Kind: captions
Language: en
[Music]
a devastating epidemic
we just didn't know what to do
we just felt powerless
a parent's worst nightmare
to find my kid not breathing
he was always very good at telling us
mom and dad everything's gonna be fine
but it wasn't
addiction is ruining lives and ending
them too soon
overdose is the number one cause of
death for people under 50.
we are racing against time
we have the equivalent of a boeing 737
crashing every single day
but what causes addiction
individuals struggling with addiction
are actually battling millions of years
of evolution
because our brains are exquisitely
evolved to seek rewards it's those
cravings the inability to stop
a dangerous cocktail of biology and
medicine
made deadlier by a drug 100 times more
potent than morphine
fentanyl is super toxic so you get a
batch that comes on the street that's a
little bit hot
and on those days it's like bam
somebody's going down bam somebody's
going down bam
but can new treatments offer hope
we have extremely effective medications
that are life-saving
this is a very treatable illness
the solution to this
is for us to embrace addiction as a
disease to bring it within the house of
medicine
people recover from addiction
nobody is unreclaimable
the only thing that you can't recover
from
is death
addiction
right now on nova
[Music]
mcdowell county west virginia
feels like a place left behind
yet its miners helped power america when
coal was king
back then the largest city welch
was a thriving community
[Music]
but as coal jobs vanished by the 1990s
the poverty rate in the county climbed
to 38
then investigators found that over a
six-year period drug companies had
flooded the state with 780 million
highly addictive pain pills
west virginia was the perfect storm
the whole state's dominated by one of
the hardest and most dangerous jobs in
the world
most of the old-timers that work in the
mines work with pain
and then pain pills started flooding the
community and people that you used to
know
weren't the same people that they used
to be
i mean it
it just it ruined everything
jason edwards and his two brothers scott
and mark grew up in sofia west virginia
the town was near the winding gulf coal
field
most of its residents were minors
including the edwards family
all three sons would struggle with pain
pills
jason got his first prescription after
crushing his leg in a mining accident
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they cut my leg off the day after
christmas in 2008
and i was back underground
mid to late february
first day i went back to work
i had to
crawl everywhere or ride everywhere i
went because
my stump was still too swollen to put my
prosthetic leg on
a man hurts his back if he is not back
to work they will replace him
and i could not have supported my family
on the disability
soon a few pills a day could no longer
stop the pain
but jason could easily buy more by
visiting doctors and showing his
artificial leg
first time i realized that i was in
trouble is when i couldn't go to work
because i didn't have any pain pills
and it wasn't because of how bad i was
hurting
it was because of the sickness due to
detoxing
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jason was addicted to a powerful opioid
painkiller called oxycontin
opioids like oxycontin are chemically
similar to morphine
found in the opium of the poppy plant
they mimic the body's natural pain
relievers like endorphins
which bind to proteins called receptors
calming pain and inducing euphoria
prolonged opioid use can alter the brain
and lead to addiction
manifested by cravings and compulsive
drug use despite
negative consequences
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as opioids were aggressively marketed
west virginia soon had the highest rate
of overdose deaths in the u.s
alarming health commissioner dr raul
gupta
we were amongst the top states
prescribing pain pills in the nation at
the same time people were losing their
employment
they were also losing a way of life
expelled the perfect conditions under
which
addiction
began to creep in
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at stanford university psychiatrist anna
lemke also feared big pharma's pressure
on doctors was creating an epidemic
when she got access to patients
prescription records her suspicions were
confirmed
many people abusing pain pills were
getting them from doctors
not drug dealers
[Music]
i'll never forget when i first looked at
the drug database for a patient of mine
i mean it was just glaringly obvious
she'd been doctor shopping you know 1600
pills i think in the span of a month
and i think it's important to know that
doctors were being sued if they did not
do everything within their power to
address a patient's pain so there was a
serious problem going on here
lemke was also seeing a new type of
patient
an opioid refugee
how's your chemistry class coming it's
quiet what are you guys working on in
there like compounds chemical compounds
so you have to mix like iron casey leads
a protected life
her father ken watched drugs destroy his
brothers
so he moved his daughters out of the
city and put them in private schools
in her teens casey stayed busy with
sports
but she began having severe muscle
cramps
i remember one game in particular
all of a sudden i just started feeling
