← The Clay Travis and Buck Sexton Show
The Clay Travis and Buck Sexton Show
Wellness Unmasked: America’s Opioid Crisis Explained: Dr. Stephen Loyd on Fentanyl, Addiction Treatment, and Criminal Justice Reform
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Kal Penn
Hey audiobook lovers. I'm Kal Penn.
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Dr. Nicole Safire
I'm Ed Helms.
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Kal Penn
Ed and I are inviting you to join the best sounding book club you've ever heard with our new podcast, Earsay, the Audible and iHeart Audiobook Club.
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Dr. Steven Lloyd
Each week we sit down with your.
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Kal Penn
Favorite iHeart podcast hosts and some very.
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Dr. Nicole Safire
Special guests to discuss the latest and.
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Kal Penn
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Season two of Unrivaled Batt Basketball is here and the talent is unreal. Paige Beckers, Nafiza Collier, Kelsey Plumb, Brianna Stewart and more are back to redefine the game. Unrivaled basketball season two, sponsored by Samsung Galaxy, tips off January 5 on TNT, TruTV and HBO.
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Kal Penn
Max support for the show comes from Public the investing platform for those who take it seriously. On Public you can build a multi asset portfolio of stocks, bonds, options, crypto and now generated assets which allow you to turn any idea into an investable index with AI. It all starts with your prompt. From renewable energy companies with high free cash flow to semiconductor suppliers growing revenue over 20% year over year, you can literally type any prompt and put the AI to work. It screens thousands of stocks, builds a one of a kind index and lets you back test it against the S&P 500. Then you can invest in a few clicks. Generated assets are like EFTs with infinite possibilities, completely customizable and based on your thesis, not someone else's. Go to public.com podcast and earn an uncapped 1% bonus when you transfer your portfolio. That's public.com, paid for by Public Investing Brokerage Services by Open to the Public Investing Inc. Member finra SIPC Advisory Services by Public Advisors llc SEC Registered Advisor Generated Assets is an interactive analysis tool. Output is for informational purposes only and is not investment recommendation or advice. Complete disclosures available at public.com disclosures protect.
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- [02:25]
Ross/Optum Advertiser
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- [02:44]
Dr. Nicole Safire
Welcome to wellness unmass. I'm Dr. Nicole Safire and we have a really good guest joining us today. Today we are talking about fentanyl, not about a political issue, but as a public health emergency and what we need to do about it. This synthetic opioid is now the leading cause of death for Americans ages 18 to 45. Killing quietly, quickly and indiscriminately. Just a small dose the size of a few grains of salt can be fatal. This isn't just about addiction. It's about poison, supply chains, failed policies, and the urgent need for accountability, prevention, and real solutions. So let's unmask this fentanyl crisis and dive right in. Well, with the President's war on drugs right now, there is nobody better to be joining us on wellness unmasked than Dr. Steven Lloyd, internal medicine and addiction medic, physician, president of the Tennessee Medical Board. And he has many more titles which I'll leave to him to tell you all about. But Stephen, thank you so much for joining us today.
- [03:44]
Dr. Steven Lloyd
Thanks for having me, Nicole.
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Dr. Nicole Safire
So, I mean, big news out of the White House. Obviously, President Trump has had a war on drugs, but he's now declaring fentanyl to be a weapon of mass destruction. What's your thoughts on that?
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Dr. Steven Lloyd
Well, you know, I'm not sure what all that entails, but, but from an awareness standpoint thing, Nicole, I'm all for it. You know, we know that we're losing about 220Americans today to drug overdoses, and the large percentage of those are fentanyl. And so, you know, if you look at 220 people a day dying, that's a 737 crashing and killing everybody on board every day of the year. And so anytime that, you know, you can raise awareness about that, then I'm all for it. I think it's the right move. I don't know what some of the ramifications of that are from a military standpoint or a border control standpoint. That's not my area of expertise, but I am certainly in favor of it because interdiction efforts do help us. Keeping deadly drugs out of the United States.
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Dr. Nicole Safire
Yeah, I mean, you know, you make an interesting point. So as Physicians, we think of drugs as a medical condition. It's a physical health issue, but also a mental health issue. From a physician's perspective, how do you actually feel about it turning into kind of a criminal justice crisis?
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Dr. Steven Lloyd
Well, you know, that's the part that always worries me, Nicole. Right. You hang the weapon of mass destruction thing on there and then people who are addicted to it get tied into that. And as you know, stigma is the biggest thing we have to overcome when we're trying to help people with any type of substance use disorder. So I do get worried about that. At the same time, our partnerships with law enforcement, the criminal justice system are key. We're not going to move the needle on the opioid crisis in the United States until we address this in our carceral setting. I mean, it's just a fact. There's so many, you know, so many people in there. And so I think there's pluses and minuses to it. But overall, I'm glad that he's done it. It certainly puts it on the radar. And if our president thinks it's that important, it certainly raises the level of awareness in the every everyday Americans lives. Except for the people who aren't going to like anything that President Trump does.
