Ask Dr. Drew - Abortion Pills Break Google Search Records: Dr. John W. Ayers & Dr. Rebecca Heiss on the Aftermath of SCOTUS Roe V. Wade Ruling – Ask Dr. Drew – Episode 97

Episode Date: July 8, 2022

Dr. Rebecca Heiss & Dr. John W. Ayers join Ask Dr. Drew LIVE to discuss a new study on the effects of the SCOTUS Roe v. Wade decision and access to abortion pills – specifically a record-shattering increase in Google search trends for mifepristone / mifeprex and misoprostol / cytotec. Dr. John W. Ayers is a Johns Hopkins and Harvard trained computational epidemiologist who uses big data to yield rapid and novel insights with measurable public health impacts – for example, the discovery of seasonal patterns across mental illnesses, and forecasting algorithms for infectious diseases. Dr. Ayers will reveal the results of a new study that shows how internet searches for abortion medications reached record highs after the draft Roe V. Wade SCOTUS ruling was leaked, and what that means for the future of women's access to healthcare. Find more from Dr. Ayers at https://JohnWAyers.com  Dr. Rebecca Heiss is a physiologist, author, and keynote speaker dedicated to guiding women beyond toxic patterns that hold them hostage. Dr. Heiss is an evolutionary biologist and stress expert whose research has been designated "transformative" by the National Science Foundation. She joins the show to speak on the implications of Roe v. Wade being overturned by the Supreme Court. Find more from Dr. Heiss at https://RebeccaHeiss.com READ THE RESEARCH STUDY HERE: "Internet Searches for Abortion Medications Following the Leaked Supreme Court of the United States Draft Ruling" https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2793813  Originally broadcast on July 5, 2022 SPONSORED BY • GENUCEL - Using a proprietary base formulated by a pharmacist, Genucel has created skincare that can dramatically improve the appearance of facial redness and under-eye puffiness. Genucel uses clinical levels of botanical extracts in their cruelty-free, natural, made-in-the-USA line of products. Get 10% off with promo code DREW at https://genucel.com/drew Ask Dr. Drew is produced by Kaleb Nation ( https://kalebnation.com) and Susan Pinsky (https://twitter.com/FirstLadyOfLove). THE SHOW: For over 30 years, Dr. Drew Pinsky has taken calls from all corners of the globe, answering thousands of questions from teens and young adults. To millions, he is a beacon of truth, integrity, fairness, and common sense. Now, after decades of hosting Loveline and multiple hit TV shows – including Celebrity Rehab, Teen Mom OG, Lifechangers, and more – Dr. Drew is opening his phone lines to the world by streaming LIVE from his home studio in California. On Ask Dr. Drew, no question is too extreme or embarrassing because the Dr. has heard it all. Don’t hold in your deepest, darkest questions any longer. Ask Dr. Drew and get real answers today. This show is not a substitute for medical advice, diagnosis, or treatment. All information exchanged during participation in this program, including interactions with DrDrew.com and any affiliated websites, are intended for educational and/or entertainment purposes only. Learn more about your ad choices. Visit megaphone.fm/adchoices

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He's a Hopkins and Harvard-trained computational epidemiologist. He published a study in JAMA computational epidemiologist. He published a study in JAMA regarding internet searches for mifepristone, which is the abortion medication. For the majority of abortions these days are done that way, as well as helping people with incomplete abortions. We'll talk a little bit about that. And Dr. Rebecca Heiss is in here, a stress physiologist. She's going to about uh what this is doing to women generally uh and she's also an evolutionary biologist stress expert who research has been transformative according to the national science foundation so we'll get into all that and uh let's try to have

i know there's feelings all over the place on all sides of this uh as usual i'm sort of i i'm sensitive to both sides i I understand both sides. I'm not strongly one way or another. As you know, I get upset when the proper practice of medicine is interfered with. So that's sort of where a lot of my energy is going to be sort of placed. But let's try to have this just a good conversation about this, see if that's possible. All right, let's start after this. Our laws as it pertains to substances are draconian and bizarre. Psychopaths start this

right. He was an alcoholic because of social media and pornography, PTSD, love addiction, fentanyl and heroin. Ridiculous. I'm a doctor. I'm just saying you go to treatment before you kill people. I am a clinician. I observe things about these chemicals, but just deal with what's real. We used to get these calls on Lo line all the time educate adolescents and to prevent and to treat you have trouble you can't stop and you want to help stop it i can help i got a lot to say i got a lot more to say just watching our little intro today it has more meaning than usual that particular interview when I was speaking to Anderson Cooper about going to treatment before you kill people I was talking about the Sandy cook hook kid I might have been the the Florida shooter I mean these were again

these are all the same story these are kids with severe chronic mental health issues that the parents ignore and the one kid what was the name of the Florida story. These are kids with severe, chronic mental health issues that the parents ignore. And the one kid, what was the name of the Florida school? Anybody who helped me with that? The Florida school. Parkland, thank you. He had been in treatment

and was doing well. His mom died and they had no way to get him to stay in treatment because the laws don't allow that. And you get a bunch of dead kids as a result. Well done, everybody.

And we've done really very little to correct that.'ve sort of changed how access to guns maybe here and there can be influenced that we've done nothing to urge people with serious illnesses that go to serious places to stay in treatment so anyway so something called assisted outpatient treatment takes care of that very nicely who is the shooter in chicago I didn't want to get into it. It's just some kid. Was it another kid? Clearly, yes. Shoot, you made me lose my train of thought completely here.

Just the image of that kid is so disturbing to me and what he did. I just almost can't even think about it. Anyway, let me talk about what we are going to get into today. We're going to get into another disturbing topic for everybody, but it's on people's minds. And, of course, the overturning of Roe versus Wade has created a whole bunch of issues. As I said, I want to have just a conversation about it, talk about it as realistically as possible. As I always say, the part that gets me is when they interfere with practice of medicine. That is frankly disgusting when they do that. They have no business there,

but strangely enough, the government seems to be there. Also we are, of course, on Twitter spaces as we always are. And if you want to speak to my guests or ask me a question, you just raise your hand and the requested... Just request. Yeah, you request and the requested thing turns on and I can bring you up to the podium. And if you

do come up and ask a question, you are also by requesting you are agreeing to be streamed on YouTube, Facebook, Twitch, Twitter, Rumble, wherever else we show up. You will be there. So first to my guest, Dr. John Ayers, Johns Hopkins, Harvard-trained computational epidemiologist. His study is, I wonder if, Caleb, we can post a link to it or Susan, you can post a link to it. It's a JAMA study, Internet Searches for Abortion Medications

Following the Leaked Supreme Court of the United States Ruling. Very simple title. And indeed, guess what? Showed a markedly positive result. And also, Dr. Rebecca Heiss, a stress physiologist, keynote speaker, talking about women and toxic patterns that hold them

hostage is one of her topics of interest. And of course, she's hearing a lot about how this decision is affecting women as well. Please welcome our guests. All right, guys. Well, John is up here first. John, you are first, which is exactly what I intended. Oh, there's Rebecca. Thank you also. But Rebecca, we're going to push you back into the green room for a second while I talk to John about his study, and then we'll get your thoughts on it, okay? There we go. So, John, how did this study come about? Did you see some data that you suspected might be positive? Was it just a hypothesis you figured might yield fruit, or how'd this come about?

Really, it connects to a decades long stream of research that we've been doing. And that is often in public health, we the experts feel like we already know the problems and we already have the answers to those problems. Instead, we have a bottom up approach of dealing with public health. And that is saying, what are the needs of the public? And one of the ways you can hear those is by going where they're already voicing them that's on internet search engines which is in this case and we looked at aggregate internet searches on Google weekly and before and after the leaked SCOTUS one we saw a hundred sixty three percent increase in searches for abortion pill and specific abortion medications above what was expected and And that was an all-time national high.

And in addition to that national high, we saw that there was more searches in states that had more restrictive reproductive rights. And that just wasn't on the extremes where you see like California compared to Oklahoma. It was a dose-response relationship. And that is the more restrictive the rights to access to potential abortion medications were, you saw more searches for these. And so that all-time high was about 350,000 women searching for abortion medications the week of the SCOTUS leak. Our study was done before the ruling came out, but it may presage what's happening now and what will happen again in the future as

the abortion landscape becomes more fractured. We see policies are going to be changing by state and also federally with the FDA getting involved now. What will that do to demand? So I'm just curious, was it just the word mifepristone or abortion pill or was it a whole series of words you screened for? Or was it, how do I get? Or where can I find? It's more the latter. So it's a measure of demand for these medications. So Mifepristone and Mizoprostol are the two abortion medications. We looked at queries involving those. And then, of course, layman terms like get an abortion pill. Yeah, I'm actually surprised it wasn't even higher, to tell you the truth. And I bet you maybe after the decision, it have a restriction where you live in terms of access.

