Opioids, Inc. | Crisis Next Door | The new face of fentanyl addiction | Episode 108

Opioids, Inc. | Crisis Next Door | The new face of fentanyl addiction | Episode 108

They say the truth can be more chilling than fiction, and nothing exemplifies this more than the opioid crisis sweeping through America. In our latest episode, we confront the stark and sobering realities of opioid addiction, from the brain's hijacked reward pathways to the chilling progression towards dependency and, ultimately, overdose. We unravel the science behind the high, exploring the alarming intersection where prescription meets addiction and the controversial practices that have fueled this epidemic.

Our narrative takes a personal turn as we share a harrowing account of over-the-counter medication misuse, a stark reminder that the journey towards opioid dependence can start in the most innocent of places. The conversation also casts a critical eye on the players behind the scenes—from doctors to pharmaceutical giants—and questions the ethical implications of their roles in this ongoing tragedy. By constructing a metaphorical house, we lay bare the need for a strong foundation of understanding to address the systemic issues entrenching the opioid crisis in our society.

The episode culminates with a hard-hitting look at the economic currents powering this epidemic, charting the course from legitimate medical treatment to the shadowy corners of illegal drug markets. Shining a light on the deadly trade that feeds the beast of addiction, we discuss the dire consequences, as substances like fentanyl claim lives with a ruthlessness that outpaces car crashes among adults. Knowledge is power, and by the end of our discussion, we aim to arm you with the insights needed to recognize the signs of opioid influence and take a stand against this life-threatening issue in Summit County and wherever the call for awareness is heard.

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Chapters

• 0:01 Understanding Opioids and Their Effects
• 10:46 Opioid Addiction
• 21:17 The Opioid Crisis
• 34:06 Opioid Effects on the Brain

Transcript

Justin Alan Hayes, Voices for Voices: 0:01

Hi everyone. It's Justin Alan Hayes, founder and executive director of Voices for Voices, host and humanitarian. Please like and share this episode or podcast so we can reach as many people and help as many people as possible right here in Summit County, as well as throughout the United States and eventually across the world. So thank you for joining us today, and we're just going to start with a fact that I didn't know.

Justin Alan Hayes, Voices for Voices: 0:36

In the United States, more people are likely to die by an opioid overdose than car crashes. I know, growing up in my 20s and still having car insurance now you know a big talk was about. You know, the younger that you are, the more potentially reckless you may be. So insurance rates go up and, at the same time, your risk of death via a car crash was one of the high possibilities to have occurred. Now, as we sit in the year 2023, going into 2024, things are changing a bit. There's this shift, as I just mentioned, that here in the United States, more people are likely to die by an opioid overdose than car crashes, and between the ages of 18 and 45 here in the United States, that as well also your deaths are going to come from those opioid overdoses. So very shocking information to find out, because there's been a lot of talk across the world, across the country, about opioids, about fentanyl and all these terms, and I know it can be pretty confusing. It's confusing to me. So I wanted to take this episode to focus really on what opioids are, how they affect us, how they can lead to a constant yearning for more and, if the proper safeguards are not in place, potentially could lead to an overdose and a death. So we're going to start with something I didn't know. Also, again is, in our brain we have all kinds of parts of the brain. We have all kinds of receptors, and I didn't know that we have receptors that are called opioid receptors, and so we have those in our brain, all of us. So that is where the term opioid comes from, and that is just interesting just in its own right, because in my mind I thought that a particular prescription would just overrun just the entire brain, the entire body. But the fact that we already have all of us just as we have physical and mental health that this is something that we all also have we have opioid receptors. So we're all susceptible, probably on different levels, different extremes that we could get to as far as if we were prescribed an opioid. So let's get started.

Justin Alan Hayes, Voices for Voices: 3:49

Opioids in general interfere with the pain signals in our brain. Long term opioid use also changes and causes the brain to make it harder to stop using them. And as far as what classification? Sometimes we hear controlled substance in different terms. So specifically opioids, they are a class of drugs that include prescription pain relievers and also illegal substances such as heroin.