- [05:40]
Dr. Nicole Safire
Well, there are definitely a handful of them. Right. It doesn't matter what he does. He could cure cancer and they criticize him somehow.
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Dr. Steven Lloyd
Right.
- [05:49]
Dr. Nicole Safire
You know, President Trump obviously has emphasized, emphasized border security and targeting these cartels. And you know, from a medical standpoint, you know, I think about it, and the reality is disrupting supply is going to eventually have to trickle down to a reduction in overdose deaths, don't you think?
- [06:07]
Dr. Steven Lloyd
Yes, ma'. Am. Yes, Nicole. You know, it's one of the things that kills me. You know, I hear this. The war on drugs has been a failure. Right. And from a strictly drug using standpoint, I guess it has been, but it hasn't been a failure across the board. I mean, we have stopped a lot of dangerous drugs from entering the United States. That's a good thing. Right. If nothing else, it drives up the price of what's here and it makes it harder for people to access. Right. And so I don't buy into those arguments. Our partnerships with law enforcement, criminal justice are key. They're absolutely key to us coming out on the other side of this. And so I don't buy those arguments. The interdiction efforts don't matter, because I think they do. And I think it does trickle down. And matter of fact, I think you're seeing it right now, you know, look, in the United States right now, you know, our drug overdose deaths are going down in the state of West Virginia. They're down over 40% year over year. And I think interdiction efforts have something to do with that. Now, is it 100%? No. But is it a portion of it? Absolutely.
- [07:03]
Dr. Nicole Safire
So now, what do you think the role like Narcan has played in that?
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Dr. Steven Lloyd
I think it's been a big, huge role. Right. I mean, if I was in the decision making position to be able to address this on a national scale, you know, the first thing I would do is blanket the United States with Narcan or overdose reversal drugs. Because you and I are physicians. Right. And I don't know about you. I mean, I think you're an anesthesiologist or a radiologist.
- [07:25]
Dr. Nicole Safire
Radiologist.
- [07:26]
Dr. Steven Lloyd
Radiologist. Right. You haven't figured out how to treat dead people, Nicole. And neither I. And so, so we have to keep people alive. And, and so the easiest thing to do right off the bat is blanket the country with Narcan. But, but, but, you know, then you just have people coming in and out of the systems. Reverse go right back. So you do have to have that intervention where you actually direct people towards treatment. And that would be, you know, step two of the process. But I think it's key. I think overdose reversal drugs have played a big role in this.
- [07:51]
Dr. Nicole Safire
Yeah, but I mean, the overdose reversal drugs are for the fentanyl and the drugs that are currently in the system. President Trump's working to try and decrease that supply. But I'm, you know, I still look at our system and, you know, just to bring a little current events to the conversation, I mean, what happened just in California with the, the Reiner family, you know, they have a son who since his mid adolescence has been in and out of rehabs. I think by the age of 22, he had been in rehab like 18 times for polysubstance abuse. And now he's been arrested for murdering his parents. I mean, at what point do you say if one of the most privileged children in our country, I mean, I would say he's privileged. He obviously was born into a house of privilege. If one of the most privileged children in this country has failed these multiple rounds of rehab, like, is it a system problem?
- [08:49]
Dr. Steven Lloyd
Oh, Nicolette is for sure a system problem. I mean, it's why I'm on here with you. It is a system problem. I mean, any other medical condition that we put that we treated somebody for, you know, and we're unsuccessful, we Have a. We have a second. You know, we have a second line treatment option, right? And a third line and a fourth line and a combination of things. Addiction treatments basically not changed the United States in the last 100 years outside of some medications. But they don't get people into recovery. They quell cravings. They're important for keeping people alive. But, Nicole, we got to change our fundamental system. You know, I was always. I was told, I don't know if you know about my past, but. But I'm. I'm recovering from opioid and benzodiazepine addiction for 21 years. As a young doctor, I got addicted, and I stepped into a system of care for doctors that is very good addressing those underlying drivers of addiction. And I've got no idea what happened in the Reiner family, and I have no insight into it. However, from my point of view. And I look at this and I see, you know, young Nick's issues. I wonder, were you just addressing the drug use or were you trying to get at some of the underlying drivers that was pushing Nick in that direction? And then a lot of times, it's untreated mental health issues. And so the system of care that we have today is not meeting the standard. The average person with addiction issues takes eight years to get one year of sobriety. And in that time, they go to five different treatment programs. I mean, come on, Nicole. There's something wrong with that system.
