This crisis. This Opioid Crisis that has taken hold starting in Rural America and you do such a great job of telling the story maybe i could begin by asking you why the title dope sick. What is dope sick mean . Its kind of an inyourface title. We need a reality check on how bad this issue is gotten. I think a lot of our leaders and a lot of people in our country still dont have. Dope sick is the word that her number number from users. It is the word they use to describe the very painful withdrawal when they cant get the opioids that they are now addicted to. Its like the worst flu times a hundred. His diarrhea, vomiting, nauseating restless leg and somebody early in the book says, at the end of the journey, you are not doing drugs to get high, you just doing it not to be dope sick. I was in importance concept. The people and get. Says not only to get that but try to not get sick. In an ironic way. Right you started out this journey as a reporter in virginia. You discovered that there was a problem in appalachia i think you start out in a covering harry and lee counties in particular in rural virginia, is that correct . Yeah, i didnt cover the oxycontin epidemic when it first developed in the late 90s, was the purview of the court. The reporters at the time, but when i wrote factory man, but to finish up around 2013, its a book about the aftermath of globalization and henry county and martinsville and all of this stressed communities. And what happens to a community the jobs go away. I started to hear from policeman and other sources that so much of the drug crime in the crime and the communities was drug fueled. Mostly by methamphetamines and heroin. I thought heroin, like heroin in rural areas how is that happening . Sure enough it was. And i didnt understand at the time, how it had been or how heroin and oxycontin and other opioid pills were connected. I didnt understand the work chemical cousins that if people were initially to prescribed opioids, both of it be oxycontin or percocet or delighted, or whatever, once there addicted, and they get cut off, they get dope sick. That fuels them to have to get more and when the pills got expensive and hard to get, around the time oxycontin was reformulated in 2010 in the early teens, drug cartel started bringing heroin and knowing that the fear becoming dope sick pretended one hell of a business model. The and setting the stage, like you i think a lot of americans would be surprised even now to learn that there was an opioid and heroin crisis in Rural America. The counties for example, your profile nearly parts of your book, not so long ago, there was poverty and economic stress but these were tightknit communities with strong value systems. They cared about their families they left their doors unlocked because crime was so low. Thats exactly right. Is all revolutionized today are was. Because frankly this drug crisis. Write. Doctor nancy who is one of my people that are profile in the book was the first dr. From lee county to pick up the phone and call purdue and say i know in your information here it says your dog is an addictive or addiction is exquisitely rare but weve got kids that i babysat and i immunized as babies who dating in our High School Library this is the huge addiction problem. Before oxycontin came out he said he had one until maybe three drug dependent cases a year and now almost his entire caseload, theres no one in the communities that havent been affected by this epidemic. Want to come back to the dr. Who you profile because he was an Early Warning profit in a sense, on what was happening. In terms of Prescription Drug problems. I may just set the scene, for whats happening to Rural America, one of the things that struck me on page 125 of your book, this is extraordinary if i may read these three paragraphs and get to the comment. You say if oxycontin was the new moonshine, in Rural America, this ability was a new factory work. By 2016, for every unemployed man between the ages of 22 and 55, an additional three with neither working nor looking for work. Having dropped out of the workforce entirely, they had not medically vanished to the kind of monthly jobs reports by politicians and reporters. Many turned up instead and disability statistics which were largely ignored in headline grabbing economic reports. Disability flames. Doubled from 1996 to 2015. Federal government spent an estimated 192 billion on disability payments in 2017, alone, more than the combined total for food stamps. Welfare and housing subsidies and unemployment assistance combined. That it is extraordinary. In terms of what happened. The bottom fell out. For a lot of white working men especially in women and that is sort of the precursor for why there was a receptivity to to start crisis as you laid out. You and comment. Yes. I describe it to moonshine. He became a side hustle. If you lost your job and your unemployment had run out, you can get your dr. To write your prescription for oxycontin and he could take half and still have two neighbor. Who was in the throes of dope sickness. I need it to get the drug. It became this way for people to sort of treat their own psychic pain. The story in the book early on where some bloody asked a kid in high school what he wants to be we need grows up and he said a drawer. The tshirt said zero you want to be an artist, they said no i want to be a drawer. Somebody who draws disability. This all he could envision for himself because thats what he saw his parents and grandparents