be able to buy it very easily.
Let Let me ask a question for for people who are not as uh you know, I I obviously just did a lot of research around that, so I maybe know more. I'm dangerous.
I have the curse of knowledge.
Um but uh how is it that we Are there any legal ways for a person to get fentanyl, or is it entirely a black market trade?
Fentanyl started out as a hospital drug, and it still is a very important medical drug.
Like when men get colonoscopies, they're often given fentanyl.
Um and when uh women have uh an epidural in childbirth, that's often fentanyl as well.
Um and it is the same molecule.
It's the same molecule as the stuff that's on the street, but the difference is that in a hospital setting, you have trained anesthesiologists who measure exactly the right dose.
Um whereas on the street, because this stuff is so powerful, and only two grains of rice can be enough, you know, two grains of rice worth can be enough for an overdose.
Um these guys on the street just don't know how to measure it, you know, at all.
So, you you've you've written uh a lot also about now it's kind of getting into the whole uh war on drugs, which I think we both agree has failed miserably.
Um what What what's the answer?
How do How do we stop this epidemic?
Yeah, I think you you know, you hit on a good point.
Um I call these these interdiction attempts, these attempts to stop the drugs from getting into this country as the new war on drugs.
Because I don't think people realize that tens of billions of dollars every year are spent to try to stop this.
So, you've got, you know, not just customs and border patrols trying to stop drugs from coming in from Mexico.
You've got the State Department, you've got um Homeland Security, you know, even the the Bureau of Land Management, you know, you think about they're the ones who regulate you know, where cows can graze on federal land.
Even they're part of this new war on drugs um trying to capture uh Mexican cartel members, um bringing them to justice in the United States, things like that.
And so, you know, I I have no doubt that all these people are well-intentioned, you know, the DEA, everyone.
They want to stop deaths.
They really uh believe in their mission.
It's just not cost-effective by any stretch of the imagination.
In fact, the more money we put into it, the more people are dying.
Um so, for for me, what I believe after many years of studying this is that there's really only two things that we can do to start moving the needle.
And the first is education.
Um because there are so many people, especially young people out there who don't know what fentanyl is and think that, you know, they can do a drug at a party and they'll probably be fine.
You know, the fact is that any pill or any powder that comes from the black market can, and often is, adulterated with fentanyl.
Uh my second uh thing that I think we should be investing in is medication-assisted treatment.
Because the biggest group of people at risk of dying from opioids and fentanyl are long-time addicted users, you know, and that overlaps a lot with the homeless population, um people who have trauma in their past.
And we have these great drugs, and we'll talk about that later, um for medication-assisted treatment, these great medicines.
But most people don't have access to them.
And you know, when I talk to addicted users, I say, "Well, why don't you go on this treatment?"
And they say, "Well, I couldn't afford it."
Um but they don't realize that there's so much federal money, there's so much state money out there right now that almost all of these these treatment programs are are pretty much free.
You know, uh before we began recording, uh I said that your body of work was so impressive that you've done a lot about hip-hop as well.
But I've invited you back for a separate podcast about that, but I do want to ask a hip-hop related question here.
W- Would one way for education be to like enlist hip-hop artists?
To enlist uh the types of people, you know, not not those horrible you know, this is your brain on drugs.
And you know, they're horrible they're awful, right?
And I I I I remember the book Thank You for Smoking.
And one of the bits in it was they they were trying to make them make worse and worse disclosures on a pack of cigarettes.
And one of the lobbyists for big tobacco was like, "Well, hell no.
Let's do skull and crossbones.
That'll increase our market share by, you know, a million."
And and and I wonder whether whether we could take a different uh tact at education involving hip-hop artists, involving things that might actually get through to the most vulnerable population.
Yeah, I think that's a great idea.
And I have spoken to people who have done it.
You know, there's um Are we allowed to swear on this program? Oh, [ __ ] yes. Okay, great. Yeah.
Yeah, I'm uh on the board of directors for a group called [ __ ] Fentanyl. F U C C.
That is really involved with the hip-hop community, trying to get to into festivals, hip-hop festivals uh to provide education.
And um you know, unfortunately in a big way hip-hop is been kind of part of the problem because, you know, no no rapper would ever glorify fentanyl.
No rapper would ever glorify heroin.
But there is a lot of talk about pills, you know, even like Xanax.
There there was a rapper actually who called himself Lil Xan.
You know, that's that's the level of this glorification.
And I think even these rappers themselves often don't realize that they're this fake Xanax they're buying off the street it it could well have fentanyl.
And and in fact a lot of very well-known rappers have died from that exact thing.
So, let's talk a bit about your documentary because, you know, at Gabe I don't know whether you know about Shawn Ryan's Adventures, but we do have a film division.
And uh when you just said that, like that might even make a really interesting documentary about all the rappers who did in fact die from adulterated fentanyl.
Um but let's talk about your documentary because there is a drug uh that I'm going to let you tell us about uh that, you know, is almost a force field against uh the effects of heroin, other opioids, uh etc. , fentanyl.