- [10:11]
Dr. Nicole Safire
So what do you think it is?
- [10:13]
Dr. Steven Lloyd
Well, I think it's. If you're a hammer, everything's a nail, right? You know, you come in, you have this problem. This is what we treat you. You're unsuccessful at it, you go back out, you come back in, and we hit you with the same thing that you came back in with the first time. Right. I learned early on in recovery that the definition of insanity is doing the same thing over and over, expecting a different result. That's what we do in addiction treatment. We do it all the time. We do it every day. And then when people are unsuccessful, we kick them out. I mean, what if we treated heart failure that way? You know, the day after Christmas when papaw was loaded up on country ham and salt, gets fluid overload and fills his lungs up. If we treated him like we do people with addiction, we'd kick him out.
- [10:50]
Dr. Nicole Safire
Of the ER that's actually a really interesting comparison. You're right, because all of the time we have either non adherence to medications, non compliance with diets and recommendations, and yet we treat them just the same. We just give Them more diuretics. We up their medications and we just move on. But when it comes to addiction medicine, they lose their privilege for certain things. They get kicked out of rehab. That's really interesting. So that stigma is still there, despite how much talk there is about getting rid of the stigma.
- [11:19]
Dr. Steven Lloyd
It's the biggest roadblock we have. Nicole. People are always asking me, steve, if you had pixie dust and you could wave it, you know, spray that pixie dust, and you'd have one thing in this whole system, what would you want? And the thing that I want doesn't cost any money. Right. It's just a change in attitude. And, you know, the attitude of which I was approached back in 2004 when I found recovery. You know, they didn't tell me it was okay. They didn't tell me that, you know, that. That, you know, what I've done was great. They did tell me that there's an avenue here for help, and if you choose to help, if you choose to follow it, then. Then we're going to be beside you the whole way. We're gonna support you and we're gonna help you in your job as you reenter medicine. And so, you know, those are the type things that really helped me going forward. Most people don't have access to that. Most people, when they come into the system, this is your last chance. If you mess up, we're gonna kick you out. And it's this tough love approach. And I'm not above tough love, but I can tell you, for the most part, it doesn't work. And so we. We absolutely have to change our system. And the thing that we can do, first of all, is change our attitudes about addiction and the stigma around it.
- [12:21]
Dr. Nicole Safire
You know, one thing, you know, to bring in a little bit of health policy, and I'm not sure how familiar you are with it, but one thing that came out so the Affordable Care Act, I'm not. I'm not going to ask you your opinion on it, because we don't need to go there. But I have always been not a huge fan of it. I think there were some good, good impetus behind it. But the way. I'm not a fan. Let me put it that way.
- [12:43]
Dr. Steven Lloyd
Got it.
- [12:44]
Dr. Nicole Safire
You know, I think there are significantly more consequences than benefits to it. But one thing that did come out with the Affordable Care act was that addiction treatment was deemed one of those essential health benefits. And they classified substance use disorder treatment and mental health care. You know, that insurance plans must cover them. Detox, inpatient rehab, outpatient treatment, Medication assistant treatment. While we also, we obviously saw improved in access, the quality and the continuity didn't necessarily improve in itself. Like, what do you make of that?
- [13:16]
Dr. Steven Lloyd
Well, I think, I think we have to work on the things that you just talked about, the quality and the continuity. And are we using evidence based approaches to treat addiction? I mean, that's, you know, from a system standpoint you have to do that. But I'm in your corner with the Affordable Care act, you know, and it was actually, you know, I think it was Wellstone, Domenici act of what, 2008 or somewhere, the Parity Act. They said insurance companies have to cover substance use like they cover everything else. And there's never been any teeth in that and it's really never happened. And so I think that, you know, we have to, we've got some systems problems we got to look at from a coverage standpoint here to give people access to care. You know, if you break your leg, I mean, there's certain things you go through when you break your leg, right? You see an orthopedist, they set your leg, they put you in a cast. Your insurance company, you know, your insurance pays for the majority of that. You pay your co pay and deductible. I mean, you have access to care for that broken leg if you have addiction, right, which can kill you much quicker than a broken leg. A lot of people don't even have access to the care that's going to help them, and they wind up in the criminal justice system. And the weird thing, Nicole, is that they get the help once they get in the criminal justice system. How messed up is that?
- [14:20]
Dr. Nicole Safire
I mean, it is. And that's an interesting concept in itself because going back and forth on whether you should criminalize drug use or not, you know, my thing with the Affordable Care act was the ACA expanded coverage for addiction treatment. And therefore, I know it saves lives in terms of making sure there's a lot of those medication assistant treatments. But it obviously created a bloated bureaucratic system that prioritizes access over outcomes. And so we may be treating addiction more often now, but I wouldn't say that we're treating it better. Yes, we have more medications, but that's not a result of the aca. They only care about the metrics. They care about the numbers saying, well, this many people went to rehab, okay, well, how many people are now sober?
