Opioids in America: Part 1

TOPICS DISCUSSED

  • Checking in with the Headlines

    • Jack Teixeira Arrested for Leaking Classified Documents

    • Supreme Court temporarily stays Mifepristone Order

    • Congress Comes back into Session

    • French Pension Reform Approved

    • Violence in Sudan

  • Opioids in America: Part 1

  • Outside of Politics: Felix Holland’s T1D Diagnosis Anniversary

Correction: Diane Feinstein has stepped down from the Senate Judiciary Committee since this recording.

If you or someone you love is struggling with Substance Abuse you can get treatment referrals if you call 1-800-662-HELP (4357) or text your zip code to 435748 (HELP4U). Visit SAMHSA.gov. Addiction Recovery Resources from DEA are also available.

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EPISODE RESOURCES

CHECKING IN WITH DEVELOPING HEADLINES

OPIOIDS IN AMERICA: PART 1

FELIX HOLLAND’S T1D DIAGNOSIS ANNIVERSARY

Yom HaShoah, Holocaust Remembrance Day (Wikipedia)

TRANSCRIPT

Sarah [00:00:07] This is Sarah Stewart Holland.  

Beth [00:00:09] And this is Beth Silvers.  

Sarah [00:00:10] Thank you for joining us for Pantsuit Politics.  

Beth [00:00:25] Thank you for joining us here at Pantsuit Politics, where we take a different approach to the news. Today, we are following up on stories that we have discussed last week and stories we've been talking about for a long time. We have a bunch of updates, including the arrest in the most recent leaked classified documents case, a court ruling on mifepristone, a drug used in abortion care, and the violence that broke out this weekend in Sudan. Then we are going to turn our attention to the opioid epidemic for the first of two conversations this week about where we are in America's struggle with addiction. And Outside of Politics, Sarah is marking one year since her son Felix, was diagnosed with Type One Diabetes.  

Sarah [00:01:03] We have two events left this spring, one in Fort Wayne, Indiana, and one in Fort Worth, Texas before we take the summer off. And we only have about three spots left this fall in the fall of 2023. And we're also now booking for 2024. So, if you want to bring us to your community to talk about conflict, to talk about conversation, to talk about connection, we would love to join you. Please reach out to Alise for more details.  

Beth [00:01:28] And some of you have said, "Why are you in Texas so often?" It's very simple, because we get invited to Texas so often. We would love to be in your part of the country, too, especially if you're on the West Coast. We have been looking for quite some time for the right opportunity to get out to the West Coast to see you. So, if you're looking for a speaker at your organization or school or business or conference or church or whatever, let us know. We would love to join you. Next up, we're going to continue talking about stories from last week and some dramatic developments in those stories. It can be very easy to feel like we need to talk about brand new information every time we sit down. But I was thinking as I was looking at the stories today, that everything is an outgrowth of what's come before. And that is certainly true of the top stories as we're sitting down to record. So, we're going to talk about some of those both at home and abroad. Starting with Sarah's spot on prediction of who was responsible for the leak of classified information in such a bizarre and haphazard manner last week. Are you feeling really vindicated, Sarah?  

Sarah [00:02:38] I am. I mean, I predicted that it was somebody young who was trying to prove themselves. I kind of thought, well, that they would be more motivated by right wing theories about Ukraine. But I guess really that was kind of true too. There's a lot of obsession with far right wing racist ideology, orthodox Catholicism. That went through me for a little bit of a loop among Jack Teixeira and his crowd. But the youthfulness, the sort of previous experience, the sort of tech background, all of that lined up pretty closely with what I thought happened.  

Beth [00:03:14] Teixeira is a member of the Massachusetts Air National Guard, 21 years old, has been arrested and charged because that's usually what happens when you take classified information that doesn't belong to you. They come real fast and get you.  

Sarah [00:03:26] He's going to go to jail for so long.  