really shaky and then
everything just started hurting
my legs and my arms just cramped up
really tight she fell straight to the
ground screaming in pain
it took me and one of her coaches to
pick her up put her in our car
rush her out to children's they did a
million and one tests and then they
found you know an ovarian mass well an
ovarian mass and a teen that's scary so
then that required more medical work up
in order to discover that the mass was
in fact benign but by then you know she
had a surgery it had been removed and
through all of this
she received copious opioids
once i left the hospital i noticed that
i was still having a lot of pain but it
was nowhere near the surgery sites that
they had operated on
we couldn't even touch her she was in so
much pain she described it as
it felt like her bones were being ripped
out of her body so the pain she was
experiencing was opioid withdrawal pain
but they didn't know
so they whisk her back to the emergency
room what could this possibly be she's
got terrible pain and essentially every
single time the solution was
prescribed more opioids but after a
while they didn't help as much anymore
so i started taking
way too many
until at one point an emergency room
doctor realized she's addicted and what
was his reaction he basically went out
and he shamed them and he's like your
daughter's addicted we never want to see
her here again
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stunned ken drove home with no idea of
how to help his daughter
casey was now an opioid refugee battling
cravings and withdrawal on her own
we just felt powerless
and as a dad i'm supposed to be her
protector and i just felt like i had
i had completely let her down that
i i just didn't i mean i just didn't
know what
what to do anymore
there was implicit trust
if this medication were dangerous they
would tell me
as long as we take it just as prescribed
everything is going to be okay
and that is totally untrue
casey's a great example
now given her family history of
addiction she probably had an underlying
vulnerability right but what made her
addicted was the opioids that she
received from her doctors
addiction runs in families and studies
suggest that genes play a role in
determining one's risk
addiction is a complex disorder and as a
complex disorder there is not one
addiction gene it's multiple genes and
multiple other factors that interact
with your genetics that increases risk
over 90 percent of addiction cases start
before age 21 when the brain is still
forming
[Music]
for jason's brother mark it was a time
of impulsive decisions
i had no idea how dangerous pain
medication would be
i never woke up
any day
and said man
i want to be an addict today
and i asked myself how did you end up
here
and i look back on my surroundings and
everything that was around me
people everywhere
was was doing this
it was almost like there was nothing
else in life
as doctors prescribed fewer pain pills
drug cartels filled the void by selling
heroin
an illegal opioid cheaper than oxycontin
[Music]
overdose deaths climbed as heroin long
available in inner cities turned up in
rural communities
[Music]
in a single year more than 70 000
americans died of an overdose
addiction is america's number one
domestic issue today
we have
hospitals that are overwhelmed with
people who need help we have a prison
system that is filled with people who
actually need treatment
we have judges that are often seeing
more people with mental diseases than a
psychiatrist or a primary care physician
like me sees in a day
the entire fabric of our society is
being destroyed
as a result of addiction
addiction is often viewed as a moral
failing
stigmatized by words like clean dirty
abuser addict
but scientists now know it's a disorder
that occurs as the brain changes in
response to drugs
individuals struggling with addiction
are actually battling millions of years
of evolution because our brains are
exquisitely evolved to seek rewards to
seek reinforcement wherever and whenever
we can
to understand how reward shapes behavior
robert malenka simulates a famous
experiment
a mouse is attached to a fiber optic
cable and placed in a cage with two
holes
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when the mouse explores the hole on the
right a flash of light sparks a feeling
of pleasure in its brain
at the other hole nothing happens
yep there he goes again right now
we are learning machines our brains have
evolved to be exquisite reward seekers
and that was important for our
evolutionary survival but that came with
the price
our susceptibility to developing
addictions
obsessed with that burst of pleasure
the mouse will probe the hole several
thousand times over the next hour
i mean look at this he's just doing
nothing else
[Music]
this experiment revealed the reward
pathway in the brain primarily
controlled by a chemical messenger
called dopamine
dopamine tells your brain to pay
attention that whatever it just
experienced is worth getting more of
it's released by endorphins
or when we encounter anything
pleasurable or exciting
especially drugs that can push dopamine
levels 10 times higher than normal
all drugs of abuse cause this unnatural
rise of dopamine and because of that
they're among the most powerful
experiences our brains can have