doing. If you havent visited Rural America, it is shocking. Even the little towns i grew up in ohio, disarming towns basically with some factories and factories are gone. I was home recently visiting and taking my nephews out for hotdogs and were going to go to the park across the street and i said okay lets go and they said no lets try. They said that beth, i dont want to step on heroin needles. It just shocks me. Even though ive written this book. It still shocks me. One of the people you talk about early in the book. His doctor cosby he based on his only strengthen your book, he is thoroughly aware of the fact that opioids like oxycontin are being over prescribed and are highly addictive and its not being reported properly. He also was aware or becomes aware of the fact that one Pharmaceutical Company purdue, parma, is pushing these prescriptions on the argument that the vital sign on be pain thresholds. We physicians are to be conscious of leaving our patients and no pain. Not that the perfect way for you doctor, to handle that. He becomes alarmed by the practices of this Pharmaceutical Company. Tell us a little bit about that story and how that turned out. He starts writing them letters. What is said, weve got people overdosing. Crime in this community where ive been practicing for decades. You need to take this drug off of the market and reformulated it to be abuse resistant. The way pal kellan had done earlier. They wouldnt do it. Actually wrote them a letter in early 2000 that i staying that my fear is this distressed communities which now have rising drug crime and even murderers on a scale they had never had before, our sentinel areas for this epidemic. Much the way San Francisco and new york were for hiv. Think about that, he was so precious. When i met him for the first time in 2016, he said of that letter, he said i know it was just a bunch of poor people in the mountains dying nobody would take us seriously. I thought when epidemic hit the cities and suburbs, then government would take it seriously. And he said of course i was absolutely wrong. Hes just on the if it this now for two decades and nothing has been done to turn the numbers down. Can you refresh your memory of the growth of this crisis. What are the numbers in terms of the growth of the addicted population in the Overdose Deaths. 72000 Americans Last year died of Drug Overdose. It was up about 10 percent from the year before. At of pittsburgh, looked at drug deaths going back to 1979. He said we lost 300,000 americans to Drug Overdose in the last 15 and projections are the real is that many and just the next five. That show use you how high that curve is and how fast its going up. There is some good news though. In the last year numbers from the cdc, the 72000, we started to see slight decreases in three states in new england, vermont massachusetts and rhode island. And so we know they are doing innovative things that work. We are not doing them enough to match the scale. But the problem is. I sort of what to almost and on that note. Tarzian of this i can. But i want to get the scope, lets go back to those numbers. Were talking about extraordinary numbers. 72000 people dying last year of overdose. This mother died in the entirety of the vietnam war. Every year. As you pointed out in the book, its accelerating and projected to accelerate of the next five years. Potentially another 300,000 people will die of opioid. X in the next five in the next eight decade nursing 650 which would be equivalent late of the entire state vermont. That would be the equivalent of the entire number of deaths in the American Civil War over a fouryear period. Just the numbers are mindboggling. Tell us a little bit about so this miracle drug, oxycontin its not the only culprit in the story what kind of start there. It has enormous positive powers put out the flame of pain. So somebody in acute pain, that feel really can work. But its also discovered is it not that it is highly addictive which is denied by the Pharmaceutical Company purdue but all of the data in front of say dodgers like clark and z otherwise. Were not only staying addictive patients, actually staying Overdose Deaths. There being discounted by this Pharmaceutical Company. Can he talk a little bit about this. Sharp will the fda allow them to make this squishy claim that because of his time release mechanism, oxycontin first of all is the higher milligram than its competitors that were immediate released. The fda allow them to say that because of the brandnew time release mechanism, this very high milligram dosage drug was supposed to bleed out over 12 hours. And you give people in severe pain the miracle of uninterrupted sleep. Thats a good thing. But what people quickly learned how to do was to do an engineer on that time release mechanism and they would put it in their mouth and get it soft and wipe off the coating which has the time release cut mechanism on the shore sleep and then either crush it in a distorted and injected getting the full rush. Right away. Theres discrepancy and when fernando was being done. They had said all so long that they didnt know until 2000. People like manzi were telling them they were seeing overdoses. A new Justice Department set of documents that the New York Times reported last summer shared that they knew much earlier than that. It took me about a off an hour to find the policeman who first saw it on being diverted on the streets in the late 90s. He said he could walk around town i see people with orange