And then potentially there's a baseline number there, people who are actually pregnant or at risk of becoming pregnant who want to get access to it in the near term. And that's the combination of sources here. But the big thing here is what are they finding? And so when you see that need, what's the results that people are getting, right? And what's our message to them? And if you look at what people are getting on these search engines in terms of results, it's appalling. You know, we're not there. You know, you have a Google One box for suicide, for addiction. You search for those. You get,

here's the number to call. Here's the information that's curated. It's at the top of the page. We do the same when it comes to COVID-19 now. But when it comes to abortion, it's the Wild West. Women are in dire straits. They're searching for these medications. And when they need an answer, it's just up to the whims of, you know, PageRank, whatever website that day happens to have more links to it, or advertising where you can have potentially nefarious actors, you know, promoting black market medications and taking advantage of people, maybe they do or do not even get the medication. Right.

So it's, it really, what our study does is it identifies this need, but it says, what should we be doing to meet the need? It doesn't end with just saying a description. It's like, now you know what you did. I'm guessing that is it, I was looking at at the top i just put it in my you know google search and i got receive abortion pills at home ships directly to your door fda approved then the abortion pill get the facts how does the abortion pill work those are the first four things that come up for me as well as uh some locations where i can get uh to actually go to

get that but this cal is California, right? I mean, I'm assuming it's almost, is it user-specific, what comes up in these first four or five entries? Yeah, what comes up is going to be user-specific, and it's clearly changing. You know, we don't know, you know, who should be the source of this information, right? It's complex now, right?

So before, when we did our study, there wasn't even these advertisements. These advertisements have come up since our study. That's what's in the top of your search results is actually advertisements. You know, who's advertising? What are they advertising? Who should be the messenger in a theoretical way of information that provides people with their options? You know, healthcare, we're about providing people options. We're not about sending them down a one track path here. We want want them to have evidence-based information about the options that are available to them. What does that look like? I know that gets more complicated now because it may vary by state, but we need to meet women where they are. And when they're searching, you know, what should be that approach? And should we take it in to public health care and go, what can we do to prioritize information? And we haven't been doing that. And even though you're seeing results in your specific search, that's not indicative of what all women are potentially seeing. And also, that's not necessarily indicative that that is actionable information that is guiding you in the best way forward on making your ultimate decision about how to or if not to access these

medications. Caleb, are you saying put up a private window and then do a search? Is that what you were saying? Because I did that, I got the exact same results. Yeah. Is that what you're saying? That could sometimes happen. Usually it's Google traces and tracks what you're doing all the time. And so then they'll change the results that you see if you're logged in on Google. But if you open an incognito window, sometimes it doesn't have the same cookies and tracking. And so it might show a different result. Yeah.

But the thing is, Dr. Drew, just keep in mind here, it's search for suicide and there's one uniform response, right? Search for COVID-19 and there's one uniform response. There's curation happening and we're reaching out to people

and we're not out to people. And we're not here and we should. No, I get where you're going. And I'm struggling with that now because I don't understand the nuances of the legal landscape. Because on one hand, I think to myself, well, let's let the states figure this out. California, New York, we're good. Let's go one at a time here. And California is going to have a whole tourism thing to bring people in here for abortions and whatnot, which is of questionable constitutional legality given interstate commerce laws.

And so then the same thing occurs to me. How can you have a single unified national number without violating interstate commerce laws? And do we have to have another Supreme Court decision about what public health is able to do in response to this crisis? You know what I'm asking? You see what I'm trying to figure out as we go here. I get that it's complicated in that sense, but I'm a keep it simple, stupid kind of guy. You know, and information, there's no restrictions on information that can or cannot be available, right? And in that vacuum. I don't know.

Wait a minute. If it's how to make a bomb or how to kill somebody or something, I think somebody might take an issue with it. And who knows what they would do with this? I don't know. If you search for how to buy OxyContin, you'll find results that will direct you you don't oh yeah you will you'll find international mostly going to be fake and who knows what you're going to eat you might end up with fentanyl and then dying we we don't want that no yeah you're right listen i again i have an opinion about i'm trying to figure out how we deal with it but in terms of the opinion i

think you know one of the ways of looking at our study is by identifying a need. I'm all about data-driven public health. How do we respond to the needs? And by identifying a need, you can engender responses. I don't know what the policy response is, but imagine on the most extreme pro-choice, you can see like, oh, this is this need, we need to meet it, get access to these pills with the least amount of restrictions as possible. On the other end though, maybe what we're seeing here is hundreds of thousands of women each week, you know, who are in a situation where they have this need, and maybe that perspective is harm reduction. How do we minimize the risk they have to go it alone? 7% of women of reproductive age

have attempted a self-managed abortion in their lifetime. That's women 18 to 45. That's women who lived entirely under the Roe v. Wade era. What does that number look like now? What will that number look like in the future? And how do we minimize those harms? I think from a policy standpoint,

when we talk about the harms that exist here and the need that exists here, I think it will soften even the hardest heart, whether it's extreme pro-life or extreme pro-sure, it's because you can see that need. Right. And it feels like it's going to be a tapestry of state laws unless these interstate commerce issues, or if the federal government creates legislation, right? The point is it's not gonna be, I don't think the courts are gonna be a place where this all gets figured out. It's gonna be the legislatures. Well, that's kind of the thing here to keep in mind is,

like, here we are talking, you know, couple of smart fellas, right? We're aware we have our finger on the pulse and there's confusion about what the landscape is now put yourself in a different situation right and so that's when it becomes important yeah and the amount of misinformation on this you know misinformation is now the the hot term right the amount of misinformation on this is extraordinarily hot you know where people think like oh it's now i can't get it in this state or that state and they don't know you know worse available people think like, oh, it's now I can't get it in this state or that state. And they don't know, you know, worse available and not available. I mean, take, for example,

the actual case that SCOTUS ruled on was Mississippi. Mississippi's law was restricting access to abortion after 15 weeks. Now, if you read the news, you might think, well, it's zero weeks now. You can't get it to Mississippi. But the specific law there that they were arguing over was 15-week restriction. Now, obviously, abortion medication has its own restriction. It's only viable up until 10 weeks or 11 weeks on the most extreme case. But here is a case where if you're searching in that state, you may not realize what's available to you and then you don't get it. Or you may get misguided down the process of going to other nefarious providers and get confused and end up in a host of situations of harm and so we just want to minimize that harm by giving people action but now you're getting into yeah i i get you and

now you're getting into the zone that troubles me greatly which is these these women that are confused should be able to go to a medical practitioner and get a an opinion and a treatment and a treatment plan even if it's not available in that state there should be some way the medical system does what it does even if that doctor feels an ethical obligation not to allow this abortion to go through i i would argue that he or she would have an ethical obligation to refer that patient to somebody who could help if that's what that patient wanted and i and i don't think we would understand as physician yeah i don't think we as physicians understand how this is going to work and there's a lot of weird situations too you know with really serious medical problems to both mom and the baby and And what are we supposed to do? I'm

hearing lots of hysteria around incomplete abortions where people need a DNC and just remnant products of a placenta aren't going to be able to be removed. No, that's not going to be the case. That's insane. But maybe doctors are going to get nervous about it and refuse to do those procedures. I don't know. This is the part of this that gets wild for me. Do you know anything about how this is going to play out or is it just going to be literally state by state? I think it's literally going to be state by state. President Biden, in response, the day after the SCOTUS ruling was actually announced, said that he was going to maintain access to these specific abortion medications throughout the country. That was then said by the Attorney General and then followed up by the FDA the next week that they're going to maintain access.

But that's a little complicated, right? The federal government, when it comes to these medications, only regulates the marketplace. That's what the FDA regulates, what products and devices can be sold or can be available for use in the United States. It doesn't regulate the practice of healthcare. You know, what physicians actually do. Right, which I, listen. That's left up to the states.