Justin Alan Hayes, Voices for Voices: 4:27

These opioids bind to the opioid receptors in our brain that I just alluded to a little bit earlier, and it can cause a number of different effects. When this occurs, when this binding of the opioid drug binds to the opioid receptors, and what this does, what it can do it can decrease our ability to feel pain and give us a sense of euphoria of everything's great, everything's awesome. I want to continue this feeling and that's where we're getting a little bit of trouble. When we want something, we want a certain feeling, a certain effect over time that if we do take these prescriptions for longer than prescribed, we could have very serious side effects that can happen, not to mention dependence, addiction and then also accidental overdose. I'll refer back to kind of my story of over the counter Koldenkopf medicine pills right out of high school where I ended up taking way too many 32, ended up in the hospital and that, and so that progression was very similar to what we're talking about here with opioids is I started out with a smaller amount and then over time, whatever that time period may be maybe it's a series of weeks, maybe it's months, maybe it's years, maybe it's days, whatever that is, that yearning and that feeling was looking to increase each time. And so, let's say, when I took the first eight, the first eight pills, I had a certain euphoric feeling. And then the second time, if I tried to take eight again, I wouldn't have quite that same feeling euphoria, and this is awesome and this is great. And so that's where my competitive spirit negatively impacted me. And then those feelings that I wanted to continue. So that's a little bit of my story and how that progression of wanting more, wanting to continue a particular feeling or feelings, and so opioids are very much similar to that.

Justin Alan Hayes, Voices for Voices: 7:14

Before we get a little bit too much into this episode, what I also wanted to do is to thank the Akron Community Foundation. We voices for voices, we applied for a grant and we were awarded a grant through the Akron Community Foundation in what we dubbed Project Purple, and so Project Purple is partially what you're seeing and viewing and listening right now. It's content that shares education, as we're going to do again throughout this episode, as well as talking to guests that have gone through tough times, that may have been in an addiction setting and been affected by opioids, and so bringing all that content together throughout the 52 weeks of the year. We're providing great content to you and we want to continue that, and so that's where our organization wanted to apply it to be able to do that. So a big thank you to the Akron Community Foundation for helping us continue this healing from the opioid epidemic, again, provide education, providing experiences, all in the hopes of helping at least one person. We want to help everybody, but if we can at least start with helping one person, take a step back maybe, speak to somebody, listen, allow an intervention, some of these scary type of topics that we're talking about. So again, thank you to Akron Community Foundation. We're grateful for the opportunity to be able to continue this program and continue to bring fantastic content and guests to you here in Summit County, and then we also get some of that perspective in the United States with individuals and guests, and we've been grateful to also get perspectives from individuals and guests throughout the world that are having the effects of whether it's opioids, whether it's being abused, could be a suicide attempt, whatever those things may be. We want to just give everybody the platform to share their story, and so that's where we are at a holistic level. So, getting back into opioids, us as humans, we've been using various forms of what we consider as classification of opioids for hundreds of years, which, again, a lot of these facts I'm sharing are very shocking to me, because my thought process was that these events just started happening a few years ago, but that's not the case. So, again, we've been using various forms of opioids for hundreds of years.

Justin Alan Hayes, Voices for Voices: 10:46

The difference is now is the addictive properties of the opioids and binding to those opioid receptors is starting to be more recognized and understood. And we talk about these opioid receptors. So what do they do? So what they do is activate the reward circuitry, so that really, in a more simplified manner, means that the feel good chemical that we call dopamine, that makes us feel good, whether it whatever makes us feel good, whether it's a relationship, whether it's traveling, whether it spends time with family, whatever those things are, that feeling of, ok, I'm having a good time, I'm liking life at this particular time. And so these endorphins, also with the dopamine, are these feel good chemicals.