as drugs raise dopamine levels they also
alter the connections between brain
cells creating memories of euphoria that
trigger fierce cravings
but it's not just about seeking pleasure
people struggling with addiction soon
use drugs to avoid the pain of
withdrawal
withdrawals will make your bone take
i couldn't leave the house because
i couldn't take a step
without soiling myself from the
withdrawals
you couldn't talk to me
i'd throw something at you bite your
head off
when opioids are abruptly stopped stress
hormones are released at catastrophic
levels
this imbalance triggers the opposite
symptoms of opioid use including shaking
anxiety pain and intense dysphoria
many times i would lay my head on a
pillow and think i'm done i can't live
like this i don't want to be this person
and i would wake up the very next day
and i would just do more drugs
i was powerless
over
my addiction it consumed me it owned me
i was a slave to it
[Music]
this cycle of addiction says dr corey
waller starts as the brain struggles to
rebalance as drugs overwhelm it with
dopamine
when that happens the body decreases the
production of dopamine and eventually
you can't even get enough dopamine
produced to get out of bed let alone
produce good relationships and good
decision-making
to understand what happens to dopamine
dr nora volkov has been imaging the
brains of people with and without
addiction to search for changes that
occur with drug use
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we systematically were investigating
individuals addicted to different
classes of drugs and we found that a
common change across all of the
different types of drug addictions was a
reduction in the levels of dopamine d2
receptors
the number of receptor proteins seen
here as read in the brains of control
subjects are reduced in brains exposed
to drugs
fewer receptors means the brain is
starving for dopamine
[Music]
drugs interfere with your motivational
drive
so imagine what it means to lose the
motivation to do things to just not have
it
and so anytime someone hears the term
motivation they should really supplant
that with dopamine because without
dopamine you don't have motivation
and so when we look at a person who is
in the throes of an addictive disorder
and say they just need to motivate
we're telling them to somehow magically
make dopamine
and it's not just drugs
gambling or eating can also spike
dopamine levels and become addictive
volkov found that people with morbid
obesity also have fewer dopamine
receptors
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once those receptors are going down
you are going to have a great difficulty
in self-regulating the desire not to it
because cognitively your brain is
fighting on the one hand you say i i'm
obese i don't want to eat anymore
and at the same time there is intense
craving
and if your brain is not functioning
properly
you cannot
win the game
you are going to give in and impulsively
and compulsively eat that food
and drugs can unleash even stronger
cravings
my wife at the time went and seen her
sister for nine days
and i spent 21 thousand dollars while
she was gone
uh
on pain medicine
i did lose my job i didn't care
only thing i cared about was that
magical date on the calendar when i went
back to the doctor
the body has a drive for dopamine and
that craving flips them into survival
mode
if you understand that this is about
survival for them you can understand why
they steal 20 bucks out of your wallet
why they hock jewelry from the house
my habits was putting my wife and my
daughter in danger
finally she just done what any mother
would do
and they left
jason attempted suicide after his
brother scott died of an overdose on the
outskirts of town
for mark edwards it was a moment of
reckoning with his own addiction
i did not want to be that person that
was broken
and i wanted to get help but every place
that i called didn't have beds available
i felt like that if i didn't do
something that i would end up dead
another drug is making the epidemic even
deadlier
especially in vancouver canada
the city has become a gateway for
illegal fentanyl made in china
normally used for anesthesia fentanyl is
so potent it's often shipped a few
ounces at a time and later mixed with
other drugs
hidden in innocuous looking packages
much of china's fentanyl is headed for
u.s markets
but it's also devastating vancouver
fentanyl is a synthetic opiate created
in the lab it is super toxic so you get
a batch that comes down the street
that's a little bit hot
and on those days it's like bam
somebody's going down bam somebody's
going down bam
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up to 50 times stronger than heroin an
amount of fentanyl equal in size to two
grains of salt will kill you
fentanyl's path of destruction is
closely monitored in west virginia by dr
raul gupta
using a digital map gupta follows
overdoses as they occur
circles stand for non-lethal incidents
squares indicate fatal ones
and a spike of deaths in nearby states
means fentanyl tainted drugs may soon
show up in west virginia
on one day we had 26 overdoses reported
to us it was almost like a communicable
disease outbreak
and here's the scariest part we found
that of all of those people who
overdosed
none
no one
was ever admitted into a treatment
facility
but many people don't survive at all