You're so right. You know, and so here you have an issue where. It's barely up to the states. Frankly, it's up to professional societies and things also. And so, you know, it's the licensure is one thing, but the professional standards really are the professional organizations. And it's funny. I was on a local television show here back during, I guess it was something, one of the crazy things that was happening across COVID.

And my co-host was yelling at me, but the FDA says you can't do that. I said, no, the FDA doesn't do shit. The FDA has nothing to do with the practice of medicine. The FDA determines what can come to market and the parameters under which they come to the market. What we do with it, that's up to us as physicians, period. Now, we have a malpractice liability on one side. We have our professional organizations

that have professional guidelines on the other. But ultimately, our job is to make the best decision for the patient sitting in front of us, independent of all of it. And the FDA has zero to do with it, which people need to understand that. But the FDA does determine what can come around. And they've said access will remain for these medications because obviously abortion medications don't have the sole use of being used for an abortion. They can be used in other situations. Actually, potentially a majority of use cases of these medications is used for us to initiate a stillbirth where the child has already died. Right. Or incomplete products, that kind of thing. But so, so one of the concerns I have is that the, the issue around implantation is going to become it just seems to me like there's

no way around that not being raised as an issue in other words i remember back when early well i remember back in the morning after pill days when the very strongly pro-life people were saying this pill interferes with implantation, therefore it's an abortion pill. And my point at the time was, it could interfere with implantation. It predominantly works by suppressing ovulation. Your birth control that you take every day, the one you take every day predominantly works by suppressing ovulation. It can also interfere with implantation. And your IUD

is designed to interfere with implantation. And guess what? There are blood pressure medicines that may interfere with implantation. We're going to have to outlaw all of that? Are we going to be totally, I mean, is that where we're headed? Or do you have any opinion about that? Yeah, I mean, plan B, as you said, is not an abortion medication. You know, basically, in layman terms for the audience, you know, it prevents fertilization of the egg. You know, you have sperm in there, and you're trying to prevent the fertilization of the egg with a two-meat, and you prevent that. You know, you're preventing the actual initiation of potential pregnancy. Plan B is not affected by these current rulings. There's concern, like you said, that it could be

You know, there's been some anecdotal evidence That demand for Plan B is up That people are potentially stockpiling Plan B to use Obviously, Plan B will not be effective If you ovulate it and had sex Or, you know, if you've had sex You know, you're already pregnant So Plan B works for up to five days, three days preferably.

And that's because sperm sits in the tubes for three days waiting for the egg to be released. Right? So it's for three days after the act. That's right. Three days sitting in the tubes waiting for the egg. If the egg had been released before you took the morning after pill, well, then you're going to get pregnant in all likelihood. It could interfere with the implantation maybe a little bit,

but really you're probably going to get pregnant. As we know, it's not 100%. It's like 85% effective up to three days. And if you take it at one day, again, you're really shortening, you're lengthening that duration of suppression of ovulation. So don't confuse these pills. I think the reason Plan B demand went up is people are still having trouble differentiating between Mifepristone and Plan B. They just don't understand it, which is unfortunate.

Again, that's back to your public health argument. That's back to that. We need to educate. And again, some sort of centralized information system. Yeah. I would be very in favor of centralized information that, that I think, how can you argue with that? I mean, people, I don't know. Then we're getting into weird territory if we're not giving people information.

I think part of the issue here too, is we don't talk about is, you know, we look specifically at people searching for abortion medications, but when it comes to women's reproductive health, obviously there's hundreds of issues that they're searching for. Are those needs also being met? So maybe this debate helps us think about things more holistically. You know, right now we know abortion medications are used predominantly in certain populations, certain income levels. You know, so how do we think about meeting people's needs where they don't get in the position where they need the medications? Can we have a holistic conversation about reproductive health and public health?

Can we do that? Maybe why we haven't done that though, Dr. Drew, is because we've left this up to the judiciary, right? We've never engaged with this as a policy issue, right? There hasn't been federal legislation when it comes to managing reproductive health and access to reproductive health. Within that vacuum, we also have the liability of, we don't have a safety net to capture people. You know, if you debate abortion, and my opinion here is immaterial to our study, you know, we observed a need. But if you debate it from a policy standpoint, invariably, the nuance of other needs will come up, and you will react to those and we never did you know

time and time again we've missed on opportunities you know president obama didn't see that you're you're making this number one deal listen i i i agree that that's why i'm i personally i'm not that upset by the ruling because the court shouldn't be where this is being done anyway we hope and i actually saw a thread from AOC where she had a bunch of suggestions, and I was like, yeah, those are all good ideas. I don't agree with all of them, but at least you're moving in the right direction. And also, I'm saying all of this myself from a perspective of being deeply sensitive to the argument against abortion.

I'm deeply, you know, Susan is personally against abortion, but completely exercised by the restriction of rights for women. So she sits on both sides of the argument. I just deeply appreciate both arguments. I get it. I get why people are so affected by this and upset about it. Where my sort of sensibility has always come in is what dr ayers is talking about which is medicine medical information you can't imagine all the wild

variable unpredictable circumstances that can develop during a pregnancy where doctors need to be able to do their job and and this is scaring everybody to get proper care. And that's where I object. Dr. Harris, let me bring Dr. Rebecca Heiss in here. How about, because I think that's where we're landing right now. So sit tight. I'm going to switch you guys. We're landing now at the effects on women.

And this is Dr. Rebecca Heiss, who studies that. That has seen this with boots on the ground. Correct our conversation or give us your thoughts thus far. Oh my gosh. There's so much here that I'm right on board with you guys the scariest thing that I've heard so far is that the SEO experts are going to become our medical experts right it's it's the people with the SEO that gets that first click and now that's the people that you're taking information from that's that's terrifying

and well that's that's already that's already medicine that's the people that you're taking information from. That's terrifying and really detrimental. That's already medicine. That's the medicine in the age of the internet already. You know what I mean? We're sort of there. But yeah, so keep going. Yeah, no, to the point of how this affects women, I think twofold.

One, your introduction to this entire conversation actually I think is a lot more relevant than you might have realized with the school shootings, the mental health aspects of these kids. One of the most fascinating studies around abortion has been the Donahue-Levitt hypothesis, which looked at crime about 20 years after Roe v. Wade and saw a dramatic reduction in crime because the idea being unwanted pregnancies often lead to higher crime rates. And you're seeing the exact same thing happen again, which is really fascinating. So thinking about the effects of not only the obvious trauma and psychological anxiety, life satisfaction, financial hardships of a lot of women that will be forced to carry

to term, but also the add-on effects for the child. I don't think we're talking enough about that. Pro-life, pro-choice, wherever you stand on that, I think we'd all agree that kids should have an opportunity to live a full, healthy life. And if you are forcing unwanted pregnancies, there has to be some policy that protects those kids because you're not only increasing, you know, preeclampsia and all kinds of high cortisol levels in the women that are carrying these babies to term that may not be wanted, but that then affects their offspring for years and decades to come. Yeah. And I, having worked in the field of mental health and also in adolescent health, I have zero faith that anything will actually change because I've heard lip service to all these

things for decades and nothing ever changes. I don't know why. I don't know why we have such a weird... In fact, things are a lot worse a lot worse you can't you can't things are just a lot worse in mental health the resources aren't there we have a psychiatric shortage we have any psychiatric beds we we don't have no laws that allow us to bring people in to help them when they're really really sick and it's just just a mess so uh and business case, too. You think about that.

We're having a really hard time in the workplace finding workers, a massive shortage of workers. Well, now, just take the Roe v. Wade overturn. One in four women have had abortions. So now you're looking at a quarter of the workforce potentially that is now, and that's exaggerated. I'm being you know real rough estimate here but that is now again out of the workforce needing higher uh health care bills uh higher mental mental health services their kids are needing more mental health services we're we're not doing anybody favors here well let's let's talk about what women are actually facing

if they get pregnant and they're in one of the states where things are highly restrictive which is not that many is what is it five states now and there's a concern there may be eight or nine states ultimately uh it's then that's you know that's not that's not a large percentage of the female population in this country it's a small percentage in states that don't have large populations. And it's one in four. And yet, if they're motivated, I'm imagining most, if not all of them,

will find a way to do it. They will find a way to get whether it's, again, the uncertain part is, I know a lot of people are setting up organizations to help with access, to mail stuff in. How much risk is that to that individual are they really risking legal action or do they have to travel across state lines and then what's the federal government going to do with that you know the interstate commerce laws and

are they going to legislate on that and all of this sort of falls down on the shoulders of a young woman typically who's pregnant and so what what i just wonder what the reality is going to be for women and and then physicians we don't seem to be of that much help well i mean and that's you just nailed it and i i i would say i am not certain actually that those those women in those states are are have the access that i would have for example i'm very lucky i can hop on a plane tomorrow, get to New York and get any service that I need. But most people, a lot of people that are in these positions don't have the socioeconomic stability in order to A, get time off work, have somebody

watch their kids, get transportation, get the mental services that they're going to need, because it's not just physical, right? These procedures can be relatively straightforward and easy. But then the add-on of now the shame and the guilt and this feeling of I've lost, I've done this thing, I've killed a life, I've murdered, that is a huge add-on to the back of these women. Yeah, but they already don't get that. It's not like this law has changed that. They don't get it at all.