and grain state senators from where they had wiped the coating off. It was clear to the policeman into the pharmacies whose pharmacies were being broken into. It was clear to everyone there. I would love to have some sort of accounting for what the executives of the committee knew and when they knew it. Also some things the company was asked to do include done, in terms of reducing the potency of the drug itself, and attaching it, i think its called an antagonist drug to the oxycontin that would make it either nonaddictive or a lot less addictive is that correct and they chose not to do that. [speaking in native tongue] right and some of the early parents of lost children are begging them to do that. Barbara then run out of california lost her son after one oxycontin pill. She begged them to make it only for use with severe pain. She said i would never want to take it off on the market entirely it of course is the great drug for in live severe pain. Cancer pain. What they had done between the mentally 90s was they had split the narrative. They were seeing it was now safe or moderate pain so that anybody with back pain osteoarthritis payment tmj which is dropping now the strike was safe to use for these conditions. And so that you went from 1996 when the drug was introduced opioids were largely only prescribed by cancer provisions. Oncologist. Five years later, they had one that narrative battle. They had convinced people that opioids were safe for moderate pain. Thats really flipping the narrative and it was whats really seated the Opioid Crisis therein now. In the pharmaceutical companies purdue, claimed that only 1 percent of the people who used oxycontin would ever get addicted. What was wrong with that citation. What is the real number . They claim less than 1 percent and addiction was exclusive rare, they came up with this term called pseudo addiction where they said dodgers of somebody comes to her office and they seem like they are in the throes of addiction, really theyre just being undertreated so the cure for that is more oxycontin. They hired an army arrives to go out and using old data including 1980 letter to the editor of the new england journal of medicine, they sort of ballyhooed this old out of date data they did an applied outpatient settings. And then just to have the reps repeated and repeated until this uncertainty is believed to abu abuse, the fda had allowed them to say that the time release mechanism may drug, they believe the abused the risk of liability of abuse and addiction. The reps repeated until it was like an oldfashioned game of telephone gone terribly awry. It was repeated as a certainty. He just saw this happening over the course and some people now think that you can get addicted after taking opioids for just five days. And the addiction i can goes as 56 percent customer. Yes some studies have said that. Some studies are lower. The science is unclear on this. But clearly its a lot more and less than 1 percent. Back i think your book points out to that that 1 percent was a plea of gas was not based on an air goalsetting of any kind. And yet they cited it as gospel truth. To the will the cost lives frankly rely on that. And the authors of that, yes it was just a letter to the editor. It was a study. In the authors did it for it to be repeated like that. He actually use that as a promotional thing. Theyre sending their marketers in to the dodgers offices and clinics of rural areas. Theyre targeting rural areas initially. There citing this leading 1 percent even though the evidence ours to melt pretty quickly that its actually highly addictive. Its very potent and is being sold on the street very rapidly because of the potency. In the kind of high that users can get. Is that correct . Thats right. And the pain dodgers that paid 5000 dodgers pharmacists and nurses to become paid to speakers. At the time, doctor art was staying kids are being in the library and some of his colleagues were being sent off to places like boca raton on in arizona and florida resorts where they were becoming paid to speakers for oxycontin. They coopt the system medical system. Actually recruited dodgers to become purdue marketers for the product. Yet. And so, a lot of people then have a vested interest in overlooking what is in front of them in terms of the crisis is growing in their community. Right. To have a chapter called swag and ash. I dont dodgers like. If you know a dr. That you and to keep you cuban cigars, they would show up with, is the bunch of cuban cigars, the very best ones. Just in exchange for ten minutes overtime to tell you about this new wonder drug. Of course we know from studies that dodgers are twice as likely to prescribe these drugs when they been exposed to that kind of behavior. The free lunches and all of that, a lot of the big gift a lot of the the dodgers are still allowing up to come in with lunches and things like that. In journalism, were not allowed to accept a gift of over 25. When i worked at the newspaper, some elect an article you wrote about them, and seo bunch bunch of flowers the next day, when to give them to the Domestic Violence shelter. Pocket dodgers not of known that that was wrong to take all of these gifts angst free trips. Also at some. , even if you were initially seduced by that, we do start to see the evidence that your patients are getting very addicted and very sick, and dying presumably. You might want to rethink the relationship you got with purdue pharmaceuticals. Never do is sued multiple