Here are a few short Takeaways from the conversation with Dr. Gupta
The Evolution of U.S. Addiction Treatment Policies
So like I said, the doctors were not being trained in addiction. In the year 1999, CDC for the very first time reported that 16,000 people have died of poisoning. 106th Congress studied that problem for a year and a half, and a law was passed called Data 2000. It allowed any practicing doctor to take a course, pass an exam, apply for an X waiver, and then they were qualified as addiction providers. That's how I started learning in 2006. So the law states In the first year, after you do all these steps, you are allowed 30 patients per month for the first year, expandable to 100 thereafter. Okay? And that law stayed like that until 2016. And the crisis took a hit in 2016. Several meetings happened in Washington, and they said, We can let doctors take 275 patients, but they put more restrictions, use the EMR, this, that stuff, seven different conditions. Currently 4,300 doctors in this country have a limit of 275.
The Dark Business Behind Addiction Deaths
So I'm going to tell you the sad business portion. If an addicted patient overdoses or is in bad withdrawal, they go to the emergency room. It costs the insurance $20,000, $30,000. If they have no insurance, it costs the taxpayers that kind of money because the hospital has to recover somewhere. Now, the same person dies at a young age of 20, 30, 15, 40, whatever. They have a functional brain, heart, liver, kidneys. Each organ is harvested at half a million dollars. So I spoke in Boston at a physician's meeting in 2016, and I did my, that time kind of old presentation on addiction, not the one I do now, but mine is changing.
Portugal's Successful Approach to Addiction Treatment
10 million people, and they, in 2008, felt that they have this crisis. And so what did they do? They created a central agency and they said, we're gonna treat addiction like any other disease, a chronic disease for long-term. And they felt treatment was not enough and they felt these patients were demotivated to do anything. They just wanted to lay low. So they created programs to reverse their demotivation. Then they rehabilitated it. Then they educated them. They put them into job training and job placement. Everybody is in treatment, what I'm talking about. And now, after 15 years, they have 90% of the budget in treatment and social programs and only 10% in law enforcement. We have it the other way around.
Staggering Statistics on Addiction
So there are two organizations at a national level. One is called Substance Abuse Mental Health Services, and the second is called American Society of Addiction Medicine. The Substance Abuse Mental Health deals with the psych portion. ASM works with the addiction portion. They both say, as of now, this year, 49 million people in America are at risk of polysubstance abuse. We're not talking just pills. We're not talking just alcohol or smoking or marijuana. These people are doing four to eight, nine products a day. Of that, only 46 million people have no access to care. Only 2.4 million have access to care. That means 6% of all the addicted patients have access to care. Last year, 114,000 died. With COVID, the death rate went up 30 to 40%. while less than 7,000 providers actively provide care to patients with addiction. Even though 150,000 providers had the credentials, only less than 7,000 do it.
Policy Changes and the Fentanyl Crisis
So when Trump got elected, we were noticing eight years ago, 10 years ago, that fentanyl would show up in the drug test and we thought as medical community the fentanyl that i write as a patch for pain control or the surgeons use in the hospital setting for surgery was the source of this fentanyl on the street it usually when new crises happen the researchers and government takes about three to four years to figure it out and they figure out it's coming from china so trump administration put pressure and stopped that local pharmaceutical businesses cannot import that precursor and then manufacture and repackage and sell it so then administration changed and the borders open and then it's coming freely so our friends in uh in the media uh and and in the similar business recovery coaches and halfway houses and stuff and they tell me that 10% of the cars that cross the border in san diego are randomly checked for drugs. A million cars cross in a month. So the drug dealers know that. So if 90% of the cars are crossing, there's enough fentanyl coming. And so that is the difference. And now it has become such a problem that both sides are wanting to talk about it. But in the meantime, we have lost 1.2 million people in America, probably a lot more, 1.2 million from drug overdose are documented.
Teenage Overdose Epidemic and Societal Priorities
Tell me about the age of your practice, kind of your 275, just if you could. I know no violation of HIPAA. I mean, we're not using- No, no, no, no. There is no HIPAA issue. So addiction was primarily a problem between the ages of 18 to 56. That's the most difficult age. But in the last two, three years, when pills are being pressed in Mexico and come here, we're noticing about two dozen teenagers in a week dying from accidental drug overdose. They were never addicted. They took a pill. Somebody gave it to them for pain or anxiety or whatever. So that's created a new level of problem now. Okay, so you're saying we're talking under 18. Under 18, 12 to 18, yes. Wow. Two dozen young teenagers are dying a week. And we have 300 to 400 people die every day. That's like one jumbo jet coming down every day, and we don't want to do anything. you know my my other situation is look at your father my father and other 85 90 year old patients we want to do everything to save these people at the when they've lived a very good life and they're at the end but we don't want to do anything to save the lives of these 20 30 year olds why
The Inefficacy of Current Drug Policies
Well, so it took me five years to finish my book and I felt bad that it took so long because I was hopeful things would change after my book comes out. And unfortunately, it's been out for two and a half years and the death rates are going up and nothing is helping people. More people are dying. So even though I'm talking to a lot of people, I tried to reach Washington a couple of years ago. It was very expensive and laborious. I tried to reach my state legislators, the local policymakers. They keep on funding the failed policies, the war on drugs
Additional Resources
Monroe Presentation from Dr. Gupta
The Preventable Epidemic: A Frontline Doctor's Experience and Recommendations to Resolve America's Opioid Crisis: Click here
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Ep 107 100,000 Deaths a Year in US - Opioid Crisis - Preventable Epidemic with Arun Gupta, MD