Governor Rick Perry (58:26)
Is it all right if I talk about how I came to learn about this, please? I'm going to have to start at the beginning, and I will try to be as economical with the use of words as possible. I was raised in Warner, Virginia. Five coal mining counties, Russell County, Virginia, which economically and culturally is much more similar to eastern Kentucky and southern West Virginia than it is to any other part of Virginia. I come out of a coal mining family. My grandfathers were both grade school educated. My father's father stopped attending school in the third grade. My mother's father stopped attending school in the sixth. Both of them are underground at the age of 16, and that's where they spent 40 years of their lives. My family has been generationally devastated by profound effects of alcohol and substance abuse as well as untreated mental illness. It has blighted us for as long as anyone can remember. This is the environment in which my parents grew up. They married early. My first memories as a child were of screaming, cussing and chaos. I can remember my grandfathers who lived incredibly difficult lives. My mother's father was one of 16, had a pair of shoes give to once a year. My father's father was one of 11. Neither one of them had a full set of fingers. You could hear my dad's dad breathe 50ft away from the combined effects of black lung and tuberculosis that he contracted in the cold camp in which my father was raised. When I was a young boy and I would go and visit them, each of them separately and independently would at some point pull me aside and they would say, papaw knows that you're scared and that you're anxious, but you need to know a couple of things. Number one, Papa loves you. Number two, and most importantly, God loves you. You have a special and unique purpose to achieve with your life that has been handed to you from on high. And no matter how scared you get, no matter how rough you think things are, if you will have faith that God will take care of you, you're going to come through just fine. If my grandfathers had not provided me in those very early years with sanctuary from that early chaos, the stability of their love and an affirmation of their spiritual. Of my spiritual significance, the chances are, if I were alive at all, I certainly would not be sitting here. I would be looking to people like Governor Perry and people who held jobs like I once did, wondering what they were going to do to pull me out of the ditch. I went through school at a time when Ronald Reagan was president and just like the duckling to the duck, he was my North Star as to what America was all about. I had a very idealized version of American history and civics education delivered to me by grade school teachers who had come of age during World War II, or ladies who had been trained by those teachers coming out of a working class family. My dad was an installer for the telephone company and a lineman for 40 years. He had some struggles with alcohol when I was very young that he through iron will overcame and today he is one of my absolute best and dear friends in this life. I was raised along with my brother to recognize the benchmarks of success as becoming either a doctor or lawyer. I wasn't much good by way of math or science, but I could write and talk a little bit. And I was also taught that law was the way in which you could defend truth, justice and the American way. So with dewy eyed optimism I went to undergrad and had a wonderful time. And then I went to law school and by the end of that first semester, with the acquisition of significant student loan debt, all of those dewy eyed notions had been crushed and destroyed before my very eyes. At the end of the three year legal education process, I came to know and to understand that law has nothing to do with any of those things that I was raised to believe that law is often nothing other, oftentimes than the tyrant's will and always so when it is used to produce predetermined, manipulated outcomes in the hand hands of judges who drive results based on their own individual biases, predilections and preferences. Because I owed such debt, my first job was to just get a job. And I found myself with an accidental career practicing workers compensation law in Kentucky. I had the privilege of being mentored by a lady named Mary Kay Williams. For one year she had managed to achieve partnership with the law firm at which we worked together. But In May of 2002, tragically at the age of 33, she died as a result of a fall from her attic at her home after a Memorial Day party. The next day I went into the office. The senior partner called me in and said there's no easy time to have this discussion, so we're going to have it now. There is a 300 caseload, 300 case caseload that Mary Kay handled. The bulk of those cases belong to Walmart stores. They are A significant client to this law firm. I don't know you, but you are the one of the few associates of which she had glowing things to say. I need you to get in there and get your hands around that caseload and anchor this client to this firm. That touches off what was a 16 year legal career practicing workers compensation law across Kentucky. In the years which coincided with the onset and explosion of the opioid epidemic out of central and southern Appalachia. I traveled from one end of the state to the other representing Walmart, Tyson foods and Tennessee valley authority, practicing thousands of cases over the course of those years. I can remember taking the deposition of a particular individual who I would describe as representative of the dynamics of the opioid epidemic. This person was usually a