American Thought Leaders - Dr. Drew: From the Opioid Crisis to COVID, the Physician–Patient Relationship Is Increasingly Impaired

Episode Date: December 10, 2024

Drew Pinsky, popularly known as Dr. Drew, is an addiction medicine specialist and host of the TV series “Ask Dr. Drew.” For decades, he has been studying public health and drug addiction in America, exposing its ongoing challenges in nationally syndicated television and radio programs. He saw early on during the COVID-19 pandemic that the response from the authorities would cause unnecessary harm and suffering.“A member of the school board came in and said, ‘We’re going to lock the schools down.’ And I said, ‘Why? Why are you doing that? Who did you consult with? Did an infectious disease doctor come in and say you’ve got to do this?’ ‘No, it’s just the right thing to do.’ ... I knew then that was big, big, big trouble,” says Pinsky.He says that how authorities reacted to the pandemic followed a similar playbook to how they responded to the opioid crisis. And in both cases, he argues, the physician-patient relationship has degraded.“The physician-patient unit is so badly encumbered and so badly adulterated right now that it’s hard for it to function,” says Pinsky. “There are some of us that can’t get over COVID—not the virus—the way our country dealt with the COVID, just mind-boggling.”Pinsky is particularly concerned about the centralization and algorithmizing of medicine.“The young folks are being taught to look at the computer and just fill out forms, do an algorithm, look things up if you don’t know—I mean, I don’t know how you develop judgment. I don’t know how you think about a risk-reward if all you’re doing is following an algorithm on your electronic medical record. It’s really disturbing,” he says.Views expressed in this video are opinions of the host and the guest, and do not necessarily reflect the views of The Epoch Times.

And a member of the school board came in and said, we're going to lock the schools down. And I said, why? Why are you doing that? Who did you consult with? Did an infectious disease doctor come in and say, you've got to do this? No, it's just the right thing to do.

I knew then that there was big, big, big trouble. Drew Pinsky, popularly known as Dr. Drew, is an addiction medicine specialist and host of the TV series, Ask Dr. Drew. For decades, he has been studying public health and drug addiction in America, exposing its ongoing challenges in nationally syndicated television and radio programs.

The physician-patient unit is so badly encumbered and so badly adulterated right now, it's hard for it to function. The idea that medicine can be centralized and algorithmatized is disgusting to me. There are a lot of parallels between America's COVID response and the policies that led to the opioid crisis, he says.

There are some of us that can't get over COVID, not the virus, the way our country dealt with the COVID, just mind-boggling. This is American Thought Leaders, and I'm Jan Jekielek. Dr. Drew Pinsky, such a pleasure to have you on American Thought Leaders. Pleasure to be here. So you're going to be giving the keynote pretty soon at this Brownstone conference, but tell me a little bit more about what you're expecting to see here, what you hope to get out of it.

You know, it's already exceeded my expectations. Jeffrey Tucker Brownstone is such a genius. We live in a weird time of almost salons, of these gatherings. I had the privilege of having been in several of David Rubin's salons where I met interesting people, learned a ton. This is the same phenomenon. Fortunately, I've also interviewed many of the people here, and it's always been at a distance via Zoom. A lot of it started during COVID where you weren't allowed to travel or come see anybody, but it was great to meet everybody in person and to hear

them and to have them sharing thoughts amongst themselves. It's been just, I mean, I just took notes all day long. I just found it a thrilling experience. Well, and it's really interesting. You've been doing something that I've really only been doing, i.e. like being on camera talking to people. I've only been doing this for maybe five, pushing on six years. You've been doing it for quite a bit longer. I've been doing it only, let's see, five, number nine, 35 years. 35 years, to be more precise. Yeah, a long time. And you've had quite the evolution in your thinking. That's what I... Thinking. Keep going. Because I've had evolution in what I've been doing. Fundamentally, I got involved

in media to try to do good, to use this juggernaut, this leviathan that is media, to try to help people be healthier, make good choices, be happy. If there's anything I can use the media to try to climb into, even in environments where I don't belong, if I can reach people that need what I've got, I'm happy to go there. And so this all started my digital stuff. I do a thing called Ask Dr. Drew now, primarily Tuesday, Wednesday, Thursday at 3 o'clock Pacific time in Los Angeles. And we started that during the darker hours of the lockdowns in COVID, particularly in California, which were draconian. And I just started answering questions live on

this stream. Actually, I think we even started on like Facebook Live or something. I just wanted to just interact with people and try to reduce their anxiety and answer their questions. And about a month into it, I started feeling like I was the French underground. I mean, it felt illicit. They were so aggressive with not allowing for any discourse or any opinions to be offered, it just felt weird to me. So I just answered questions as I saw it. And then it evolved into other things.