And and you're making a full documentary about it. Tell us about that.
Yeah, this medicine is called naltrexone and it's best known as the Vivitrol shot.
And what happens when you take the Vivitrol shot is that it blocks all of the opioid receptors.
And so you could literally take, you know, a syringe full of heroin or a syringe full of fentanyl and not feel any effects at all.
And so some have called it like a wonder drug, basically.
Um it's one of three FDA-approved medicines to fight opioid addiction.
And the other two are a lot better known.
Uh you have methadone and the other one is buprenorphine, uh otherwise known as Suboxone.
And so these are really important medications, too.
I'm not trying to to take anything away from them.
But the problem that some people have is that they're also addicting opioids in themselves.
And so you have a situation where someone is addicted to heroin, they go on to methadone, and now, you know, they're they're addicted to methadone.
And you know, for a lot of people this is this is a much better outcome.
Like if you're getting your, you know, your supply, your safe supply of what you need every day in the form of methadone, that's much better than robbing and stealing out of the street to try to get street drugs, you know, like heroin or fentanyl.
But on the other hand, um there's a lot of limitations when you're sort of you have to get this medicine every day, you know, you can't it's it's hard to be hard to hold down a job if you have to line up at 7:00 a. m.
to to go to the methadone clinic, for example.
Um Naltrexone the medication that my film is about, um it is not for everyone.
Um for one thing, you have to be completely detoxed from opioids to start on it.
So that can be hard for for people, you know, that's like 7 to 10 days of of withdrawal, you know, so so just clearing that hurdle uh is a challenge for for some people.
But for those people who can um naltrexone is is basically like an insurance policy.
You know, it it it really is like a vaccine.
So when you think about it, it's a 30-day vaccine where you can't uh be affected by these bad opioids.
Is there uh I I am not a fan of command and control and authoritarian measures.
Let's get that out of the way.
Uh but like is there some way where if somebody was undergoing a detox uh that just a part of the protocol was when they were completely detoxed, they they got this shot?
Well, you know, I know there's a lot of pushback against that, this idea that someone, you know, there's a law enforcement requirement or, you know, a a judge is requiring this.
But my contention is that this should be an option, you know?
And there are so many of these kind of rehab facilities where they they dry people out, they detox people, and then they just send them right back onto the street.
You know, I I I had a friend who compared this had an analogy.
He's like, "It's like being pushed out of a burning airplane with no parachute."
You know, it's like these triggers, once you get back out in the street, you're seeing the people you saw before.
You know, there's there's just these drugs are everywhere now.
And so, being on Vivitrol is like having a parachute.
You know, it's it's it's an insurance policy, and it's just crazy to me.
You know, if you read these articles in in the the biggest papers out there, the New York Times, the Washington Post, CNN, everywhere, they always talk about medication-assisted treatment, but they never mention naltrexone.
It's always methadone, it's always Suboxone, and a lot of doctors don't really even I don't know anything about naltrexone at all.
Now, tell us a bit more about that, because from what I've read of yours, there seems to be an actual active effort to suppress knowledge about this drug.
That is what I've experienced, definitely.
And it started at the very beginning of when naltrexone was approved by the FDA in 1984.
So, on the right right then, like the next day, it was on the cover of the New York Times.
It said, "FDA approves this new drug naltrexone."
And the first sentence said something like, "This could really benefit a lot of addicted opioid users."
And the second sentence said, "But, anyone who has any sort of liver issues, as almost everyone in the substance abuse community is is prone to, um, won't benefit from this because it's it's very dangerous to take if you have liver issues."
So, that that is not true.
That, um, was planted there by, um, by people who are affiliated with the the methadone lobby.
And, you know, the the there was even a black box warning placed on naltrexone packaging that said, you know, "Liver warning, shouldn't take this.
I couldn't or could cause liver damage."
Um, and so that that kind of set the tone.
And from the start, there's been a very concerted effort to to sort of suppress naltrexone in favor of these other, you know, frankly more profitable drugs.
I mean, methadone, like I said, just to reiterate, it works great for a lot of people. It's very important.
But there's no denying that the methadone industry is, um, just a giant cash cow.
You know, um, until recently, uh, Bain Capital, um, you know, Mitt Romney's company, owned more methadone clinics than any other than anyone else.
And, you know, I as you as you think Bain Capital is worried first and foremost about the lives of addicted users, you know, I've got a bridge to sell you.
Um, and and and that that's still true today.
There's there's so much profit that's being focused on, um, this the the methadone lobby, they've got a a page about naltrexone.
They supposedly offer it, too, in their clinics, but their whole page is full of all this misinformation, outdated information about how naltrexone could literally kill you.
Um, you know, it's it's not it doesn't it's not too complicated to put the puzzle pieces together.
But, uh you know, presumably those are legitimate uh uh businesses, right?
