tv After Words Ben Westhoff Fentanyl Inc. CSPAN September 16, 2019 12:01am-12:47am EDT
>> great to be with you. thank you for all your effort what an incredible story on your book fentanyl inc. let's dive right in my interest in this is i come from new hampshire and i started the bipartisan task force on the opioid epidemic we have 100 members of congress working together and we have been hit very hard in our state. 471 deaths last year but the mix of that is changing. it is fentanyl but what you
write about in your book is mixed with cocaine and methamphetamines. so start off with the big picture and what got you into this and what gave you the incentive to spend four of your years of your life? >> i had a friend who died from fentanyl in 2010 before people were talking about it and before i knew what it was. but it wasn't until four years ago as a music journalist i was doing a report on why so many people were dying at raves. with this electronic music with tens of thousands of people partying and somebody would always die in the death would be blamed on ecstasy.
i had never heard of ecstasy being such a lethal drug before and i found out that almost all of ecstasy is adulterated. >> mixed with other chemicals. >> exactly there was almost new one - - no real true ecstasy it's all of these chemicals so i wanted to find out what the drugs were. and it turns out there are hundreds of new drugs that i had never heard of and most people had never heard of that are all synthetic, made in a lab and almost all of them were in china. i heard about drugs coming from mexico, afghanistan or colombia but i had no idea that china is where the new drugs were being made for go the most deadly i learned was
fentanyl and that sent me on a quest to get to the source. >> to understand where it came from. you did such a fascinating job in your book. as it describes the infrastructure that developed. one of the hearings we have had with the dea that spoke about a chemist in china. tell the story because you went there. how did you make the connection and how did you get it back to china? >> the first thing i learned buying drugs online is incredibly easy. you don't even have to go on to the dark web necessarily. so i started to google the names of drugs like fentanyl
and found these chinese labs and all i did was send an e-mail pretending to be a drug buyer with a fake e-mail address and asked if i was ever in china if i could visit their lab. some of the different chemists said yes. so i went. i went early last year. what i found was shocking. i was expecting like again underground, cd laboratory but it wasn't like that at all like mexican or colombia cartel that this was a legitimate business. >> to some extent you describe they are legitimate businesses
staying one molecule ahead of law enforcement trying to schedule the drugs to make them illegal so describe that proces process. >> when it comes to fentanyl band in china and the us but there are this little offshoots that are called analogs you can make the analog by tweaking the chemical structure a tiny bit. for years that's how the chinese chemist stay one step ahead of the law. so whenever china would ban a drug they would tweak it slightly and then sell the new drug until it was illegal so they were operating within the law. that has only changed recently in may when china agreed to ban all types of fentany fentanyl, analogs, everything
even before they are invented. >> so to understand, people here in the united states are buying the precursor chemicals to make fentanyl. and then they are mixing the ingredients before they sell that in a retail capacity. you kept having visuals and one was a coffee grinder and using that to mix the substances. but then it seems that is part of the risk. help people to understand the lethality of fentanyl and its small amounts like grains of sand that could be a lethal
overdose that could kill someone and if they don't understand when they buy that and what the mix is. >> you hit on the important point because heroine is from the poppy it's a natural plant. but fentanyl is made in a lab and is 50 times stronger. so drug dealers will not use peer heroine they will cut it with fentanyl because it's a way to save money is so much cheaper to make and so much more powerful but the problem is the way they mix them together is not precise at all the scientific. so the dealers in st. louis said they would mix the heroine and the fentanyl using a mister coffee grinder.
but the problem is you can't do it precisely. so one dose might be weak but another might be so strong to kill someone and that's exactly why so many people are dying. >> and one of the comments you were quoting because it does seem counterintuitive if this is a product that is literally killing the purchaser that doesn't sound like a very good business model but you quoted people to say if they find out about a death then they will want to get that batch because it stronger. so help us to understand. is at the level of addiction that causes someone?
were did you get more behind the users and the highs they chase? >> many long time heroine users don't get high anymore from heroine. all it does it takes away the withdrawal symptoms and gets them back to baseline. but with fentanyl they can get high again because it's so much stronger. so unfortunately what happens is when someone overdoses, and another addicted user hears about that, they don't say i will stay away from that they say this must be a really powerful batch. i want that. >> that is a very unfortunate. >> and it's hard to get your brain around.