Well, but even before this, you've focused on, for example, opioid addiction, right? Addiction in general. A lot of my life was running a large addiction program. Right. And I mean, that hasn't gone away. No, it hasn't gone away, but there's movement at least. I mean, look, the playbook by which the opioid pandemic was delivered, at least the pharmaceutical opioid pandemic,

was the exact same playbook that was used in COVID. That's something I'm going to talk about on my presentation tomorrow night. Well, maybe, you know, tell me a little bit, because, you know, we're going to publish this after. Okay. So the first opioid crisis in this country was towards the end of the 19th century. The hypodermic needle, morphine sulfate, methadone, these things were all developed the latter part of the 19th century. And the physicians were the delivery system for the opioid pandemic in that era. And it was massive. The Harrison Narcotic Act that came in in the early part of the 20th century actually is alleged to have jailed as many as 20,000 physicians for their excessive opioid prescribing. and it stopped immediately. And that intervention

was so draconian that physicians turned away from opiates for 80 years, or at least certainly 60 years. And we were sort of cautious about them, afraid to use them, not using them. In the 60s and 70s, we started seeing the advent of more effective treatments of cancer. And so we had a lot of people living with cancer and developing more advanced stages of cancer before they died with pain. And a group of people emerged who said, this is ridiculous. We should be treating this, which was absolutely great. For sure that was true. And opioids were the answer.

For acute cancer and surgical pain. Opioids are the solution. They were never, ever shown to be useful in chronic pain. In other words, after about two weeks, opioids, they generally don't work. They cause headache, back pain, and something called hyperalgesia, which is the intensification of pain. So everyone was getting strung out in oral opiates because my back hurts. Well, that was the opioid withdrawal. And the pain was overwhelming and disabling because of hyperalgesia, all opioid-induced. So that's the background where that group that came in that

started managing pain in the cancer setting and surgical setting and getting very good at pain, acute pain management and cancer pain management, looked around and said, you know what, there shouldn't be any pain. We are the saviors for the American public. We're going to prevent them from ever experiencing any pain. I have all these quotes from the pain specialist of the day saying, we considered ourselves a white hat profession. We were going to rescue the world from pain.

Then the evangelist from that discipline of pain management, which became a highly ensconced specialty of medicine, psychiatry, and anesthesia, it became a structured, board-certified discipline. The leaders in that group went out and got control of the regulators so these evangelists went out and got the medical societies the VA the local departments of health and the first to adopt was the VA system who took the position the adopted what these pain management guys were suggesting which is that pain is more important than any other vital sign.

Forget your pulse. What's the pain scale? Pain, the fifth vital sign. Do you remember that slogan? Pain is the fifth vital sign. That was a mandated measurement. When you got the pulse, the blood pressure, the temperature, the respiration, and the pain scale, top of every physical, every time a doctor interacted with a patient, mandated by the medical societies, the insurance agencies,

the medical society, everybody mandated it. And doctors were trained to give as many opiates as the patient wanted. If they left with less than 60 pills of Vicodin, you were potentially doing patient abuse. At the same time as all these regulatory standards kicked in, the lawyers caught wind of this and started, again now, this is the legal system stepping in, and suing doctors and criminally prosecuting doctors

for undertreatment of pain. So in North Carolina, Florida, and California, doctors were going to jail again for not using enough opiates. When that happened, immediately doctors froze, stopped prescribing, sent everything to the pain management teams, and pain management said pain is what the patient

says it is, pain control is what the patient says it is. So if that's true, you don't really even need a doctor. And in some parts of Florida, that's exactly what happened, for instance, where you could walk into a pain management clinic and just go, yeah, I'm in pain. I'm a 9 out of 10. I need that Demerol. I need that fentanyl.