Wha- why can't the uh regulatory bodies that govern the regulation of those methadone clinics, for example, Wha- why can't they say, "This is [ __ ] Take it off the uh Take it off the box.
Take it off everything that you're doing."
Well, fortunately it was.
Yeah, that black box warning was removed.
So, that's So, that's good news.
Um What is What What's most controversial about the methadone industry um is that there's no other medicine where you have to go to a specific clinic, a specialized clinic to get it.
There's no other medicine like that.
And so, there have been, you know, bills, most recently a bill that would allow doctors to prescribe methadone, you know, just like any other drug.
But, you know, that that just the the the the lobby is is firmly against that.
Um there methadone is a uh is a generic drug, so that's not necessarily where the money comes from, but it comes with the counseling services that are provided at these clinics.
It comes from the billable office visits, things like that.
And again, I'm very much in favor of counseling.
Um it's a integral part of medication-assisted treatment, as is, you know, providing housing for addicted users, uh helping them in job searches.
You know, we need to be holistic.
It's There's not just one medicine that's going to be a silver bullet.
But, we need to um we need people need to have options.
And I've talked to so many addicted users on the street.
I just went to San Francisco.
We just filmed uh for for this for my documentary called Antagonist.
And San Francisco, as I'm sure you know, uh has become kind of the public face of the crisis in the whole country.
And there are open-air drug markets, you know, like right near downtown. I used to live there.
It's almost unrecognizable.
Um and I talked to a bunch of users on the street, you know.
I said, "Have Have you Have you heard of Vivitrol?
Have you heard of naltrexone?"
And they said, "No, we We've never heard of it."
You know, so there's We We have all these great tools in our toolkit, so why aren't we using them?
You know, uh I had on one of my earliest podcast, Chris Arnade, who wrote about um the challenges of people in poverty.
Um and, you know, he would ask them, "Why don't you go to this, you know, there are all these things that you can get benefits around, etc."
And, you know, one of the most common responses were they they the way they were treated by the employees at these various government uh facilities was so demeaning and so like you are idiot, a fool, you are my property almost, and you're going to do it exactly the way I tell you to do it, or you're not going to get it.
Now, to me, since we can swear on this podcast, that seems really [ __ ] up.
Is there Is there a like uh Is there a third way that the these centers could be run where where people who are like most vulnerable could could not be demeaned, etc.?
Yeah, there There definitely can be and should be.
I think we're we're seeing some progress on that front.
Um there's a guy who I've talked I'm talking to for my documentary named Percy Menzies who has a clinic in downtown St. Louis called ARCA.
And they see people right off the street, really try to to meet them on their level, you know, and you know, the fact is that a lot of doctors don't want addicted opioid users in their in their waiting rooms, you know, I mean, my my own dad was a doctor before he retired not long ago, and he, you know, he would see these guys, they would keep coming back every month and making excuses about how they needed another prescription, another refill.
And you know, it's hard not to feel some sympathy, um you know, not just for the people, but for these doctors and for these these caregivers.
Um But but but the fact is we have to um take care of these people, and and these are the people kind of at the heart of the epidemic.
And um the you know, we've seen this great rise in homelessness and sort of visible homeless encampments, especially on the West Coast, you know, I've been doing all this reporting in Seattle, Portland, San Francisco, Los Angeles, San Diego, you know, it's all getting increasingly visible, and you know, there's there's a lot of talk about affordable housing, and that's definitely a big problem.
But you know, this drug crisis is is rolled right up into that, and we need to be again tackling these problems holistically.
You know, it just seems like almost the perfect storm, right?
Because we have uh an organized lobby that makes lots of money.
Uh you know, the the classic example of regulatory capture, crony uh capitalism in my opinion.
Um you know, I'm I'm a huge believer in free markets and nothing annoys me more than people thinking that these are free markets.
These are not free markets.
These are markets that were captured by the people making the most money on the thing and the regulators are, you know, doing it their way cuz they're making huge contributions.
Like is there a solution to that?
I mean, you know, I don't think there is and and you know, I should say that the maker of Alker excuse me, the maker of Vivitrol has also engaged in what a lot of people have called sleazy practices you know, in terms of marketing.
They market to judges and prison wardens and saying you should only allow the you know, the convicts to take to take Naltrexone.
Um but I I was talking to someone recently who who really had the ear of uh of a big pharma marketers and and what these from inside the big pharma companies they're saying is that like like overstepping, you know, the regulatory bounds like doing unethical stuff like pushing the envelope as far as you possibly can, that's not an aberration.
That's like baked into the business model.
You know what I'm saying?
Like these companies they do this unethical stuff and then they get caught and then they pay the fine and it's just part of the cost of doing business.
So all of these pharma companies are doing it and and I mean, I guess one of one way to help with it might be to give some actual prison time, you know, like the Purdue pharma makers of Oxycontin, none of those people have seen any prison and just paying a big fine is is not much, you know.