certainly the policymakers trying to educate members of congress from all over the country that are dealing with is to understand the impacts and how people are responding. the other part of the book that i thought was fascinating with the war on drugs with president nixon and nancy reagan to just say no. talk about that with your impression if that approach has been successful. >> ever since i was a little kid i have heard just say no about the war on drugs. unfortunately where we are at right now is that fentanyl is killing more americans every year than any drug ever.
we have been to the crack epidemic, math, pills like oxycontin that was the first part of the opioid crisis, the first wave then heroine and fentanyl is the worst killing the most people. so to me it is all evident the war on drugs is not succeeding. we check out pablo escobar the cocaine kingpin but yet his death did nothing to slow the flow so we get more cocaine from colombia than ever before. l chabot who was imprisoned and tried recently that's not stopping the flow of drugs from mexico at all. locking people up for a small drug nonviolent offense has
been devastating for minority communities in terms of money spent. so it's not working. >> it is a public health issue. one of the issues that we focus on is to understand that people who are incarcerated typically do not get access to substitute treatment or even the underlying medical health or trauma they might've been dealing with. the reason for that 50 years ago when congress created medicaid they had an exclusion for people in incarceration so the coverage stops the day they go when weather jail or prison or penitentiary.
for 50 years people have not had sufficient healthcare access to treatment. than they come out and react shocked when they go back to their addiction and their crime. we live with the high recidivism rates people going back in. if you think about it we are not surprised they come out with diabetes. and i keep talking with law enforcement to say we will not arrest our way out of this. it is a public health issue so we want to bring medicaid and treatment for the underlying mental health issues into our communities and into the jails and prisons.
>> that's a great piece of legislation. everything you are saying is completely shown to be the case with drug use and recidivism. medication assisted treatment has different names but this is a two-pronged approach. it is attacking the chemical problem, the drug problem using the low level opioids like methadone and what they do is help people to hopefully taper off from these destructive opioids like fentanyl and heroine. >> and it can quell the urge to take the other drug.
>> yes. beta blockers. and at the same time combining that with therapy and counseling because we found in almost every case there are personal problems that people have in their lives. they are out of work. severe health problems. personal issues. if they can be addressed in tandem, then the ability for someone to get off has been found to be pretty good. >> page 76 to say one of the people working with the therapies set exclusively focusing on the chemical aspect overlooks another important factor.
100 percent of my patients have experienced childhood trauma or have a mental health disorder. and it is interesting that statistic 100 percent i women recently asked the women's prison in new hampshire because they are starting to bring medically assisted treatment and therapy in-house and already having profound results. and they told me 100 percent of the women incarcerated in new hampshire have 75 percent are sexual assaults in 25 percent have abuse and neglect in their childhood. so if you are not treating the underlying health issues then you are spinning your wheels
trying to help someone get past their addiction and into treatment. and long term recovery is not 28 days proposition there is a very high rate of relapse and we need to realize that's true for a lot of different healthcare issues we don't say to a diabetic i can't treat you because you just ate cake because that is a difficult disease how can we help you and your family because you should not eat cake. we need to help you for the rest of your life because there is cake everywhere and you cannot have it. talk about that harm reduction model. >> as you know new england is really where the opioid epidemic and fentanyl in particular kickoff.
it was the worst a few years back but the encouraging thing is that we are seeing the death drop in new england the last couple years even while they are still going up and places in missouri like where i live. unfortunately the epidemic is headed west. but with harm reduction there has been an incredible success with the medication and assisted treatment, medicaid expansion. >> there is a program we call safe stations you can go to a fire station and without risk of incarceration you can say i
need help. i have a health issue which is addiction or substance abuse disorder and enable get you into treatment but the medicaid expansion is critically important. the people to walk through the door 95 or more were eligible of the 100 but the reason they were not getting the help they needed is they had no place to turn. we didn't have sufficient treatment capacity the hospital would not help them getting past detox. and that is the critical link talking about how they will keep taking heroine not to go through withdrawals. and to me that should be a
public health issue they should be able to walk into any hospital and we should help them get through the withdrawals and also learning about medically assisted treatment sometimes you don't have to go to the withdrawal. you could get directly onto the medication and then that allows you to taper off. >> of course that is known as narcan and basically it is a miracle opioid reversal drug. >> it has saved thousands of lives and is extraordinary. >> yes. in some states they have made it you don't even have to have a prescription it is a matter of providing funding for firefighters and first responders and even librarians because now there are situations where people are passing out in library the
bathrooms overdosing it's an epidemic and they are not trained. >> they need to have narcan on hand. >> but the families are so beleaguered in the communities are so exhausted. so talk about what you learned about the harm reduction model how we can educate and prevent overdosing in people harming themselves. >> i went to barcelona spain they have supervised injection facilities it is where addicted users can go get clean needles and shoot up and
even smoke crack cocaine and it is legal to do so inside the facility and then they are watched over by trained medical staff. it's a little outside the box even for a met one - - americans. >> so with a moment of clarity ready for help in making that readily available. >> that is part of it and these bring the addicted users out of the park they had a scourge of needles in the parks and kids were stepping
on them they have them in canada, europe no one has ever died at one of these facilities but in the us they are banned. there is a number of cities that is tried to have them like philadelphia recently but the federal government has banned them it is called the fentanyl testing strip. >> with these kits with narcan these are all part of the harm reduction strategy but it looks like a pregnancy test. you take your drug you don't know what's in it. it could be.