In fact, this may be a good thing that comes out of it because they're told it's no big deal. It's just a simple procedure. Don't worry about it. It won't bother you. It bothers women. You are absolutely correct about that. And now they're going to have the added guilt

of doing something illegal and maybe, who knows what religious overlay in the particular areas they live. I mean, it's complicated. I still believe you're really just talking about if you're talking to people that don't have a car and don't have access to a bus station, then you're going to be in really difficult straits. I mean, that's going to be. But I'm guessing that's not. That's not. that's not what's that that's a lot of that's a lot of the people that are falling through the cracks of health care already in this country right that's the that's the majority of people that are struggling already to get the services that we need so well but that's a that

you're right that's absolutely true and and but's now, now we're into a different topic, which is they probably wouldn't have gotten it anyway, because we do such a horrible job at delivering healthcare, which is yes, yes. And yes, I, whenever, whenever the healthcare part of this is brought up, I just like, yep, it's absolutely true that that's part of this. Well, I got to take a quick break here. Um, Rebecca, does there a website that you want to refer people to um for me i guess you can go to rebecca.com um that's probably the easiest way to reach out

to me and i'm happy to help and talk people through any any way that i can help there's your book they come and that's my book and your book that um yeah and what's the subtitle there what's the what instinct the subtitle is what i can't read it from here rewire your brain with science-backed solutions to increase productivity and achieve success so um i work a lot about um reducing stress helping people find their calm uh rewiring this medieval brain of ours this stone age brain of ours uh recognize that you know there's not tigers leaping at you in every corner um and so how do we reconcile an age brain with the modern environment interesting that's uh i spent a lot of time thinking about things like that

also dr areas you can get at john jo hnw airs a y r e s dot com take a little break and hear about our friends from genu cell be right with you I think we have found the holy grail of skincare. GenuCell has absolutely changed certainly my skincare regimen. I like that vitamin C serum, the under eye creams, skin nourishing primer. Susan loves the eyelash enhancers, uses it on her eyebrows as well. GenuCell has everything to make us both feel and look amazing. Best part, the quality of the products. Using pure ingredients like

antioxidants, copper peptides, and a proprietary calendula flower base, GenuCell knows how to formulate products to perfection without irritation. For Susan, she hates that annoying dry area on her nose during allergy season, like right here. She's tried everything, but no matter what, the skin is flaky and dry. Nothing seemed to help until she started using genucell's silky smooth xv moisturizer soaked right into the skin she was hooked after one use and now loves all their products as well every single product is developed by a pharmacist making sure that all the ingredients are safe and effective right now you can try genucell's most popular collection of products and see what i'm talking about for yourself go to genucel.com and enter code drew for 10 off that is g-e-n-u-c-e-l.com and the code is d-r-e-w i literally use this stuff

just before we got in the air this is the under eye stuff i use you see and this is the retinol the actually hyaluronic acid and uh margaret campbell very kindly sent me an email saying that she had been using it successfully and that it was less expensive than many of the other things that they find in australia which i was delighted to hear and susan just ran in here yeah look at how good drew's eyes look i put a little bit of that eye cream under his eyes the dark circle eye cream this stuff works great i love it my um esthetician the other day said hey that dark spot under your eye looks lighter and i said it's genius so so yeah i've tried lasers i've tried everything it really works brightens it up for the summer so there you go let me get back to my guest uh

rebecca heiss uh i hope i'm hope I pronounced your name correctly, Rebecca. Did I this time? When it's not in front of me, I worry that I'm mispronouncing it. Where is Rebecca? There you are. Did I pronounce it correctly? There you go. And now I've lost your sound for some reason.

So there you are. You're back. Talk to me a little more. Oh, people are asking if the uh instinct is available by audiobook on amazon or at your local bookshop or wherever you prefer to find it thank you audiobook audiobook also yes audiobooks yes right so because you i lost your mic for a second so that's why i was double checking um so tell us a little bit about the book before we go back into the abortion conversation because you know i i you know trauma survival trauma, post-traumatic stress, dissociative disorders. I mean, I watch these things become its own pandemic as we hit the 80s and 90s.

And very little is available for people to properly manage and regulate those issues. So what are they going to get from the book? Well, from the book, we go through seven of your, well, evolutionary instincts. So the way your brain was wired was really not for the modern world. You have to realize that this brain of ours is ancient and it responds to things really inappropriately. So each of the chapters is divided into the instinct itself. So the first instinct is survival. Like that's sex and survival are two big things, right? That's all our brain

really cares about at the end of the day. The second chapter is on sex, surprise, surprise, fear of the other. All of these, these things that we see cropping up again and again in society, you know, people hating other groups of people because they look different. Why? Well, it makes perfect sense when we remember that the tribe that was over there wasn't coming over to borrow a cup of sugar. There were real threats that were going to kill us and steal all of our resources. So recognizing, understanding how our brain processes this information from an evolutionary perspective, and then giving tools and insights as to how to rewire it reshape it um to function a little bit better in this modern environment that we live in i i was i was

aware of your book and one of the reasons i was so glad to see you uh writing about this material is that i i'm sure you're aware evolutionary biology had been under attack for the last 10 years or so and and i i yeah and i understand evolutionary biology sometimes tells just so pretty evolutionary psychology tells just so stories but the fact is if you understand everything in biology is about evolution it's just it's just it just is just you want to you understand why something is the way it is what was its adaptive advantage in the environment of evolutionary adaptiveness period uh and as such if you understand it you can look at it see it see it when it's coming and not respond to it when it's unproductive or or dangerous in today's world this idea that somehow it's giving

people permission to be as they were in their evolutionary psychology is exactly wrong the actual purpose of understanding this stuff is so you see it realize you don't have to give into it and find a subdominant impulse to follow so that's why we can have conversations like this and say pro-choice no pro pro-life and wait a second wait wait wait let's just take a breath let's look at policy. Let's understand that these are not tribalism groups that we have to get into one or the other and hate the other team. We have to figure out how do we solve the issue at hand.

And when we actually frame it well, it's not a threat to our brain and we don't have to just annihilate the other person and say, ah, they don't know what they're talking about. We can have intellectual conversations. We can respond rather than react. And everything that you just said is spot on. Actually, the final- Yeah, what does it have to be bipartisan? Why can't it just be like, you want to have people

who are pro-abortion and you want people to be pro-life? Why can't it be a tapestry? I have more than one feeling about it. I'm not 100% pro-life where everybody has to do it. For me, I'm pro-life. If I got pregnant, I have to take the responsibility and I'm going to raise a child. I don't think I could live with myself. But you would enforce that. But on the other hand, I had a tubal pregnancy. We had to take that out. If I was pro-life, I'd be dead. Then I had another pregnancy that was in the wrong place.

I had to remove that my first time after IVF. And that was painful. I had to go to therapy for a couple of months. But I had to do it. Otherwise, my life would be at risk. And the child was not viable. You have to remember this part of it. But it hurt.

It was very painful to do, especially for a married woman, and I was ready to have kids. But I also understand that women do have mental health problems later because they are told that they killed the baby, and their life was not as important as the baby, and you shouldn't have done that. And then there's especially young girls you know like 16 year olds that get an abortion thing it's going to be fine after they do it they feel terrible they're remorse and they have other

problems later so you know there's reasons to do it but there's reasons not to you know that's how i i but i love it you don't have to be one side or the other. Well, that's sort of what's kind of mysterious to me. And I may be missing something, but it's all the rhetoric around women's rights being trounced. I don't understand that rhetoric because in California, New York, well, come here then. It's fine. We're fine here.