Yeah, that's been kind of a theme of mine on not just Big Pharma, but you know, at the last really big banking related financial crisis where people actually went to jail was the savings and loans crisis when George Bush senior was president, right?
And you know, that's called actions have consequences and a lot of those people went to jail and when I was chatting with a friend about the great financial crisis he said what troubles you the most and I said nobody went to jail.
And like so we we socialize losses and we allowed privatized gains and again that is not free market.
That that is anything but a free market solution.
And and so I I wonder you know, obviously big money, so follow the money that you know, it's trite sounding, but it really works, man.
If you just follow the money into a lot of things, you can see, ah, okay, I get it.
I see why this is going on.
But then the other thing is are are we dealing mostly with what we call a marginalized community of of people like or or is this or am I wrong?
Is this affecting people like in the middle class or the upper class to the extent that it is affecting those who are living in poverty?
There's definitely it cuts across all socioeconomic distinctions, all age categories.
Um we probably hear the most about young people who are overdosing and dying just because the landscape is so different.
You know, if I were a 20-something college sophomore nowadays doing the same things I did back in the day, you know, I remember I was at a party one time and someone offered me a pill.
I didn't even know the guy, you know, but he offered me a pill and I just put it in my mouth straight away.
I didn't even know what it was and that's the kind of thing that that could kill me now.
And so, that, you know, we're hearing the most about, but but I do think it is the marginalized people all who are bearing the brunt of this and statistically most likely to die.
So, you know, I'm you have kids.
Uh what do what do you tell your children about drugs?
Yeah, well, that's a good question.
I mean, I think honesty is really important and I came up in the D. A. R. E.
program and uh it was easy to laugh off that stuff because it was so scaremongering and um they they wanted you to believe that just smoking a joint was going to uh send you over the edge somehow.
Um even now, there's a lot of scaremongering around marijuana.
And I think it's important to to come to this with a little more facts because, like I already said, fentanyl can be any powder, any pill, you know, it's a white powder, so it blends right in.
It's it's indistinguishable from cocaine or heroin or mass arson.
But the thing is with marijuana, it's not, you know, there there's there's not a financial incentive, first of all, to spike marijuana with with the fentanyl powder.
It's not making It's not stretching the product the the product further and also it doesn't blend, you know.
Um there is, you know, I have heard records about people kind of distilling down it that fentanyl into a liquid and then putting it into uh a solution that burns at the same temperature as marijuana because that's an issue, too.
Um and there's a lot of police chiefs who insist that people in their community are dying from fentanyl-laced marijuana.
All that said, I have not seen a single credible example of this, you know, I I don't think it's a widespread spread problem.
And especially in this era of legal marijuana that you buy at a dispensary, um there's almost no chance at all that this this legal weed you're going to buy is going to have any fentanyl in it.
So, so I think it's important to to be real when you talk to your kids.
You know, I don't want my kids smoking weed especially, you know, when they're young.
Um but I I it's important to tell them the truth, I think, because they're not going to believe me if I do not do otherwise.
Yeah, and I I I just keep coming back to like the the the people doing this.
I I I don't like to do dichotomies but because I think the world is gray and much of life is maybe.
But like it just seems like pure evil intentions.
And like which you know, here here's another question.
It one of the things that um as I was as I was reading your stuff, I was thinking, you know, drug dealers appear to be like really good business people.
And you know, I guess the question would be can you think of other business people like who are legit who under different circumstances maybe would have been, you know, incredible drug dealers?
Yeah, I think that there are a lot There's a lot of innovation that goes on in the field.
Um I will I traveled to Slovenia for my book Fentanyl Inc.
and um when I got there, everyone was talking about this drug they called ice cream.
And you know, it was ice cream this, ice cream that.
I said, "What is this What is this drug ice cream?"
And I actually got to meet uh the guy who coined the phrase, the creator of ice cream.
And what he had was a a kind of a meth a methamphetamine derivative that, you know, kind of made you all amped up, like that feeling of of being on meth.
But what he did was as a cutting agent, he added a bunch of uh vanilla protein powder into it.
And so when people snorted it, they got the taste of vanilla in their nose and they said it tasted like ice cream.
And so this was incredible branding because he actually tried taking it out.
He took the the vanilla protein powder out and people complained.
You know, so he had to add it back.
So it's it's a rare case where the customer actually wants more adulterants in their drugs.
I'm almost feeling guilty for being a big fan of Breaking Bad, right?
Because, you know, the the color was the marketing genius there.
And of course the fact that it was nearly what, 98% pure?
It might even been higher. Uh-huh.
do you What do you What do you think about shows like The whole education thing, I agree with, by the way.
Um, but I think that the traditional, you know, schoolmarmish, don't do this, it's bad for you, actually will literally increase the number of people who you know, kids especially, like, yeah, lady, [ __ ] you, or man, or whoever is delivering that message.
Like, Could Could you You're You're doing a documentary, so obviously you're a very creative guy.
Is there like could there be a a fictional show that was kind of the anti-Breaking Bad?