- [15:03]
Dr. Steven Lloyd
So it's so beautiful. I couldn't have said it better. I mean, this is, this is my soapbox. If I have it, I could Care. I could care less about the metrics. Right. I know those things are important. Right. You've got to see somebody in this amount of time and you've got to do an asi. And this. And those are things are all. Nicole. What I care about is outcomes. Outcomes are the only thing that matters. You know, in our current system, if you're getting federal or state dollars in a lot of our treatment programs, you get the money you got this year and then next year, if you spend all your money this year, then you get, you know, 5% or 10% more. Whatever the budget says, I don't care about that. I want to know what your outcomes were. How many people went from having no job, you know, living on the street to being in recovery, having a job, paying into the tax base, getting their family back, getting their kids. That's what I care about. Right. Recovery. When are we going to start looking at outcomes? Because outcomes are the only thing that matters. And I think that we have to take the third party approach here, bring them to the table and incentivize people for those outcomes. And I think there's a way to do that. But Nicole, it's the only thing that matters are the outcome. Nothing else matters.
- [16:03]
Dr. Nicole Safire
You're listening to Wellness Unmass. We'll be right back with more.
- [16:08]
Unrivaled Basketball Announcer
Season two of unrivaled basketball is here and the talent is unreal. The best women's players on the planet are running it back with even bigger moments and bigger stakes. Don't miss as Paige Beckers, Nafiza Collier, Kelsey Plumb, Brianna Stewart and more. Take the court and redefine the game. This isn't your regular season. This is unrivaled, where the pace is faster, the energy is higher and every athlete shines. Unrivaled basketball season two, sponsored by Samsung Galaxy, tips off January 5 on TNT, TruTV and HBO.
- [16:36]
Kal Penn
Max support for the show comes from public, the investing platform for those who take it seriously. On public, you can build a multi asset portfolio of stocks, bonds, options, crypto and now generated assets which allow you to turn any idea into an investable index. With AI, it all starts with your prompt. From renewable energy companies with high free cash flow to semiconductor suppliers growing revenue over 20% year over year. You can literally type any prompt and put the AI to work. It screens thousands of stocks, builds a one of a kind index and lets you back test it against the S&P 500. Then you can invest in a few clicks. Generated assets are like EFTs with infinite possibilities, completely customizable and based on your thesis, not someone else's. Go to public.com podcast and earn an uncapped 1% bonus when you transfer your portfolio. That's public.com podcast paid for by Public Investing Brokerage Services by Open to the Public Investing Inc. Member FINRA SIPC Advisory Services by Public Advisors, llc SEC Registered Advisor Generated Assets is an interactive analysis tool. Output is for informational purposes only and is not investment recommendation or advice. Complete disclosures available at public.com disclosures protect.
- [17:48]
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- [18:17]
Ross/Optum Advertiser
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- [19:04]
Dr. Nicole Safire
Well, so I mean, you're not just talking the talk, you're walking the walk. One you lived it. You're a professional. But you are chairman of something called Reach United. Tell us a little bit about that.
- [19:17]
Dr. Steven Lloyd
So Reach United is a nonprofit that started with some other folks to raise awareness about how the opioid abatement money is being spent. I was actually one of the expert witnesses in the cases that secured about 55 to 60 billion dollars for the United States.
- [19:32]
Dr. Nicole Safire
Yeah, hold on. So I know what that is because I was a part of a lot of the conversations in here in New Jersey, and Jack Cittarelli had he won. Like, he had a strong plan as to what to do with that. But some of our listeners may not Know what that is? So break it down.
- [19:48]
Dr. Steven Lloyd
So multiple states sued industry for the opioid crisis. Not only Purdue Pharma, but the other manufact distributors, McKesson, Cardinal Health, AmerisourceBergen, and then Pharmacy chains like Walgreens, Walmart and Kroger, some of, you know, some of the big pharmacy chains. And so when that happened, the federal court system took those cases and lumped them in all into one a multi district litigation. And then as a result of that, we won about $55 billion to abate the opioid crisis. And abate basically means to make whole. Now you're not going to be able to bring people back from the dead. But the money is supposed to be spent by these individual states going forward to build a system of care for the United States for the next two to three decades. And that money in a lot of places now, some places it's going well, but in other places it's sitting in bank accounts. The process is not transparent and in some places it's being used for things that aren't related to opioid abatement. And so that's the whole reason we started Reach United was to shine a light on that, to advocate that this money be spent to build this system of care for substance use and mental health that we currently do not have. Nicole?