times and with every lawsuit, until he comes up against them, a virginia u. S. Attorney, his name is bromley, tell us a little bit about that. Thats a critical moment in fortune produce behavior that changed a little bit. Prior to that time theyve been in denial and they were pretty aggressive. About their denial. So John Brownlee is the sort of young brass u. S. Attorney working out of the office. Using his caseload become increasingly overtaken by oxycontin related crime. They start investigating a company, i think it was around zero two, i think of any breaks and Rudy Giuliani to sort of try to work the investigation. Just to be clear, they hire a former u. S. Attorney and mayor of new york really Rudy Giuliani to defend their practices. And if in the drug company itself. In the u. S. Attorney. Right after 911. Right after 911. Some of us are not surprised. You can trust him, you can trust us. He works for us. He was man of the year, and there is some intimidation that happens rally has to meet with him and he is much over as his famous person. Anyways, these two u. S. Assistant attorneys working at a tiny everton near the coalfields where a lot of the uses going on, they really take it on. In the government masses of boxes in charge of data and the people in the lawyers who have sued purdue and lost. They have funneled all of this data and case information, depositions and boxes and boxes of stuff. These two basically government lawyers working out of this tiny abington office, put together this very compelling case. At the last minute, giuliana sort of orchestrates this plea deal in the Holding CompanyPurdue Frederick, is basically admits that its criminally expanded the drug for felony charge one felony charge, the top three executives received a misdemeanor version of that charge but because it is Purdue Frederick and not purdue pharma, is the that frederick which is then banned from doing business with like medicaid medicare and tri care. So the pharma continues to sell oxycontin and it does and it increases. After zero seven. None of those executives went to jail. As another important moment in the epidemic when it couldve, people wouldve gone to jail, that wouldve had a chilling effect. The prosecutors that we work on it now, we were helping that would let people know that this was a really bad thing that is happening and we should turn this around. But that didnt happen. The sales continued. In fact they went up. One of the things that struck me the book to beth that was sort of a chemical changes that go on in a person his body and brain with this addiction. In those chemical changes create a craving that is very hard to describe because most cravings for most human beings dont begin to rival this craving. Describing gets parents to frankly no longer care for the children. This craving totally disrupts and destroys normal relationships. It achieves to destroy the barrier between right and wrong. Possessed in large measure. Because of that, we see hell enter into the picture. You may be to talk a little bit about that. Why would somebody who has an opioid addiction suddenly also turned to heroin. What is the connection. So when the bills get hard to get, purdue finally reformulate the drug in 2010, 14 years after nancy and others first wanted them to, 14 years after it was first introduced. The bills get harder to get. Hydrocodone is scheduled. The drug cartel are bringing heroin and because they know their chemical cousins. The fear of doped sickness for all of the who are already in narrowness is one hell of a business model. Like were going to be able to sell this drug. We can bring this and all day long from various measures. So you see people like the former cheerleader and the football star people started kind of recreationally using the drugs for they had an entry in the football field for the case of bronchitis and were over prescribed cough syrup with codeine and then i drove 404 sore throat pain you see them getting in steadiness and going from the pill in the feels good hard to get the get more expensive, hooked up with dealers and they themselves start becoming dealers because theyre dealing their middle manning as they call it this is for their own habits. Then they recruit new users because thats the way they can get their products. It just almost has this astonishing exponential effect. Ali goes back to this craving doesnt. You talk about my constituent dawn flattery and spoke. He lost a son. Athletic accident was put on opioids and developed an addiction. We need was in rehab and he couldnt get the pills, heroin was readily available because it was more available is cheaper. And i think thats another reason why its such an easy substance. Their chemical cousins but it is also actually more readily available and more affordable to maintain that craving and that high that they developed on opioids. And then could you describe a little bit, then theres fentanyl. As if the opioid isnt bad enough, and the heroin flooding markets that were sort of advance by opioids, and there a synthetic drug called fentanyl that is introduced to the market and often laced with heroin. Its a bad bad actor. Can you talk about that a little bit. In general is the synthetic analog of his 50 times stronger than heroin. Theres also youve heard of car fentanyl is an elephant sedative. Its a hundred times stronger. Just a little bit of that introduced into the heroin, they call cutting the heroin with these synthetic analogues. Makes it very dangerous