← Economic Update with Richard D. Wolff
Economic Update with Richard D. Wolff
Economic Update: Capitalism and Addiction: The Opioid Epidemic
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Welcome, friends, to the latest edition of Economic Update, a weekly program devoted to the economic dimensions of our lives. Jobs, debts, incomes, hours, those looming down the road, those facing our children. I'm your host, Richard Wolff. I've been a professor of economics all my adult life, and I'm hoping that it prepared me well to present to you a kind of overview of some major economic events of the very recent past. Let me begin today with introducing you electronically, of course, to Philip Alston, a gentleman from Australia who has a very interesting title. He's the Special Rapporteur on Extreme Poverty and Human Rights. He started working for the United nations back in 2014. He's part of what is known as the Special Procedures of the Human Rights Council of the United nations. And in that capacity, he spent much of 2017 studying poverty, and particularly extreme poverty in the United States. He issued a preliminary report in December of 2017 and will be issuing a final report sometime in the spring of 2018. But he's already found enough to say in his interim report of last month, things that I think we as Americans and for those others around the world interested, need to know. We have in the United States a very serious problem of poverty and of extreme poverty. Rather than describe it in general terms, let me go over a few of the findings of Mr. Alston that I found especially striking. The United States spends more on health than most other advanced industrial countries, and yet it has many fewer doctors per person and many fewer hospital beds per person than those other countries. We seem to be spending more and getting less. And indeed, if there's a single theme running through this report, that's it. Let me go on. In 2013, the last year for which we have statistics, infant mortality in the United States. The percentage of newborn children that die in the first year is greater in the United States than in any other advanced industrial country.
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Wow.
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The US has the highest prevalence of obesity overweight conditions of any industrialized advanced countries. In a ranking of access to water and sanitation, the United States ranks 36th in the world. We have the highest rate of incarceration putting people in jail. It's ahead of such countries as Turkmenistan, El Salvador, Cuba, Thailand, and the Russian Federation. We are incarcerating people at five times the average rate of advanced industrial countries. The youth poverty rate in the United States is the highest across the the Organization for Economic Cooperation and development, the OECD, which is a association of about 35 advanced industrial countries. One quarter of youth live in poverty in the United States. The average for the OECD, 14% I could go on, but the story is the same. We spend more than other people on the quality of our health care and we get less in the way of health outcomes. And clearly associated with that, across the board of indicators is the extraordinary inequality of wealth and income in the United States. The extent of our poverty problem is extraordinary. And just as extraordinary as the extent of our poverty problem is the need of our leaders not to confront it, not even to talk about it on a scale that the problem clearly merits. I want to turn next to a very brief economic update. It has to do with about Oreo cookies. If I get it correctly, our president, Mr. Trump, is a fond consumer of Oreo cookies. And you may remember during the campaign that he made a point of the importance of keeping the Nabisco company that makes Oreos producing them here in the United States. Nabisco is now a subsidiary of the Mondele Corporation, which is.
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Which is a global mega corporation.
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So it is with a certain sadness that I need to inform all of you that Oreos are now going to be shifted to being produced in Mexico. Turns out when all of the television lights are turned off and the reporters aren't paying attention, the promises of jobs staying here turn out not to work out out so well in the months that follow. There is nothing unique about Oreo cookies. Ford Motor Company has recently announced shifting more production likewise to Mexico. And the same is happening with automobile production in China and so on. And I will from time to time bring you these sad tidings in the interests of knowing what's actually going on. The bipartisan Market Watch survey that is well known to people who are active in the stock Market reported on December 20. Another economic update, which is one in five American households, according to MarketWatch, has zero or negative net worth. Let me explain what that means. You can add up what a person or a family owns. The home, the car, personal belongings, savings accounts, everything. You can add it up and call that assets. And you can subtract from that amount that a person or a household has their debts. And what you get when you subtract the debts from the assets is what we call net worth. How much money? How much value? The monetary value of what you have minus what you owe to somebody else. One in five Americans have zero net worth. That is, when you subtract their debts, nothing's left from their assets or negative. And what does that mean? It means that your debts are greater than their assets. That's a condition. Which means if you had to pay all your debts, you wouldn't have enough wealth to your name, home, land, property, business, whatever, you wouldn't have enough to.