Justin Alan Hayes, Voices for Voices: 12:02

And so when we bring the opioids into the mix, these opioids bind to the opioid receptors and they kind of replace these endorphins and endopamine, and so that replacement happens and that's where maybe the more the addictive properties start to come out, because I'm feeling good on this trip or doing this thing or spending time with friends or at a concert or whatever that may be, and we want that to last, want those feelings to last. So when we replace those endorphins and dopamine with the opioids, we want to continue that feeling. So, whether it's one pill, we get a certain feeling, and then after a period of time, that feeling is not quite there. It's not that as euphoric or what we would think is positive feeling, and so that's where that addiction takes hold is. We want to keep getting there, just like when I was trying to, in a negative sense, be competitive and get that euphoric feeling from my overdose story with prescription, non-prescription, over-the-counter medicine. I wanted to continue that feeling, and so the feeling was like, okay, let's take eight. And then I took eight again and I get that feeling. So then it's like, oh well, let me take nine. And then that period of time I just continued to take more and more and more until I ended up in the hospital and luckily I'm here to be able to share this story and hopefully help somebody to recognize this and to help, because the other side of it is I wouldn't be here, I wouldn't be alive, and so we all know that being here is a much better thing and a better place, I think, to be at the time.

Justin Alan Hayes, Voices for Voices: 14:21

So the misuse can happen of these opioids, just like anything, like alcohol abuse. We start with one drink and then we do two, and then we go to shots, and then reckless decisions of do I drive or do I get a ride, and all these things that really just start to pile up. So, whether it's alcohol or, in this sense, opioids, that feeling we keep searching for that kind of first feeling that we had, of that euphoria. And again, the more we would take these opioids, our brain eventually starts encouraging us to take more. So that's where sometimes crime takes place of stealing, of going to a doctor when you or I don't need a prescription or we're not having these after surgery, these events that happen where the opioids would be prescribed to you or I, in those sense.

Justin Alan Hayes, Voices for Voices: 15:33

And so that's where we get into talking about physicians and doctors and prescribers and their role in kind of the opioid crisis epidemic and the healing is people are incentivized to buy money in a very straight, blunt message is, you know, money talks in a lot of different ways and, as a physician, that may think they're helping people or they think, oh, I can help more if I do this thing, which is prescribe more, because I'm going to get paid for each prescription, a part of that fee. And so that's kind of where we get into that next layer, and so I have the brand of also called the House of you, of talking about. We have to have a blueprint. Then, when you lay the foundation, then we do the first floor, the second floor, the roof and the house maintenance, and so this is where we take this information. I just talked about what an opioid is, how it binds to the opioid receptors, and then we get into this next level of how are people getting these opioids and some physicians over prescribe.

Justin Alan Hayes, Voices for Voices: 17:04

Again, this isn't calling out any particular field or any particular person or entity. These are just facts that happen. And so when you're incentivized by money and more money comes in and then a lifestyle starts to ensue, that's not a good thing, especially when we're talking about things that are affecting us psychologically and our bodies and it's causing, again, people to become more addicted to them, needing more, and those things are generally not very helpful. So you have these physicians that kind of come into the mix, so that's kind of the we call it the legal way of going to a certified physician to be prescribed, so it's legal, but you call it kind of semi-legal, because when you're taking advantage of the system to get that reward of the more money, that's not really helpful. And so who's paying these physicians? It's the pharmaceutical companies, and the pharmaceutical companies many of them are publicly traded companies. Even if they aren't publicly traded companies, they have financial statements of how much money did we make and what were our expenses, and so all these things.

Justin Alan Hayes, Voices for Voices: 18:34

Again, we're talking about money. So if every quarter, so every three months, we got $10 million, and then the next three months we got $20 million, then $30 million, then $40 million, the company is getting more revenue and then they're able to give more of the pie of that revenue in commission out to physicians, because, as a pharmaceutical representative, it goes into a physician's office, says, hey, we got this new prescription called X just as a hypothetical, and this helps individuals in these particular conditions. And I don't know what the breakdown is of how much a physician gets per prescription that they prescribe. So maybe it's a dollar per prescription and so if a doctor's prescribing 50 over a course of a month, that's an extra $50. Well then if that rate goes up to $2, then that two gets multiplied out and then the numbers start to increase. So the pharmaceutical companies gaining more money, the physicians are gaining more money.