Yeah, you know, it's a good question.
I was just act actually talking to a marketing company this morning that's been hired by the state of Minnesota to bring this message to kids, and um there is a big debate.
Um, the the schoolmarm approach is definitely out.
And I think uh trying to meet kids on their level, um but also not glamorize, you know.
Um, we they we talked about this word stigma.
And you know, it's very trendy right now to say we we don't want to stigmatize drug use, you know.
And I think about that, and I'm like, well, why not stigmatize it a little, at least, you know?
Like, there are people out there who are using fentanyl as part of a healthy lifestyle, you know, where they're you know, it's just a little treat on the weekends.
I mean, there probably are people like that, actually, but but the truth is this is this is deadly stuff, and we we need to portray it as that.
Is there any way to at least ensure that the the what I guess we'd call legal fentanyl, right, given given in hospitals, potentially not now, but maybe by prescription for through a an MD uh is can we ensure that that that is clean and clear or or is that also Yeah, that that is. Yeah.
All all of the hospital and medical fentanyl, it doesn't come from China.
It comes from manufacturers in the US.
I mean, the the fentanyl from China is actually really pure, too.
It's not until it gets to Mexico and the streets of the US that it's really cut, but uh you know, one issue is diversion, you know, of medical-grade fentanyl.
And so, if you go on the dark web right now, you can buy fentanyl patches you know, that are completely pharmaceutical-grade, you know, and um and people use them recreationally.
And you know, it's a big problem for anesthesi- anesthesiologists.
Like, they were the first addicted fentanyl users really in the country, and there still is a lot of misappropriation, you know, replacing the fentanyl with water, for example.
Um so, that's continues to be an issue.
So, like, wow, what a thorny, difficult problem on so many different levels.
Um I you know, maybe thinking back to the documentary idea about the hip-hop stars and rappers who died because of this.
Uh you know, maybe maybe that kind of stigmatizing uh uh type of entertain- what looks like entertainment, but actually delivers a message as well.
Because like, it just seems to me that the the the standard playbook just is not working. And Yeah.
I I think um some of these stars really illustrate your point.
Um a lot of these rappers There was There was a guy called Lil Peep and he had pills all over his videos, you know, they were like pill bottles rolling around in the cars he was driving and every the images were like hyper-saturated with these pastel colors, you know, it almost felt like being on pills.
And there was a rapper called Juice WRLD who who rapped about taking pills and he even rapped, I'm probably going to die from these pills.
You know, and then he did.
Um and so um it's it's it's really hard to know when the glamorization, you know, because all of these movies that 90% of it is like they're having a great time, they're getting high, you know, it's it's it's parties and glamour and then the very end of the movie they say, "No, this is bad."
or or someone dies and it's it's a tough line to draw.
So, the the other thing that you mentioned as being potentially effective here um is the the general idea of harm reduction.
Um and could you just walk you've already mentioned a few, but could you walk us through a few more of the ways, like I think it was Spain that had such great results with Yeah, Portugal is the best known, but Spain also has has legalized decriminalized drugs.
Um yeah, and so when it comes to harm reduction, the thing people think the most of first is Narcan.
And Narcan is this incredible miracle drug that reduces an overdose, you know, brings people back to life if they've overdosed on opioids.
Um interestingly, naltrexone is actually almost the exact same molecule as Narcan.
It's just instead of being used to reverse an over an overdose, it's used to prevent an overdose.
It's given prophylactically.
But that's a that's a side note.
But uh another thing that's coming into, you know, popularity are these supervised injection facilities.
And these are places that are staffed by doctors and nurses where people can go and use drugs, you know, and then they won't be prosecuted by law enforcement.
And you know, there's there's movements to you know, needle exchanges.
These places are have been gaining speed for for a while now.
The basic idea behind harm reduction is that, you know, we can't stop people from using drugs, so we might as well help use them safely.
And the harm reduction movement has been one of the fastest growing, sort of most quickly adapted to movement I've ever seen, you know.
It reminds me almost of gay marriage, for example, you know, where it's like 50 years ago, 80% of the population was against it, and now suddenly 80% of the population is for it.
You know, harm reduction is almost the same thing.
Whereas even Republican governors and Republican states are all adopting harm reduction and tactics.
And so now I think the burden is actually fallen on the advocates for for harm reduction because San Francisco, for example, is one of the cities that is the most friendly towards harm reduction in the whole country.
And you know, the problem is is just gotten worse there, you know.
I mean, it's gotten worse everywhere else, too.
So I don't think you can say that these measures aren't working, but but but I don't I'm afraid that I don't think harm reduction is is going to be a panacea, unfortunately.
I wonder about that because as one who lives in the New York City area, uh I was out in San Francisco not too long ago and I got to tell you, I was truly shocked by what I saw.
I mean, like literally it looked a lot of like they looked like zombies.
And you would think that that kind of shocking um visual that there would be some way that they could use that to get people to be like, "Holy [ __ ] we we really have a problem here."