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Pay off your debts.
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One fifth of Americans. That's why you hear those remarkable statistics that for half the American people, maybe more, an unexpected bill of $400 for.
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An illness, for an accident, is a crisis.
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Those are the people who have no net assets at all. It's a statement and it's a situation that we will have a lot to say about in the years and months ahead. It is a sign of an economic system that isn't working for the majority of the people in this society. That's what these statistics are all testimony to. But when I say it isn't working for the majority of people, I need also to remind you that it is working for some of the people. And here I recently saw a statistic also carried by that same Market Watch story and by MarketWatch as a investor service that did an interesting thing. It added up the net worth of the 25 richest individuals in the United States. These include Bill Gates from Microsoft, Jeff Bezos from Amazon, and Mark Zuckerberg of Facebook. They are among these three gentlemen, among the 25 richest. Now, hold on to your hats. These three men together own with the 25, the top richest 25, a trillion dollars in combined assets. These 25 therefore hold more wealth than the bottom 56% of the American people. In simplest terms, the 25 richest people in America have more wealth together than the majority of the American people. That's a level of inequality that boggles the mind and that shapes almost everything else one can say about American society and culture. And it stands as a screaming criticism of an economic system that would distribute its output that we all help to.
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Produce in such an unequal way, as.
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If to drive the point home that.
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Things could be different.
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My next update has to do with Germany. And Germany is going to be figuring more than once today. Germany made a commitment some years ago to sign off on nuclear energy won't do it. The aftermath of the Fukushima disaster in Japan provoked such a revulsion in Germany that they swore off. And Mrs. Merkel, their leader, went along with the mass feeling not for Germany, no nuclear power to be produced here. And they're also a leader in shifting away from fossil fuels as the source of their energy, preferring wind and sun and so forth, natural forms of energy. So successful have the Germans been in providing energy production even to the individual household, through solar panels, through wind farms and so on, that over the last year, 2017, repeatedly in Germany, the price of electricity was negative. Let me explain. That means on a particular day, or maybe even for a particular week, the utility companies pay you to use electricity, not the other way around. That's what a negative price means. So much energy is being produced, not nuclear and not fossil fuel, that they have more than they need and can provide a rebate to people to use it when it's available in abundance and get paid for doing so and thereby save from having to use it when it is costly and has a positive price. Remarkable. Something, of course, that could and should be studied in other countries. Next economic update is also about Germany. But here it's kind of the other side of a capitalist economy. Not the efficiencies it does achieve, but.
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The inefficiency that is so basic to it.
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Germany, like many other capitalist countries, including the United States, Britain and many others, has been delivering a disproportionate amount of its increase in wealth to the richest people at the top of the society. It's not as unequal as the United States or Britain for that matter, but it is moving in that direction. And that has got the working class.
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Highly organized in Germany. Very angry, resentful.