on this people who are doing the cutting the mixing are not chemists. The drug dealers. The people working them and so it is easy for it to get a bad batch to get out. I first started seeing this in my community in june 2015 or so when fennell started entering the supply. It is catastrophic at the time we had the highest rate in the state. Fentanyl. Fentanyl is the really dangerous, you brent make reference to police the seizure. It took about an august 2017, only seizure of. 4 pounds fentanyl. Not tons, pounds. And then you say, thats enough for 1 million fatal overdoses. Thats an extraordinary fact. People are ordering it off of the darknet. Hong kong and china. One of the things im happy about with the new opioid bill informers now is that theres money to be screening that coming in and the u. S. Postal service. That seems like low hanging fruit. Lets piece craning our mail for this. We know that its coming in. Theres another story in the book that to educated Virginia Western Community college selling xanax but its actually pressed fentanyl. It was like 700 pill selling them in the parking lot. Think about if that had gotten out there. Its shocking how easy it is for people to get this and its easy to smuggle. It just makes everything so much more dangerous. This what you are staying most of the increases in deaths are Overdose Deaths are being fueled by fat now now. Lets talk a little bit about Opioid Crisis and a heroin crisis and now we had a fentanyl crisis we have soaring addiction rates. Starting a large part of Rural America now spreading to the suburbs and certainly the cities, we are seeing skyrocketing rates not only of addiction but of Overdose Deaths. So is talk about treatment. Because one of the things that comes clear in your book is the, it is very hard to get somebody to agree to treatment. P starting at them and because of long waiting list. Busy is prohibitively expensive and finally d, it is a very advantageous. It doesnt work very well. Talk about that. The choices, the desperate loved ones who want to help somebody with an addiction in the family, or friend, are actually very limited and not very promising. No, i saw family after family, remortgaging their phalluses borrowing from the grandparents, spent 30000 to get a kit to an abstinence only rehab facility. It is actually not the right kind of treatment for opioid use. Study after study shows that the most efficacious treatment is medication instead of treatment. This offer usually in an outpatient setting. With counseling. It cuts Overdose Deaths and relapse by 50 to 60 percent. Thats compared to abstinence which is more like 10 percent. So is a lot of activity around a lot of herculean efforts to get young adults off to rehab and then i would watch them sort of bomb out of that. And they relapse and if they wanted the fit no, they die. And our people in my book who died before i had a chance to type up my interview notes. , the stories where people have been trying to get some and they were and jewelry have Treatment Facility and finally been accepted and then they died the day before. Yes in that case you are talking about the story of joey gilbert. Beautiful 27 yearold girl have been doing fine on the medication of the treatment from the morphine. In order to get to this rehab because she herself believed that that was the best way for her to be clean, because of the stigma against people who are on mat, a lot of people in the 12 Step Community believe thats just substituting one drug for another. Abstinence work for them, where alcoholism, why cant it work with a start. But its different. You see joey, wanting so badly to get clean. She starts cutting her pills in half because rehab center that they wind up for her, his faithbased and doesnt permit any drugs at all, not any medication. She relapses while she is trying so hard to get there because in irvine, is the only way she is going to be well. She relapses and dies. Just a tragedy for her and her beautiful family that tried so hard to get her help. So worn out so her behavior and yet still seen in that Community Meeting still telling the story that telling the fact that if joey had had a way forward for continuing our mat, or having back then, virginia had yet approved the Medicaid Expansion, that they believed shed be alive today. His claim just a little bit more. A lot of people look at the aa model which as you go cold turkey. You give it up. You are not on any kind of substances for alcohol and is the 12 step program to get you sober. For a lot of people, that therapeutic intervention, that works. We have Rehab Centers across but not always regulated or certified i might add. And thats a problem to. But as a philosophy that if you know in any kind of drugs including a substitute drug that is designed to help you come down off the addiction, that is a bad thing. From their. Of view philosophically as i recall in your book, about two thirds of all Rehab Centers, refused to accept you as a patient if you want any kind of drugs. Seen at the site. Only 3 percent allow all three kinds of maintenance drugs. Which are morphine methadone and physical or tried picture. Theres a huge bias against mat. Mit being medical assistant treatments. Thats right when the World Health Organization the drug, the cdc, all concur that mat is the best treatment for opioid use disorder. My constituent don who lost a son certainly would hold that philosophy is one of the reason his son died because going cold turkey was simply physically