We're Out of Time - CDC Foundation's Fight Against Overdose Deaths | We're Out of Time

Episode Date: August 11, 2026

Overdose deaths have touched nearly every community in America — and this episode, released for Overdose Awareness Month, brings on two women working from inside the system to change that. Host Richard Taite sits down with Dr. Judy Monroe, President & CEO of the CDC Foundation, and Terri Perez, JD, a public health analyst and former deputy district attorney of 31 years, for a conversation about why overdose prevention has to be treated as a public health issue, not just a criminal justice one.Dr. Monroe explains what the CDC Foundation actually is and how it differs from the CDC itself, shares stories from her early career as a rural physician in Appalachia, and walks through a real public health investigation that stopped a multi-state outbreak before it made headlines. Terri Perez brings a rare dual perspective — decades prosecuting narcotics cases in San Diego, and her own family's experience with addiction and recovery. Together they talk about stigma, the partnership between law enforcement and public health, harm reduction on the ground, the new drug trends they're watching most closely, and what ordinary people can do in their own communities.This episode is part of the CDC Foundation's Community Overdose Prevention Efforts (COPE) campaign. Richard is matching every donation dollar for dollar, up to $25,000, to help expand education, strengthen communities, and give more people a chance to get help before a crisis becomes a tragedy. To learn more or donate, visit: cdcfoundation.org/COPEIf someone you know is struggling, One Call Placement can help, affiliated with Carrara Treatment, Wellness & Spa and 1 Method Centers.

Anytime you see the numbers rising like they did back in 2021 and 23 and over 100,000 people dying in our nation, how could it not be treated like a public health crisis? And the criminal justice system alone can't do it all. You know, I mean, you can arrest one dealer, another one pops up, but you really have to make sure you're dealing with the demand because the supply is always going to be there. It's just too lucrative. If someone has a problem with substance use disorder, please call one call placement. That's 8888-8-8-1-1581. And if we can't help you, we'll make a referral to someone who can. Please, we're out of time.

One Call placement is affiliated with Carreira Treatment, Wellness, and Spa, and One Method Treatment Centers. Before we start the conversation today, I want to deliver a personal message. Every day, families across America lose someone they love to an overdose. Many of those deaths are preventable when communities have the real. right education, resources, and support. That's why I've partnered with the CDC Foundation through their COPE, Community Overdose Prevention Efforts Campaign, and committed to matching every donation dollar for dollar up to $25,000. I've spent my life helping people recover from addiction,

but if we can get to the place of prevention first, this would help save so many more lives. I hope you'll join me in supporting the CDC Foundation's overdose prevention work at cdcfoundation.org slash cope. You can also visit the link below in the show notes to donate. Thank you from the bottom of my heart. Today's episode matters because whether people realize it or not, public health affects every single one of our lives, especially when it comes to addiction, overdose, mental health, and the systems that either help people survive or fail them. And right now,

America is still losing tens of thousands of people every year to overdose deaths. Families are overwhelmed. Communities are exhausted. And stigma still keeps too many people suffering in silence. So today, we wanted to bring on two people who are working directly in that fight, not from the sidelines, but from inside the system itself. Our first guest is Dr. Judy Monroe, President and Chief Executive Officer of the CDC Foundation. She's a physician by background, started her career serving in rural communities in Appalachia, and have spent decades helping shape public health efforts across the country. We're also joined by Terry Perez, a public health analyst whose work focuses heavily on overdose prevention, recovery, and helping communities respond to one of the

biggest public health crises this country has ever faced. She served as a deputy district attorney for the county of San Diego for 31 years, and her background in criminal justice gives her unique perspective on how addiction, recovery, and public safety intersect in the real world. This is a very important episode. Judy, Terry, thank you for showing up today on We're Out of Time. Welcome. All right, we're going to jump right into it, okay? All right, Judy. A lot of people hear CDC and CDC Foundation and assume they're the same thing.

Can you explain the difference and how the CDC Foundation supports public health work across the country? Yeah, so first of all, thanks for having me on. both Terry and I, we're really excited to be with you. The CDC is a federal agency, and everybody hears about CDC when they're either outbreaks or chronic disease. I mean, there are a lot of things in the news about the federal agency. CDC Foundation was actually created by Congress, but we are an independent 501c3 with CDC, obviously, in our name. And we were created over 30 years ago to bring in public-private partnerships to help support the work of public health. So when you look at large outbreaks or as an example like the eradication of smallpox, that took a lot of partnerships

to be able to do that. Public health can't do it alone. Federal agencies, government can't do it alone. So we step in with private sector, philanthropic support. The other thing that the foundation brings, and we're an operating foundation, so we're not endowed. We raise money when, you, when the need arises. But we move with speed and flexibility that, quite frankly, government can't match. And that's because we're an independent 501c3. We're not a political body. We're not government. So we're a little bit like if CDC were the cruise line, we would be the tugboat that's helping it navigate. Why not an endowment? So the foundation was created with actually in the congressional language, they mentioned endowment, but there was never one really built. They never really built one. And I think it's because the foundation hit the ground running. There have been so many emergencies. So like we activate, we'll activate and fundraise when there are emergencies. But we also fundraise for chronic diseases, for infectious diseases like malaria. If you look at our global work, malaria, even

like lead poisoning, those types of issues. There are donors that have stood up. But that's not to say I wouldn't love to build an endowment. Good, because that was my next question. Right? All right. Good. All right. Judy, public health can feel invisible when it's working well. What's a simple example of public health in everyday life that most people take for granted? Yeah, the example I would give is just clean water. That's a simple example. we all rely on clean water, whether you're at a restaurant or when you turn the tap on in your homes, public health is assuring that that water is safe. So that's one example. Flint, Michigan. What's going on with that? It's like heartbreaking. Yeah. Yeah, Flint,

Michigan is one example, obviously, of lead poisoning. The pipes were corroded. I mean, so forth. I know the pediatrician that stepped forward and kind of discovered that. We have too many children that have severe lead poisoning and started the advocacy and the investigation in that. That's a great example, one of public health, but it's also an example of we can't let up on infrastructure. And there's so much infrastructure that does matter. Yeah, we can't have clean water if you've got eroded pipes.