Beth [00:03:28] He is probably going to go to jail. I saw like up to 15 years. And I think he's maybe not the only one because some of the people who then disseminated this information on other channels could be subject to arrest. So, a lot of people just got in a whole lot of trouble here. And it makes me sad in a way. Like, a 21 year old, his life is really altered by these decisions. And it's too bad. And at the same time, I feel like there is sort of a push to say, how are we going to keep this from happening again? And I just don't know. I don't know how you deal with a system where you've got more than a million people with security clearances and you do need people who are young and who are working on the IT side of things. It cannot just be that only the Joint Chiefs have access to our national secrets. So these are tough problems and I don't envy anyone who is trying to figure out how you react to something like this.  

Sarah [00:04:25] Well, now, Beth, that's not the only push. Marjorie Taylor Greene entered the chat and said if you disagree with something the United States government is doing, well, then maybe you should leak some information. I think this tracks along with her advice around January six, which is y'all get arrested. How about you guys all get arrested and I'll sit over here and milk it for as many campaign donations as I can get while you chumps get arrested. How long are people going to fall for that?  

Beth [00:04:56] Yeah. It's Marjorie Taylor Greene. It's Tucker Carlson. It's a whole class of people who have just utter contempt for all the folks whose actions they make money off of. You have said often that we shouldn't have people running the government who hate the government. And there is an argument to be made about that when it comes to policy and people who believe the government is not the right actor to dive into a certain field of policy. And I think it is important to have people in government who are skeptical of government as a solution to a lot of problems. It is another thing entirely to have someone who thinks just do what you will, just follow your heart. Even if you are a sworn official, just follow your heart. If you don't like it, say something. It's gross.  

Sarah [00:05:50] Well, she just lives in sort of that emergency mentality, right? Like everything is justifiable because everything is a crisis and we have real threats, mainly our fellow citizens, particularly our fellow citizens who we disagree with, who serve in positions of power. I mean, she's the one who articulates all that civil war nonsense. So, it's not surprising to me that this would be justifiable under her particular worldview. I just always hope we'd take these moments when she speaks like that to remind ourselves that she's not normal. As much as Kevin McCarthy would like to normalize the way she behaves, she is not a normal congresswoman. She does not belong there. She does not live up to that oath of office. And when she speaks and says these ridiculous things, it's just another brick in that wall that I hope eventually will fall on top of her.  

Beth [00:06:36] Well, I hope the people of Georgia are with you on that. Okay. Let's talk about the court system, because we also have an update there. We talked last week about these conflicting district court orders concerning the availability of mifepristone for use in abortion care. I'm trying to be really careful to say that we're talking about mifepristone for abortion care because it is also used under a different brand name to manage blood sugar levels for certain patients. But we're talking about its application to abortion. So, we had a federal district judge in Washington say to the FDA, keep mifepristone authorized and available under the same terms during the COVID pandemic. Do not limit access in any way. And at the same time, we had a federal district judge in Texas say, remember when you authorized this back in 1996, you were wrong. We're going to undo the whole thing. That all made its way to the Supreme Court as we thought it would. And an order was issued over the weekend that just puts a hold on everything. So, mifepristone is still authorized and available in states where abortion is legal right now, at least until 11:59 p.m. Eastern Time on Wednesday when this administrative stay expires. Responsive briefs in this matter are due today, Tuesday at noon Eastern, so we'll see what the justices have to say.  

Sarah [00:07:55] A lot of blue state governors, California, Massachusetts, are stockpiling this medication out of concern over the direction this new conservative court could take on this widely available and longtime available drug. I also just think this this high stakes ruling coming as we just continue to learn more and more about Justice Clarence Thomas's almost soft approach to digital ethics lacks unethical. Whatever adjective you choose to use, I just feels like in so many ways our understanding of the court, our approach to the court, our policy surrounding the court is coming to a head.  

Beth [00:08:42] I bought a couple of books over the weekend about the court, and I really want to spend some time thinking about how much of this is new and how much of it we're just discussing today. But for how long has our sense of faith in the justices and our sense that this court can be trusted with these kinds of decisions been as precarious as it feels now? I don't want any of that to be true because I do not know how you do a democratic republic without an independent judiciary and a Supreme Court that is empowered to weigh in on massive questions of rights. So, I feel myself resisting all of the discussion about the difficulties with the current court. And I thought history might help me a little bit, so I'll report back. Moving on to the first branch of government, our Congress is back in session and a whole bunch of issues we've been talking about the debt ceiling, the ability of Kevin McCarthy to corral his conference around the budget, and just the precariousness created by these tight margins in both the House and the Senate are back in the spotlight. So, we have a debt limit fight happening. Sarah, how did you feel when you saw that Kevin McCarthy went to Wall Street to chat about the debt limit and to get people to come with him to put pressure on the White House here?  