because opioids if taken in excess can
quickly shut down breathing
and because of the potency of fentanyl
the risk of a fatal overdose is high
no matter who you are
or where you live
[Music]
jonathan was a wonderful young man from
a very early age compassionate smart
loving
our family did
go through many moves we lived all over
this country overseas
so that was i think tough for jonathan
jonathan winnefeld was born into an
accomplished family
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his father james rose through the naval
ranks to become the vice chairman of the
joint chiefs of staff in 2011
by that time jonathan was struggling
at one point he was in five different
school districts in six years which is
tough for a kid
and so what became apparent to us over
time was that jonathan as great a kid as
he was was suffering from some form of
anxiety and depression
unfortunately jonathan was misdiagnosed
with attention deficit disorder
and prescribed adderall a powerful
stimulant
[Music]
soon to unwind at night he began to
drink
to calm his anxiety he used xanax a mild
tranquilizer and smoked pot
[Music]
then
he experimented with heroin
so we got him into counseling and i did
what a normal parent would do i took
away the xbox i took away his phone i
monitored all of his moves
in retrospect it was probably the worst
thing i could have done for him because
it isolated him even more
and ultimately he tried to take his own
life
he ended up wrapping his car around a
telephone pole
it was at that point when we realized
that we needed to get jonathan into
inpatient treatment or we were going to
lose him
i went on the internet and searched and
it's overwhelming there are so many
different places out there you don't
know who's good who's bad
who's just trying to make money
financially our insurance covered
nothing we really tried to find the best
treatment possible out there but in
america there's not a lot of support in
the mental health
and especially in substance abuse
the winnefelds found a center in
connecticut to treat jonathan's
addiction and anxiety
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like some 80 of programs it followed the
12-step model of alcoholics anonymous
where patients admit they are powerless
over drugs need help from a higher power
and commit to abstinence
if we look at the legacy treatments that
have been around for 70 years they
revolve around going to meetings and
working through the 12 steps
generally doing that a lot with
self-help and group-based therapy and
then maintaining that abstinence by
using that alone
jonathan's treatment for 15 months cost
the winnefelds hundreds of thousands of
dollars
but it seemed worth it
our son came back to us
we were able to have a real conversation
with him we saw
about a year into his treatment that he
regained his ambition
seeming confident of his recovery
jonathan enrolled as a freshman at the
university of denver
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day we dropped him off at his dorm he
was excited looking good
fired up and it was one of the best
moments of my life seeing him doing so
well
three days later
their hopes were shattered
i was not prepared to get a phone call
saying that my son had passed away in
his bed in his dorm room
from heroin and fentanyl
never never never would have guessed
that in a million years
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with failure rates nearing 80 to 90
percent
is the abstinence-based approach to
opioid addiction scientifically flawed
abstinence-based programs really for
opioid use disorder are setting people
up to fail and to relapse and in the
face of this crisis where we know that
every single time that somebody uses an
opioid they are at real risk of
overdosing and dying this should never
be recommended as a primary intervention
in morgantown west virginia dr james
barry also believed abstinence-based
treatment was failing his patients with
opioid addiction
we would get them successfully detoxed
get them exposed to family therapy group
therapy individual therapy
and we'd find that they would invariably
relapse and they'd just be out there on
the streets using again
frustrated barry considered using
methadone a long-lasting opioid that
curbs cravings from heroin and pain
pills without causing euphoria
methadone binds to opioid receptors and
normalizes brain functions altered by
addiction
including dopamine levels
here is the medications
under current laws most patients must
take it at clinics
education
in 2003 the opioid buprenorphine became
available under the brand name suboxone
which could be taken
at home
less potent than methadone suboxone only
partially activates opioid receptors to
reduce cravings
if taken as prescribed and not misused
both drugs cut mortality by about half
[Music]
after a year forty to ninety percent of
patients are in recovery
you feeling better barry began giving
patients suboxone
oh yeah 100
they started doing well they started
getting their lives back they started
getting to work again
uh lawrence how are you good
and how much time you got today i got
like 260 or 252 245 days 245 okay yeah
tell us what you've been doing for the
last two weeks
work is picked up i'm about to buy into
my boss's business yeah 35 he's gonna
let me buy in so that'll be awesome for