- [20:55]
Dr. Nicole Safire
Yeah, I mean, and you know better than anyone, there's a lot of money sitting there and if it's not used, it's going to be misappropriated and it may go away. So I mean, it's really been kind of like the COVID funds. You know, it's people, you know. Who's not good at managing money? The government. I'm sorry, I agree. So, I mean, it's great. So what are some of the things that you want to see the money being used for?
- [21:21]
Dr. Steven Lloyd
You can even go back further than the COVID funds. And I know you remember this, the tobacco settlement money, I mean it was huge. And very little of that went to prevent kids from taking up tobacco in the first place with evidence based programs. And so that's the fear. And so I think that, you know, we need leadership from a national standpoint on this to ask mayors and county commissioners across this country how to allocate these dollars to build a system of care for people with substance use disorder. I believe that solutions are local, Nicole. I've always believed that. However, this is a complex issue and I think we need leadership from the top down in helping these folks work together to build the system of care that they need for their communities. And this is a community issue. The opposite of addiction is not recovery, it's community and relationship. So where is the leadership from the top down that's helping form this system of care that no matter where you touch the system, you get the help that's right for you? And I think there's a way to do that. We've got technology, we've got tools that we've never had in the past. We have a sense of urgency because, you know, we're losing 220Americans a day to this. So I think the timing is perfect. And we actually have funds, right? We have money. We don't have to go to individual state legislators and argue for, you know, our tax dollars to be distributed. This, we have a separate pot of money. My fear is, is that we're going to waste it.
- [22:42]
Dr. Nicole Safire
Well, I mean, I agree with you because this money was, is supposed to be legally restricted to opioid remediation, like addiction, treatments, medication, assistant treatments, Narcan distributions, housing prevention, education. But data tracking and surveillance, which, that's an interesting one. They're not supposed to be used for like the general budgets or pensions or unrelated projects, but it seems like sometimes some of it is. But the problem is, as you're saying, if there's not a cohesive plan and there's not an evidence based formula that people are looking at like, like we're gonna be wasting all of this money. And this, it's really gonna be a missed opportunity. And so, you know, is this something that you think, like, President Trump needs to have a task force that they're looking at to make sure that Trump that the funds are being used? Is there something that on a larger scale that they can put out a playbook to say this is what needs to happen, this is what will work so that this money's not just sent piecemeal to already broken programs?
- [23:46]
Dr. Steven Lloyd
You stole my word, Nicole. Which is playbook. Yes. And we already have that mechanism in place in the federal government's bureaucracy. Right? I mean, we have the Office of National Drug Control Policy. And I get the federal government saying that these are community issues and the solutions will be local. And for the most part, I agree with that. I think this issue is so complex with so many moving parts, it's ripped at the fabric of our families in this country. And if you look at our healthcare expenditures, and you will look at this from a financial standpoint, healthcare expenditures, the majority of our healthcare dollars go to treat chronic disease. You know that. And the Biggest economic burden of any chronic disease is actually substance use disorder. It's not diabetes, hypertension, or any of these neurologic diseases that wound up being chronic diseases. So yes, I do think that there needs to be a top down plan, and I'm not a big government guy, but I do think that we need leadership from the, from the top down to help these communities and help these individual states formulate a system that's going to stick together and get people the help they need. We don't get a second bite at this apple, Nicole.
- [24:54]
Dr. Nicole Safire
So if part of your playbook, what are some of the things that you think needs to be done?
- [24:58]
Dr. Steven Lloyd
Well, I think the first one right off the bat you've already covered, which is, you know, Narcan should be like, like, you know, it should be in the drinking water, okay? It should be literally everywhere. I mean, you shouldn't be able to walk into a restaurant, a school at any level, any kind of place where, where people are in the public athletic venues, you know, orchestras, plays on Broadway, whatever, and not see on the wall, overdose, reversal drugs. I mean, that's the first thing you can do, to slap a band aid on it right off the bat. And then the next thing that needs to happen is, is building this recovery oriented system of care that is data driven, right? Data driven. We, we have access to, to, to medical records, we have access to technology, we have access to now machine learning, artificial intelligence. Some of these things, I think are going to be real tools for us to put together individualized treatment plans for the people that we're trying to help. And then last but not least, you have to start looking at things like social determinants of health. A lot of these folks have lost everything. And so, so it starts with housing, right? And a way to make a living. You know, every time I ask my son to help me with something on my phone, right, and you know, he gives me the old teach a man to fish lecture. I'm about tired of hearing that. Right, but his point is, let me show you how to do it. The next time you won't have to ask me. And so I think times that we just hand out money instead of helping people, you know, find a way to be able to provide for themselves. And I think a lot, most people want to do that. So Nicole, those would be my strategies. And then the biggest one for me is addressing this in the criminal justice population and then the carceral setting. I mean, until we address it in that setting, we're not going to move the needle in The United States, the numbers are too big.