Everything's protected. South Carolina, not so good. In Oklahoma, not so good. in oklahoma not so good but if you have a strong feeling about it but by the same token or fight for legislation that does protect you you know what i mean and if not federally at least in your state and if you can't i mean you know it sounds cruel to say well then leave your state and some people can't i suppose is really the reality we're dealing with. But I don't know.

There's something about this that needs – it's unfortunate. We're working through it, it feels like, and it's not done. And people are probably going to get hurt because of this working through process, and that's sad. I agree. And it's the same process that we're talking about here with gun control or Second Amendment rights. It's saying, well, look, can we all agree that kids should go to school and be safe in schools? Yes, of course, everybody agrees with that. Good. So let's start solving the problem, right? And the problem is not women are getting pregnant. No, that's not the issue. Or men, you can't control yourselves. No,

that's not the issue. The issue is that there are unwanted pregnancies, right? And the issue is that there are certain people that can't get to those states where it's safe. And we know from the data, right, this Roe v. Wade being overturned isn't going to reduce the number of abortions. It's going to reduce the number of safe abortions being had. And that's the really scary thing. When Dr. Ayers was coming up here. I don't know that that's true. I don't know that's true.

I'm not sure. I don't know. Because again, let's get John in here because he actually probably has the data. Is that true or are people just going to, are we going to have the other part of what Rebecca was talking about, you know, children in the hand, you know, people having children that don't have the resources to take care of them? I think, you know, there's potential for it to go either way and we don't know now, but we do know that we can do things already that we're not doing.

It's something you were talking about earlier about abortions in general. America is an outlier when it comes to utilizing abortion medications. You know, the rest of the Western world has abortions far earlier during pregnancy than you do in the United States. Well, is that a consequence of access to healthcare? You know, is that a consequence of access to health care you know is that a consequence of you know delayed decision making for a host of reasons you know when we start talking you know 15 16 20 23 weeks you know now it's like we're very much an outlier and so i think you know part of the issue here is so state that again wait let's let hang on i want to make sure we state that data correctly are you saying that other countries don't allow abortion after 15 weeks?

Well, other countries utilize abortion. Hang on, hang on, hang on. And or there's something about our decision making and our access to health care that people don't get to the health care system until they're 15 weeks in? I don't know why, but in terms of abortions that do occur, we are an outlier in the sense that we don't utilize abortion medications. A majority of abortions happen with abortion medications, which is before 10 weeks, sometimes up to 11 weeks. But it's a small majority. It's not the vast majority.

It's like 61% happen with abortion medications. So we are an outlier. Now, from a policy standpoint, and again, I'm not articulating my position here at all, we're a bit of an outlier in essence, too. I think of 23 European countries, about 17 or 18 would have just as restrictive policies as Mississippi would in the SCOTUS ruling, you know, restricting access. I think in France, it's 14 weeks up from 12 weeks. Recently, they moved it up. And other parts of the nation, I think the average is like 12 weeks. And again, in Mississippi, it was 15 weeks. Now,

again, I'm not talking a position on either way. I'm saying there is a difference in policies, but there's also an issue of people who want to get an abortion, how do we make it accessible to them in a safe way? One way we can improve the safety is by utilizing medication and not waiting for a procedure. And does restricted access make you more likely to engage in procedural abortions because you time out the period when the medication will be viable for you and because that's your next study that's your next study right gotcha I think it's part of a bigger issue we're the only we're the only country where we're seeing developed country where we're seeing increases

steady increases in maternal deaths during pregnancy like this shouldn't this shouldn't happen we we doubled the number of women who die from childbirth in this past decade what what is going on right this is this is a bigger issue around health policy and access to um women's reproductive rights and women's reproductive health care. It's not just this one issue. It's an access throughout healthy pregnancies, throughout unhealthy pregnancies. It's a bigger access issue.

John, do we have a doubt on that? I'm frankly surprised about the lack of, I'm surprised, I'll say one thing about the lack of engagement on this this issue from a public health framework the the amount of action uh federally uh has been astonishingly low uh given the change in the and the policies that exist through the judiciary you know it's basically like we will act we will do this and there's been a lot of inaction. And I don't know if the issue given, you know, that impotent response we've seen

from the federal government, if, you know, women can wait for them to respond, what can we do in order to engender any response instead of just, you know, words? You know, I think part of the issue here is maybe, maybe we can start thinking about reproductive health holistically and do legislation towards that end yeah i i got to tell you my fear is having worked

in those clinics and seeing the way they approach my patients uh just look on the streets and there are my patients uh there is gross inaction and stigma when drugs are being used. And most of these, and I fear that a large piece of this is going to be a drug story because that's where the government just goes, they're on their own. And rather than saying this is a medical problem that needs a medical management and we need to create resources for it and find ways to motivate people into treatment because part of the illness is an unwillingness to participate in treatment. So I fear that's what we're going to find here because that's a lot of where we're falling out of bed in healthcare right now. And it makes me sick because I know how to treat this

stuff and it's treatable disorders, but you can't leave it to the patient because they're back to Rebecca's instinct stuff. All those instincts are taken over by the pharmacology of the drug. Yeah, and so it's just makes me – I'm so angry about all that. So anyway, that's a separate issue. I digress. No, it's not. I think you have a perfect point. It's all intertwined, right?

That's not a separate issue at all. It's a huge issue. It isn't. And unfortunately, it falls out as one, though, and it shouldn't be. I absolutely agree with you. But, John, we've got to do the data. We've got to get the data so we can keep pushing on this. What are you studying next?

We study a host of things. I think the last time we spoke was actually 13 Reasons Why Causing Increased Suicide. We do a host of these types of studies focused on the needs of the public. We have a few forthcoming that will be of substantial national and international interest. Well, that is a talk about a tease. Talk about a tease. Talk about a tease. When? How about that?

Well, it turns out the vaccine you may want may not be available to you. We'll just say that as a tease. Well, I want Covaxin or Novavax, and the FDA is certainly taking their time about that. And I think a lot of the vaccine resistant would do that, too. So I'm guessing there's something out there we could help use breakthrough vaccine resistance with traditional platforms. But there is overlap in what we're talking about. I'm thinking in terms of like,

the statement was made earlier about search engine optimizers are going to decide what is the information that people get. And I just made the connection now, we did a prominent study on COVID-19 where the vast majority of misinformation, as defined by, you know, the arbitrators that do decide that, comes from bots. You know, so if all these bots are out there talking about vaccines, what would they be talking about when it comes to abortion and reproductive health care? And, you know, do we want to leave it up to that? You know, and we do see like social media, you know, I think Twitter and Facebook were omitting posts that may have been talking about how to access medications or potentially selling medications.

But there's a large, you know, diversity of the type of information that can be made available online. We really do have to engage on it. And we really have to engage on it holistically, not just around specific abortion medications. You talked about other procedures, at home procedures, not medications, not medicinally induced abortions, but the coat hanger. What does that look like now?

When someone seeks out information on how to do that, are they being discouraged? Are they being encouraged down a pathway where they can access it in a safer way? You know, and how should that look? You know, and that's the thing is we have to think about that. And we have not been because, you know, the internet's been among us now for nearly two decades in the form that we utilize it now in terms of search engines, etc. You know, we haven't been meeting these women's needs. How do we start to meet those needs? And we have to think about those other outcomes that we may be neglecting now. Our brain loves information. It doesn't care if it's right or wrong. It just likes the information. And that's the crazy thing about it, right? We're going to get those dopamine hits. Dr. Drew will tell you all about it, right? We're going to get those dopamine hits dr drew tell you all about it right we're going to get those dopamine whether or not good information bad information we're just like oh info this is good this feels good so if it's the bots it's a problem when john you mentioned

earlier at at home procedures what are you talking about exactly i'm talking about not medicinally induced like the coat hanger you you know, where people attempt to. Those are extraordinarily rare. But, you know, I'll be honest with you, Drew, that Vice News motherboard, I believe, well, may have. I can't remember specific publication, but there was a publication came out in May talking about here's how to do abortions at home. And procedural abortions were among the things that they provided information on how to do abortions at home and procedural abortions were among the things that they provided information on how to do. Now let's hope that's exceptionally rare, but it would be extraordinarily high risk and if it's engaged in by just hundreds, you know, it could potentially lead to increased mortality in a significant way when it comes to, you know, the public public at large did I hear you wrong before when you said 7% yeah that's the estimate 7% of attempt have attempted

an at-home abortion or no after that now that comes from a study I'll be clear that wasn't our study that was study about two years ago also published in the JAMA family of journals and there was some math magic to that study because obviously this is something people want to discuss. It's one of the reasons we looked at searches because people don't want to talk about it. There are so many... Go ahead, finish.