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They've absorbed this inequality. It is getting worse and they've decided to put a stop to it starting on January 8th. The largest union in Germany, IG Metall, is the name of this union. It has 3.9 million million members in Germany. They've started on January 8th, a series of rolling short strikes. Before it's over in the very first week, they expect over 700,000 German workers will walk off the job for longer or shorter periods of time. What are they demanding? Three things. First, an increase in wages. An increase in wages, specifically and openly defended on the grounds that it is intended to reduce the inequality between the top 5 or 10% on the one hand, and everybody else in Germany. The the second demand of the strikes may strike you as even more bold. They're demanding a 28 hour work week for people who have responsibilities at home. Children under the age of 15, elderly folks they're responsible for, sick people that they're responsible for. And certain other kinds of workers are under special stress or having odd shifts of work. They should be reduced. And here's the productivity has grown in Germany. Workers have been better trained, workers have been working harder, workers have been working more intensely. And the result is growing productivity. And the workers want to share in the benefits of that productivity, partly by higher wages and partly by lower working hours. So there's a better balance, as they put it in Germany, between work and the rest of life. Among the companies being struck Volkswagen, Porsche, Bombardier, Otis Elevator. When it's over, 143 firms will experience the strike. Because the third goal of the German unionsan old one for them is to say what we do as unions is for all the working class. We want the workweek for everyone to be reduced. We want wages for everyone to be made higher so that the inequality in the society is reduced. Notice it's unions whose demands are for social change, economy wide change, not just changes for their members, but for the society as a whole. And the German unions then can make the claim as they do that they are a social force that the vast majority have working for them, the only real serious counterweight to the power of the large corporations. And it should make all of us wonder what it means if a society doesn't have a labor movement organized that well, militant in that way, committed to these larger social changes.
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It's an important question that I leave with you for your answers.
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Before continuing with my updates, I want to remind you that we maintain two websites that are full of this sort of information and that provide you with many kinds of services. Both websites are available 247 at no charge whatsoever, ever. The first one is democracy at work. All one word democracyatwork.info and the second one is RD Wolff with two Fs.com democracyatwork.infoordwolf.com through those websites you could communicate to us what you like and don't about this program, what you'd like us to cover. We look at all of these emails. You go to these websites very easy to do. Likewise, you can follow us with a click of the mouse on Facebook and Twitter, Instagram. We maintain these websites and indeed our social media contacts. In order to have you partner with us, you can take what we do on this program and share it with your co workers, with your neighbors, with your family. That makes the reach of what we do many times larger than what we alone could achieve. We want you as partners and we hope you make use of of what we do on this program and what we provide on those websites to partner with us. Finally, let me address a word to those of you that are listeners on the radio. If you would like to see this program as a television program, the easiest way to do that is to go to a website called patreon.com p a t r e o n patreon.com economicupdate and that will allow you to see the entire program as a television program.
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If that would be A preference for you.
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Let me return then to the economic.
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Updates we have left.
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I want to celebrate with you an action taken by the small country of Iceland. It has now taken leadership in something where it was already a leader. That is, the gap between what men and women earn for the same work in Iceland is smaller than in most other countries. But it wasn't enough for the people of Iceland. They recognized that even though they, like other countries, have on the books laws that say you should pay equally for equal work, equal, it wasn't in fact being enforced in many workplaces. So a new law took effect on January 1, 2018 in Iceland. Every enterprise with 25 or more employees must be annually certified by the government, which is going to come in and review statistics of the firm as to who's getting paid how much money for what kind of work, to prove which each firm has to do that it is paying men and women equally for equivalent or equal work. It is a commitment to overcoming centuries of unequal treatment between the two genders. And it is long overdue. And it's a recognition that merely passing a law without making sure it gets enforced is leaving to the market forces what in fact the market forces have done, which is to maintain inequality of pay even when a majority of people pass even the laws that make that illegal. Iceland is taking the next logical step, and it is something worth noting. Our next economic update returns us to a theme that we often revisit on this program. This theme has to do with the untruth of claiming in simple language, that we're experiencing a recovery in our economy. The mythology goes like back in 2008, we had a crash, so second worst crash in the history of capitalism, exceeded only by the Great depression of the 1930s. It was really bad in 2008, 9, even into early 2010. But since then, here we go, we've been on a recovery. Well, the truth of it is not.
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So much of a recovery.
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Depending on how you look at the.
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Economy, you don't see a recovery at all.
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And it is important to point out that yes, some folks are recovering, but others are not. Not even close. And here's a statistic not to lose sight, the median net worth of American families. Here's what that 50% of American families do better than what I'm about to describe. 50% do worse. In 2007, the median net worth of an American family, the assets it had, minus the debts, it also had worked out to $120,000 per family. In the middle, half did better, half did worse. Fast forward to 2016, the last year for which we have comprehensive numbers. What was the median net worth of.