me so you really showed him what you've
been able to do yeah
the main thing that makes suboxone so
effective is it's helping with these
cravings that people are experiencing
but it's so hard to break that chain
patient after patient after patient will
tell me the same story listen doc i am
not using to get high anymore i am just
using not to be sick anymore what
suboxone does is it satisfies those
cravings in a way that they're under
control it works so much better
i'm calming that demon inside you
if i went home and started doing
opiates again i was gonna kill myself
with cravings under control patients can
take advantage of a range of therapies
to help them cope and rebuild their
lives
there are fantastic psychosocial
interventions like retraining your brain
being mindful learning more adaptive
coping strategies the night before i
would say you know this last time
because it's not just one epiphany
moment it's a learning process you have
to learn to be sober and it takes
practice it takes trial and error and
you've got to be ready for the ups and
downs
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one challenge according to psychologist
rita goldstein are the changes that
occur with addiction in the brain's
executive control center
the pre-frontal cortex
this is the prefrontal cortex in the
front of the brain and we're looking at
gray matter separating it from the white
matter so you can see it's actually
tinted dragging this scan
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scans reveal that chronic drug use is
associated with reduced gray matter
especially in the pre-frontal cortex
those regions are essential to make
advantageous choices to make the right
decision at the right time so the lower
the gray matter the more the decision
making is impaired you have a decrease
in the ability to control your behavior
neuroscientist yasmin hurd has found
another way that chronic drug use
impacts the brain
by analyzing the brains of overdose
victims she's discovered that heroin
changes the activity of key genes
heroin changes the way our dna functions
it turns on genes that should not be on
and turns off genes that should be
and so that imbalance changes the brain
function
the genes most effective regulate the
brain's key chemical messenger called
glutamate which is essential for sending
signals between neurons making thinking
memory and learning possible
it's not that addiction completely takes
away every aspect of your cognitive
function in fact you have to work even
harder so i think people need to
understand that people with these
disorders are actually fighting a very
strong battle
but is this a battle that can be fought
and won
opioids are still being studied
but scans reveal that dopamine receptors
reduced by other addictive drugs can
come back with
recovery
rita goldstein has seen evidence that
gray matter can increase
the ability of the brain to heal and to
recover is amazing so definitely there
is a lot of hope
the question is how long does it take
and everyone's brain is different
yet most people don't have access to
effective treatment especially
medications for opioid addiction
for dr corey waller the problem is that
addiction is not handled like other
diseases
if a patient comes into an emergency
department with chest pain we have a
pretty standard set of approaches we
evaluate whether or not the heart's
being injured we look at an ekg that
tells me do they need to get something
done quickly and no matter what the
answer is we actually have a place for
them to go
for overdose victims the focus is mainly
on revival
these are patients who are basically
dead they're not breathing they are this
close to being dead forever let's give
the narcan real quick the drug naloxone
sold under the brand name narcan can
reverse an overdose by pulling opioids
off receptors in the brain
all right
good
and in most emergency departments around
the country that's the extent of the
intervention
check the box sign the chart discharge
the patient
unfortunately we discharge them back out
into the wilderness where there is no
consolidated appropriate care for them
although narcan saves lives it can also
put patients into acute withdrawal
without medications to control cravings
many will overdose again
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this human tragedy
really is a human rights issue
the last thing we should be doing is
kicking people out of care that's when
they're in crisis
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massachusetts general hospital runs one
of the few programs in the u.s that
immediately offers overdose patients
medications to control cravings
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this is a treatable illness we have to
have people in that moment who can say
hey
i'm here to help you are you interested
in engaging in care we have suboxone we
can start you on right away
we're seeing people come that day and
engage in care and the vast majority of
them 75 to 80 percent are returning
since effective treatment is hard to
find the costs of the epidemic continue
to rise
[Music]
in charleston west virginia dr stephen
maxwell cares for babies born dependent
on drugs
it's a withdrawal syndrome
they have vomiting diarrhea
frantic behavior they may scratch
themselves