And then you walk out with your bag. My patients were killed by the hundreds by those practitioners. Of course, opiate addicts loved that. And so they were causing opiate addiction on one side, and they were killing opiate addicts on the other. And I got so tired of taking patients off opiates, their pain going away. It was the same thing with every single patient.

They come in, they go, what's your pain on a scale of 10? They'd always say 15 or greater always then three days in we detox and we take them off three to five days later you go now you they would not talk about pain anymore but before that's all they could talk about and they would you'd ask them what's your pain on a scale of 10 they'd say five with no treatment off just get them well other than detoxification or something, right? And so this was happening to me all the time. I was getting these patients off opiates.

Their pain was being managed. They were not troubled by pain anymore, but they're drug addicts, so they'd go back to their doctor, and the doctor would go, why do you listen to those people? I told you you're going to need to stay on this the rest of your life. Dead. Killed so many of my patients that way. That is not a story that I'm aware of until this moment.

Now think about COVID. You have these bureaucrats who are evangelically possessed that they're in the right. Guys like Scott Atlas and Robert Redfield try to reason with them with data. They're like, you're an outlier. Get out of here. We know what's right for the American public. Birx evangelizes in every state, gets control of the governors and the regulators. Now you have lockdowns. Same playbook.

The exact same playbook. Again, perpetrated by my profession. And so how early did you see that something was off? With opioids or COVID? With COVID. With COVID, I knew something wasn't right as soon as two weeks to flatten the curve, so-called, which to me sounds like a marketing ploy, but okay, we're going to see what's going on. Two things happened to me. One, the governor of California came on and said, hey, man, we're going to do this. We're going to lock us down.

I was like, I can't believe you're doing it. I couldn't believe it. It just seemed like such a terrible idea. He brought in the Navy's hospital ship into Los Angeles Harbor. And I was like, what is he expecting? I don't see it. But okay, he's preparing for the worst. I'm a good citizen. I'm going to support him.

Even though I think it's a terrible idea, he doesn't need to do it, fine. So that was when I was like thinking something wasn't right. Then I was doing a nightly news broadcast in Los Angeles trying to help people understand what was going on and we were probably a week into that broadcast and a member of the school board came in and said, we're going to lock the going on. And we were probably a week into that broadcast,

and a member of the school board came in and said, we're going to lock the schools down. And I said, why? Why are you doing that? Who did you consult with? Did an infectious disease doctor come in and say, you've got to do this? No, it's just the right thing to do.

I knew then that there was big, big, big trouble. And that was March, March of 2020. I just thought the people, the press was taking advantage of us to get our eyes, make us panic, enhance their business. So I made a mistake of starting to run around going, just don't listen to these people. Just don't listen to them. The mistake I made, I kept saying was, listen to the CDC and listen to these people just just don't listen to them the mistake i made i kept saying was listen to the cdc and listen to dr fauci i worked with them for years they will get us through this that was the only thing i really got wrong i didn't realize how adulterated they would be i was also saying look we intent 12 years ago we just went through another pandemic did you

know that the h1n1 pandemic was nasty that was a terrible illness I had it had patients that had it was an awful illness killed 300 000 people and you don't know it happened and we're going to go from that to destroying the world on behalf of this one isn't there a somewhere in the middle we could be and that went down for the world as Drew says, this is just the flu. There was a hysteria. Look, Ike was saying at the time that if I had a very seriously ill patient, I stood at the end of the bed and went, oh my God, oh my God. Is that going to help?

Or are we going to be, look, we're going to take this, we're going to do the best we can. It's a serious situation. Sit tight. We're going to get this. That's how you manage people. You don't scream hysterically. And you also don't undo all your ethical standards and throw away the Constitution and the Bill of Rights. That's what I can't get over. There are some of us that can't get over COVID. Not the virus, the way our country dealt with the COVID. Just mind-boggling. I felt like my world changed in March of 2020. I can't believe what happened. What would you say are the biggest

lessons you've learned over the time that you've watched society responding to these kind of new medical scenarios, right? Most of my learning has been in the last four years because I had a lot of assumptions about how things worked before that. Something I was fighting against for many years was the insurance companies and the regulators interfering with my ability to take care of patients. That is constant. And the COVID experience has re-entrenched my sense of the importance of the autonomy and the sanctity of the physician-patient relationship.