- [26:34]
Dr. Nicole Safire
So you think that we need more robust programs within the, like, the penal system?
- [26:39]
Dr. Steven Lloyd
Absolutely. We already have. What are you. What are you doing all day long? Right. I mean, you know, we could be using that time to do things that, that are going to help you when you. When you're. When you get out of that carceral setting. 95% of the people who are incarcerated in the United States today, we'll walk the street again. That's a fact. And so if they're going to walk the street again, I want them healthy. And we're missing a golden opportunity, and we have leverage. Right. And I'll get killed by the harm reduction people on this, but I don't care. Nicole, when I went to treatment as a young doc, and you've been through the process, right, Medical school, residency, I was in my chief resident year when I got addicted. And when they came to me and said, steve, you have a problem. You know, and here's what we'd like you to do, Nicole. I didn't have my pom poms out cheering, right? I was just trying to save my medical license. But they had leverage and said, here's the process, and if you don't do this, then we're not going to let you practice medicine. That was the leverage. And, Nicole, what I got was recovery. It changed my life, it changed my profession. It changed me as a father, it changed me as a husband. It changes me now as a granddad. And simply using that leverage that we have to hold people in the treatment process when they're already there. And I don't know why we're not doing it now. We have courts around the country that are doing it. Drug recovery courts, family treatment courts, veterans treatment courts. And I think it's a great thing. And I think we need to expand the use of that leverage to behind the walls in our carceral setting and start the treatment process while we still have people, you know, still have the ability to direct that while they're incarcerated.
- [28:10]
Dr. Nicole Safire
So as someone who's been through it themselves, not just on the doctor side of the room, but the patient side of the room, Someone, anyone out here listening who may be struggling themselves or they know someone who is struggling with any sort of addiction, what is your advice for them?
- [28:25]
Dr. Steven Lloyd
Addiction's treatable, treatment works, and people recover. That's a fact. And, and so there was a time in my life, Nicole, where I had all these things, you know, that I'd work to put on my wall. My medical degree all the stuff that I had won in my academic life and income, I never imagined as a little boy growing up in Jonesboro, Tennessee. Right. I had all of those things, but they didn't matter. When I was addicted, the only thing that mattered was this thing out here I thought I would have to have or I would die. And the people that are in that situation right now and have cravings for that and are willing to sacrifice everything that they have for that. I understand that addiction is a disorder of the brain. It is about our reward system and our frontal lobe, which gives us insight and judgment. And there are effective treatment programs out there to help you with the cravings so that you can find long term recovery. So the people out there who are struggling, I tell you, there is hope and don't give up. The problem is, Nicole, is that the help that they wind up getting is dependent upon where they get sent. Okay? And they get whatever the place that they get sent to provides. And that's asinine. Why do we not have individualized treatment plans that are built on real data? Right? You know, what have you already failed at? What have you not been successful at? You know, what's your DNA? What are the markers? What are the drugs that are most likely to help you with cravings? What are the things you need to do from a preventative standpoint? Your sleep, your diet, Right? We spend all these money in the United States on pharmaceuticals, and we keep going further down that rat hole instead of talking about what we can do from a preventative standpoint before this happens in the first place, and we have to treat it as a chronic disease. So taking all of these factors into consideration, what is the best treatment profile for you going forward, that gives you the best chance at recovery? And, Nicole, we have that. We actually have the technology and the infrastructure to be able to do that when we have access to medical data buried within electronic medical records across this country. Sorry, I got on the soapbox there for a quick. But I feel strong.
- [30:20]
Dr. Nicole Safire
Oh, I wanted you on the soapbox. You're the perfect person to talk about it.
- [30:23]
Dr. Steven Lloyd
I get so frustrated because we spend all this money on the back end, you know, that the pharmaceutical industry wants us to be depended on, and it just blows me away. I don't understand why we're not doing more on the front end. It's like sleep. Sleep is a risk factor for relapse, Nicole. Right. I've got a wearable, right? I've got this. This oura ring thing here. I wear. And when I wake up in the morning. I can see the quality of my sleep. I can see I got the bed later last night and I should have. I'm a little worn down today, Right. So I don't have my normal energy level because my sleep was disrupted because me and my wife watched the TV show. That upset me.
- [30:57]
Dr. Nicole Safire
Right.
- [30:58]
Dr. Steven Lloyd
And so now tonight I've got a chance to make a correction in that and do better with my quality of sleep. Now, am I worried about relapsing today? No, I'm not.