Yeah, the San Francisco issue is really confounding to to lots and lots of people and you have, you know, big companies that are pulling up stakes and and moving out of out of San Francisco and you know, their employees are don't want to go have lunch in the area.
You know, um I talked with the DEA special agent in charge in San Francisco, you know, based in San Francisco and I just walked to work.
He was like stepping over, you know, people passed out, people using fentanyl or meth right in front of him.
You know, and he's the head of the DEA.
And uh it's really, you know, I've heard other people say in Portland like, you know, it's illegal to smoke cigarettes on the streets in some places, but you could you could smoke fentanyl.
Um and that's, you know, a lot of that is changing like in Oregon and they just passed a new law.
Um I think it's a misdemeanor to uh have a small amount of fentanyl.
uh have a small amount of fentanyl. But in San Francisco, you know, there there is a there there's kind of these competing ideas, you know, the idea of the war on drugs still lingers heavily in people's minds and all this like
incarceration for weed users, you know, and people put away for for these crazy sentences for small drug offenses, you know, you know, black people, brown people more likely to face these penalties and and this this really lingers in people's minds and they don't want to return to that. But but
But but meanwhile, in real time, you're you're having a situation where, you know, people are coming from out of town, out of state, you know, I talked to people in San Francisco.
They're drawn very often to the the the tolerance that the city has, you know, and and tolerance is a great thing for in for in so many ways, but when it comes to allowing people to um hurt themselves, you know, it it seems like it's gone too far.
You know, the conundrum for me is so, for example, I'm a big supporter of all these studies being done with psychedelics, uh specifically for our vets who are suffering from PTSD.
But the deal there is there there set setting, right?
They're they're medically supervised.
They're being done by Johns Hopkins and other major institutions.
And and the the composition of the drugs, uh they're you know, if they're absolutely pure.
I It just seems to me that the the like is there a way that decriminalization and and as as I'm thinking about this, I'm going to I'm anticipating your response is going to be a simple no.
But is is there is there a way that um that decriminalization, in terms of harm reduction, could in some way make it so that the the Listen, black markets The minute you make something illegal, a black market reproduces it at 5x the price, right?
And and so I'm I'm I'm not a huge fan of prohibition, all of those things.
I mean prohibition is a classic example.
The first order of thought was right because you know what?
Back then, the United States did have a very serious drinking problem.
And so they're like, "Okay, we'll just make it illegal."
Well, that corrupted the judiciary, it corrupted the police, it corrupted like it created Al Capone at all.
And and so is is there some kind of cogent plan where you could do a decriminalization but then heavily regulate or that's just a crazy idea?
Well, regulation is and it's not a crazy idea at all.
And in fact, in in some countries in Europe, they have a safe supply of heroin.
So, you have government-distributed free heroin to addicted users.
And um one advantage of that is like it's safe, you know?
And and the truth is if you're using safe heroin, you can live a long, healthy life, you know?
And um but but we, you know, the US is a different animal and we've actually had our own experiment with safe supply here. It's called marijuana.
You know, and and the marijuana is is often regulated.
Um but that has not solved the problem.
In fact, there's there's new problems arising from that.
One is that there's a ton of pesticides and carcinogens in the marijuana that you buy even from, you know, state-sanctioned dispensaries. That's one issue.
Another issue, particularly in California, is that um the black market is still incredibly powerful.
In fact, it's more, you know, in some places the the black market is bigger than the the the regular market, the the legal market.
And so, whether that's because it's been overtaxed or because there's, you know, too much too much regulation.
I'm not an expert on this at all, but a lot of people are saying that the legalization the rollout, particularly in California, has been a big failure.
And these are all things that that we need to consider.
Um we need to get the tainted drugs out of the marketplace.
That's that's definitely sure, for sure.
And so, I am in favor of of of a type of safe supply program for addicted users, you know, and and it doesn't mean just some 18-year-old kid can come in off the street and get heroin.
It means you have to have tried other programs before, and they just had to fail, and then you can try then you can use this safe supply operation.
Yeah, I mean, it just seems to me that we need to think about things that sound crazy.
Like, I'm not advocating this.
I'm just suggesting and the thought just occurred to me, like, could could uh US authorities flood the market with safe versions of these drugs and and drive out, you know, you've heard of Gresham's law. Maybe you haven't.
Gresham's law is an economic rule that bad money drives out good. Right?
And and and so, maybe we could reverse Gresham's law and and flood the market with actually safe uh versions of all these particular drugs. Not advocating it.
Well, I I I just worry that the dealers, again, these wily dealers, I feel like they would quickly capitalize on this, you know, and and still find a way to adulterate the supply. I I I don't know.
I mean, my sense is that we're already flooded with so much like cheap fentanyl everywhere that um you know, it is we couldn't even flood it any more than it's already flooded practically.
So, you know, it it sounds also like we're dealing with an allopathic type situation where we're treating symptoms and not causes.