Justin Alan Hayes, Voices for Voices: 19:55

They think they're helping people and some, many physicians are well-intentioned and we have busy lives and sometimes we might not read all the way into the fine print of a particular thing, such as in the United States Congress, these different bills that come up and we find out that there's 5,000 pages or 700 pages, and the expectation is for the representatives and their staffs to read all those pages and then be able to kind of formulate their response. The fact of the matter is that doesn't always happen until after the fact. Well, we need to vote, so we'll read it after the fact. So some physicians might be in that standpoint where they're just swamped, they're so busy. They hear some of the buzzwords, other medications, and so they say, yeah, I'll start including this when patients are coming in for this particular, this manner. So again, there's money that is causing this kind of.

Justin Alan Hayes, Voices for Voices: 21:17

We call that the legal or the semi-legal side. But then we have the illegal side and that is we talk about controlled substances like heroin, cocaine, these, what we've historically considered illegal substances that if you are caught with them potentially you could go to jail and face time and have to pay fine and have that negatively affect potential job perspectives of having that mark on your record. And so coming into that side, the illegal side, where there is demand, and so you know you talk about economics, there's supply and there's demand, and so there's demand for these particular prescriptions because of the feelings, that the euphoria and that feeling that some people are feeling. So if they go to their physician and they're not able to accomplish the task of you know, if they're in that addictive mindset because of the opioid binding to the opioid receptor and each time they've got to take a little bit more and a little bit more, they go to the physician and they're like no, we've got to cut you off, you don't need this, the time frame that you should be taking this is long past. So we need to, you know, wean you off and get you so you don't continue that addiction. So some individuals, they're like the heck with this, I'm going to look and see if I can find an alternative place to get the same feeling. And so that's where they come into that illegal market. You know the drug dealers say, well, I can get you this and you know, here's what the cost is.

Justin Alan Hayes, Voices for Voices: 23:24

And so then individuals that potentially might not have started in kind of the illegal side of things, of purchasing off of the street versus, you know, the physician, but because of those receptors they got to have that feeling. They got to keep increasing that feeling over time. So these are drug dealers. They're incentivized by money. They're being paid by, you know, wherever they're at in the supply chain. They're being paid by the person kind of behind them. And if you take that and pull the curtain back, just as you have the pharmaceutical company that is producing, in this case, these opioids, the hydrocodone, the oxycodone and others in the illegal side, it's very similar. So you may have organizations that are kind of underground, meaning that they're doing things that they know that are probably illegal and they're still continuing to do that. And maybe 80% of what they do is legal. And then they have excess quantity of a particular ingredient and so they sell it to who will make that purchase? Because they're going to receive money and reply for that.

Justin Alan Hayes, Voices for Voices: 24:58

So you take a look at these manufacturers on the illegal side. Okay, where are these opioids coming from on the illegal side? So, yeah, you're going to have some people that are obviously abusing from the physician's standpoint. But then you're going to have people that are taking that to the next level of trying to have a prescription for something that they don't need. Or maybe they should only get maybe a 30-day supply and they're going into a 90-day supply and they're going into every 30 days saying I need another 90-day supply. So you do the math and say, well, the physician can say well, we gave you a 90-day supply and you keep coming every 30 days. So you're either taking more than what we're prescribing per day or there's nefarious activity of selling that is done much as illegal.

Justin Alan Hayes, Voices for Voices: 26:02

So you back all that up, you pull the curtain, you see the manufacturer. They're getting the ingredients, they're selling it to the next person in the supply chain. And so, in this case, we know that a lot of these opioids and the precursors to the opioids, in specific fentanyl, are coming from China, and so China is selling these ingredients in precursors, like, well, hey, we're not putting it together, we're not putting the pills together, and so we're selling the ingredients, and then the next person online is putting, mixing together and pressing the pills, and then the next person online is like, okay, where's that demand at? Oh well, there's huge demand in the United States. How do we get in the United States? Well, right now, regardless of where we're at politically, what side of the aisle, there's a lot of people coming in through the Southern border that we don't know, I guess, who they are, and so they're bringing in, you know, some times, these ingredients, these opioids that now are not only an opioid, but it is taking the opioid and multiplying it by 50 to 100 times the strength with fentanyl, and so that feeling of euphoria has just been blown through the roof. And so individuals, they hear about that and they're not able to get the prescription from the doctor. They're able to get it on the street, the availability's there and you have an ingredient that isn't really supposed to be in there. Not that heroin's good by any stretch, but if you have heroin and these other, these other classification, these drugs that have another ingredient, this is gonna make that feeling just so incredible. So people have that demand for that.