And those are policy decisions, right? I mean, that's where the resources go, who's watching the shop, a lot to unpack them. Is it ever going to be resolved, do you think? Will it be resolved in Michigan? Yeah. I mean, they're working on it. And yes, I mean, I think there's absolutely there are people that are paying close attention to that and are pushing every day. So I'm hopeful that it will be resolved.

I know it's not your thing. I just, you would know more about it than I'm. I would, and so I thought I'd throw that in. Judy, you started your career as a family physician in Appalachia. What experiences there shaped the way you think about health and community today? Yeah, you know, my first thing, when I was right out of my residency, I started in this small town, in a very small town in the mountains of Tennessee. And the first thing that really struck me was how I had to earn their trust.

They were very distrusting in the beginning, many folks. And that was the starting point, was I had to build that human-to-human relationship. And the other part was people wanted to be treated humanely, right? They wanted to be treated with respect. And I think there had been some experiences where they had doctors coming in from the big city that they felt like didn't respect them and looked down upon them. I learned that really fast, that I had to win that their trust. And once I established that, then I will tell you they would do anything. I mean, we became partners. They would do anything I asked them to do in terms of

treatment because I showed up. And one of the things, I think that's a big lesson that they, if you're not showing up and showing up every day to help people. But I made home visits. I got into homes. I went to community events. I became part of the community. I took my children. I had little kids at the time.

I took my young children to the nursing home. And everybody thought they were the grandma. And it just endeared, you know, you have to be part of the community if you really want to make a difference. Yeah. So that was that was thing. And then here's the other thing. is once you do that, they have so much to teach you.

That community taught me so much about medicine. So one about family dynamics and how this quick story. I had a patient come in one day. Just in the office, I could tell he was super, super sick. He actually had an infection of his heart. And I could tell that just from some simple tests in the office. He had never crossed the county line, had never been outside of the county.

And we had to get him to the high. I had to get into the university. I couldn't manage him in this small rural town. It took us three days to convince him that it would be okay to go to the hospital because, again, he'd never been to the big city. And the power of the family and the community, I had to partner with his family and his friends and his neighbors. They were the ones that actually convinced him that he should go. It was like a damn intervention. Exactly.

It was an intervention. That's exactly right. And I had to do, we did that a lot of several times. The other thing I was taught, there were people in the county that were very, you know, many of them had very strong faith. They relied on their faith. But I learned from them, I would say the good death, right? When someone had come to the end of life, had lived a long life, maybe had cancer or something, they knew they had terminal illness. They didn't want the heroism. They wanted to be in their home. They wanted to have home care.

I made home visits. And they wanted to die with dignity and with their families around them. I didn't see that in my training. In my training, everybody was having, you know, was being coded and was in ICU's. And I really learned the value of that when the, when the time comes. And everybody's in agreement. It was a powerful lesson. Yeah, that's beautiful.

So they literally have in their, in their, community or culture there, hospice. Exactly. We actually created the hospice while I was there. I worked with the health department. I worked with some of the nurses in the community. And we basically created hospice because there was a request for it. And then later, you know, the formal hospice came to the county.

Do you know what I love about this, all your stories, really, is you do it with the heart of a servant. And if you're of service without getting soft and really being intellectually curious about that human being, it doesn't work. That's right. You're just going through the motions. That's right. You're incredible. Yeah, we have to lead with heart.

I really, I believe that. Terry, your background is in law and criminal justice. What made you want to move into public health? and overdose prevention work? Well, I was a deputy DA for 31 years and did a lot of cases, and thank you for that surprised look. I did misdemeanors, felonies, I did a lot of gang prosecution, and then ended up in narcotics. And as the chief of narcotics, that was in 2017, I saw a fast rise in our county. So we went from 33 deaths in 2016, then it went to 82 and then 94, and then within five years, it was at the 800 point.

So I was talking to parents that were losing their kids. We were developing protocols to handle the dealers that were poisoning people and killing them and trying to figure out how we're going to charge them. But at the same time, I had a son that was struggling with addiction. and people think, oh, it can't happen to me. Well, it happened to the chief of major narcotics. So I could either ignore that or I could share my story and reach out to our law enforcement community, try to figure out how we could hold the dealers accountable, support the victim's families.

And, you know, talking to moms that lost their children was something that was extremely difficult, but it was so important to me to be able to connect with those parents and let them know that they were going to be treated with compassion and to tell them, I'm going to try and get justice for you, for your loved one. No matter what that looks like, I will do my best. And I think for them, it was so important to be heard and for their child, for their lives to mean something. So for me, it was an easy transition. That's beautiful. So there's nothing more unnatural than bearing your child. So what you guys are doing is the greatest thing you can do. It's why I came back to work.