middle aged woman somewhere between the ages of 45 and 70. She would have worked tirelessly her entire life, usually in eastern Kentucky, working in low skill, low wage jobs, convenience stores, family dollars, walmarts. And she worked hard and she worked consistently. And she would have been someone whose labor was a monument of devotion to her family. At some point in time she would have had a work accident, a slip and fall or a lifting injury. She would make her way to either of his or in some cases, a lawyer. She would undergo an evaluation and she would endorse the existence of pain complaints throughout her body. This person would undergo a series of diagnostic studies that failed to reveal anything that was significant. Certainly not enough to explain all of the pain symptoms that this person endorsed. As a young lawyer, I took this lady's deposition probably 30 or 40 times. And I would get them to speak to their pain, I would get them to speak to their debility. And then I would pull out their medical records which demonstrated that CT scans, MRIs, electrodiagnostic studies, all had failed to reveal any objective physiological explanation for their complaints of pain. And being enthusiastic and wanting to defend the very best interests of my clients, I thought that I was being put on that the plaintiff's lawyer had sat with this lady and had come up with a sob story to tell me in order to pull money out of my clients pockets. I was always very patient and I was kind with the individual. But I would say, ma'am, we have gone through a stack of medical records and there does not appear to be anything wrong with you. And this lady would start to cry and she would say, Mr. Hubbard, I'm not a doctor and I can't tell you what's wrong with me. The only thing that I can tell you is from the time I open my eyes until I go to bed. I hurt from the top of my head to the bottom of my feet, and I can't hardly make myself get up out of bed. This person's medical treatment, by the time they got to me, had consisted of the application of high powered narcotic medications in response to their complaints, along with habituating psychotropic medications. Oxycontin, Xanax, Xanaflex, the whole nine yards. If they were not physiologically disabled by their accident, they had been physiologically disabled by the pharmacology that had been thrown at them. I took this person's deposition hundreds of times, and one day, driving down the road, it dawned on me that whether these ladies had physical symptoms which were identifiable or not, they were truly, genuinely experiencing profound pain which had caused significant debility. That pain was not physical, it was emotional and it was spiritual. These ladies had worked lifetimes looking at a dead end. And at the time that they had their work accident, it was the straw that broke the camel's back for any hope they had of a future defined by dignity and autonomy. And their hope had been broken. And that broken hope came through as profound physical pain that was rooted with within their spirit. By virtue of my connection to an expert who I had utilized in my workers compensation cases, In December of 2016, I received a call from the member of the then administration of governor Matt Bevin. And they were looking for an individual who could come in and look at the state's Social Security disability system. That's a federal program that exists to help individuals who are disabled as a result of either physical or mental maladies. And while it's a federal program, it is administered by the individual states. And I was asked, what do you know about Social Security disability? And I said, well, not much. I know it and workers compensation go hand in hand. And I know that Kentucky, for as long as anyone can remember, has a significant portion of its adult population receiving that benefit. We've been second only to west Virginia for at least 30 years. And they said, well, we're looking for someone who can come in and evaluate the system, understand how it works, and understand why Kentucky has so many people receiving it. Is this a job that you think that you could do? And I said, I don't know, but I'll sure give it my best try. And it's an honor to be considered. I'll take it. So in February, February of 17, I went in and began to lead Kentucky's Social Security disability system. My first job was to understand why things were the way they were. I assembled a team of high caliber intellects who had years decades of policy experience with the Social Security Disability Program. And I wrote down 19 different statistical metrics that I wish for us to evaluate around these enrollment into the Social Security Disability Program, as well as different socioeconomic factors which were unique to Kentucky. And In October of 2017, we issued what was the very first of its kind retrospective study of the evolution of the Social Security Disability Program in Kentucky, covering the years 1980 through 2015. And here were some of the statistics that were the highlights of that report. Between 1980 and 2015, Kentucky's population grew 20%. Enrollment in the Social Security Disability Program grew 249%. Childhood enrollment. Now, these are children who are under the age of 18. Most of them come from highly impoverished backgrounds where there's very little opportunity to have what we can consider to be a conventional healthy childhood. Childhood enrollment grew 449% over those 35 years. We paired the enrollment statistics with the state's Medicaid database, which tracked the issuance of every single pill that was capable of habituation to the state's SSI Medicaid population. Between 2001 and 2015, the issuance of