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An American family these seven eight years after the great crash?
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The answer, 78,000. Notice the drop. Median 120,000 in 2007, 78,000. That's not a small drop. That's a catastrophic drop in the wealth.
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Assets minus debts that an American family had.
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To which the only honest answer was or response would be what recovery with a big question mark. The last update we have time for has to do with a situation in Canada, but it is applicable to capitalism everywhere. The largest fast food chain in Canada is called Tim Hortons. Started out as a coffee shop, but is now into many different kinds of food. And in the province of Ontario, the minimum wage was raised recently to $14 an hour this year and 15 next year. And how did the Tim Hortons restaurants respond? Well, they responded basically by sabotaging the whole point and purpose of the law. Here's what they did. Many of them, not all, they cut the paid breaks that they had given to their workers. They made the company's share of the health insurance fees go down and the workers had to pay more. In other words, they took away from the workers as much as the rising minimum wage gave to those workers. Since the whole point of the legislation was to improve the lives of the workers, to make those at the bottom of of the income distribution not as bad off as they had been, what these companies were doing was to literally sabotage the law. What is the point here? Well, let me read to you one statement that was made by one of the companies involved. Quote, unfortunately, when wages rise at such a fast pace, we cannot raise our prices at the same rate to affect the cost to offset the costs. And something has to give. I love that something has to give. Yes. You know what has to give? Profits. Those incomes. The profits that go to a small minority of the people have to be reduced so that what you pay to the vast majority of the people is not as miserly as it has been. No mystery, no difficult problem, no quotation needed. Do the right thing or admit that this is an economic system that puts most of the cards in the hands of the employers who do not hesitate to use them to get around what a majority of people and their political representatives have decided to do in the.
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Way of raising the minimum wage.
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Same thing happens in the United States and is a shocking reminder that the system is the problem. And passing laws is never in the end an adequate way to change how this system has worked. Continues to work and is driven to work by the very mechanisms of profit and competition. We've come to the end of the first half of Economic Update. Please stay with us. We will be right back. Welcome back to the second half of Economic Update. As this is the beginning of the month, it is my pleasure once again to welcome to this program Dr. Harriet Fraad, who is a practicing mental health.
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Counselor and hypnotherapist in private practice in New York City.
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She also writes for a variety of journals and also has a very important.
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And interesting website and blog. You can find her at.
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Harriet, that's with two Rs. Harriet, fraud, F, R, A, A D, all one word. Harriet Fraad.
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It is with great pleasure that I welcome her once again.
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Thank you. I'm glad to be here.
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Well, today the topic that you and.
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I have gotten ready for is about an epidemic here in the United States. And I can think of no more dramatic way to introduce the topic that we're going to discuss than to point.
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Out that the last two years have.
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Seen the life expectancy here in the United States drop for two years in a row. We haven't had that for half a century in this country. Other countries are not experiencing this sort of thing. Life expectancy is getting longer. And when you look at the statistics.
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As everybody has pointed out, it's not.
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That our elderly are dying sooner.
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They aren't. It's what's happening are young people, people in their 20s and 30s who are.
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Dying in disproportionate numbers. And it's very easy once you look.
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At the statistics, to find out what the problem is.
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It's called opioids. It's called a disaster in which opioids, which I'm going to ask you about, are taken in too great a quantity or in too great a strength. And basically, people kill themselves by overdosing on this drug. So it is having staggering effects. And to give us some idea, perhaps we can start off by your telling us what's the scope, the scale of this problem in the United States?