It's why there's a podcast called We're Out of Time because we are out of time. You know, when I was in this thing the last time with my last place before I sold it and took a five-year break, wasn't a thing. I sold that place at the beginning of 2018. And so it was just coming on, you know? And by the time I got back, it was a full-blown crisis, you know? I didn't look surprised because you were a DA. I looked surprised because my lawyer is now the DA in Los Angeles.

And I absolutely love him. And he's done a lot of great things around this. And one of them was there was something called Alexandra's Law. My buddy Matt Capiluto lost his daughter, Alexandra. He's the nicest man. That was folded into something. I think it was Prop 36 and passed. And what it really does is it holds these dealers accountable for poisoning our children.

Right. Because that's what they're doing. They're poisoning them. They are. Yeah. And I've spoken with Matt when I was the chief of narcotics. And our district attorney was also very supportive of all the outreach we were doing because we realized that we could not arrest the problem away. You can't just arrest every drug dealer.

You also had to bring awareness to the issue. So we did a lot of education, spoke to children, put flyers out, billboards, opioid campaigns. I did a juvenile opioid summit. So, you know, it is something that you have to bring. awareness and Alexandra's law is amazing. We started doing that in our office through our law enforcement partners before the law passed so that we could try to hold them accountable and be able to charge them with second degree murder if they ended up killing a second person or a third person, God forbid, and charged them with second degree implied malice murder.

I did a public service announcement. I called in all these mothers and fathers who lost their children. And I started, like right when I started. And I ran that public service announcement in Sacramento for 13 months. Just that's all they saw on social, on TV, on streaming. That's all these people saw. Now, I don't think I had anything to do with it. Okay, because these people have no shame, right?

but you never know. Maybe 1%, quarter percent, who knows, but it made me feel good like I was doing something to support Matt and his daughter. Terry, how is your experience as a prosecutor influenced the way you approach substance use and recovery today? We are dealing so much with victims and witnesses as prosecutors and you don't choose your victims or your witnesses.

Sometimes they're unhoused, sometimes they're incarcerated, and you have to approach it with compassion. That's our job to represent them in the criminal justice system and to help them through the process. And then, you know, like I said, as a mom, just showing compassion and watching somebody struggling with addiction and understanding that people don't want to talk about it. They feel a lot of shame. It's something that occurs, you know, in secret, in the darkness. And I think you need to really try to connect with people. And we do that as prosecutors, and we do that now in our work.

When you're dealing with somebody that's struggling, I think, to have somebody say, how are you doing? I care about you. What can we do to get you help? How can we get you into treatment? You know, I think it's the same type of approach. Yeah. How is your son now? He's great.

He's been sober for seven years. And thank you for asking. Of course. Of course. And you know what else I love? I love the fact that you do what you do for a living and you didn't care what the neighbors thought. You know, and that was in the neighborhood where my kids grew up, everybody's in everybody else's business, everybody's judging. And at the point that my son was struggling, I wanted him alive. And I didn't care what he did. I mean, this was a, he was a division one athlete that committed to Stanford. You had a kid go to Stanford? He didn't go. He got there, started running cross-country and decided that he didn't want to be there. He wanted to come home. He was struggling with mental health issues. He said, I should have gone to Cal. So we brought him home. And my neighbors did ask me, your son left Stanford. Who leaves Stanford? I'm like, you know, I just, I want him home. I want him healthy. And we're going to get him healthy. And, you know, he did. He graduated from Cal. He continued to struggle. But now he's a software engineer. He's clean and soap.

and just doing wonderfully. It might be harder to get into Cal than it is Stanford right now, to tell you. Yeah. But that's my dream for my kids. Yeah. Good luck. All right. I mean, they get straight A's, but I don't know.

All right. How did what happen with your son change your perspective on addiction and recovery? I had never really been around addiction or recovery and just under. understanding how important it was for our family to be there, to support him, you don't have control over it, which is really hard as a parent to see your child struggling. And he worked, he's now working his steps. He's done him multiple times. And for him, the connection was the most important thing.

We've talked to mental health providers that said, you just have to walk alongside them. and support them, let them know you love them. And that's what we did. But he had to want to do it. And, you know, my husband and I both coached sports when our kids were little. And some of the young kids that we have coached have also struggled with addiction and recovery and have reached out to both of us. One young man passed away many years ago back in 2011. His mom at that point tried to, you know, report it, tried to get help. But nothing was being done. It wasn't it wasn't law enforcement's fault because nothing was being done about that at the time. It was just take a short death report and that's it.

Back in 2017, the person that provided their son with the drugs overdosed from so, you know, just it came full circle. So my husband and I both saw kids that were struggling and there's, you know, a young woman that still continues to call me and she's struggling with opioids and just for me to tell her, you know, I care about you so much. I love you. And I'm here to help you. I'm here to offer support. And tomorrow will be better. You know, you just have to believe that the next day can be better. If you want to, if you want to send that person here, I'll find somewhere for her to go. It's very hard. Like one in 500 people get to come to Carrera. Right. Wow. Thank you. And so I'll find,

I'll find, I do have an in-network facility, but we're almost always full. But it doesn't matter. I'll make your problem or my problem and I'll find a place for her. That's amazing. Thank you so much. This is for either of you or both of you. Substance use disorder touches nearly every community in America. What are people still misunderstanding about addiction? Yeah, I'll jump in. I was actually hearing those stories, Terry, that you were telling.