prescription opioids to adults within the Social Security disability system grew 210% from 47 doses per adult to 147 doses per adult. The issuance of habituating psychotropic medications to children, whether it was amphetamine, whether it was antidepressant, anything that could create physiological dependence, grew 168% from 275 doses per child to 457 doses per SSI Medicaid child. My first month on the job, we had the Social Security Administration's Federal liaison to the state of Kentucky come in for what was called the home agency visit. This was a semiannual review of the state's Social Security Disability Program and the way in which it was meeting federal performance standards. I wish that I had had a recording of this meeting when it occurred because this person gave me a gift of truth right off the bat. I assembled the management team. I was sitting at the end of the table and this person began by saying, folks, claims are down and that's bad because claims equal budget. I came to learn that the Social Security Disability Program was not necessarily run primarily for the benefit of of the Social Security disability recipients. It was run for the perpetual expansion of the SSA's own bureaucracy and that while Social Security disability benefits represented 16% of benefit payments within the system, it consumed 45% of the agency's budget. In order to get more money, you must have more recipients. Despite the nature of those outcomes. I came to also run the state's child support enforcement system. Within that role, it was perceived that the state was not delivering child support payments to children. It is the largest single anti poverty program, not just in Kentucky, but in the country. Direct payment transfers from an obligated parent to the custodial parent. It was believed that there were a number of deadbeat dads who were just not paying the bill. And what I came to find out was that those officials who were responsible for running the program and in Kentucky that was 120 individually elected county attorneys, in fact had some systemic issues. There were a cohort of county attorneys who were running that program perfectly. There was another cohort that were running it with some degree of success, but not necessarily at top performance. And then there was another group that were running their operations horribly. I discovered that within the cohort of 117 elected officials, 40 of them owned their own property, which they then turned around and charged the child support child support program rent. Essentially federal and state tax dollars through rent payments were going to allow for the acquisition of private real estate equity interest by elected officials at the county level. Something that was immediately ended when I came into that job. Governor Bevin lost his race for re election in 2019. And because of some of the measures that were taken to bring accountability, transparency and performance expectations to that child support program, I was terminated from my job on hour one of day one of the administration of newly elected Kentucky Governor Andy Beshear. I was picked up by a gentleman who is my dear friend by the name of Daniel Cameron, who had been elected attorney general in 2019. He asked that I run his Office of Medicaid Fraud and Abuse Control, a law enforcement office which investigates and prosecutes medical providers for being engaged in fraud against the state's Medicaid system. This coincided with the onset of COVID I brought in a deputy by the name of Matt Kleinert, who was a Medicaid policy expert. And over the course of two years, despite the shutdown of the state's court system, we doubled the number of criminal indictments and convictions of medical providers on that system. A significant portion of that caseload was comprised of providers of opioid maintenance treatments who were using their clinics which were intended to help those who were struggling with opioid addiction as glorified drug dealing operations which fomented the diversion of Suboxone in every little town and county. In Kentucky. And it was an eye opening experience to recognize the predators within this universe of operation that is supposed to be restorative and helpful to people in recovery. Because of the way in which I believe I had developed a reputation as a no nonsense, get it done public servant. The deputy attorney general at the time, his name was Barry Dunn, asked me if I would have any interest in running the state's opioid commission. The Kentucky legislature had set up a framework to administer what is now $1 billion in settlements from opioid distributors and manufacturers for their role in the creation and perpetuation of the opioid epidemic. While the people at home are wonderful and beautiful, many of the conditions that exist there exist because of how terribly Kentucky state government has functioned since the end of the civil war. Kentucky, in many categories is first where one would wish to be last and last where folks would wish to be first. It has one of the highest rates of childhood poverty in the country, one of the highest rates of child abuse in the country, one of the highest rates of parental incarceration in the country, one of the highest rates of child sexual abuse in the country, all of the tender and material that is necessary to create the devastation associated with the opioid epidemic. Kentucky was like a drought stricken forest and oxycontin was the lightning bolt that set it on Fire in 1996. Like Louisiana, there has been a history of systemic political corruption which has impaired the ability to produce progress for our people. So when I was asked if I had an interest in doing that