I feel that we have lost that battle, so much so that I'm working now with companies to try to deliver products and services directly to patients and put the autonomy now with the patient, maybe with some telehealth support, but that the physician-patient unit is so badly encumbered and so badly adulterated right now that it's hard for it to function. And that the idea that medicine can be centralized and algorithmatized is disgusting to me. It's the exact opposite of how we're going to get good health care in this country. Well, this is very interesting because I've spoken with a number of people at this conference on the show talking about, I guess, the Hippocratic Oath meaning a lot less, or some people would even say being thrown out the window or something like that. Certainly not being properly understood. Well, do no harm, risk-reward, gone.

I feel like do no harm is my mandate, risk reward is what I must consider in every moment of my evaluation with a patient, even advising them to cross the threshold of my office. There's a risk reward in that. Francis Collins said it out loud that, well, you just become, when you're in this position, you just focus on one thing, the virus, and nothing else matters. When I was training residents, if they couldn't come up with their risk-reward analysis on every decision they made, I would crucify them. And the thing that if they ever said to me

that was the most intolerable, if I'd asked them why they made that decision, and the answer is, I just had to do something, no way. I'm not going to be kind to that, let's just say. Because that's how you harm patients. So it's the opposite of do no harm, because that's how you harm patients. So it's the opposite of do no harm, and it's the opposite of risk-reward consideration.

And what about this element of, I guess, disclosure of risk? No, that is informed consent. That is the basic job when you offer a treatment for somebody. You have to make sure that it's done with the patient. I mean, look, it may have been before my time that doctors would just do things and, you know, the patient would trust it. I was trained that it's a co-decision and every single decision is made with the patient and the treatment is agreed upon with the patient based on my ability to communicate the risk-reward analysis to them. I've recently become aware of this. Actually, it was talked a little bit about in today's meetings,

about the increased commoditification of the human being and the rise of this utilitarian bioethics. And I haven't been following this closely at all. I've been reading about it. I'm curious if you followed that. I don't, but Brett Weinstein said something very, I thought, prescient today when he talked about the public health being the opposite of health care. That, you know, a master in public health is somebody trained in a system of transference of the well-being of one person to somebody else or the whole. And that is anathema to health care.

I can't even imagine that we allow that, let alone train people to do that. Except that public health, I mean, there is a place for public health, right? Looking at things from a broader perspective. For sure. And acting. Yeah, and provide that information to the doctors and to the local communities so they can make the decision where they can weigh these things and make a good decision. I see.

So it's like this, what is it, subsidiarity principle, right? It's the mandating. It's the decisions from on high. Look, Alexis de Tocqueville, when he ran around this country, he's a French aristocrat, was here ostensibly to evaluate our penitentiary system, as it was called at the time, because it was so effective. And he, on the DL, actually wanted to figure out why democracy, which he thought was the new movement worldwide that was inevitable in all countries, why democracy was working in America. So he wrote a book called, a two-volume book called Democracy in America, and he concluded that the reason democracy worked here was because of the mindset,

or it was practiced all the time, but most importantly, it was a local practice of democracy. Local. Decentralized. That's why this country works. Centralization. Federal government was never supposed to be in my life. Supposed to deal with interstate commerce, make sure the states got along, common defense, that's it. Maybe protect some rights. Okay, done. So, have you thought about, at least in the medical context, how to challenge that, I guess? That's why we're here, trying to figure it out. Again, I've been working with companies companies are trying to get services and medication things directly to patients in a cost-effective way that that's been my latest thing because I

don't know what to do with the practice of medicine generally it's just it you know the young the young folks are being taught to look at the computer and just fill out forms do an algorithm look things up if you don't know I mean you don't know. I mean, I don't know how you develop judgment. I don't know how you think about a risk reward if all you're doing is following an algorithm on your electronic medical record. It's really disturbing. It's interesting. In the last panel or the second last panel, we talked about parallel structures, something that came out of discussions under communism in Central and Eastern Europe. Your thoughts?