Um and you know, you you wrote a really excellent book uh about your experiences uh with a little brother through the Big Brother uh association.
And uh his name was Jerrell.
Can Can you tell us a little bit about that? Yeah, thanks for asking.
Um Jerrell Cleveland was my mentee in the Big Brothers Big Sisters program and we were together for 11 years.
We got together when he was eight and I was 28 and uh I watched him grow up, you know, and we we spent a lot of time together.
His family lived in Ferguson and uh you know, Ferguson became most famous when uh Michael Brown was killed by uh a police officer and um kind of kicking off the Black Lives Matter movement.
And Jerrell, my mentee, actually knew Michael Brown.
They grew up in sort of the same sort of completely disadvantaged like, you know, suburban poverty. And you know, that's St.
Louis uh has it really bad where I live.
But uh even the suburbs of St.
Louis now, particularly to the north, are just full of poverty.
And um Jerrell, you know, as he got older, I still thought of him as this great kid, like super enthusiastic, but kind of behind the scenes his life was falling apart.
Um and he was murdered when he was 19. Uh this was in 2016.
And he was murdered just a few blocks from his house.
And when it happened, I was completely shocked.
You know, I like rushed to the scene. I talked everybody. I said, "Who did this?" And nobody knew.
Um the police didn't know either, and the case went cold.
And eventually it became clear that the police were never going to solve this.
And so I started employing my skills as an investigative reporter to find out what really happened.
And so I started doing all these, you know, searching documents, going to police stations, interviewing everyone who knew him, kind of retracing his steps.
And I, you know, talking with all these guys in prison who actually, strangely, knew more about the case than people who were free on the outside.
And uh eventually I was able to figure out who killed him and kind of bring a sense of closure to his family.
Um unfortunately, the this the guy who killed him was was not arrested because the the witness to the crime refused to testify.
But but but all this informed my book, which is called Little Brother, you know, which which it's you know, it's kind of like a who done it, but it's also really an investigation of like generational poverty and how, you know, she and I lived just a couple miles apart, and how was it that I was kind of on this track of like safety and stability my whole life, and he was almost kind of doomed from the start.
And you know, that that brings up the question actually two questions for me.
What do you think that Americans most misunderstand about the nature of poverty in this country specifically?
Uh, I think there's this idea that like, you know, you can get out of it, you know, America is the land of hopes and dreams and uh, you can overcome your circumstances and just got to apply yourself a little bit and uh, that's the American dream.
And I'm sure it does work out for some people.
But for the vast majority of people, the situation you're born into is the situation you're going to die in and you know, part of that has to do with uh, just how difficult it is to to to pull yourself up when you've got all these other things pulling you down at the same time, you know.
Jarrell, he his family had like food instability, you know, he was like using his money from mowing the lawn to like keep their refrigerator full, for example, a lot of times, you know, there was a shooting, he was shot at getting off the bus one time, you know, it's like I was worried about he was failing out of school and I was helping him learn about the Great Gatsby, you know.
But it's like when he's getting shot at getting off the bus, you know, learning about the Great Gatsby is not really the top of his issues, you know.
Yeah, no, I would guess they would not be.
Um, so so what what what do you think the single most impactful thing that people who are listening or watching us right now, what do you think the the single most impactful thing that if they wanted to try to do something to help, what what would that be?
I really am a big proponent of Big Brothers Big Sisters, and um you know, especially men, they're they're really looking for male volunteers like all the time.
And uh you know, women too, but particularly there's young men who need mentorship.
And you know, I think I got just as much out of it as he did, you know, like I got to see these places I would never see.
I got to learn about his life, his the world he lived in.
Um you know, I was a hip-hop fan.
He was He introduced me to all this music I never would have known about otherwise, and it's not always tangible, you know, I mean, I blame myself for his death, you know, which is is a lot of people told me is ridiculous, you know, but I I thought I should have been there.
I should have seen the warning signs.
But even despite that, you know, you know, it it just brought so much into my life and I think his life to have these relationships.
And I think the biggest issue right now is that the you know, the wealthy people and the poor people just live apart, and there's now you know, never the twain shall meet.
And I think you know, you could write a check to some nonprofit who says they're doing something and sure, there's a lot of great nonprofits doing great work, but if you're really putting yourself in these situations, really seeing how the other half lives, um then you can understand what's really needed there. You know what I mean?
That that's the way to to put yourself into it. That's my advice.
And uh what has what you when you were doing the investigation which led to the book, um Little Brother, uh it did what you learned about him affect how you interact with other people?
Uh, yeah, definitely, you know, uh I in some ways it it kind of made me cynical because he presented himself to me as like this great kid who never did anything wrong basically.
He only told me about the good aspects of his life.
And so going back and learning about all this stuff, it turns out he was using heroin, um he had a gun, you know, all this stuff I never knew about him.
Then he was kind of recklessly using this gun in the neighborhood.