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Well, there are estimated to be 2 million addicts in the United States. However, there are probably a lot more. People don't answer questions and say, hey, I'm an addict. So, you know, you have a wild death rate not only in the 20s and teens, but also the 30s and 40s. Opioid addiction, overdose is now the biggest cause of accidental death for people under 50, the biggest cause in the United States. Since the year 2000, 200,000 people have died of overdoses, usually from opioids which are synthetic opiates. Opiates are things like heroin that are grown poppy extracts. Opioids are chemical opiates. They're things like fentanyl or Oxycontin. Oxycodone. Oxycontin and oxycodone being the biggest offenders, the biggest killers of all.
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And what's the number for 2016, the last year we have, how many people died from overdoses of these drugs?
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64,000 people died directly from overdoses. Another 95,000 died from the indirect causes of opiate addiction.
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Wow.
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So this is off the charts. This is an unbelievable killer. Worse than aids, worse than almost anything one can think of. More deaths in a year than any war we've participated in for decades has caused. I mean, it isi'm overwhelmed every time I see this number, thanks to your intervention.
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Give us an idea.
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As a practicing mental health counselor and so on, why is this problem? How do you account for the United States being awash in this level of. Of self destruction? There's no other way to describe it. What's this about? Why is this happening?
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Well, addiction increases. It's a combination. It's a combination of the direct hustling of OxyContin by the Sackler family's Purdue pharma company, for which they have no accountability. And it's also that thing. Addiction increases with inequality. Only a small percentage of addiction has a chemical hook. The rest, according to Dr. Carl Hart, the authority at the Columbia Study Laboratory for Addiction and author of an impressive book, the rest is due to isolation and trauma. Americans are more lonely and isolated than they've ever been before. They don't go to work with other people. They don't join unions. They don't join clubs and bowling leagues and anything else. And they're terribly lonely and isolated. The people at the top and the middle don't associate with the poor. The public schools don't bring people together as they used to. Even our Cabinet member Betty DeVos, in charge of education, is a believer in charter schools and private Christian education, which isolates some people from the rest. So that we have a very isolated society and people are very lonely and a very traumatic one. I must say that the big increases in employment are in the gig economy, which you do all by yourself. You drive your Uber car, your own car, of course, for Uber, for Lyft or whatever. You deliver packages for Amazon in your own car as part of this great gig and so on.
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So if I can call you out, the conditions of work being isolating, the conditions of work in which the majority of people are falling further and further behind the image of what the American dream and the good life is like, that you're producing conditions of work and life life that are driving large numbers of people to seek some sort of escape in an addiction.
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It's not really an escape, it's something to look forward to. I have a client from Alabama and she said that all of the cousins in her very large family have left Alabama, where they came from rural Alabama, because if they stayed, they'd all be addicts because the only thing they could look forward to that was exciting was getting high.
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Not a family, not a job, not a career.
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Families have broken down, marriage has broken down, careers have broken down, opportunities for blue collar Americans have broken down. It's the end of an empire, even though the military doesn't seem to believe that and the society is breaking down. And so that people are terribly lonely and isolated and they want to look forward to something that makes them happy. And drugs can make people feel happier even if they introduce you, particularly when they're criminalized, as in our society, into a life of criminals, into a life of substances which are doctored and often kill you, into a whole abandonment of work. Because if there's a drug test and you get caught, you lose your job. None of which are true in a decriminalized drug culture. But nonetheless, people are isolated and lonely and traumatized.
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Well, let me break this down into a couple of directions first and excuse my naivete, but I'm trying to learn about this. And partly that's, I think my audience is too. Why are people dying from it? It's one thing to be addicted and then to take a drug that you're addicted to, but it's another thing to take it in such a way that you end your life. What is going on that would account or how do you explain the level of death that is flowing from this particular addiction?
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Well, one of the reasons reasons is let's look at OxyContin, which is the biggest offender because addiction rates started to have a meteoric rise in 1996, a year after OxyContin was introduced to the market as a safe drug.
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It was an anti pain drug, anti.