No, I do think there are going to be parallel systems. I do. Look, just the insurance situation in and of itself is so egregious. I don't know if you understand how they muscle us. So if you're a Medicare provider, meaning you want to take care of old people, you are required to charge exactly what Medicare tells you to charge. And if you make that charge, you have to justify it in the record that you meet the Medicare criteria for that charge.

That charge, on average, is about $38 every 15 minutes. Mind you, it costs over $100 an hour to run a practice. But it's about $38 every 15 minutes. So you're it costs over $100 an hour to run a practice, but it's about $38 every 15 minutes. Okay, so you're making $20 an hour. That's Medicare. On the regular insurance side, everything has to be pre-approved and everything has to meet criteria. They set the criteria.

Their criteria are arbitrary and they evaluate the criteria at a distance based on what I tell them. Forget the fact that it's my opinion that this patient needs this care and here's my justification. If my justification doesn't meet their criteria, no. Let me show you how it works in an addiction unit because all the time this would happen. They'd go, Dr. Penske, I need this patient out in three days. Now, these are people that need weeks of treatment, if not months of treatment. So I'm trying to figure out ways to extend their care and provide services any way we can to keep these people okay. The patient, of course, is mortified. They can't believe that they're going to have to be out of a—they're not well.

They're in withdrawal. Why are they supposed to be out in three days? They feel like they're going to use. They need more help, more treatment. They call their insurance company. Insurance goes, of course you can stay. If Dr. Pinsky would just tell us what your criteria are. Doesn't tell the patient, we set the criteria.

He's already done that. We don't feel like his criteria and our criteria quite meet eye to eye. So I have to tell the patient that, and I have to say, and tomorrow, if you're still here, I can't rescue you from the cost of further hospitalization. It's going to be out of pocket, which seems your drug addict, you know, it's going to be, this is gonna be challenging. So I got to figure out a place to put you something to do. The insurance company takes the position that let's say that patient goes out and overdoses or kills themselves, the company goes, we didn't discharge the patient. We don't practice medicine. There's Dr. Pinsky's

name right there in the discharge order. He wrote the discharge. So several times I got very upset by that nonsense. First of all, you make lots of appeals. The appeals go nowhere. I finally called the California Insurance Commission. My hospital gets a report from the insurance company. We understand Dr. Pinsky is not approving of our business practices. I'll tell you what, we're going to no longer provide services for him. We will not certify him or the hospital. We're going to decertify the entire hospital because of his complaint to the insurance commissioner. That's the game they play. We've been four years through COVID. There's still a lot of challenges, a lot of questions about what the future holds, right, in terms of pandemics, in terms of healthcare in general. What do you think needs to happen now?

I wish there would be... You've heard in the room today a lot, there needs to be a reckoning, there needs to be apologies. I mean, there needs to be acknowledgement where there are errors and then corrective action put in place. But I'm fearful that there will not be enough of that to make a difference when another pandemic comes around. So there are going to have to be lots and lots and lots of lawsuits so people understand the liability attached to making outrageous demands and outrageous mandates and outrageous decisions without considering the impact of those decisions. I think there's a whole lot of people out there, and this is something like I have a deep interest in communicating with these people they don't necessarily realize that the approach that there were issues with the approaches that were actually

used yes you know people don't understand there were issues with that yeah like I think there's a lot of people actually who don't who think it was a good thing an okay thing yeah It's hard for me to imagine that. Or people just did their best. Yeah, look. Of course, it didn't work out perfectly. We didn't know I did our best. How did we know?

How did I know? How did I know that there was something wrong with what they were doing? We knew early and quick. And the part that I take issue with more than anything is they did not change direction. They did not adjust course when there was evidence that what they were doing was harmful. And they kept going and doubling down. Even this day, this moment, why, if you're going to have a vaccine mandate, why only two vaccines? Why only the Moderna and the Pfizer are you mandating? What's wrong with Novavax?