One that I'll begin to share is I directed a resident. program. After I left Appalachia, I got into academics. We lost two residents to overdose. One was an anesthesia resident, and another was internal medicine. And so what folks misunderstand is they see it as a moral failure, I think, many times, lack of willpower, a series of bad choices. It's all this other, when this serious and complex. And, you know, we know, we know, we know. We know, we know. that there's many times there are other stressors that have led to whether it's mental illness, whether it's depression, anxiety, stress. Stressors, like with the medical residents, some of the pressures on them, they're so complex that we can't write it off as lack of

willpower or moral failure. The moral failing was picking up in the first place, right? Getting addicted wasn't your fault because once you took it, it had you, you didn't have it, right? It had control over you. You didn't have control over it. But I think people, and I'm not against, you know, therapy and treatment isn't something you have to do. It's something you get to do. It is the ultimate luxury. So I'm all on board with that.

but it just feels to me like that's what the law, the judicial system, the society, it feels like that's where they're going with that. And I think it gets misused with the moral failure. I don't know. What do you guys think? I think a lot of people don't understand that it truly is an illness and that it can happen to anyone. You see kids that are prescribed pills for wisdom teeth removal or people to get injured. One of the industries that's been hit the hardest is the construction industry. And why are they

hit so hard? Because you have a lot of pressure. There's deadlines. You know, you also have people that get injured on the job. They don't get paid if they don't go to work. And so they have to, you know, take some type of pain pill or some type of pill to deal with it. And how else are they going to be able to support their families. And what if they don't have another job behind that? So addiction can happen quickly and it's not their fault. You know what else I get all the time because of the pain, firemen and police officers. Right. They're always in pain and they're always coming here. I'm sorry, Judy. Yeah, no. Well, the same thing. I mean, athletes. I was involved in Indiana. I was at CDC at the time. But

the big HIV and hepatitis C outbreak that took place in Indiana there in Scott County. And I went there to visit. And there were some of the stories of there was one young man that it started down the path of getting pain medication after he had a sports injury. He was a basketball player and had had knee surgery. And then that was the starting point. And he ended up with HIV and hepatitis C. And so that. That's hardly his fault. Right. Listen, I'm all about when you're in pain, sometimes you make a bad decision, right?

But you're trying to survive. Okay? And the opposite of that. You know what? I always tell people, you know, they get into this and the alternative could be worse. You go through so much pain and you can't self-medicate. That's where a lot of the suicide happens, right? So in a lot of ways, it's saving your life because you're in too much pain.

And when you're young, you don't have the tools to ask for help. Exactly. Right. All right. Why is it so important to treat substance use disorder as a public health issue? Yeah. What I would jump in, I mean, the thing about public health, and I don't know if we, yeah, tease that apart a little bit more.

But a public health approach is one that considers the system at law. large, you know, whether it's the community, the nuances of the community, housing, you know, what we sometimes call it the social determinants of health, mental health. It just goes on and on what public health. And then it's the data sources. So that's looking at the big picture. I mean, one way, and let me tell a quick story that I think drives home. We love the stories here.

Yeah, well, let me tell you one that folks need to know about because this, this is one of my, I think one of the best stories out there that helps drive home the difference in health care and public health. So this was back in 2023 here in the United States. Individual gets an eye infection, goes to the ophthalmologist in Los Angeles, goes to see them. The ophthalmologist says, whoa, this is really severe. They take cultures. They send that off to the state lab. State lab, in turn, sends those, that culture to CDC.

So CDC has the sample. In short order, the same ophthalmologist ends up with two or three more patients coming in with this really bad infection. Now, we're talking people losing their sight, losing their eye, having to have their eyes unucleated. So that goes to CDC. Now, in Florida, people start showing up to their doctors with eye infections. Then in nursing homes in Washington State and Texas, other places, you start having folks in nursing homes. that start having these unusual infections starting in the lung and then some of them dying, having sepsis. They take the samples, they send it to CDC. It turns out, because we've advanced

our science, CDC, you know, is able to understand that this is a highly resistant bacteria. Pseudomonas eruginosa was the name of the bacteria. And here we've got it in, you know, bloodstream infections and people are losing vision. They're losing their eyes. Some are dying. It ended up ultimately being in 18 states and 81 people were impacted by this. CDC, thanks to genomic sequencing and new technologies, and because this is the public health approach, because everything went to the central lab, they were able then to begin this investigation. The drug disease detectives start going out, the disease detectives at CDC, and they start getting

histories and they're trying to figure all this out. They finally crack the mystery. what had happened was there there were liquid tears that were sold at drugstores across the counter that had been imported from India that at the time of manufacture had been infected by this horrible bacteria. So here we are. If you didn't take a public health approach, every doctor would have treated the individual patient. And guess what? There would have been a lot more cases, a lot more infections, deaths, and so forth. If we're not taking a public health approach, we're not gathering the data, interpreting it, and turning that back into actions.

Of course, in this case, they withdrew, you know, all of them. None of us, you didn't hear about this because 81 people got impacted, not 8100 or 81,000. Then it would have been all over the news. But they stopped it in its tracks once they identified it and took this off the market. We need that for, look at the new drugs coming in. Look at the new challenges. Every day, there's something new that if you don't take a public health approach, the individual doctor or the individual providers caring for that individual patient, we're never going to see the big picture. Which then the obvious follow-up question would be, I heard, you know, it's all over the news, that the CDC funding in some way was cut back or something like that with this new administration.