The actual number who affirmatively said they had was 2%, but based on response bias, etc., they inferred 7%. 2 percent affirmatively say they have the best estimate is seven percent potentially have in their lifetime about that that's a even two percent is a really big number like two percent is a very big number in itself yeah there's a lot of things flying around there's

a there i realize there are so many things that fly around the internet that are not connected to reality i have performed dncs i've done them there's no way you could do it with a coat hanger there's no way you could try and puncture your uterus, and I'm sure that's happened. Nobody does procedural abortions with a cohen. You can't. You need a big piece of instrument. You need a dilated cervix. All right, all right.

I'm just telling you, it doesn't happen. Now, people may hurt themselves with coheners. I get that, and they may hurt themselves with lots of things. But part of the information that needs to be pushed out, John, is how ridiculous these mythologies are and what actually will happen to people so they don't try it. Imagine how desperate they are, though. That's what's scary, right? You have to be really desperate to be inserting a code. And uneducated.

And uneducated. Yeah, it's uneducated. Correct. Correct. This is what scares me the most. If you are searching for this on the internet and you're getting how to give yourself an abortion, you are in a desperate space because

you can't get to a safe place. That's the policy that I think you need to be talking about here. How do we get those safe places for this procedure? Yeah, and it's back to John's point about information. If there's a place they go for centralized information that they trust and go,

oh, this can only hurt me. I know I'm desperate, but there's no way it's going to work. I won't do it. That's very valid, it seems to me. It's taking my breath away all this stuff it's uh speaking of uh the primitive brain my anxiety system is my sympathetic system is turning on just thinking about all this stuff uh yeah exactly calm yourself um john have we missed anything today have we sort of hit the landscape or i can't when is your next stuff coming out too

that's the other thing i want to know when can we because it's been the 13 really reason 13 reasons why and suicide was like seven years ago it feels like it's been too long it's like four years ago but i can't help it you don't want to talk to me you know but we'll we'll let you know about the next one i'll text you about the next one then we'll bypass all right all right good all right good so all right john i'm gonna let you go i I want to talk a little more. I looked it up. Delum is the name of the, if you want to Google it for your viewers, it's called a Delum. Yeah, yeah. A D-E-L-U-M.

And it's a device that you can use for at-home abortions. And the article in question that I made reference to talked about how to use this combination of a syringe and then you know a tube and one last thing let me go yeah Google it doesn't come up John doesn't doesn't when you guys del half an EM I'm looking at the article right now talking about how to make it. D-E-L hyphen E-L. Holy smokes. Yeah, so it's a tubing, a stopper, a syringe. Don't show it. Okay.

Induce abortions. And also, if you look at the articles and mention those and how to make those, they also talk about over-the-counter abortion medications that you can use potentially at a later stage. Oh, my God. I think about ones that that result in contraction uh so dangerous so dangerous potentially so these things do exist i don't know what percentage of people are searching for these or maybe engaging with those but it's certainly something we should be thinking about how to capture yeah somebody on the twitch said one word condoms.

Yeah. Yeah. That's good. All for it. I mean, I guess if we try to educate people a little more, they won't get as pregnant as often, but it happens.

It still happens. I spent 30 years on the radio trying to change behavior. It's not easy. It is not easy. I mean, but, but that is, that is the thing though.

It's not. So we think of things in aggregate and we also think of things through the lens of our own experiences. And we don't realize the community is actually at risk here. And the community actually has a need here is very different than what we may be. Right. And our experiences are. They're typically going to be very, very poor, you know, very, very limited access. They typically are more minority, you know, specifically African-American. You know, so so why is it, you know, we have this this population at time in terms of like how we make sure everybody has equitable opportunities to reproductive health, equitable opportunities to even prevent pregnancy in the first place, let alone get to the abortion stage. So I will just say that my profession is going to great length to try to achieve exactly what you're talking about. The two big areas that people don't often think about is we need more african american physicians which we're making great strides on that on that front and number two

because of the the way we have ill-served the african-american community in american medicine there's a lack of trust and so there's just generally a you know unwillingness to to to engage with the medical system but that can be systematically improved of course as well but we have to we have to identify it as a problem and go after it though so you're right there's a bunch of there's a bunch of layers to this and we need to do something about that there's no doubt no doubt about that okay so now i'm sufficiently anxious and i appreciate do you want to see if anybody wants to talk on the. Dr.

Drew, we can get some of that. Remember there's no tigers charging you. It's a. Right. You're right. There you go. Somebody doesn't want to talk.

Her name. It's slay. It's a nurse. Oh, slay. There'll be a little. There you are. Your mic is still muted.

There you are. There she is. Your mic is still muted. There you are. There she is. Oh, goodness. Go ahead. Go off the speakerphone. Yeah. I think your daughter answered for us. I appreciate that.

I heard somebody say mom. And now the mic is muted again. They're working on it. They're getting the technology. Tracking her down. Get mom to the phone. You know where that goes. She's muted again.

She had unmute. They're probably tossing the phone back and forth between each other. She answered it. Well, we're on speaker phones. There you are. Okay, there we go. Oh, can you hear me better now we got you now loud and clear what i said was hi dr mommy hey mommy what's happening long story guys so um my

question for you dr drew is um and it's really more of a concern of mine is i grew up in a time where the reason i didn't get a girl pregnant was because we talked about abstinence and it was it was a really important part of sexual education for me as a young person about just like maybe don't maybe don't have sex and I and with all this talk about abortions and I know it's important for people to have abortion rights but I wondered about your thoughts on how we educate our young people, especially in regards to maybe just waiting on sex. Well, let me give you my thoughts on that. It's not, that's not an easy sell, especially with the world they live in today. But the way we shape, we discovered this during the AIDS epidemic, is that the way you shape these very powerful behaviors is you tell stories.

Just like I, in medical school, learn from cases. Everybody learns from stories and cases. When they see an experience of somebody that they can relate to, somebody the same age as them, somebody that looks whatever, somebody they can relate to, tell that story. Point out the consequences of the choices use some humor use some cultural elements music something like that and that actually and repeat it and repeat it and repeat it and that actually has a very high probability of changing behavior so to your point i mean i used to talk about all the time i would say you know that's that's certainly an option i would always say the only really safe sex was no sex, right?

Everything else was risk reduction. And, of course, again, it was a hard putt. It could work for some people. Yeah, absolutely. I will say this. One of the things, you know, your caller mentioned abstinence-only education, right? And, you know, that's kind of like a stop word in today's environment. But actually, there's a randomized control trial from JAMA Pediatrics in about 2011 on the effect of a theoretically based abstinence-only education program.

And it was actually more successful than the control. It reduced the number of sexual partners people had. It did not affect condom use. Condom use was similar among the two groups. And it delayed the time of first intercourse. Now, the delay was marginal. It was about 18 to 24 months. But that's a substantial amount of time when you're talking about a 14-year-old versus a 16-year-old. A hundred percent. A hundred percent. That's a big deal. So part of the problem is we have these stop words where we go like, he said abstinence only, so I can't engage on that.

That's a negative, right? And we need to go to where the data point is to. And in that case, a theoretically framed, now that's the provision here, right? You know, a theoretically informed, a scientifically informed. This may not be the one that you got, you know, at your Catholic high school. But one that's abstinence know, at your Catholic high school, but one that's abstinence only can be effective at preventing pregnancy, at least more than the standard control in this one study. Very interesting. I want to pull in that just

really quickly because while I have no doubt of that science, my guess is the control was a no education versus a full sex education, which might provide both abstinence only as well as safe sex measures and condoms and birth control. And so, again, information is really important and it's important to communicate clearly, I think, that, yes, absolutely. Abstinence only is is one route and it's probably better than having zero sex education. But we also have to consider other alternatives. In this case, I'm not going to disagree with you here, but in this specific case, this specific study, it was an eight hour training, abstinence only, eight hour training on safe sex.