not possible given the enormous power of the addiction and he was there for a to the heroin substitute. See the play out over and over my book. Not only was together then we slattery, with carrie electra right now with her picture in it than another gave me after her death. An indictment overdose. We sorta thought we would get a call monday staying that she had died of an overdose but she died because lacking her access to mat, some family members who didnt believe in it, nor did she herself because she had abused before, she went off to an abstinence only Treatment Center in las vegas and then when she relapsed and failed out of that, she was living homeless on the streets working amid prostitution and drug gangs, and she ended up murdered. Her body was discovered in a dumpster on christmas eve. And she was 29. She was 28 at the time. She was 29 by the time of her funeral. I think of it as patient abandonment. We have banded these people, hard to deal with and they are so driven by this drug and what tess said to me was the first time i interviewed in late 2015, she describes how shed initially been addicted by an Urgent Care Center with 230 day opioid prescriptions. She said what we need, is an urgent care for the addicted. So thats his message im trying to Carry Forward with this book. We need to make these medications lifesaving medications it has herself couldnt get that done flattery son, lost his access to, we need to make them available the way remain hiv medicine available. A low threshold setting where Everybody Needs to get it has access, just like Everybody Needs to get here heroin has access. We need to make these mat drugs is accessible as the street drugs are because there really really work when they are used correctly. Not a quick fix. Im sorry didnt mean to interrupt. In your book, in the they work in you compare it to the relapse rate and recovery sustainable recovery rate and they are pretty dramatic differences when you are on mat versus cold turkey and not being on anything. 60 percent with mat versus about 10 percent on abstinence only. Abstinence only facility was the only way for her to get clean. She knew she had a friend for whom networked and thats when they had both been heroine addicts and their families spend 300,000 on multiple rehabs it didnt work for tests so many people dont have this kind of Data Available to them chances are only 10 gets better using that model. It doesnt leave us feeling very hopeful we have this massive crisis its grown almost seemingly overnight. The community as you describe in the book are at these resources to combat this threat and almost right for the picking by drug dealers coming down from say baltimore or philadelphia to new york and even if somebody is motivated to cure themselves of this section frankly the options are so limited and not so necessarily sciencebased is there any hope at all for these families the state states in new england that arnewengland that e their Overdose Deaths go down and that is because theyve offered Harm Reduction facilities in the form of Syringe Exchange recovery programs and business places users can go, trade of dirty needles for clean ones to stop the spread of hiv and hepatitis which is sky rocketing by the way, and they can hopefully a lot of these people are leaving homeless to get their drugs. Once they make a relationship with somebody thats working in this program, then they can start to give them an informed consent and starts to make referrals to treatment, to medication assisted treatment and you see this happening in these New England States and its working. So, we need to have those available everywhere. We still have 17 states that havent passed the Medicaid Expansion and that has proved to be the number one tool giving people access. 70 increase in the states whove expanded medicaid but we still have only one in ten people with opioid disorder getting access to a group of experts, faithbased communiti communities, communities need to get organized and start these collaborations with to convince people as they try to convince the community to open up this methadone clinic some lady shouts at him how many chances are we supposed to give these drug addicts the doctor says he thinks of the disciple the disco jesus how many times should a sinner be forgiven, should he be forgiven 70 times and the doctor says to the 17 woman 70 times seven, as many times as it takes or relegate as many people how to help them get ways to prevent them from getting it now which will be cheaper in the long run. I was really struck by a Medicaid Expansion. This is a very expensive thing to try to treat this is very expensive and a lot of people simply dont get treatment because they know they cant afford the doctors visit or the medication to try to offset the addictive power of the opioid with a heroin addiction. They cant afford the rehab which is often going to a facility for weeks at a time, so they forgo it because they cant afford it. Medicaid allows them to have access to those treatments and in that sense as you said it is a lifesaver. But when you are writing this book you are writing about virginia. Virginia hasnt yet expanded medicaid. In fact, its role as legislators often conservative and republican legislators to resist the very expansion of medicaid that would save their constituents lives and you talk about that. What is the nature of this political resistance when they can see in front of themselves the nature of the crisis that their community is facing