Is anything going on with that? they still support like opioids but there have been some cutbacks on on funding absolutely there have been some pulling back on some of the public health funding and and i think for opioids as well right terry has there been some pullback you know right now i think um our hydas are funded i think we're okay on funding for what we're seeing right now yeah yeah um well i know he he took funding away from narcan okay which i i wasn't completely completely upset with because of what he did with the money. And it's $22 a shot. And my feeling is if you're going to get loaded on $100 worth of dope a day, okay, you can afford a $22 shot. Okay.

So, I mean, I'd love to give it to everybody, but there's only so much in the pie. So I understand that's a policy decision. I don't have to agree with it. You know, we have a president. we get to pick one, but, you know, and we wish him well. What he did with the money, just so you know, is he took 400 million of that money and put it towards veteran treatment and homelessness here at, in Los Angeles, at the VA there. It's the biggest VA in the country.

So, you know, it was just a policy decision that he made. Well, and Richard, you're getting into the whole, there's never going to be enough money. right? I mean, where there's there are a lot of issues facing human health. And, and, and, and so there's never going to be enough money. So there are hard decisions and policy decisions. And that's also, though, where philanthropy can come in and help fill the gaps or local communities can rally and do match grants. I mean, there's a lot of different ways to think about the funding. Did you see how I set that up for you? That was perfect. Thanks. Thank you again, Judy Monroe and Terry Perez for joining me on this important episode. It would mean a lot to me if you joined in supporting the CDC

Foundation's Community Overdose Prevention Efforts Campaign, where I'm matching every donation, dollar for dollar, up to $25,000. Your contribution helps expand education, strengthen communities, and give more people the chance to get help before a crisis turns into a tragedy. If you believe every life is worth fighting for. I hope you'll join me and support the CDC Foundation's overdose prevention work at CDCFoundation.org slash cope. Just click the link in the show notes to make your donation. Together, we can make a real difference.

Thanks again for tuning in. I was just going to follow up on the question about why should it be treated like a public health crisis. And I think anytime you see the numbers rising like they did back in 2021 and 2023 and over 100,000 people dying in our nation, how could it not be treated like a public health crisis? And the criminal justice system alone can't do it all. You know, I mean, you can arrest one dealer, another one pops up, but you really have to make sure you're dealing with the demand because the supply is always going to be there. It's just too lucrative. And you mentioned the number of increasing drugs, and we are here at the border.

in San Diego, and we're trying to obtain data from Mexico to see what the new emerging drug trends are looking like so that we can prepare both the public safety and the public health side of the house for when the new drugs hit San Diego when they hit our illicit drug market. And as you know, okay, that's the problem with, and that's what Alexandra's law and Prop 36, I hope it's Prop 36, I don't know. It is. Thank you. that's what it was meant to do right because what happens is these dealers are always 10 steps ahead of the law

and what the law said basically look anything close to this or resembling this doesn't matter you're going to jail because or you're being tried for it and and the reason that was so special is because the overlying concept around criminal law is, if there's not a specific law, you didn't commit a crime. Right. Right. So this is now covering that whole thing, which is what I really love about that law. Because that's the problem.

That's the problem. You can look in Mexico all you want, okay? And that's the way to go, obviously, because you get the, you're the first mover. you're in and you get you get a head start but it's going to be one thing and then the next thing and then the next thing and it just goes on and on and on with these designer drugs right right and so when you mentioned trying to change the law we were essentially trying to hold people accountable under either a murder or a manslaughter theory where we didn't have the tool some states have overdose death laws. And, you know, unfortunately, we didn't have that. So we're having to look at

what can we prove that they knew at the time? Did they know it was dangerous? And now I think it's very clear. Everyone knows it's dangerous, just like people know drunk driving is dangerous. But trying to get that into the mainstream dialogue was hard. But we could see that people were selling, even though they knew they were selling poison. They knew that somebody had gotten sick or that somebody had almost died and they continued to do it anyway because of the money. There's still a tremendous amount of stigma around addiction. How does stigma prevent people from getting help? Like I said, I think it's the shame.

They don't want to admit what's going on. They feel like it's a moral failing, like you mentioned. They blame themselves. They don't understand addiction. They don't understand how easily it could happen to them. And so I think they're hesitant. They don't want to talk about it. I think just like with mental health issues, a lot of people don't share the fact that they're struggling.

People try to hide it. Which is why what you did was so heroic because what you did for a living was you're an assistant DA, right? And you didn't hide that. I've got parents who have kids that have died of family and said that their children died of a heart attack. It is, it is, I won't even talk to that parent anymore. I've completely cut him off. Okay. Yeah.

That was, that was an opportunity to help other parents not go through that pain. And he was more interested in his social, uh, uh, position in the world than he was about that. What a huge miss. Right. You know, I've talked to moms that have. lost their children, and the mom herself has struggled with substance use disorder. So she really felt uncomfortable talking in a group of other families. She said, I feel as soon as I open my mouth, people are going to say, well, of course her kid's going to be an addict. She's an addict.

What would you expect? And it's just, it's so sad because, you know, I mean, she's already grieving because she's lost a child. She has turned that around now, and now she shares her story. and she goes out in the community. She provides naloxone. She talks about her son. She really just wants to spread the word and bring awareness. Hero. Hero.

Yeah, she is. Do you know that's my worst fear? Yeah. It's why I came back. I swear to God, I thought I was going to be punished if I didn't come back. I've never heard a podcast. I've never watched a podcast. Wow.

I just felt like this. This was something that I needed to do and get important people on here and have important discussions. So thank you guys. No, I just said, good for you. That's awesome that you're doing that. I was retired for three weeks and felt that I had to come back as well. It's very important work.