So it was a legitimate control that represented the standard of care. Now, granted, that's one randomized control trial. I don't know what the meta analysis is, but I would guess that randomized control trials on abstinence only education are probably rare and probably because we have a political valence where we say we won't study those. So that could be a problem. I'm just saying in this case, your college framework of, I remember I was told delay, delay, delay. That's what actually something really means. It doesn't mean never have sex. It means delay.

You know, in this particular case was successful at delaying and reducing the number of sexual partners you have compared to the usual mode of care. We got to be able to ask these types of questions and part of the reason we don't is because we approach this from our political framework, right? The politicalization that happened around COVID is already entrenched here, where we already know what the solution is, we already know what the answer is without engaging in data collection and assessing the evidence. And science is very antagonistic. We're not just supposed to be like, here it is. We're supposed to interrogate the data. Tell me, how confident are we this is true? Is this replicable?

You can't prove anything. Engaging that type of debate, right? And so we don't when it comes to these issues, and that's a problem. And I'm afraid that is a problem. Like, if you look at our study and you know, we have done scores of interviews for this study, you know, when I talk to reporters, they immediately have the framing

that they're going to use, right? And you can guess, you know, it depends on which media I'm talking to. And when I talk to people who are experts, you know, their reaction is again, attenuated. We have to move away from that, right? And you know, you know, their reaction is again attenuated. We have to move away from that, right? And, you know, it's definitely hard to remove political isolation when it comes to healthcare and public health, but we really do have to do it here. And, you know, I think this

issue foretells what could happen when it comes to like infectious disease management, because we see what's happening with like COVID and, you know know we don't want COVID to get to this point right how do we undo this one I think right now most of what we're doing is making public health more political not less yeah this is one way to make it a lot less you know I agree I think you have a great tribal brain this that instead of saying what's the common enemy right the common enemy is there's a problem and and i i i immediately jumped to a conclusion there i'll be the first to raise my hand and say well that's probably because and that's my framework because i've read a lot of studies that say opposite but again science isn't about this side or that side it's getting to the

solution so i appreciate that the truth the truth. And that's the genius of science. It's supposed to step outside of the weaknesses of this instrument, the glitches, the cognitive glitches that we have that are features of this system. We step outside of it with the scientific method. I'm just curious, John, what do you see to see? How do you put together what you perceive to be the issue in COVID? Because I obviously see the same thing you're seeing. I just don't, I characterize it in a lot of different ways. It seems, I feel like you've got one frame on it.

What is your characterization? Well, I have a frame. I don't have a frame. I have a frame of, you know, we should be doing randomized control trials on these outcomes. We should be using all available evidence. We should be approaching things as meeting people where they are. I think there is some analogies here. The response to ivermectin and the response to abortion medications

used potentially outside of healthcare professional advice, outside of working with a physician, is very different. One's potentially being encouraged now and one was strongly discouraged but they're both the same behavior you know i'm an old school keep it simple kind of keep it stupid you know keep it simple stupid kind of guy you know i'm like well they're both the same phenomenon so they should have the same response and that is present people the best evidence right and you know allow them to move forward in a way where they've reduced the chance of harm and improved the chance of benefit you know but we

don't do that very well in public health right we don't we typically live in the wild west and that's very problematic but but you're fighting you're fighting a media that loves its narratives, that loves these extreme shibboleths, frankly. They're just empty slogans. And that's where people are getting their information from. So it's really a marketing problem. It's getting the information right, getting through the media mess. I don't want to pull us in one direction, but there's a term for that called information laundering.

And, you know, the growth of the online media landscape means that, you know, you can present things as information and dilute what the source was, right? And so you think of like research as marketing, or, you know, here I have this idea and I'm going to present it. And we see that happen all the time. You know, I mean, we can all now look back and be like hydroxychloroquine you know the meta-analysis say it probably killed more people than it definitely helped you know potentially with more these things didn't they didn't work yeah they didn't work but

people were trying nothing worked and nothing worked and they were trying stuff they weren't trying to kill people. They were just trying stuff. And, you know, there was some reason that it might have been okay. The failure we had with that, when all eyes were focused, right? The entire infrastructure, public health, to focus on one issue, think about how we failed. How easy will it be for us to fail again when it comes to reproductive rights and access to reproductive health care? How easy will it be to have a failure here? And I think the chance of failure is sadly high.

I think one of the things we can do is get out there and talk more about identifying the needs of people and then responding to them instead of saying this is my framework. And I do believe that too often in public health we we have this top-down, I already know the problem. I already have my answer. I planned ahead of time, you know, and that's the way the infrastructure is set up, you know, in public health. We plan to study five years ago to have the results now. Well, how often were you able to predict what would happen five years in the future? Public health hasn't done a very good job of that in general. And so we need to move more towards a responsive public health system and respond to the needs. And hopefully this issue when it comes to abortion medications and reproductive health doesn't just become another blip on the time series of media coverage and people discussing this issue. It becomes an actual intrinsic change

in how we think about these issues. But it's back to what I was saying at the very, very, very beginning, which is from my perspective, a lot or may not have agreed with rather than it being a healthcare system that operated in an integrated manner. The same thing I think is unfortunately going on here too. People want it to be highly centralized and yet the reality is if they just let the medical system work and let doctors represent the patients to do the best on behalf of those patients with the guidance of public health, wouldn't that be a better way to do it, John? You know, the centralization problem you talk about, the reaction you have to it is not from our many, many past successes. I'll give an example of one. When it comes to suicide, right, the WHO created guidelines about 30 years ago saying do and do not talk about suicide in this way to reduce the chances of copycat suicide, right? Don't focus on the modality of suicide, et cetera.

And we're seeing discussions now about when it comes to mass shootings, engaging in similar procedures. When it comes to suicide, they were extremely successful, right? The centralization of thinking about it from the scientific framework, this communication, it worked. And getting things like the 1-800-SUICIDE-HOTLINE number out there and promoting that worked. And I think part of the reason centralization worked in those cases is it passed the sniff test, right? People at home could hear that and be like, yeah, you know that, yeah, call that number. Yeah,

that makes sense. Don't do this. Reporters could see and be like, don't frame suicide in this way, and they could respond. When you're talking about the failures, you're talking about potential censorship and other issues going on with centralization. In this case, centralization can be more evidence-based than what we've seen maybe in the recent past, and as a result, can potentially pass that sniff test and actually be utilized in a way. And centralization doesn't mean getting in between a physician and their patients. It's about connecting a physician and their patient. Too often we think of it as like this intermediary, but really it's about, it's a linkage. You know, we got to get people linked up. And that's one way we get linked up is getting people access to information and getting connected.

I don't know what that looks like, right? If you live in a state that has strong restrictions on abortion, what does it look like in terms of like what information we make available to you i don't know it's very complex but i can give you some basic rundown of the list you talked about aoc streets you know here's how to here's who to call how to call you know who should be talking maybe it should be you know like a johns hopkins or a uc san diego you know doing the talk when it comes to reproductive health care and how to access it rather than like a political advocacy organization. Right. Right. So, you know, these are things that we need to think about, you know, when it comes to these issues. I think we can. I think centralization here can have a powerful effect by linking people to their physicians rather than being one to move them away from physician guidance.