these babies may go for many days
without sleeping or eating
and symptoms it may last up to three
months
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babies in acute withdrawal are weaned
off opioids by giving them smaller and
smaller doses
i just gave her method out about five
minutes ago
every 25 minutes somewhere in the u.s a
baby is born dependent on opioids
many will become wards of the state
we have amongst the highest number of
foster children
in the nation per capita we're having
difficulty finding parents and providing
services in fact we believe it costs
over a million dollars per child
additionally
if they're born dependent
on drugs
many parents with addiction are also
facing challenges like poverty and
trauma
trauma is an experience that overwhelms
you
that leaves you bereft
paralyzed
and with no way out and it can come in
many different contexts it can be
physical verbal sexual abuse childhood
neglect and these problems early in life
put you at risk later in life
studies show experiencing a combination
of five adverse events
can increase the risk of addiction
tenfold
trauma can cause long-lasting changes in
the brain leaving sufferers like marie
also vulnerable to depression and
anxiety
we had somewhat of a decent family life
you know but i watched my dad be my mom
my whole life you know
my dad was an alcoholic
they finally divorced and me and my mom
moved out here
and my mom kind of lost it
that's when i started really just you
know going wild
what you're left with as a kid
is these heartbreaking
feelings of i'm no good and the world's
a terrible place
somebody says to you here is something
that will make this phoenix go away
and so people take drugs because they
can't stand the way they feel
after marie had her first child she
became addicted to oxycontin
child protective services took custody
of her son until she could pass her drug
tests
for a while things went well
[Music]
but marie began struggling after giving
birth to her second child
i'd went home to see my first son you
know because i hadn't been spending time
with him
and then i got a phone call ncps said
get ready because we got to meet you in
charleston and take your kids
during her pregnancy marie had been
given methadone for free
[Music]
but after her delivery she had to pay
for her treatment
with no money or insurance she relapsed
it's a reality faced by countless people
without resources
by that time i was methanol clinic over
600 some dollars you know of course when
you go back you know they wouldn't see
you no more because i owe them too much
money so i couldn't
i couldn't dose no more so here i am
back at it again you know
she needed services that we're lacking
here in rural west virginia
she needed those to be available for her
and they're not
and that saddens me because
because i know
that their mom's
hearts break
i'll never forget that whole
scene in my life they surrounded us with
cops and that was not needed you know
and my three-year-old said mommy hold my
hat while i'm gone
and
he took him away
people always want to talk about how do
we
stop the cycle
that's how we stop the cycle you don't
stop the cycle by pulling the baby
because mom took drugs
we just need to see it and treat it like
it's any other disease
you get the mom stable you get baby
stable and you go home with the family
[Music]
back in vancouver the opioid epidemic
spurred the city to take bold steps even
before fentanyl tainted the drug supply
in 2003 it sanctioned the first legal
site in north america where people could
inject illegal drugs under medical
supervision
called insight the program provides
clean needles to prevent the spread of
infectious diseases
drugs to reverse overdoses and help
accessing services like medically
assisted treatment
when people come to insight often the
first thing that they're thinking is i
need a safer place to use i don't want
to die in the alley i'm tired of living
in essentially what are third world
conditions so what we're doing is we're
saying come on into first world
healthcare and in the years since
insights opened overdoses in the area
have gone down and our hiv rate in
vancouver has plummeted dramatically
insight's success boasted other efforts
at the overdose prevention society sarah
blyth helps people test their drugs for
fentanyl
but that's not the only contaminant
she's worried about
[Music]
because we've seen everything from
cement filler to comet to pig dewormer
like you name it anything that they can
put in there they do
and it's dangerous
a pink stripe indicates the presence of
fentanyl
it's now found in 88 percent of illegal
opioids here
like many long time users daniel knows
he's injecting fentanyl
but the fear of dying isn't as powerful
as his cravings
he first took opioids in prison to calm
his anxiety
there's always a fear
of something horrible about to happen
there's going to be somebody getting
stabbed a fight's going to break out and
so when i did that first hit it was the
first time i felt like i could relax and
not have to worry
[Music]
to my mind obviously the most important
thing about supervised injection sites
is that it implicitly says that these
lives are worth saving these people are
valuable to us what's really important
about it as well is that it's a space of
connection
that's the space that people are going
to ask for help from