Sarah [00:10:04] He's trying to sell big business on this idea that overspending has been really harmful and to kind of adopt his view of the world. I was more interested in the fact that he was criticizing his own conference for their lack of a budget deal to offer in response to the Biden administration's budget proposal. Just a very interesting approach to leadership Kevin McCarthy takes over there, which is criticizing his own lieutenants and saying they can't get it done, which of course they fired back. Ultimately, it's your job Kevin. So, we'll see what happens. I don't think this Wall Street public relations tour is really going to move the needle. What's going to move the needle is when you have something to show people and you've already undercut it before it's even come out.  

Beth [00:10:45] I don't love that the White House has said we will raise the debt limit and then talk about the budget. I don't think that's a realistic situation when you have Republicans in control of Congress. I also think Republicans look extremely foolish right now for saying we just want to cut things. We don't know what things, but we would like to cut some things. And then to start talking about SNAP and having Medicaid recipients work longer hours. I mean, some of what they're talking about, you just think, on what planet does this make sense politically or as part of the budget? This seems bananas to me, but we have that intra conference feuding among House Republicans. We got a little bit of it happening on the Democratic side of the aisle, too, because of this very delicate situation regarding Senator Feinstein's health. So, she is out with shingles right now. We hope she recovers very quickly and fully. She serves on the Judiciary Committee though, a whole bunch of judges that President Biden would like to have confirmed. And she has asked for Senator Schumer to appoint someone to temporarily replace her on that committee, but they would have to have some Republicans vote with them to make that happen. And it is just a dance right now. I read through several permutations of how this could go down this morning. And it's really hard. And I think it's made even harder by the fact that you have some people saying she should resign. People like Nancy Pelosi speaking up and saying kind of how dare you talk about her this way. What are you doing? It's a mess.  

Sarah [00:12:25] Yeah, she's been out for a while. It's not like this is a recent diagnosis with shingles. I'm assuming she's probably over the shingles at this point, but she's not recovering quickly because she's 89 years old. And you had Representative Ro Khanna from the California delegation officially step forward and say it is time for her to step down. It is time for her to retire. And I think this judicial committee situation was offered as a compromise, and I don't think there's a compromise. I agree with him. She should just step down. She can no longer fulfill her duties. And these are duties with very high stakes because of the close margin in the Senate. And I do I think it's time for her to step down. Now, that's going to really complicate this primary because Governor Newsom will have to appoint a replacement. And then what does that mean when you have such a contested primary? It is an extremely difficult situation that I wish we could have avoided and could go back in time and she could have just not run again, but that's not where we're at.  

Beth [00:13:23] If I were Senator Schumer, I would be practically begging Nancy Pelosi to help me out here, because I do feel like Pelosi is probably the right person to try to negotiate something that could happen here. Some gracious exit for Senator Feinstein, some triangulation of that race with the needs of the Senate currently. I think it was probably a mistake for people to jump into a primary with Senator Feinstein before she announced that she wasn't running again. For her Democratic colleagues to circle her like that, I think was probably a mistake that probably caused her to double down. And I can imagine that in this current situation, she has a little bit of a I will do what I want mentality because there's been so much pressure. This just needs a lot of finesse. And I feel like the person with the longest proven track record of that sort of finesse is Nancy Pelosi. So I would be asking her to please, please help me here. When folks should retire is a big part of the news in France right now as well. So, we're going to go outside the United States now to follow up on some stories. We've talked quite a bit about President Emmanuel Macron's proposal to increase the minimum retirement age in France by two years from 62 to 64. And despite massive protests and just real resistance across the country of France, he is doing it. Constitutional Council approved it. It will take effect in September. He has invited unions to sit down and talk with him about it. They're saying pass. We've got protests planned in May. We'll see you then.  