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Pain meds, but it was recommended by their hired and financed doctors as something not only for short, short term pain like an injury, but long term pain like arthritis pain and things like that, chronic back pain. And the way it was marketed was very clever. Only 2 in 24 hours. However, in their initial tests in 1996, written up by CNN and written up in by the New York Times. They tested it in Puerto Rico and they found that half of the people tested needed more, more than two, evidence more than two that the drug wore out in eight hours, leaving them with withdrawal symptoms for the other four hours and needing them desperately to get their hands on more. The Sackler family and Purdue was totally unwilling to change that marketing strategy which was so successful. And so people became addicted also. Once their prescription rights ran out, they were stuck with a tremendous addiction. It's a very addictive drug. It was marketed as non addictive, but it is proven to be addictive. In fact, there are 10 states suing Purdue Pharma for deliberately and fraudulently pushing OxyContin across their huge connections in the medical community and their basic bribes and owning labs and their gifts because this family has remained untouched, in part because they give wild gifts. For example, the Sackler gallery in Washington, D.C. is from the Sackler family. Surprise, surprise. The Sackler Museum at Harvard, the Sackler center for Arts at the Guggenheim, the Sackler gifts to the Metropolitan Museum of Art, even the Sackler Wing at the Louvre Museum in, in Paris. And the endowed professorships and the underwritten laboratories have given them a name as philanthropists rather than murderers. And they have been able until fairly recently to escape fraud. And even where they are being pursued, as 10 states are now pursuing OxyCondon, they're not pursuing the family, the Sackler family, which owns it and knows about this epidemic of murder, but the company, and therefore what they're doing in true philanthropic fashion, is shifting their marketing campaigns to South America and Asia.
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B
Let me ask you to comment on another way of getting at this. Other countries have also had epidemics of drug addiction.
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C
Absolutely.
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B
And it's not only the United States. Even though this particular drug addiction has been more virulent and more destructive here in the United States than anywhere else, than anywhere else on the earth. But tell us a little bit about countries that have responded to their drug problems by taking a step that we aren't even seriously considering in the United States, namely to decriminalize it, to make an addiction no longer a criminal act to be punished by incarceration, but rather to be seen as an illness that society wants to help a person overcome. The way we have looked at AIDS or polio or, you know, diphtheria and others in the history of illnesses. Tell us about that and what the experience of these countries has been that might be instructive for the United States.
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C
Well, there are five nations that have done that. I must say that there were a few states in the United States that began by decriminalizing marijuana, and the federal government is down on them. However, we have Portugal, a very strong example, where 1 out of 10 people was an addict before they decriminalized drugs. Portugal, the Czech Republic, the Netherlands, Uruguay, and some of the districts in Australia. Portugal and Uruguay are the most dramatic. They totally decriminalized drugs. And what they did instead was they took the excitement out of drug use by making it legal, just like going to the drugstore and getting a drug isn't all that exciting. And they also made sure that the isolation of its people and their proneness to death with an unregulated system was regulated. And the trauma of being on the street was no longer. Because if isolation and trauma are the biggest causes, that's what you get when you're criminal for drugs, hiding, going into the underground, being unable to work because you'd be exposed and so on.
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Fear of the police, all of that.
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All of it, that drives you away from other people. What Portugal did, because they had a terrible epidemic, one in ten was an addict. They decriminalized drugs. People can go and get their prescription filled. And where they get. And the government produces all the drugs and gets all the revenues which they have committed to rehabilitation run by the government. It isn't some kind of capitalist scam, rehabilitation, like we have. It's really rehabilitation. And when you pick up your prescription, you're offered a chance to go into a rehabilitation program and give it up, or without any judgment, given your prescription. And because of that, people don't die from overdoses because their heroin, if that's what they're getting, or is not cut with cement or some other lethal substance.
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By criminals who are engaged in the illicit trade of.