supervised injection sites are illegal
in the u.s
but in canada the controversy is waning
[Music]
for 22 years bill spearn has walked the
streets of the downtown east side
[Music]
although drugs are still here
overdose deaths decreased 35 percent
after insight opened
[Music]
once a skeptic of supervised injection
sites
today he's not
does it increase crime
does it encourage drug use
is inside a big magnet that attracts
drug users from all over the world and
the answer is no it doesn't and i think
that harm reduction is something that
every city should consider
because it keeps people alive
it actually saves taxpayers dollars
the most expensive housing that we have
in this society
emergency rooms and jail cells
we need to quit putting people in those
and start putting people in more
compassionate spaces like supervised
injection sites
[Music]
meanwhile in west virginia
health commissioner dr raul gupta is
also trying to reverse the soaring
number of overdose deaths
[Music]
today he's traveling with a volunteer
medical team to bring free health care
to mcdowell county and take steps to
stop preventable deaths
because overdose fatalities here are
seven times the national average
gupta and his colleagues are trying to
get naloxone the overdose reversal drug
to as many people as possible
that's how this drug works to save your
life okay
but after that you've got to get help as
well
i don't look at this as a single
epidemic i look at this as multiple
epidemics coming together and evolving
in real time
gupta is worried about the huge spike in
hepatitis and the rising number of hiv
cases
patients are offered free testing to see
if they need treatment
it just takes 20 minutes
now i want to talk to you about needle
exchange are you okay with that okay
mcdowell is one of the few counties that
allows needles to be handed out to
prevent infections inside okay the idea
here is to have your own set
according to gupta's analysis every
dollar spent on harm reduction saves up
to seven dollars in medical costs
and steers people towards treatment
when you do want to get help whether
it's counseling on any other aspect
we're here to help you
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the costs are really unsustainable if we
continue this path losing over half a
trillion dollars a year for multiple
years
in our economy
we've got to be smart about addressing
addiction we have to
find ways to prevent it from happening
in the first place as a country we have
neglected it
and we have stigmatized it and we have
criminalized it and that has not solved
the problem in fact it has made it worse
but america's addiction crisis is not
just limited to opioids
each year over 80 000 people die from
excessive drinking
[Music]
smoking is responsible for over 400 000
deaths
and so if we don't build
a stabilized appropriate evidence-based
treatment system for addiction
then the reason that medicine gets so
costly every year is because what we're
trying to do
is not intervene on the front end we're
trying to fix everything that's broken
on the back end
the solution to this
is for us to embrace addiction as a
disease to bring it within the house of
medicine so that anybody struggling with
addiction can walk into an emergency
room or a pediatrician's office say i'm
having a problem with drugs or alcohol
will you help me
and that the answer is an enthusiastic
yes
[Music]
today most people struggling with opioid
addictions cannot access medications or
treatments proven to be effective
[Music]
some people recover on their own
but it's rare
[Music]
jason is one who beat the odds
he is remarried and delivers cars for
his brother mark's business
[Music]
i'm not the man that i want to be but
i'm not the man i used to be thank god
i try to become better every day
sometimes i fail sometimes i succeed
but i keep trying
mark recovered after five years of
methadone treatment followed by a
faith-based
program and that love began to change me
in a way that i didn't think would ever
be possible
[Music]
good job
casey is now on suboxone and studying to
become a doctor
her muscle cramps have been diagnosed as
fibromyalgia and rheumatoid arthritis
[Music]
to control her symptoms she takes 11
other medications but none
are opioids
recovery is definitely possible it might
take
years or months or however long but it
is possible
marie is on suboxone and getting group
therapy paid for by medicaid
today she is going to see her youngest
son who lives with a foster family
[Music]
mommy
come here
what are you doing get me here
[Music]
that baby means so much to me
now that i'm getting it together i hope
that as time goes by they'll see a
difference in me you know
as long as marie is in recovery she can
visit her children
[Music]
i wish you could go with me bubbe i want
you to go with me if you only knew
[Music]
people recover from addiction
they need basic stability stability of
relationships
they need housing
they need that sense of a future that
they can look forward to
when we offer people things like that
they get better they are better
nobody
is
unreclaimable
[Music]
[Laughter]
[Music]
to order this nova program on dvd visit
shop pbs or call 1 800 play pbs this
program is also available on amazon
prime video
[Music]
[Applause]
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you