Sarah [00:15:12] [Inaudible] possible.  

Beth [00:15:14] That's right. 

Sarah [00:15:14] Well, this is where one of your predictions came true. You said he'd carry it across the finish line. I was skeptical. I mean, we didn't just have protests. We had like nationwide strikes. We had burning garbage on the streets of Paris. But he did not blink. And I am very impressed. I'm not going to lie. I'm very impressed.  

Beth [00:15:30] My feeling all along has just been that you don't touch an issue like this unless you intend to get it done.  

Sarah [00:15:35] Yeah.  

Beth [00:15:36] I don't know how I feel about the fact that this was done in a way that did really circumvent Parliament. But I'm not a French citizen. I don't understand the system well enough to know the ins and outs of that.  

Sarah [00:15:48] The political calculus on some issues aren't so hard. you know you're not going to get popular approval and they're still like bureaucratically policy-wise the right thing to do. I mean, maybe we wouldn't be struggling with climate change so badly right now. Some governments have just said we're going to make the hard choice and we're going to make it for everybody else because long term, it's the best thing to do.  

Beth [00:16:07] That's what I've been thinking about most. How in the United States do you get to some of these choices that are really hard choices that would make no one happy? I mean, we see that a little bit around these budget conversations. I don't take many members of McCarthy's team seriously when they talk about their concerns for our country's fiscal health. But there are concerns for our country's fiscal health that serious people do need to be working on. And it is so toxic, there's not a piece of the federal budget that you would have widespread agreement on eliminating. I'm just trying to kind of look at this and say, what's the lesson here? How can you in our country start to get to things that people will not like, but that make a lot of sense for where we need to go? Finally, we want to talk a little bit about Sudan. We did an episode earlier this year on global hotspots where humanitarian crises were in effect. And Sudan made that list because it had all these risk factors that we talked about in the conversation about global humanitarian hotspots. And we are seeing those risk factors culminate in a really deadly weekend because of this power struggle between Sudan's military and the Rapid Security Forces, or RCF, which is a paramilitary group that has been really legitimized by Sudan's government over time. And you have this sense that both groups believe they have legitimate claims to rule, even though there is a push for a Democratic sit in. And it feels like the hopes of a democratic Sudan are really being dashed by the violence that has broken out between these two groups about their control in whatever the next chapter looks like.  

Sarah [00:18:00] Yeah, there was so much political instability because there was a military takeover in 2021, and they were reaching this power sharing agreement to transition to a civilian government. But it required that the RCF be absorbed by the army. So now you have these warring generals, right? The general in charge of the army, largely in charge of the country, and his lieutenant, who's also in charge of the RCF. And not surprisingly, neither want to give up any power. And one definitely doesn't want to be absorbed by the other. This is leading to violence. About 100 civilians have been killed. One of the most interesting pieces of reporting I heard is that previously they shut the Internet down in Sudan, but that the Internet has not been shut down this time because this is also a propaganda war where both sides are trying to convince people of Sudan, who are also experiencing major economic instability because Sudan imports a ton of its wheat from Russia. So, that's been a huge problem since the invasion of Ukraine. You have massive inflation and you have all these international donors who suspended the Sudan's debt removal when that political instability came in through the military takeover. And so they have crazy inflation, massive debt coming due, a military in power. And, I mean, this is Africa's third largest nation, 46 million people, 15.8 in need of humanitarian assistance. So, it's already a powder keg. And then now you have these two violent factions warring. And I don't think that any sort of peace agreement is likely, at least not in the coming days, because both are pretty committed to just fighting it out.  

Beth [00:19:35] And three World Food Program workers were killed in the violence on Saturday. Two others were injured. So, against that background of dire food insecurity, you have the World Food Program having to halt its operations because it is not safe for aid workers to be there right now. This is all happening as well during Ramadan holiest days. And this is a majority Muslim country. So just layers and layers to the suffering that's happening. And we wanted to talk about that and express our care for it, even though there is not much we can do sitting here in the United States. I am happy to see that the Biden administration seems to be really supportive of the way that the African Union is trying to step in and encourage peace talks here. But we will continue to think about the country of Sudan and to follow up on what's happening there and elsewhere. So, those are the headlines right now. We want to turn to another aspect of American life that sometimes makes the headlines, but even when it doesn't, it is always prevalent and influential in almost every other story that we're talking about, and that is the epidemic of opioid addiction.  