That's right. You know, on the stigma, I'll just jump in. Last summer, I visited Bridget's Path. It's an organization in Dayton, Ohio, that helps with infants. the neonatal abstinence syndrome and spoke to a mother, and to me she was the heroine, right? I spoke to a mother who had suffered from addiction, had been on the streets, had had children taken from her, and now there was an incredible story of recovery and support, and Bridget's path because of the home-like nature of caring for the infants, but also the mothers,

and then the support community that was created in this was just remarkable. And it was an honor for me to meet her and interview her and talk with her. She was just such a heroine in my mind that she was willing to talk about it, be in the news. There were news cameras running when we interviewed and so forth. And I was just so impressed. And so we do need to overcome the stigma because those stories need to be told for sure. To your point, Richard, it's a missed opportunity otherwise. It's a real weird thing, though.

It's so weird. in 2026 that there's a stigma attached to this. Right. Exactly. Yeah. Judy, why are partnerships between public health care, law enforcement, and community organizations so critical to effective overdose prevention and response efforts? Yeah.

They're critical because that is the public health approach. We talked about it. We mentioned earlier. It's the public health approach. Everybody, each of those entities, and a community have either data, knowledge. It's also really important to have people with lived experience that are part of the team. You want a team approach to be able to solve because it's a complex problem. This is complex. Human beings are complex. They need to be treated with

dignity and humanity as we talked about. And so you want the team to reflect every possible piece of data and knowledge and put that together, but also the human side of it, to be able to overcome so much of what we've talked about. And that's how you solve complex issues. The other thing I would say is every community is different, too. So it's important that that's happening at that local level. And then the local communities, and that's what we do at the foundation. We've had a lot of success and we're really privileged to be able to run a couple of programs with CDC and with other federal partners to be able to bring these partners together to fund them and then for them to learn from one another. So the communities are learning at the

individual community level and then they're learning one community to the next or across the country. Which brings me up to my next question. You guys are doing something in Georgia. You'll tell me what it is. But I also wanted to know why Georgia. Yep. So, so you know, you had the settlement funds, you know, with the opioid funding that was given to the states, the states that took it. With Purdue? Pardon me? The money from Purdue?

Yeah, it was the big settlement from the pharmaceutical companies, exactly. So millions of dollars, right? This was a lot of money. Billions, billions of dollars. No, billions, exactly. So Georgia was one of the states that received the settlement funds, and they put out a competition. You could apply for,

for some of the funding to help in Georgia. And so here in Georgia, we, the CDC Foundation, based on our experience across the nation and other work that we've done, we actually received the largest award for the first year. And we're working with 18 community coalitions across rural Georgia. And this is really important because we haven't spoken of that maybe directly, but not every community has the same resources, right, and the same infrastructure. And our rural communities particularly, and you have more, you have people that have harder time getting jobs. You have harder time accessing mental health, harder time accessing health care. And so the rural communities was an area of focus that the state of Georgia wanted to do. And we are really privileged

to help support those 18 communities. I joined them for a meeting that they had back a couple of months ago, joined them for their dinner. It was so exciting to see the community partners coming together and specifically solving problems in their communities. Judy, where's the money going? How is the money being, how's the money in the settlements being used to create good in the world? Yeah, so that settlement money is determined by each state. And so each state has set up an office of some sort. It might vary state by state who's controlling that and who's overseeing it. Most of them will have a board or a board of advisors that will determine where how they want to put the money out the door.

It's typically competitive so that anyone, you know, organizations can apply for the funding and put forth their proposal. But each state's going to use it a little differently because I think they have that opportunity. Terry, I don't know if you know more about that, but so I know here in Georgia, they've got a council or a committee that oversees it. And one of the things that I thought was interesting in Georgia is they got out of the gate with rural health, but they're doing other things as well. But they've got an eye towards sustainability. So they're going to spend the money in such a way that they can basically build like an endowment.

We talked about endowments earlier. An endowment so that there will be some funding in perpetuity. That's the way it's got to be. That's the way it's got to be. So super excited about that. Yeah. You work closely with local communities. What does overdose prevention actually look like on the ground?

Okay. In San Diego, we have a great partnership between law enforcement and our public health partners. And we have a coalition that has both of those groups along with health care, law enforcement. It's S-U-O-P-T, substance use and overdose prevention task force. course, and we have different groups within that coalition. So we have the health committee, we have prevention committee. And so, I mean, that, we all work very collaboratively. And when I started in this position, I asked myself, where is the low-hanging fruit? Where should I start? What do I do in this position? So one of the first things I looked at was the leave behind program with naloxone.

I reached out to our law enforcement partners because for me, that was the easiest group to contact because I knew all of them. Growing up in the DA's office, A lot of the cops that were baby cops when I started are now in command positions. They're chiefs, their captains. So I can call them and say, hey, are you guys passing out in a lock zone when somebody overdoses? Are you leaving behind some? So in the event that they overdose, again, you can save their life. And they said, you know, no, we're not doing that.

Our fire departments are. So I wanted to work to get all of our law enforcement agencies on board with that. So they give them little kits that not only have the naloxone, but also have a QR code with access to resources. Do you know how smart that was? I can't take credit for that. It was so smart because people who overdose all the time. Because I don't know if you guys know that, I'm sure you do. But what feels best to an intravenous user is to get as close to dead as humanly possible without actually dying.