Justin Alan Hayes, Voices for Voices: 28:27

Well, what happens when people start dying from that? And so that's where we're at with the beginning facts of this episode. I mentioned the leading cause of death here in the United States Used to be car accidents, heart attacks, cancer, those kind of legacy things which are still happening. But these deaths are I'm referring to the 18 to 45, and the more likelihood that individuals are to be to die by opioid overdoses, then car crashes. It's just incredible to really dig into this and to learn some of these facts that how, how an opioid is, what an opioid is, how it attaches to the brain, and so things start happening kind of subconsciously and these feelings and I feel good when I do this and I don't feel good when I do that. So I want to try to do more of the thing and the things that make me feel better and feel the best, and so there are things that we talk about opioid use disorder. And so what is that? So that could be taking higher doses over a longer period of time than originally prescribed. As I mentioned, I go in, I get 90-day supply and I come in every 20 to 30 days needing another 90-day supply.

Justin Alan Hayes, Voices for Voices: 30:12

Craving opioids are spending a significant amount of time on activity and activities to find the opioids. I need to get that feeling. How am I going to get that feeling? I can't get it from the doctor, so is there any other way? Because I'm having a hard time. It could be having issues with family, work, school relationships. Due to that, it could have experienced unsuccessful attempts to stop using the opioids. I want to stop. I'm going to go forward in whatever program or whatever therapy I need. So that could be happening. And also we take the fatality to a higher level of using opioids in situations that are physically dangerous. So, for example, taking an opioid and driving, that could be catastrophic at some level.

Justin Alan Hayes, Voices for Voices: 31:26

So this episode has given and provided a lot of information, a lot of terms, and so the goal is to just bring these to light of. I hear the term opioid. How does that affect me? What does that have to do with where I live? And, as we've seen with previous guests we've had on our TV show and podcast that you know, talking with the Akron Police Department, that every zip code is unfortunately experiencing some type of fallout from opioids overdose. Again, some could be from that over-the-counter, from what I had when I was younger I was just taking too many cold and cough pills. It could be through the opioids. It could be through the physician again going that you know prescribed more than what you need and then you know, oh, I can make a little bit of money on the side, and so that's where that money, that reward we talked about, from the pharmaceutical companies to the drug dealer, to the manufacturers in China, and then getting those ingredients to the labs, wherever those may be, and then how are we getting those into the places that there is demand for that? You know, unfortunately, where we're at.

Justin Alan Hayes, Voices for Voices: 33:03

So the takeaways from this episode are you know, opioids act on our brain by simulating the effects of those endorphins or those naturally occurring pain relievers. But opioid medications can quickly cause a drug tolerance and a dependency, so that can happen relatively quickly. So it's essential that if you are taking opioid medications or know somebody, that is, that it is directed by a doctor and to never share them with anyone else and to cease usage. So stop using them or move to another medication that isn't in that family of opioids. And then also, you want to think about speaking with a doctor about the benefits versus the risks of taking opioid drugs just like anything. Get all the information and make an informed decision.

Justin Alan Hayes, Voices for Voices: 34:06

This episode here, it was meant to, you know, share some very relevant, very current event information with you. So, before we sign off, the immediate effect of opioids on the brain. So how can you recognize this? It can impair decision-making skills, focus and concentration problems, slower reaction times, euphoria, sleepiness, loss of consciousness, confusion, loss of awareness and then, lastly, potentially death. So please share, please subscribe to our TV show and podcast. We are again thankful to the Akron Community Foundation supporting our project Purple and to continue bringing relevant content to you in Summit County, across the United States and across the world. So until next time, I am Justin Allen Hayes, founder and executive director of Voices for Voices, and please be a voice for you or somebody in need.