it will trickle down soon. I see a lot of resistance in areas such as what i was speaking about living with this crisis longer than the rest of us largely and the lawenforcement. Many repeats are coming back and she said they sell it to buy methamphetamine and i said with all due respect come you only see the people for whom it works, so there is a huge observation bias at work in this misperception that the drug is bad when in fact they are not seeing the people that are giving their kids back some of them for eight, nine, ten years now and they are still taking some boxin and thats okay becae they are getting their kids and their jobs back. One woman is off of disability somebody willingly getting off of disability. She didnt want me to use her name because in this community she was and she still feels like people will discriminate against her. They were supposed to be helping these drug addicts and i think there is still enormous medical education and the lawenforcemenlawenforcement ant large about the nature of this addiction. This is a longterm challenge for the individual but is projected and their families and communities and there are going to be steps forward and steps backward. Our goal is to get them on a longterm password recovery. This number stood at the hair up on the back of my neck. John kelly harper researched psychiatrist said it takes the average person ate years and four to fiv45treatment attemptse year of sobriety and that is a pretty grim number, but it shows you that often people that start dont stay on it or then they go to heroine and come back and weve just got to keep making it almost like a treatment on demand and not abandoning them. They would go back and do a dozen talk about ronnie jones, hes somebody that is pushing drugs and the saint himself get addicted and ends up in jail if you interview him. Could you talk a little bit about who is he and what you stuck by this reaction the book begins with me driving to visit him at a federal prison and i am being sent there at the request of a mother that has lost her son to heroine overdose partly spawned by his bringing in heroine to this tiny farm town which is not too far from where you live. Almost overnight the town went from having a town full to hundreds because of ronnie and the people who put him behind bars. Held at half and they never missed a day at work and so they started pulling the threads on different people involved and end up getting an interview with jones himself and i want to hear what his story is. He said he was profiled, pulled over and once he had a felon thy on his record it was hard for him to get work so each time he came out of jail, he would try to get work and come out with Child Support arrears, not being able to get food stamps. When he comes out the second time hes been sent to work in a chicken plant he remembers everybody is using pills and this is in 2013 and a friend had said if they want to deal drugs this time to start bringing in heroine because you make a lot of money on it. He told me he knew he was eventually going to get caught and started making films in the day, so just an incredible amount of money. So, e. And 83 others were busted in the state and federal charges and were sent to jail. Some peopl people send a lowerl and his ring died of overdose and many of them are user dealers that when you hear politicians say things that we should be executing drug dealers, a lot of them are people that we read about in the book that are selling this for their own habit. Youre not your typical drug dealer image, these are users that resource to dealing drugs to finance their own habit. The other thing you mention that struck me, ronnie jones felt he had no option because he wasnt unplayable in a lot of places, people would turn to someone like that to hir hire se ends up in a chicken i think that you say in the book hes pulling in three or 400 a week. Working for the chicken place to pay off his bills and his event and to make his Child Support and all that. But meanwhile he could make tens of thousands of dollars selling heroin every week. He justifies it in us as im bringing in clean heroine, this is before fentanyl. The danger of driving an hour and a half to innercity baltimore, im bringing it to them, selling it to them at a slightly cheaper price, they are not having to endanger themselves by going to the innercity neighborhoods and he felt almost like he was doing a service and he justified his comic he took no responsibility can actually he did take some responsibility. I read to him some parts of the book and he said that did make e him feel bad about when i asked about jessie, he didnt even know his name. That is the young man who died. It was many steps removed from where the needle hits the pain and where he was packaging his heroine. They say we took responsibility for that 2007 plea agreement, but you know, we are not the ones responsible for the heroin epidemic and there are many steps but it also began with them sort of deluging the communities across america with this drug into this idea that it was safe based on bad data and lighting. Host thank you for writing this book. I hope it saves lives and i also hope it opens up a lot of peoples eyes in the policy world we must tackle these problems. These are our children and we cannot abandon them. Host thank you so much for your interest in the interview. I appreciate it. This program is available as a podcast. All after words programs can be viewed on the website, booktv. Org