- [31:06]
Dr. Nicole Safire
Right.
- [31:06]
Dr. Steven Lloyd
I've been in recovery 21 years. I know how to handle this stuff. And I've got friends in recovery that can help me if I start to struggle. What do you do when you're three days out from treatment? Right. And you know, what does that look like? And so we address it. Not with the things that I'm talking about. We address it with pharmaceuticals or, oh, you need this sleep aid or let me write you this Xanax to help you go to sleep or this Ambien. Well, by the way, those things have habit forming potential as well. And now we're giving somebody who already has known addiction another substance that they could become dependent on. And it just blows my mind that we don't take a different approach. Looking at some preventative things. Our diet. Right. Our brain, gut axis. Right. These type of things that the data is out there. Wearables. The data is out there. We actually know who's at risk for relapse two weeks before they actually pick up based on things that can be gleaned right out of a wearable.
- [31:58]
Dr. Nicole Safire
You hear RFK Jr talking about how he loves wearables. I haven't gotten on the bandwagon for wearables, but you know what? I'm always behind. My kids don't think I'm very cool. And even though I'm a radiologist, I'm not the most tech savvy person you've ever met.
- [32:11]
Dr. Steven Lloyd
But you are a radiologist, Nicole, and you all spend a lot of time in dark rooms. So that could mess you up with a wearable. But I get it. I get it more.
- [32:19]
Dr. Nicole Safire
Coming up on wellness unmasked with Dr. Nicole Safire.
- [32:24]
Unrivaled Basketball Announcer
Season two of unrivaled basketball is here and the talent is unreal. The best women's players on the planet are running it back with even bigger moments and bigger stakes. Don't miss as Paige Becker, Snafeeza Collier, Kelsey Plumb, Brianna Stewart and more. Take the court and redefine the game. This isn't your regular season. This is unrivaled where the pace is faster, the energy is higher and every athlete shines unrivaled. Basketball Season 2, sponsored by Samsung Galaxy, tips off January 5 on TNT, TruTV.
- [32:52]
Kal Penn
And HBO Max support for the show comes from Public, the investing platform for those who take it seriously. On Public, you can build a multi asset portfolio of stocks, bonds, options, crypto and now generated assets which allow you to turn any idea into an investable index with AI. It all starts with your prompt. From renewable energy companies with high free cash flow to semiconductor suppliers growing revenue over 20% year over year, you can literally type any prompt and put the AI to work. It screens thousands of stocks, builds a one of a kind index and lets you back test it against the S&P 500. Then you can invest in a few clicks. Generated assets are like EFTs with infinite possibilities, completely customizable and based on your thesis, not someone else's. Go to public.com podcast and earn an uncapped 1% bonus when you transfer your portfolio. That's public.com podcast paid for by Public Investing Brokerage Services by Open to the Public Investing Inc. Member FINRA SIPC Advisory Services by Public Advisors, llc, LLC SEC Registered Advisor Generated Assets is an interactive analysis tool. Output is for informational purposes only and is not investment recommendation or advice. Complete disclosures available at public.com disclosures protect.
- [34:04]
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- [34:34]
Ross/Optum Advertiser
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- [35:21]
Dr. Nicole Safire
I like what you're saying. I mean, I am for it and for me, I talk, you know, being a western doctor, obviously I rely on big pharma, but I also am very much into if you know anything about me, I love natural herbs. I am the one who tells you to go outside and sit in the vitamin D. So I think that everything that you're saying makes sense and it should happen. And you'll hear a lot of people say, well, we just don't have have the money, we don't have the support. But the reality is we actually do have the money. And you know, again, the Affordable Care act, they just looked at how many people had access to addiction care, but they weren't measuring the actual outcomes. And same with the opioid settlement money. You know, spending isn't a success. The outcomes are. So these monies should be judged by lives saved, not by how many programs they get funded. And when you look at these rehab centers, you're right. Like it should be widely available data. You hear President Trump talking about price transparency. What about recovery metrics with each rehab center? Like, what if, what if they have bad, you know, a bad track record that their patients don't maintain? You know, I think this should all be public knowledge.