Right? It's never explained that way. But that's what feels the best. That's where the euphoria is. And that's why when people get turned blue and they're almost. they almost stopped breathing and they're lucky enough to come out of it. The first thing they say is, I need another hit. And then everybody in the room has been struck sober, okay, because they're all panicked, right? You know, and that's, so that was very, very smart. Well, thank you. So that was one of

the first things we did. We also started looking at the data and what groups are in. impacted the most by overdoses. And in San Diego, we saw that the black African-American community has been on the rise while other groups have been going down. And it's not the young people, but it's the older people. So how do you reach them? It's not, you can't reach them in schools. So we have worked as a group to try to figure out how to address that. We've worked with our pastors and other faith-based groups to train the trainers, teach them how to use naloxone, how to make it available, access to resources, and we're trying to do health fairs so we can reach the health clinics, the food pantries, wherever we think that demographic can be touched and reached.

Do you guys do any therapy and group therapy for these folks? I know it's going to be hard to get them there, but when I went to a buddy of mine is doing, he's got 28 homeless, tiny houses in Los Angeles and when I was there, I walked it. He's got like a bunch of them and I walked like three of them. And I realized that what they needed was a therapist to come there three times a week, right, and just sit down and have lunch with them. Just bring donuts, whatever, and sit down because nobody wants to be in a group. But if a group's going on while you're eating, they don't know it's going on.

And that's the way to do it. And that's the way to build the therapeutic alliance, right? Because people, there are going to be some people that are going to gravitate to that. And that's when the therapist who is there pulls them in, and that's where the healing starts. I think that, you know, you guys know what you're doing, but I love that idea because I actually saw it. And I've done some living and I've done this for 20 years and I've given back probably 10,000 or more people back to their loved ones. When I say me, I mean us.

I do that all the time. It's horrible. And, you know, I love that. I love that. So if you guys are doing it or considering it, that's fantastic. I know. I like that too. And like I mentioned before, the other industry.

that we've been really trying to get into is the construction industry with the apprenticeship trainings and reaching out, bringing awareness to the fentanyl crisis, the overdose crisis, the new emerging drug trends and providing them with naloxone so that they can have it on their construction sites. I mean, that's what we're also trying to bring awareness to. They need to have it in restrooms and porta-potties because the industry that follows the construction industry is number two is the food service industry. Really?

I didn't see that coming. I thought it was going to be mines or mine workers or fishermen or some of those really intense labor intensive jobs. I didn't see that coming at all. What other careers or jobs are really affected by this? You know, those are the top two that I was focusing on. I'm not sure beyond that. I haven't taken. We're really taking a deal. deep dive right now into construction. And we've made a lot of contacts. That was the first podcast we did was with a construction group and trying to hit the ground there. And so we've done a lot of expos and talking to different contractors. So we're kind of busy with that right now, but we're also trying to work on the data from Mexico, the data sharing so that we can see what's heading our way. And we can test samples. They don't have the equipment down there to be able to determine what's in the blood or urine when people pass away.

So we're working with the medical examiner in Baja, California. One of the most powerful parts of this work is involving people with lived experience in recovery efforts. Why does that matter? Authenticity, true understanding. You know, folks aren't going to respond to those coming from on high, you know, trying to tell them what they think they should know. come on. It's making it real and giving them folks that they can really relate to and understand. What gives you the most hope in the fight against overdose deaths? For me, I think seeing the numbers go down is great, but also seeing the number of partners that care that are willing to work together and collaborate.

Seeing the cops come in and work with public health is just, it's refreshing. They're showing compassion. They want to do the work. They want to investigate the cases. They want to hold people accountable, but they also are really focused on saving lives. So that gives me hope. Judy. Yeah, I would agree. I mean, I would have said exactly the same thing. The numbers declining gives me hope. And knowing that recovery is possible. And people, you know, can recover and go forward with really good lives. Do you know what I was thinking? I tell people when they ask me, why are the deaths going down? And I tell them, but I want to make certain that what I'm telling them is correct because it feels, again, rhetorical to me. The first one is, well, there's been a lot of people dying already. They're gone. The second one is the awareness, right? People are doing what you're doing, what I'm doing, and there's hundreds of others that are doing this, right? And then the Narcan.

Is there anything I'm missing? You know, I've heard speculation that there's less available and people are adding other drugs that will prolong the effects but aren't going to kill them. You know, we're seeing more and more strong opioids coming, you know, to light, which are just frankly terrifying. So I hope the numbers continue to decline for the reasons that you've stated. And all we can do is just continue our work and bring awareness and talk about the emerging drug trends as well. And we had seven deaths last year from in San Diego. So it's, we hadn't seen any for a few years.

The numbers had, they've gone away and now they're back. So we've sent out public flyers to all of our partners, bringing awareness to the pills. If people use test strips or in some way wanted to check their drugs, they can see that. But they won't pick up. And so we did a flyer to bring awareness to that. Talk about the test strips. Because when I talk about test strips, I tell them it's, you know, for the people that can't stop using, I tell them it's better than nothing. There's no guarantee.

I mean, I prefer the message to avoid the drugs altogether and to choose healthier choices. However, I know that people are struggling and some of our partners provide test strips, and there's no guarantee. There's no guarantee. I mean, it can tell you sometimes if there's, you know, not always, especially if you're dealing with pills, you know, they're not pharmaceutical-grade pills. They're not made like you would expect, you know, a pharmacy to provide them. They're mixed up in a lab by somebody who doesn't care. We tell people that when we do our presentations that these are not pharmaceutical grade, that they have what are called hot spots, you know.