[00:20:51] Sarah, we went to school at the time of Just Say No and the D.A.R.E program. So we heard a lot about the war on drugs growing up, and I think we understood even then that drug addiction is complicated, much more complicated than Just Say No would indicate. But the complexity surrounding the opioid epidemic is something that does feel pretty new to me. The fact that we have addiction beginning with injuries and illnesses. And spiraling from there, the fact that many people have overdosed from drugs that they got at a Walgreens or a CVS written by a doctor. So it's a very different situation. We have this class of drugs, many of which are needed for some of the hardest moments of our lives and which are also highly addictive and are coming increasingly in forms that it feels almost hopeless to tell someone just say no to. And so, we wanted to start that conversation today. We will continue discussing it on Friday.  

Sarah [00:21:58] Well, I think what's so difficult is that we've had so many drug crises, right? Like the eighties came about from the crack epidemic, right? We had scares about marijuana. You can go back to the early 1900s with opium, right? You have experts saying, well, this is the worst drug, this is the one that's going to take everybody out. This is going to lead to all the addiction. The addiction is already spiraling out of control. And if you say it every time, it just loses its impact. When I went to Congress as an intern in the summer of 2004, I believe, I did like a big ole binder of information on methamphetamines and how that was rocking communities. And that was feeling like this new thing we hadn't seen before. And I do think that that to a certain extent, what we saw sort of at the end of the 20th century, the beginning of the 20th century, I heard an expert describe it as the shift from organic compounds, marijuana, cocaine, even heroin, to synthetic compounds, things that people could make themselves. That's what was so scary about meth at the beginning, right? You had heard about the meth kitchens and how dangerous they were. And now you have these synthetic opioids that you can mix in with everything else. And so, it's like this feels like a new stage. But because we were so alarmist about previous stages, it was hard to distinguish it at first. But when we graduated from high school, there are about 20,000 drug overdose deaths in America a year, and now they're over 100,000 a year. A million people in the U.S. have died of opioid overdoses since the 1990s. So it is different; and it is showing up not just in statistics but in all of our lives and our communities. And I think it's just hard to constantly be calibrating to this increasingly devastating crisis.  

Beth [00:23:58] It's not to downplay the tragedy that accompanied a lot of those other drugs. I mean, meth labs were really harmful to a lot of people and really devastating to a lot of communities. The scale of this is greater. It just is. And it is so much more complex because of the way that the health care system intersects with the political system, the profit motive intersects with the need to provide patient care. Even the conversation about pain that has been integral to more opioids getting in the hands of more patients is a difficult one. You had Purdue Pharma coming out and pushing a full scale campaign for doctors to take patient pain more seriously, supported by a lot of patient advocacy groups because a number of people have had their pain dismissed for too long. And so, you start with all of these on some scale legitimate concerns, and you start with these tools that in some situations are really important and life giving. And then from there, it just balloons. And it balloons aided by policymakers and law enforcement and industry professionals and lobbying organizations. And it has created a really unmanageable crisis that keeps transforming into something even deadlier.  