- [36:34]
Dr. Steven Lloyd
Yeah, it's reasonable when you're talking about mortgage in your house for the third time to send your kid to the same rehab you've already sent them to twice before. Yes. And Nicole, I don't want you to hear me wrong. I am not anti pharmaceutical on everything. I don't want you to hear that wrong. I'm not. Medications are there and they improve our quality of life. And some of them, you have a mortality benefit. We live longer as a result of treating hypertension or whatever. I'm just saying that the knee jerk here is as soon as you have an issue, it's straight to that without some other things that you could do from a preventative standpoint and we start looking at outcomes. You're exactly right. And you don't even have to start with punishment. Right. Well, your outcomes are bad and we're going to take your money away if my outcomes are bad. As a provider, I'm not doing the job that I need to do for my patients who are coming to see me. I want to know that and I want to know how I can use that data to improve my care plan so that they have better long term outcomes. Right? I mean, that's the reason for it. And so until we start measuring this, we don't even know what we're doing, if it's successful or not. And more importantly, we don't know what's successful for each individual person. And we just kind of throw spaghetti up against the wall and see what sticks.
- [37:44]
Dr. Nicole Safire
Okay, well, I think these are all amazing and I'm glad to see everything that you're doing. And, you know, I just, I think it's really important that people who have been on both sides of the exam table have these conversations and we need to hold people accountable. And, you know, I can go on my own soapbox and complain, complain, complain all day long, but it takes people like you working outside of the government to really make sure that these monies are being implemented safely. So appreciate all you're doing and thank you so much for coming the podcast today. We'd love to have you back on sometime soon.
- [38:15]
Dr. Steven Lloyd
You bet. I'd be honored. Nicole, thank you so much for shining a light on it. I'm grateful.
- [38:19]
Dr. Nicole Safire
Absolutely. The fentanyl crisis, it's not abstract. It's happening in our homes, in our schools, in our emergency rooms every single day. And we cannot normalize this level of loss. And we can't afford half measures. Real progress requires prevention, treatment, enforcement, and definitely accountability, all working together. The lives depend on it. We cannot keep celebrating metrics like how many people are covered under insurance that have addiction benefits. That doesn't matter. If people are not getting free from their addictions, if they are not getting clean, if they are not becoming a productive member of society. We have to stop treating the papers and the checkboxes and actually look at the people. Thanks so much for listening to Wellness unmass. I'm Dr. Nicole Safire. Be sure to listen to wellness and Mass with Dr. Nicole Safire on iheartradio wherever you get your podcasts and we will see you next time. Happy holidays.
- [39:13]
Unrivaled Basketball Announcer
Season two of unrivaled basketball is here and the talent is unreal. The best women's players on the planet are running it back with even bigger moments and bigger stakes. Don't miss as Paige Beckers, Nafiza Collier, Kelsey Plumb, Brianna Stewart and more. Take the court and redefine the game. This isn't your regular season. This is unrivaled, where the pace is faster, the energy is higher, and every athlete shines. Unrivaled basketball season two, sponsored by Samsung Galaxy, tips off January 5 on TNT, TruTV and HBO.
- [39:42]
Kal Penn
Max support for the show comes from Public, the investing platform for those who take it seriously. On Public you can build a multi asset portfolio of stocks, bonds, options, crypto and now generated assets which allow you to turn any idea into an investable index with AI. It all starts with your prompt. From renewable energy companies with high free cash flow to semiconductor suppliers growing revenue over 20% year over year, you can literally type any prompt and put the AI to work. It screens thousands of stocks, builds a one of a kind index and lets you back test it against the S&P 500. Then you can invest in a few clicks. Generated assets are like EFTs with infinite possibilities, completely customizable and based on your thesis, not someone else's. Go to public.com podcast and earn an uncapped 1% bonus when you you transfer your portfolio. That's public.com podcast paid for by Public Investing Brokerage Services by Open to the Public Investing Inc. Member FINRA SIPC Advisory Services by Public Advisors llc. SEC Registered Advisor Generated Assets is an interactive analysis tool. Output is for informational purposes only and is not investment recommendation or advice. Complete Disclosures available at public.comDisclosures Healthcare can feel complicated.
- [40:56]
Ross/Optum Advertiser
That's why Optum uses technology to connect the people and processes that make healthcare easier, more affordable and more effective. We're making it clearer for you to know exactly what your benefits cover and to help you better manage your health. We're coordinating care between your doctors and your technology. We believe better, simpler healthcare is always possible. That's healthy optimism. That's Optum. Visit optum.com to learn more.
- [41:23]
Kal Penn
Hey audiobook lovers, I'm Cal Penn.
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Dr. Nicole Safire
I'm Ed Helms.
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Kal Penn
Ed and I are inviting you to join the best sounding book club you've ever heard with our new PODC podcast, Earsay, the Audible and iHeart Audiobook Club.
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Dr. Steven Lloyd
Each week we sit down with your.
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Kal Penn
Favorite iHeart podcast hosts and some very.
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Dr. Steven Lloyd
Special guests to discuss the latest and.
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Kal Penn
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Dr. Steven Lloyd
It's the most wonderful time of the.
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Dr. Steven Lloyd
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Dr. Steven Lloyd
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