job, I said, well, this is a very treacherous opportunity because with this amount of money coming in, there's going to be a lot of buzzards gathered around the wagon who are ready to pick the bones clean. If y'all will let me set up this commission and run it in a way that is accessible, accountable and transparent to the people of Kentucky, I would be privileged to have the opportunity to do it. Mr. Dunn looked at me and said, we wouldn't have it any other way. I had to go through an interview process. And through that process, the question was asked, what do we need to do with that money? And I said, well, let's recognize that while $842 million is a tremendous sum of money to the average ear, it's going to be paid to this state. Over 15 years. At its height, Purdue Pharma was making $100 million a month off the sales of oxycontin. This settlement represents roughly eight and a half months of OxyContin sales. But we're going to be getting it over 15 years. These are crumbs off the tables of gluttons. And we have got to make sure that this one time non recurring revenue stream is utilized for its maximum best impact to pull this state out of this travesty. And I said one thing that we have got to look for is an opportunity to develop a breakthrough therapeutic that can deliver materially better outcomes than what we are getting with our existing system. Our existing system is unacceptably mediocre and it is necessary if we are going to change generational dynamics to improve upon what we have. We've got to look for Kentucky's Manhattan Project opportunity to pioneer a therapeutic breakthrough for opioid addiction. And I said, I don't know what that is, but I'm going to get to looking. In 2018, I came into knowledge of the psilocybin mushroom and the way in which it has profound impacts on treatment resistant anxiety and depression. And in the case of me, in particular, with my family's history, alcoholism. And I followed developments around its research applications. Over the next several years, I came into contact with an author who goes by the pen name of Juliana Christina, who wrote beautifully about her own experiences with the psilocybin mushroom which help her overcome a lifetime of debility anchored in anxiety, depression and a near fatal eating disorder. On July 29, 2022, I reached out to her and I said, hey, this is who I am. I've been given this job. What can you tell me about the universe of psychedelics and whether there is anything that shows special application or impact for opioid dependency? She said, have you ever heard of ibogaine? I said I had not. She said, I'm going to put you in touch with a woman by the name of Juliana Mulligan. You tell her that I sent you and ask her to tell you her story. So I reached out to to Juliana, told her who I was, and I said, tell me your story. Juliana proceeded to tell me about her life with addiction. As a young American woman, she herself had been a heroin addict, she had been incarcerated, she had been homeless. And at one point in time she moved to Columbia to teach English as a second language. And while there she discovered that Columbia has open pharmacies that are unregulated. She said that she was able to go into a pharmacy in Columbia and get as much of what she wanted whenever she wanted. And she did. And she said one morning that she woke up and looked in the mirror and she said, I knew that I was going to die. This was it. And I was desperate to give myself a chance to live. And she said I had done every form of treatment that was known. I did abstinence. I did Suboxone. And she said what they didn't tell me about Suboxone was if you try to take yourself off of it, Suboxone withdrawal made my heroin withdrawal look like a cakewalk. It was one of the most horrific experiences I ever had in my life. She said, I found about this ibogaine called alkaloid, this alkaloid called ibogaine through online Internet research. And she said, what I didn't know was that there are a number of operations that operate within the underground that don't necessarily adhere to the necessary safety practices to assure that this treatment can both be safe and effective. She said, I made my way to Guatemala. I was in the hands of a practitioner who didn't know what they were doing, and I was given double the dose that I should have received. She said, I went into cardiac arrest six times and nearly died. She said, I remember waking up in the intensive care unit of a Guatemalan hospital. And she said, I felt the best I ever felt in my entire life. Juliana put me in touch with a lady by the name of Adriana Kircher in New York City who at the time ran a boutique law firm called the Plant Medicine Law Firm. Adriana and I had a brief introductory conversation. I told her, I said, I want to learn as much as I possibly can about. I again, I've spoken with Juliana, and this sounds too good to be true. I want to know if there's any legitimacy about this, and if so, perhaps what the state of Kentucky can do to move the needle on its development. She said, I have a Rolodex of people that I think could be helpful to you. Who would you like to meet? I said, well, I don't know the names of folks around this. I can just give you generally the category of folks that I would love to be able to speak with. I need to know who the foremost academic and medical researchers of this compound are. I need to understand the existence of any activist organizations that would have particular cultural relevance to Kentucky, a profoundly politically conservative and religiously fundamentalist state. And I said, finally, I need to know whether there are any philanthropists who are willing to support or who