Um it did make me more cynical, but it it kind of reduced my um sense of purpose to try to to help help with these issues, you know, and not just kind of like say, well, these are intractable problems, nothing I can do about it.
Um I I kind of went against that attitude.
Yeah, that that that can often be one of the hardest things after um you know, learning things for the first time that are are not so great.
Uh, the it seems to me the natural default is to cynicism and and like, eh, these are intractable problems.
Uh, what do you hope that the movie accomplishes in terms of uh the impact that you if you if you like you could have the ideal impact from this movie, what would it be?
Well, you know, I want to save lives.
Um I think that um the the opioid crisis is just unlike anything we've seen and people who are addicted should have a real option.
They should have choices about the medicine that's available.
I want people to know what the what's out there and I want them to know there are resources.
You know, this the again, just like poverty, this opioid crisis is not some nebulous thing that's out of our control that is happening by itself.
I mean, with with the right decisions on a policy level, with enough sort of love and compassion, um there are real ways to help real people, and I want this film to show that.
Um I think that uh anything that we can do, like this film, for example, uh where we present these facts uh in a way that is very much not the reefer madness style that was tried, uh are probably great ideas, uh because you're probably going to be able to connect with your with the people that most need to see this type of thing.
If it's if it's presented in a in a more entertaining way, you know, couple that with uh trying to figure out like the harm reduction, I think makes a lot of kind of sense, but then you've got the alternative with San Francisco looking the way that it does, and people just who don't think about it a lot, they immediately are like, oh, well, no, we that's harm reduction? Yeah, no, thank you.
Um and and you know, the there's also the history, you know, Nietzsche said, uh beware the person whose urge to punish is strong.
And and I do think that we have a little bit of that from our Puritan past.
I think it it it it's lessening, uh thank God, uh but there is a bit of that going on as well.
And so, it just seems to me that uh the work you're doing is uh amazingly uh good to raise this issue.
Um and that's another thing.
You know, if if we just get more people talking about this, more I mean, like when I was reading your stuff, I was like, holy [ __ ] I had no idea.
And you know, I had I I had considered myself fairly well informed on some of these issues and then I realized I absolutely was not.
So, thank you very much for for doing that work.
Um well, we're we're closing.
Look, we're already after our our 1-hour time here.
I'm sure that I'll think because I've already invited you back to talk about hip hop and and maybe even talk about how hip hop could help alleviate or at least ameliorate this this problem.
Um so at the end of each of our podcasts, we we we wave a wand and we make you the emperor of the universe.
And you can't kill anyone.
And you can't you can't put anyone in a re-education camp.
But what you can do, uh Ben, is you can have a magic microphone and you can say two things into that magic microphone.
And the next morning, whenever their next morning is, all 8 billion people on the planet are going to wake up and they're going to think to themselves, I just had the two best ideas and I'm going to start doing that today.
What are you going to incept in the world's population?
I think when it comes to drugs, yeah, any pill, any powder from the black market fentanyl.
I think if everybody had that in their head, it'd be a much safer place.
Another just sort of random thing um from my colleague Ethan Nadelmann, he said if he could, you know, I'm going to steal this from him, if he could wave a magic wand and get everyone in the world who smokes cigarettes to switch to vaping, he said that would be the biggest public health gain in world history.
And, you know, I I'm certainly not advocating to start on vaping if you're not doing it already.
But, um, you know, it's it's it's it's much safer.
It's still got nicotine, which is addictive, but it doesn't have the the carcinogenic element.
So, maybe that's, uh, the other one.
The I both excellent, uh, things to accept.
Uh, yeah, that has always driven me crazy with, you know, nicotine itself actually has some pretty beneficial, uh, effects on the human body.
It's the delivery system that's horrible.
And it when when I saw the whole thing when vaping started out, I was like, "This is amazing.
This is like, as you said, this could be the biggest health public health thing ever."
And then all of a sudden, again, follow the money, all of the bad uh, news about vaping started coming out and that seemed like a very coordinated campaign as well.
Um, tell tell us, uh, what's next for you after the documentary.
Well, I'm writing, uh, this crazy novel, uh, that kind of addresses all of these issues.
It's about drugs, my first novel.
So, um, I'm working on that.
But, uh, you know, right now I go around the country, I give, uh, talks about the fentanyl crisis and they include my slides from my undercover operations in Chinese drug labs.
And, um, I speak at, you know, behavioral health conferences, universities, you know, summits, things like that.
And um I've been really happy to do this work because it it helps bring these complicated issues to break them down in front of audiences.
So, so those are kind of the two main main things for me. Fantastic.
Well, Ben, I think you're doing a great job.
I think the more people hear about this, the more people hear about how severe this problem really is, the better.
Um so, thank you for coming on.
And next time we'll be talking about hip-hop and maybe we'll also talk about how that might affect uh the problem over here.
Ben, thank you so much for being on.
Well, thanks, Jim, and thanks for all the great work you do, too. I I love the podcast. Thank you.