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That's right. Because if you're going to. If you're going to export illegally, if you're going to bring into the United States drugs, you don't bring the least expensive. Just like during Prohibition, people didn't bring in beer. There's not enough money in it for alcohol. They brought in the strong stuff, and they bring in fentanyl, the strongest fentanyl. There's a. One of the fentanyls is an elephant tranquilizer, 5,000 times more powerful than the usual opioid. They take those in. Now, of course, you take a gram too much, you're dead. And these are the people who are operating the illegal trade, are cartels, often who really are not into health. They're into Sale. And if you die, it's your problem.
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And so we hear these stories of putting all these other substances in that look or feel like the drug, and you're. And because it's all illegal, there are no controls, there are no regulations. Whereas in Portugal, if I understand the government is the seller of all of these drugs and then uses the income to pay for the rehabilitation. What's been the result in places like Portugal?
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They've cut addiction by 75% in Portugal, and they've cut crime accordingly.
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So we know that decriminalization in the cases where it's been tried has, in at least many cases, if not all, been stunningly successful, stunningly successful across the world. The obvious question why not here? Why not in the United States?
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First of all, OxyContin alone is a $35 billion operation. Also, you have an idea in the United States that the way you get people to do anything is to force them to intimidate them. Them. If you want to solve a problem in North Korea, you threaten to atomic to, you know, bomb the place. You bring our military in over 100 countries in the world to coerce them to our will. It's not like after World War II when the Europeans lauded communists as the resistance, which they were, the overwhelming force in the resistance to fascism. They had the Marshall Plan where they gave money to create enough to rebuild those economies, prosperity and rebuild the economy so that people weren't tempted to look to Communists. Well, of course, if you gave Marshall plans to poor people and you gave help and employment and health care, that wasn't profit making, corrupt health care, you could preempt some of this. But that isn't the philosophy of the government. And there are powerful forces. At first it was racism. When they started these rules under Nixon, they thought, well, those are an African American. Drug use is an African American problem. We can wipe them out. But now it's not an African American problem. It's a ubiquitous everybody.
- [46:24]
B
I think the story in the Nixon era that came out recently was that Nixon and his advisors, Ehrlichman and Haldeman, knew that voters, African American voters and young people were overwhelmingly against them. And so according to them, they've now admitted the whole business of the war on drugs had a lot to do with incarcerating these people and then making sure that once you're incarcerated for your drug offense, you then lose the right to vote. It was a way of disenfranchising. You know, Michelle Alexander comes back later and says the new Jim Crow is putting people in jail. Because it disenfranchises African Americans. And so it becomes part of a political maneuver on top of this impulse to use police and army as a way of dealing with a social problem.
- [47:23]
C
But now, in a depoliticized America where states like Kentucky, every 30th person knows someone who died within their small circle from OxyContin or, you know, opiate, I mean, opioid abuse, it's no longer an African American or youth person program and problem. It's an everybody problem. And so that that rationale, racist and ageist rationale doesn't work.
- [47:55]
B
Let me ask you another question that comes up often. There's this argument that in the United States, as a person in the psychology profession, you might have some important insight here. There's an argument that says that the kinds of difficulty that lead human beings to addiction have, as you've said, to do with trauma, isolation, depression, disconnection from other people. But we as a psychologically attuned population have been taught to believe that the problems of addiction are chemical, has something to do with a certain chemical imbalance. What do you think about these? These are alternative ways of understanding it.
- [48:41]
A
How do you explain and what is.
- [48:43]
B
Your view about this?
- [48:45]
C
Well, although if you take OxyContin and opioids for a while, that does make alterations in your brain. The hook of drugs is only a small percentage, a chemical hook. The rest is an emotional hook. It's a disease of loneliness and despair, not of chemical imbalance. The chemical everything is. Everything that the brain does has a biochemical component. So you can change your brain through therapy, you can change your brain through medications of various kinds or through opiates. But the body is. Is a biochemical psychological unity. It's not separate. And that's a bogus argument. Carl Hart at Columbia has really shown.
- [49:37]
B
That beautifully in his book here's My Economics Coming In. The story about depression being chemical is a wonderful story because it suggests that the drug, a chemical, if you add it, will correct the balance and you'll solve your problem. So that the drug company has an.