have an interest in an opportunity that may exist around ibogaine. She said, all right, let me get to work. She said, would you be willing to travel to New York City if I hosted a dinner party for you? And I said, yes, but on one condition. I said, I work in a deeply politically conservative office and I'm pretty sure I've got some people around me who would be ready to cut my head off if they knew that I was even sniffing around the area of psychedelics for a particular treatment. I said, if I come, this has to be done completely confidentially and everybody must take a bow of silence until such time as I can decide whether or not this is something to present to the office. My wife and I, along with one of my close friends by the name of Scott Hornbuckle, who was also an advisor to the commission, who I brought in, traveled to New York City on December 5th of 2022. On December 9th, we had this dinner party. I met with these individuals who had gathered the researchers, the philanthropists, veteran activists who had gathered around ibogaine as well as the application of other psychedelics for the treatment of war related trauma. When I got home to Kentucky on December 11, they opened up their networks and put me in touch with Amber and Marcus Capone, Dr. Nolan Williams, Dr. Kenneth Alper, and all other folks who have gathered around ibogaine to push for its accessibility within the US medical system. On January 31 of 23, I gave a presentation to Attorney General Cameron. And I said, I believe we have found Kentucky's Manhattan Project opportunity. And I laid out what the concrete realities are of ibogaine, and they are three. Number one, it resolves physiological substance dependence on an accelerated time frame in a manner that frees an individual from the physical consequences of their dependencies. Two, it has a profound psychological effect for the individual whereby on the back end of treatment having been physiologically restored, they have a sense of ownership over their self and their future, whereby they will live a life that is defined by choice rather than compulsion. And that is a fundamental quality that one must have if they are going to rebuild their life. Finally, and most significantly, many people, the overwhelming majority of folks who have an ibogaine experience, come away with an affirmation that they are a spiritual being who is made in the image of an eternal Creator whose essence is pure and unconditional love, and that that Creator has conferred a special and unique purpose on their life to be achieved when those three qualities were properly understood. Attorney General Cameron blessed me to lead the Commission on the Exploration of setting aside $42 million, 5% of the state settlement funds to create a public private partnership whereby a drug developer would match the state's investment on the front end by assuming all legal, logistical and financial risks. Associated with securing the FDA's approval to pursue clinical research trials for the development of ibogaine as a breakthrough therapeutic treatment for opioid use disorder, co occurring substance use disorder, and any other mental health conditions for which it demonstrated efficacy. We had a high profile public announcement on May 31st of 2023. To announce this example exploration, we conducted three very high profile public hearings, each of which lasted about five hours, about all aspects of ibogaine. These hearings are available online as a formal part of the public record for anyone to view. The first hearing involved the science of ibogaine. It included the testimony of Dr. Nolan Williams, Dr. Kenneth Alper, and Dr. Deborah Mash, who has been a pioneer around the development of ibogaine's application to opioid addiction for over 30 years. Now. We had a second public hearing which involved the testimonials of individuals who had received, provided, or had sent loved ones for ibogaine treatment. All of this was done in a very high profile and public way because we wanted the people of Kentucky to understand all aspects of this opportunity, its profundity, and the way in which it can translate transform not just the lives of their families, but the future of this state. That second public hearing was one of the most moving public proceedings of which I have ever been a part. And I don't know how anyone could listen to those testimonials, which included one from governor Perry, and come away with any other conclusion, but that ibogaine must be developed as expeditiously and safely as possible for the sake of our brothers and sisters in country. The third hearing, which occurred at the request of the University of Kentucky, which, along with Andy Beshear, fought this proposal every step of the way, centered on the question of whether the FDA would even consider approving clinical trials, given what was repeatedly asserted as the unacceptable level of cardiac risk associated with its application. Within that hearing, we were able to procure the testimony of the scientist general who was in charge of controlled substances research at the FDA, a gentleman by the name of Dr. Javier Muniz, along with his colleague Dr. Walter Dunn, who sat on the FDA's advisory board of psychopharmacology. I believe he still sits on there. And those gentlemen, after having heard the testimony, as well as questioning from the University of Kentucky's representative which suggested that the FDA would never approve it, began their testimony by saying, it has been asserted that the cardiac risk associated with ibogaine would disqualify it from consideration by the FDA for clinical trials. That is absolutely and completely incorrect. The question for Ibogaine is