her heroine, you don't know. you mix it up in a solution dip the strip if there is one stripe there means there is two strips mean there isn't. so people realize there is fentanyl in their drugs it can be mixed into cocaine, met cocaine, meth, pills, if they find in there they are less likely to take it and therefore less likely to overdose. >> talking about your friend in 2010. >> and then your friend who had graduated college and had come back and then was taking extra courses to become a
dentist. he had been to treatment. they were aware of a drug problem. but what happened he got a bad cold he got medication for the cold unbeknownst to the pharmacist and the doctor it was cough syrup with codeine and that created a drug seeking behavior in him and made a call today carolyn dealer but it turned out to be 100 percent fentanyl and he didn't know anything about it at that point. and then his mother found him
dead on the bathroom floor with the needle still in his arm. you talk about that so there is a need for both instantly. and what was it about the chemistry? you got way into that by the way. you did a really good job i was having a hard time following but what makes this a lethal dose that you would literally die? that fentanyl was created in the late 19 fifties by a belgian chemist and wanted to create better drug for use in hospitals and he did.
it was used in open-heart surgery and continues to be an important drug like for epidurals during childbirt childbirth, colonoscopies, and it still remains an important laboratory excuse me an important hospital drug for people with cancer and things like that but what he didn't realize that along the way the rogue chemist went through the scientific literature that he and other drug chemist were publishing. so if you are a scientist at university and publish your paper and it goes into a university library. one - - pretty obscure and hard to find. in the internet age all of these papers were published
online. >> and publicly available anywhere around the world so these rogue chemist began to look for these files specifically to go through them and appropriate the chemical formulas to learn how to make the new drugs. so it exploded all over the internet and made in chinese labs and now the different types of fentanyl has come about in this way. >> the other thing that made the book readable and you tell these incredible personal stories. one was the death of a man in grand forks north dakota tell that story it is the interaction with law enforcement and that
overthinking approaches, so north dakota for example had its good samaritan law and basically that means if you are with someone who dies from a drug overdose, before a loud call the police and the ambulance without fear of criminal prosecution. >> typically there is someone else there and they don't want to get in trouble. >> it's also a pretty isolated place. north dakota doesn't have many big cities and so they permitted this medication assisted treatment to be done remotely so
people could talk with doctors and other cities anin other citn this type of medicine, so they try to hand out test strips and it's a very impressive show of support from the community. >> host: i was on the house veterans affairs committee and no commerce. they started doing mental-health and now they are starting to get medically assisted treatment by long-distance treatment over the internet and a interviews and sessions they can go into a center for the comfortable chair and plant next to them and tv in
front of them and then having their sessions and it's much more efficient. i was recently visiting one of our hospitals as well but it's been to help our small rural hospitals to have the expertise to be able to do the medically assisted. >> guest: it's also ushering in a mindset i talked to the public how the coordinator service the epidemic is changing the way people think about addiction and it's no longer we've got to jail our way out of the problem we have to treat it as a disease, try to give people treatment and it spills over into alcoholism which is for a long time treated the same way. it's a social issue is a real
disease. this has been beginning with the opioid and heroine announcement that rural america has been hit so hard. is that the phenomenon for certainly in my district that has been a big part of this and trying to come to terms. we, for example have to pay for this and unemployment, an the ed what that means is that you get down to its very difficult to find talented work and employees for the workforce. what i've seen just recently is what they call supportive employment where one of our major and players is going to have addiction specialists on hand in the company to support the people in recovery, and if
they feel they are going to relax or they need resources that so many families have been hit by this. all of society gets impacted in coming to terms with that as a public health issue rather than a criminal justice issue. >> guest: is critical, and the conclusion that i come to in my book is that we can't just address the supply-side. i went to china and infiltrated the labs and found out the chinese government actually subsidizes the production of drugs and precursors and these
companies receive a tax rebate for exporting a and there's all sorts of stuff going on right now with the trade war. president trump is trying to assure the chinese president into making these changes and at the same time, what i discovered is even if we are able to control it, the industry will likely move to a place like india that is already starting to make sense fentanyl. the only thing we can do here ourselves a and that is the name of the game with all these things we've been talking about. >> host: you made a really interesting comment about that which is if they understand the