- [49:59]
A
Enormous vested interest in profiting by selling.
- [50:02]
B
Drugs to people who are convinced that the problem of their depression, of their anxiety, of their addiction is a chemical balance issue. Whereas you don't have any comparable corporation doing therapy. That's done by lots of little. It's individuals like yourself who can't mobilize the advertising, the briberies and all the rest that go with creating a market. So that we can see the economics are pushing people in the direction of chemicals and now, you've shown us that.
- [50:35]
A
One of these chemicals, fentanyl in particular.
- [50:38]
B
Has become the disaster of disasters in our culture. And that's in part because. Because of this ideology of chemistry rather than emotion.
- [50:50]
C
That's right. The most definitive studies were done, of course, in England has a public health system. They didn't have anybody conducting the studies that were financing the products. And they studied thousands of people giving them serotonin uptake inhibitors, things like Prozac and Paxil and so on. They found that in 75% of the cases, they don't work at all. In about 25%, they work only. And those are the most acute cases. They work only temporarily when you start using them and then you keep needing more so that they really don't cure you. They don't cure, so you keep taking more. That's the idea. It's a profit drug. It's not. They ought to prescribe drugs only in the case of someone who is utterly dysfunctional and not even available to talk.
- [51:53]
B
Let me ask you the big question.
- [51:55]
A
What does all of this tell us.
- [51:57]
B
About the link between capitalism as a system on the one hand, and both the needs for people to become addicted.
- [52:07]
A
And the way we handle or fail.
- [52:09]
B
To handle the very mechanisms of addiction. How is this system involved in this whole problem and how it is not being solved?
- [52:21]
C
Well, when you look at capitalism and health care in combination, nothing illustrates it better than what has happened with addiction and rehab. In 2008, the Parity act that made mental health and addiction treatment insured came into being. Around the same time or shortly thereafter, the Affordable Care act came into being. Well, you have unregulated, largely unregulated in most states, not regulated rehabs opening with no qualifications whatsoever.
- [53:02]
B
Because it's covered by insurance. Right?
- [53:03]
C
Because it's covered by insurance. They all have labs to test people's urine for drugs. Urine is considered in those labs, quote, liquid gold. Because if you get a urine analysis test outside of one of these places, it costs between $50 and $80 for a sophisticated test, it costs $1,000 at these labs and you need at least two tests a day. You also have required sober living houses which can be opened by anybody, and there is no cure rate and there's no necessary, there's no necessity to tabulate the dead so that you have one model, the California model, which costs on average $28,000 a month. The other one, which is the Florida model, which costs more like on an average $2,000 a month. They both require more money for sober living and for drug testing so that you have a wild boom of these companies making enormous money. There has been some regulation in states like Arizona now so that they require one mental health professional on staff. Now that could be a mental health professional whose specialty is marriage counseling.
- [54:35]
B
Is it then? If not, it doesn't even matter.
- [54:37]
C
I mean they're not qualified, they don't require medical, they don't require hospital connections even though quite a few people die.
- [54:47]
B
Is it then a fair summary that capitalism creates the conditions of loneliness, trauma to drive people to addiction, then make money off of the chemical solution and off the rehab centers and therefore the whole system in a way produces and sustains this disaster and then complains about it as if it weren't a system problem but blames the individual.
- [55:11]
C
That's right. And the only individuals that are not blamed are like the individuals in the Sackler company that own the multi billion dollar pharmaceutical company. They go scot free when they could be accused of hundreds and hundreds of thousands of murders.
- [55:32]
B
Thank you very much Dr. Fraad.
- [55:33]
C
Thank you.
- [55:34]
B
Thank you all for listening. I want to ask you again to partner with us to spread the word of what you've learned, hopefully in our program today. I want to thank a long standing partner, truthout.org, that remarkable independent source of news and analysis and I look forward to speaking with you again next week.
- [55:58]
A
Sam.