not one of the existence of risk. The question is how and if that risk can be mitigated. And assuming that the drug developer can demonstrate that cardiac risk can be safely mitigated and controlled, there is no reason that we would not approve that clinical trial. And with that, the chief objection was Newt. We had one last piece of due diligence to perform before my commission, which had a membership of nine, was ready to cast a deciding vote to secure the allocation of this $42 million for what was going to be a fabulous leadership opportunity for the people of Kentucky to pioneer an entirely new field of biomedical research that will revolutionize how we treat not just addiction, but the problems that we have all sat here and talked about already. And that was the delivery of testimony from Dr. Nolan Williams following the publication of his research in the journal Nature Medicine about the neuroregenerative properties of ibogaine in the brain as applied to the veteran population with TBI and PTSD. Unfortunately, there was an election in Kentucky in 2023. My boss, attorney General Cameron, ran for Governor and lost. Andy Beshear was reelected and a new Kentucky Attorney General took office. And while this new guy had gone in public and had expressed his open minded willingness to give ibogaine consideration, I had briefed him individually before we had our public announcement in anticipation that he would take office. After he won, I reached out and asked if I could have an opportunity to brief him on all of the developmental energy which had gathered around this project. That energy included the commitment of two significant philanthropic organizations. One one of which was the Jurvetson foundation, led by Steven and Genevieve Jurvetson. The other was the Steven and Alexander Cohen foundation, led by Stephen and Alexander Cohen. And then the third was the Melissa Etheridge foundation, all of which made commitments to partner with Kentucky. To make this come to pass, we had secured the commitment of two drug developers who were willing to establish corporate presence in Kentucky and to anchor all of their research and development activity around its advanced therapeutic applications within that state. On the cusp of success, I was brought into a meeting on December 15 with the newly elected Attorney General and members of his transition team. And what I thought was going to be an opportunity to explain and secure approval for the finalization of this project turned into an ambush meeting in which it was demanded that I resigned for having been an unapologetic advocate for ibogaine research, something that the new Attorney General found highly objectionable. I walked out of that meeting and was in shock and despair, not over the loss of my job, I was always going to be able to find another job. But for the loss of the opportunity for the long suffering people at home who deserved to have an opportunity to transform their future with what ibogaine has the potential to do for them individually and collectively. In what has been a tremendously providential blessing, Everything that happened in Kentucky was followed by a gentleman by the name of Rex Elsass. Mr. Elsass is an individual who in his his prior life has been a high level Republican campaign ad producer. His firm is one of the top campaign producing ad companies for Republican candidates across the country. In the country, Rex has a foundation called the Reed foundation which is named in honor of his son Reed, who struggled for a decade with opioid addiction beginning when he was a 16 year old. In high school, Reid encountered plant medicine with an ayahuasca. Five years before he passed away, Rex became a believer implant medicine because of the therapeutic response Reed experienced. After that exposure to ayahuasca. Rex was introduced to me ironically by Melissa Etheridge. In February of 23. He showed up at every Kentucky hearing. He showed up at our public announcement and he said, whatever you need to help make this successful, I'm available to you anytime. The Reed foundation stands for rescuing everyone in distress because Reid unfortunately and tragically in 2019 died of a fentanyl overdose. Rex became involved with the Kentucky movement because he believed had Reid had an opportunity to to receive ibogaine treatment, he would be alive today. When I walked out of that meeting thinking that it was all over, I called Rex and I said they've killed it. This is over. All that work and all that effort is vanished. He said, if I can procure opportunities for you to speak to what I began can do to other elected officials across the the country with whom I have relationships, would you be willing to work with my foundation so that we can attempt to preserve what has been done here and transplant it to a state that has leadership with the vision and courage to complete the job that you have begun? Joe at this point I had staked everything that I had become by way of reputation and by way of knowledge on this opportunity. I came just as Governor Perry has, to believe that this was the opportunity of a lifetime to generate tremendous progress on behalf of everyone who needs all of the restorative power that ibogaine can deliver. And I said this is the mission of my life and I will go anywhere, I will talk to anyone and will do whatever is necessary to keep this alive and thank the Lord with the leadership of Governor Perry and his allyship. Here we sit on the cusp of an opportunity for the state of Texas to finish the job that was begun in Kentucky. And I hope and pray with all my might that that is exactly what we see happen over the course of the next five months.