breadth of the demand for overweight right now it starting with it you told the whole story about that in the book as well and a shout out to the dreamland which is my bible it's an incredible book to understand this all, but your point is very well taken if we don't get a handle on helping people get well and move beyond these drugs, one of the things that has been helpful to me is to meet so many people in recovery and meeting people with successful lives that are in long-term recovery that has gotten past us in recognizing
that that is a possibility and a probable that if we can use medically assisted treatment and mental health treatment and long-term recovery and a super housing and all of these constructs that it's getting people to a holy place, then we don't need to worry in the sense that they are not going to be tempted by a just lethal drug coming from china. tell us about the incredible story so much history you can tell that you are a journalist because there was so much depth to the story. you had an incredible story about the opioid for her and the sort of ironic twist about the drugs that are being imported into the united states. if you could tell that story. >> guest: they fought a pair of fours in the early 19th century, and what was happening
is that england was sending over this opium into china and the chinese people were getting addicted to the chinese leader said he wants you to stop bringing this into our country but england refused so there were two wars were fought over that. now today, what's going o but ke described as a reverse because they are coming out of china and its people in the west who are using these drugs and getting addicted. so you know, talking with chinese officials that they don't want to take responsibility which is not surprising. they blame the u.s. for its own culture of drugs and they have a good point in the u.s. for example we use four times as many overweight as a been a
country like the uk for example so some recently released documents that you were alluding to were referencing these lawsuits against the pharmaceutical companies. now the most famous of these was responsible for oxycontin and favor shown to be really pushing this drug trying to make sales even while other studie their sd how addictive it was so they certainly get a lot of the plane but from these new documents, we learn that pharmaceuticals are a much well-known company based in st. louis where i live and made more of these pills these
29 billion opioid pills and so now they are getting into the phase that is compatible to the tobacco lawsuit. >> the states and cities and towns that have consolidated a federal court in ohio, actually oklahoma a judge recently ruled against johnson and johnson but the judge in ohio said he thinks that this will be a massive on the scale of the settlement. i have to ask one question because it's been on my mind
back to china it seems to me if you are a foreign country trying to threaten the well-being of the country that this would be a brilliant strategy to just follow out america and these communities and towns, do you ever think of this as a homeland security issue packs i mean should we be lookin,should we bn a different way in terms of our international relationships sex >> it's definitely a national security issue when you think about it 70,000 americans die from these drug overdoses and so the question you are getting at is is china doing this on purpose and a lot of people ask is china going to war essentially and that is a term trumpeter chris christie and
others have used so the way that i think about it is it didn't start off that way. to start off because china wanted to encourage its industries its exports wanted to grow the chinese economy through all these chemical exports. the problem is the tax breaks by the government incentives that were designed to go to legitimate chemical companies have also been going to these companies and at one point you've got to say who is in charge, who is steering the ship and one example is last year in the midst of the trade for it was ramping up between the u.s. and china and right in the middle of all of this, china raised its tax rebate for
exporting from 9% to 10%. so it makes me wonder is it intentional. it's certainly something to consider. >> i appreciate the depth of your research. in a couple of minutes that we have left, is there any stories that stand out or any message you want to be sure to get across? >> one thing that was interesting to me is it's not just drug abusers are suffering, it can be in any powder or pill.
so for example, the fingerprints he thought he was taking a legitimate narcotic pharmaceutical pain pill. edith and had percocet stamped right on it and looked legitimate but it was cut with sensible and that is how he died. people by taking what they think is cocaine and dying. that's the unfortunate thing is these end of drugs are not safe anymore. i had an experience when i was younger and the sad thing is maybe if i did the same thing today i could see one of these casualties. >> host: i think then that is your message at the end of the day it's a fascinating story, it is the chemistry to the history,
science, international relations, community relations, family relations but at the end of the day, the word needs to get out to every parent and young person and certainly every policymaker. i plan to share it with my colleagues and i appreciate the effort you have put into it. thank you. the book is fentanyl inc.. >> guest: thank you for the work you are doing as well. you are making a difference. >> thank you so much.