What's wrong with Covaxin? Let's use a whole virus alternative. Why only the spike protein, the one pathogenic piece of this virus? You're going to require people to re-expose themselves to that. We know that's what causes the damage. Whole virus, much better idea. Or at least Novavax, you know how much protein you're getting exposed to with mRNA you might get might get extended production you know which seems to be the problem with some of these long vaxxers so why that why are you mandating that one and why we're not allowing these other two what what's going on the the people that were in charge and just listen to what Scott Atlas experienced and Robert Redfield and inside inside when the non-physicians were making the decisions. If I learned one thing above all else, people with lots of clinical experience should be making

decisions about clinical treatments and clinical syndromes, not bureaucrats and not, by the way, most public health officials, most state public health officials are pediatricians. They should not be making decisions about adult medicine. I wouldn't make any decisions about pediatrics. This is why if you give it back to the doctor patient, healthcare provider patient, you protect against a lot of these excesses. I see. Right. So ultimately, I think you said this, but decentralization is really the... Decentralization was…I could see it immediately. And then, by the way, in terms of stakeholders, the editorial board of the New York Times should not have a vote on a medical intervention.

They can have their own opinions. They should not be mandating or demanding anything. And the fact that government officials cave to that Disgusting there's also been people who were out of school for up to three years, right? And I know even you know in some of you mentioned la you know in LA area. I know that The just the number of people that actually came back afterwards is a lot less than I expect it was Predictable I kept saying it. I said, you are sacrificing 8 to 15-year-olds. They're sacrificed.

They're either not going to return to school or they're going to be so damaged developmentally they will never recover. Or if they do recover, I certainly trust and hope they will, that they should be furious. They need their peers. They need their cognitive development, they need the activity, they need nutrition, they need to be surveyed in case there's any

abuse or medical issues. I mean, this was complete sacrifice of that population. Obviously, it was clear to me that when that school board member was sitting in my control room and we were broadcasting about them closing the schools that day. I knew that day it would be terribly damaging. Never imagined it'd be two or three years. Delusional thinking has taken hold. I don't know if it's Trump derangement. I don't know if it's COVID panic. I don't know if it's the press doing it. People are delusional. Delusions are a thought that is not reflective of reality that can't be changed through reason.

These historical things happen. They do. I mean, I started studying the Jacobins or 20th century Russia immediately because I see it. I see the same nonsense happening again, again, again. And it always ends badly. Listen, the Jacobins, right on their heels, was the Committee for Salut Public, Public Health. The committee was Robespierre's committee that brought the terror on France. We've been here before. So we have to be careful. This is dangerous, yes. You have to fight. You

have to fight back. I wanted to go back to the opioid situation today just very briefly because you've obviously thought a lot about opioids. I lived it. I lived it. I was fighting it the whole way. There's another one I threw down earlier. I was like, this is crazy. You're killing my patients.

I was sanctioned. I was brought in by my hospital administration. The Department of Mental Health came after me. My own medical society came after me. Why? Because I was a dinosaur because I wouldn't treat pain in the modern context. And I was dangerous because, again, this danger thing, again, dangerous. He's dangerous because he's interested in patients suffering. I wanted patients to suffer. Why?

Because I wouldn't give opiates to an opiate addict in withdrawal. That my heroin addict, three days into his heroin withdrawal, had a somewhat unhappy face on his pain scale. Opiate addiction is a progressive disorder that ends in death. That's it. You either get people off or they're done. Or they progress. They don't see 50.

Heroin addicts almost never see 50. What is the right way to deal with this? I'm not going to talk about the supply side because I cover that quite a bit on the show right well i mean specifically with respect to opiates because we have this you know flood flood of it right yeah well i'm dealing with in california and the reason there's a problem in california is we have a law that allows addicts to steal up to 900 a day to support their habit and they get a essentially a speeding ticket and of course they they move along and they don't pee it.