So like if you're making a cake and you have those little clumps of flour, you know, two of us could share a pill. One person could feel nothing. The other person could overdose. So there's no guarantee. It's like a chocolate chip cookie. If you take a bite into the part of the cookie with no chocolate chips, you're fine. Too many chocolate chips and you're dead.

Right. What can ordinary people do to support prevention, recovery, and compassion in their own communities? Well, they can certainly know about naloxone and carry it. You know, they can carry it themselves and be educated because we know that makes a big difference. They can help reduce stigma in the language used and learn more about that. But the area that I think is really important, we need more social cohesion. People are lonely. People don't have mentors.

I mean, you can be a mentor. You can join big brothers, big sisters, all the way from youth to teens and young adults. There's a lot of opportunity to reach out through different organizations or start some after school opportunities in the community. We need community cohesion and we've lost so much of that. Terry, did you have anything to add to that? No, I agree with everything Judy said. I think just, you know, spreading the word for prevention, letting kids know, teaching them early because kids are using earlier and earlier. We had a case, you know, back in 2017 where a mom was using her child to sell drugs at high school.

It's can't. I can't. And kids were also, you know, taking pills from other parents that were, one kid took, you know, Now, it's just like you need to bring awareness that you can't just take a pill. And a lot of kids aren't aware. Don't really think of pills as drugs. It's like this is something that's prescribed, so it's safe. So I think prevention, the more you can delay the onset of use of either alcohol or drugs or anything illicit,

I think the healthier the kids are. And I think it reduces their likelihood of becoming addicted. So making healthy choices. And I love the idea of connections and after school groups and mentoring. You know, it would be great if doctors had more than a week in medical school on addiction. Yeah. That would be, you know, I don't know who came up with that nonsense. Okay, but that's ridiculous.

These doctors don't know anything. They're prescribing these opioids, okay, for 30, 60, and 90 days. And if you take this thing for more than five to seven days, it's got you. don't have it. Right. Right. If you could change one thing tomorrow, funding, policy, or public perception, what would it be? If I could have moms stop losing their kids and somehow make that happen, that's what I would want to see. So I think we just have to keep, you know, bringing awareness that it could happen to anyone. I wish people knew that it could really touch you. It could touch your immediate family. You won't expect it. You won't know it's coming, but it could

really just, you know, that would be my goal. Yeah, you know, I agree. The education piece is so important, but educating in a way that kids really get it. You know, when you were talking earlier, Terry, I was reminded of when I was in rural Tennessee, there was a teenage boy that went into the medicine cabinet wanting to get high. Because he was a, you know, he'd heard about this at school, like he was learning about drugs. And he goes in and takes his mother's medication. And what he didn't realize is he was actually taking her cardiac medicine. And he ended up dying because he took an overdose of cardiac medicine, right? And it was just, he just didn't know. And it was tragic. I mean, just terrible. So the education has to be effective. And it needs to

start early. And there's this gentleman and his partner that were on the podcast, and they are building a team of fathers that go and speak into high schools. And they think they've got like 20-something fathers and they want a thousand to go into all the high schools and give the talk. And we went to New York together to do some press together around fentanyl Awareness Day. And I told him, I said, you got to start earlier. I said, by the time you get to high school, man, you're too late. Okay. And he said, when do you get started?

And I said, are you kidding? I got started with my kids around six. I was telling them, I was planting the seeds back then. Okay. I mean, I told my son on the way to seventh grade, it was his first day in middle school. And he gets, he's getting out of the car. And I said, hey, buddy, come back in the car. I want to tell you something?

He goes, what, Daddy? I said, you can never take a pill or a powder or a vape from any, but Daddy, we've been over this 100 times. I'll never do it. I said, I know, buddy. I know. But let me tell you how it's going to happen. Someone's going to offer you a pill or a powder. And the reason they're going to do it is because they need somebody.

to co-sign their bad behavior because they know it's wrong. Don't ever co-sign somebody's bad behavior, buddy, because that's not something I'm ever going to be able to get over. I'm in love with my son. And he said, Daddy, I love you. I'll never do it. And I got to tell you something. I honestly believe that I've done the work to deal with it.

But let me tell you how they're dying, okay, what I'm seeing on the ground. It's the kid on the weekend, the stray day student on the weekend, going to the rave, going to a party because they have no tolerance. And what's happening not a lot, but on occasion is these kids that say no, these other kids are spiking their drinks. Okay. Or their water or anything. Okay. And that's, that's, so even when you do everything right, it's, you know, and I tell my kids and I want to tell the viewers, get a bottle of water and walk around it with your thumb over the top. That's it.

That's how you carry your water. And you don't put it down. This is what you do. Okay. And you don't take a drink from anybody. If they bring you a drink, you say, thank you. You go to the bar. You have them dump it.

it and you get a new drink. Okay. So that's, you know, the practical stuff. Is there any, I'm sorry, did everybody finish what they were saying? Did anybody have anything to add to that? No, great conversation. If they want to learn more about the CDC Foundation, they can come to our website and learn more about the work that we're doing across the country.

Good. So you'll just Google the CDC Foundation, make certain you're calling the foundation and not the CDC. Right. Guys, thank you so much for coming on the show and blessing us today. Thank you. Pleasure was online. Trust me. All right, guys.

Thank you so much. Everyone. See you next Tuesday. We're out of time. Please subscribe on YouTube. Click the thumbs up and leave a comment. Please subscribe on Apple Podcast and Spotify and leave a rating and a review. And share the We're Out of Time podcast with others you know who will get value out of it.

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