Yeah, I agree with that. Rebecca, I know you've, you've, I saw many different ideas flashed across your face. Yeah, no, I think that thought bubbles. Yeah, exactly. A little thought bubbles. I think, I think the big struggle there is in, when you were talking about suicide hotlines, you know, that makes sense because I don't know anybody who's against suicide. Sorry. I don't know anybody who's forced to set that up. Right. And I think the problem with a lot of what we're talking about here is that there are very strong held opinions, tribal opinions, brain embedded opinions that say, no, no, no, no. I will consult with my group, with my tribe,

because they know the answers. i'm not even going to look at this tribe and so there's been this distrust that has really separated even even scientists there's a lot of people that don't trust scientists they don't trust doctors they don't trust and so even if you're pushing it down to physicians at the state level to communicate this there's a lot of people that say now my physician tried to push this cure for COVID before and look where it got us. And unfortunately, that comes back to this level of understanding humans at a very basic level of having to have safety and safety to them is having all the information. And the scary thing is that the fastest place they can get all that, all the information is google facebook or yeah yeah

here i go again you know i i my my response to that is it it might sound infinite but my my my response to that is to say well you know i think that even in cases where abortion may become illegal, there's going to be no illegality when it comes to providing information. Right. Clearly, you know, if the Wild West is what our default position is, then we can respond to that. I don't think our default position right now is like no information. Our default position now is potential misinformation, exploitation, et cetera. And our new position can be improved over that. And I think most states could get behind that. Hopefully, I don't know of any state where it's illegal to go out and talk about these issues. Right. I guess there's one more issue there is that we're now counting on people to get to their

doctors to actually have this information, which a lot of people don't get to their doctor too expensive. Well, I think John's saying... Yeah. So telehealth abortion is relatively new. We haven't talked about that. Telehealth abortion was not allowed before COVID-19. Prior to COVID-19, you need to get a pelvic exam. After COVID-19, the FDA allowed, again, they define the marketplace of what's allowed in terms of availability. The FDA said, no, the standard of care is this, telehealth. You can get the abortion medications on telehealth. Now, obviously some states already have put in laws before the decision by SCOTUS saying that no the medicine must

be dispensed in person it can't be delivered in the mail you know you have to be present with a physician at one point in order to get the medication I don't know what a telehealth abortion looks like in terms of like this infrastructure but there's there's a lot of potential for telehealth here and telehealth doesn't necessarily have to be here is the services that may be need. A telehealth can be an intermediary of here's how to access, right, information. Here's where to go next. And I think, you know, we could potentially do that now in almost any state. Is that being done? No. We also, we've known about the SCOTUS decision, you know, since what, May 3rd. So this isn't new, right? We're, you know, we're two months away. I'm a little surprised at the lack of infrastructure that's being rolled out now because we've known about it. And, you know, so what's been going on in these last two months is a little concerning. I think that type of infrastructure would certainly be allowable in this case. I think it's sort of follow the money. There's no money in it, so no one does it. You

know what I mean? There's no federal funds. There's no anything to get it done. Yeah. There is. There's no pay for it. So we need, and it wouldn't cost very much, but somebody would have to keep it up and keep it, you know, make sure it's done properly and that kind of thing. Well, guys, I am way out of time here. It's been a very good conversation. Is if people want to talk to you some more, do you want to engage in somewhere like your Twitter or anything,

or you guys have, what are your Twitter handles? John? I don't have a Twitter. Is there anywhere people can engage with you? He is. They can look up our research. You know, I'm the Vice Chief of Innovation at UC San Diego Medicine.

We do a lot of research. You can look at all the research we're doing there at the ProCom Institute. And look us up online at johnwers.com. Are you guys planning any kind of informational system, maybe the school or something? No, we're doing, you know, I'm more focused on the surveillance aspect of it. You know, I'm an infectious disease epidemiologist by training, but work in surveillance. The issue here is like who can do it? Who would do it? I think it can be done. We'll just see if it happens. I think,

you know, the reality is, is people, this information system has potentially been needed going back to 2004, you know, the ascension of Google. Yeah. Right. But it hasn't been developed. And, you know, now we're 18 years behind the eight ball to speak. Right. So what you're right. Definitely need to respond now. Yeah. Yeah. Rebecca.

Yeah. You can reach me at Dr. Rebecca Heiss. D-R-R-E-B-E-C-C-A-H-E-I-S-S. It's the same for Instagram. You can find me on RebeccaHeist.com. Happy to follow up, answer questions, talk about stress physiology,

try and chill you guys out. Actually, be able to have conversations like this, which was brilliant. I really appreciate both of you having a civilized discussion. I love that we came out with a little, there's a little bit of consensus here too around getting these information systems out. I mean, mean I just I feel very committed to that now I've before I was unclear how it would work and I'm like yeah we got to do this so

I hope other people hear us I'll help you let's let's put together a little essay on the screen I'm on it something it seems like we it seems like there should be a way to do this all right guys thank you so much for having me hope we'll talk again very soon as this uh landscape evolves and john when the new studies come out you're going to call me or whatever yeah i have a cell phone all right perfect all right see you guys soon and for everyone else here thank you for this and i just wanted to say something have a moment of silence for one of our favorite guests who recently passed and is safely on the other side, probably enjoying a beautiful existence, fighting, slaying the dragon from above. Dr. Vladimir Zelenko. He unfortunately passed away recently.

So let me just say that he had a terrible cancer. I wasn't really talking about it when he was still with us, but he had an intravascular sarcoma. I mean, that is a horrific tumor, and he did remarkably well with it for a very long period of time. And he did so well, I started hoping that he'd sort of keep going like that. Cause it was very weird that a cancer like that, that he was able to keep going through it. Um, but, uh, it eventually did what it, what it does. And, uh, it's unfortunate,

but he lived with dignity and he kept trying to help people all the way to the very disagree with him. He was a very interesting gentleman. Um he was certainly mistreated on a lot of platforms. And that's what I didn't like. Just disagree with him, fine. But don't mistreat him. That was not right. So here we go. So hopefully, today felt like a much more clement conversation, a much more collegial conversation.

And hopefully we can continue those. Tomorrow, let's see, we have. Can I share the last text I got from him? Sure. He's so funny. He was so great. He got canceled on Twitter, and then he went back on Twitter, and he got all these followers.

He called everybody he knew. Could you just follow me on Twitter? Can you do this? He could get followers so fast. Anyways, he said, this was on Friday, June 10th. He said, hi. My memoir is coming out in two months we will begin pre-orders it's called period zelenko how to decapitate the serpent can we

make a deal to promote my book oh is that what he wants to do well let's get he was just in the hospital i i said sure thing how you feeling today so sorry to hear you in the hospital. I said, sure thing. How are you feeling today? So sorry to hear you're in the hospital. We would love to have you back soon. The book sounds great. And thanks for making us some money on the vitamins. But you know what? He still has vitamins out there. So if you want to support his family, just go. The Z-Stack and look for the book.

I'll try to find his publicist and hook it up. Tomorrow, Mary Elizabeth Bailey, she had a terrible childhood. Actually, her mother made her shoot her stepfather, murder her stepfather. She went through horrible trauma. She's now a nurse, has lots of thoughts about getting through trauma. She has a Netflix show maybe in the works regarding her childhood. Wild. So we'll talk to her tomorrow.

A lot of different kinds of shows coming. We're pushing through. And as I always say, if you want to suggest stuff, send us an email at contact at drdrew.com. Happy to look at those as well. Susan, anything before I sign out? I'm not going to be here the next couple days. So I will miss everybody. But I will be listening. well susan anything before i sign out i'm not going to be here the next couple days so i will miss everybody but i will be listening and um i'll try to be on twitter spaces and keep an eye out

as far as what's going on and um i have to go to new york so yeah and we're going to do some shows from new york the following week next week yeah i've got my got my uh electronic case your big god it's so heavy it's like it's like the cake the briefcase with do you want to bring nuclear codes do you want to bring it i really don't but i will if you need me to i would because i have to bring an extra bag for pauline i have to leave very late as you know and i'd prefer not to wait for luggage but whatever that's no you don't put that under the plane you have to carry that on in your remember you also have a mixer board already in new york from last time no i don't it's here it's here oh i came here by accident no we had it sent here so that we could so that we could um remember we tried to order it and then it didn't happen um

because it was like a jewish holiday and they i guess they're the people that own the place are all jewish are we gonna take it well i thought we were gonna make a second studio so i i wasn't sure are we going to take it i guess i could i mean i could bring another bag and put it in there and put it seems like we ought to have it doesn't it caleb do you want me to take it yeah i'd leave that in new york just leave that one in new york we could keep making shows and podcasts from over there. Yeah. There you go. Thank you, Dave.

Okay, it's going. All right, everybody. Thank you so much for being here. We will see you tomorrow at three o'clock. Ask Dr. Drew is produced by Caleb Nation and Susan Pinsky. As a reminder, the discussions here are not a substitute for medical care, diagnosis, or treatment. This show is intended for educational and informational purposes only. I am a licensed physician, but I am not a replacement for your personal doctor, and I am not practicing medicine here. Always remember that our understanding of medicine and

science is constantly evolving. Though my opinion is based on the information that is available to me today, some of the contents of this show could be outdated in the future. Be sure to check with trusted resources in case any of the information has been updated since this was published. If you or someone you know is in immediate danger, don't call me. Call 911. If you're feeling hopeless or suicidal, call the National Suicide Prevention Lifeline at 800-273-8255. You can find more of my recommended organizations and helpful resources at drdrew.com slash help.