So first you have to tell people whose brains aren't working right, you can't lie down on the sidewalk, come with me, I'm going to give you a place to live. You have to be able to do that or they will die. They have a brain disease that causes something called anosognosia. Anosognosia is the biological block in insight, denial of sort of the mild psychological form of it. As the diseases progress, you actually can't see what's happening to you. They will die if you privilege the anisognosia. In California, we privilege anisognosia in the law. We make it legal to use drugs, legal to traffic drugs,

legal to steal to support your habit, and you're allowed to lie down on the street and shoot wherever you want. And we'll give you the needles and the heroin. And I just talked to a kid who was about three years off the street. He said every single helper that he met on the street that was giving him his needles and his heroin would pat him on the back and go, you're just a victim of capitalism. If we get communism in here, this will all go away. Don't worry. Literally, these are the caretakers of the medically ill, in the street, dying opiate addicts. That's what the caretakers tell them. You take the heroin, don't worry about it. We'll get you out of this when we get communism in place. He laughs about it now. He couldn't believe it.

He just didn't care. He said, as long as you give him the drugs, he's fine. Even if I have a nurse administering the heroin, it's a progressive illness that ends in death. You're just waiting for somebody to die when you're maintaining it like that. It's incredible that nobody's told me this. You have to be able to go, come with me. I got something for you. And by the way, I know how to design the programs.

They are a lot less expensive than what they're actually doing on the street now. It's not that expensive. It's not that hard. And the other thing that's going on in our country is that people still have in their mind one flew over the cuckoo's nest. First of all, imagine that was a documentary. That was not. That was a fictionalized version of a state hospital. State hospitals do not exist anymore. It's like this.

It's like a hotel. It's lovely. People can come, get care, and be well taken care of and well fed. And I want to remind people that that documentary of Ken Kesey's One Flew Over the Cuckoo's Nest is nearly 100 years ago. It's 75 years ago that he was writing about that. Nearly 100 years ago. You're going to allow that?

Actually, it's 80 years ago. You're going to allow that to determine how we approach modern brain services today? It's so, so ridiculous. It's disgusting to me. But there's a pretty simple approach from the sounds of it to help these people. But it's political. You can't do it. You're not allowed to.

If I were to take that ad and go, come with me now, let's go, I'm guilty of kidnapping right then. Boom. So what we do when we walk around Skid Row is go, hey man, would you want some help? No, I'm guilty of kidnapping right then boom so you what you what we do when we walk around skid row is goes hey man would you want some help no I'm fine okay and when they're really desperate they'll go yeah I'll take some help and then they clean up a little bit they go okay I'm done I'm back out I'm going back out that's because a hundred percent of the people that I've spoken with

that have made it out off the streets All have said that someone came in and did an intervention and that's what saved their life It's usually loss that causes addicts to get through their denial or anosognosia. So it's loss of your children Loss of your freedom like a court can help help us mandate some care for people for a little while Loss of your life. Like if you have a near-death experience, that's when they go, okay, I think I'm ready to do this. A final thought as we finish?

I can't believe I live in the world I live in, much like Jeffrey Tucker said in his opening remarks today. But I'm so grateful that we're here, we're having these meetings, that there are this many people that interrupted their lives and came to Pittsburgh and are sharing ideas and interested in making a difference. Even if we're radical outsiders, at least we can try to move things in a healthy direction. I'm a little bit optimistic. We'll see.

I mean, I'm tired on the opioid, on the drug addiction front. I've been screaming about that for years. Same thing with other serious mental illnesses. We treat brain diseases differently than other diseases for no good reason. If somebody's on the street with a heart attack, we treat them. If somebody's on the street with a seizure, we treat them. If somebody's on the street with schizophrenia, we leave them alone. It's stigmatizing.

It's draconian. It is medieval. And it has nothing to do with modern medicine. And these people should not be involved. Unfortunately, it had echoes in the COVID epidemic. And a lot of what happened there, I have shared similar frustrations. And we have to find ways to restore sanity and decentralize, much as Alex DeDockville suggested in 1829, that it's the local practice, the local relationships that make things work in this country. Well, Dr. Drew Pinsky, it's such a pleasure to have had you on. Appreciate it. Thank you all for joining Dr. Drew Pinsky and me on this episode of American Thought Leaders. I'm your host, Janja Kellek.