Sarah [00:25:35] Yeah, I think the phase one of this opioid crisis was definitely prescription drugs, and that was unlike anything we've seen before. I mean, some of these previous crises were devastating, but some of them were over rated, right? Like you saw marijuana used in such racist ways in the mid-20th centuries and you had fear mongering surrounding drugs that now, particularly marijuana, are used regularly by so many people. But then you see prescription drugs coming in this way. Like, I even think about how I was reading Margaret Hall's great Twitter thread about Elvis and how she was just trying to describe, like, when a drug was prescribed by a doctor, there was just this sense that it was okay no matter what. Like, it didn't matter. You couldn't abuse a drug that was being prescribed by a doctor. There was just this entire social cultural foundation that was just ripe for exploitation. And I think it felt so scary because you thought, what are you going to do about people who are being prescribed drugs? And then you had pill mills and it felt so amorphous and hard to get our hands around. And we started to chip away at it and people came to an understanding about how dangerous these drugs were. We have all these legal settlements now against the drug makers. We have some real villainization out there regarding these players in this crisis. And I think even in my own mind, I thought, well, we'll get this under control and that'll lock it down. And what you see is then will then that [inaudible] to heroin. And what we're going to talk about on Friday, which is fentanyl. And it's just like trying to grab water with these drugs. Like, it's just trying to contain sand. It just spills and spills and spills. Part of the nature of these drugs, because they are so incredibly addictive. I mean, you overdose because they basically overpower your involuntary instinct to breathe-- the most basic human function. And I think because of those complex attitudes about pain, because of our understanding of our relationships with our doctors and with drugs to begin with, because of the power of the pharmaceutical industry, we were just so outmatched. And it feels like we continue to be outmatched.  

Beth [00:27:53] It's hard to have a conversation about feeling outmatched with awareness of how many people are listening who've lost people to this crisis. And it's so many. I think it's important to say, though, that we've been outmatched for those families. There's been so much loss around this. I even feel tremendous sympathy for some of the plaintiffs lawyers groups who've brought lawsuits and lost. A lot of lawsuits have been one against these drug companies, but a lot have been lost too. And I hope that those lawyers know and the plaintiffs who sued and all the people who testified and put years of their lives into those suits know that it has mattered. You can feel outmatched to the point of hopelessness as you start to look at these issues. But as you said, these lawsuits have changed our understanding of what we're dealing with. I don't know, without our civil litigation system, if we would be as far down the path as we are in our understanding of what's happened here. So even where a judge or a jury has said, I'm not going to find fault with the makers or distributors of certain drugs, those lawsuits have mattered tremendously in terms of our understanding of this problem. And every person who's done activism in their communities, we just cannot count how many people have been saved the way we can count how many people have been lost. But I really do believe we've made progress here. I just don't know what we do about the fact that we basically have a generation of people who have lived in a completely new climate as it relates to drugs. And so, even when we started to get a handle on the pill mills, so many people had already been addicted that, of course, they had to resort to heroin because you can't just stop. It is not a just say no situation.  

Sarah [00:29:47] Yeah. I do think that a crisis on this level is like a cynicism smasher, right? That's what you hear in those state attorney generals. It's like, what was I supposed to do? Like, you're not looking at these parents. And I think you hear it among the black parent activists who went against the Sackler family. I think you hear it in the people who are trying to stand up and pharmaceutical industry circles or the pharmacies themselves, just the sense of, like, how can you face this and not feel like you have to do something? And I think not only did it activate people and motivate people, but I think the real powerful impact of all this-- and it is heartbreaking and it should not have had to come at the deaths of 1 million people. But it has fundamentally shifted how we think about drugs and addiction. When we were growing up, the Just Say No it's all right there individualized. You're making a bad choice. That's the problem here. You’re just making a bad choice and if you would just stop it, everything would be okay. And that's how it was so easily manipulated in really racist oppressive ways. And I think that the tragedy, the trauma, the tidal wave of human suffering caused by this particular class of drugs has left almost no one available to tap that sort of individualist judgment. 

[00:31:27] Here in 2023, no one's going around going, "Just try harder," when it comes to drug addiction. And if they are, they sound ridiculous. I think the problem is now that we're finally understanding and really culturally wrapping our heads around addiction and what this particular class of drugs does, it's another paradox that we have to move into that new phase, this new understanding of how to treat this addiction, because we're still stuck in a lot of that individualistic, like, it's just going to be your willpower. It sucks. It's the only way to get over it with support and all that kind of good stuff. But you know what else works to get over drug addiction? Drugs, especially opioids. You have to be under medical care. And I think we're lacking that understanding culturally. I think we're lacking that understanding in the medical industry itself. And I think we're definitely lacking the resources to give everyone who does understand that and who wants that treatment the treatment they need and deserve. So, I think we're still sort of stopping and starting and disjointed as far as our responses. But I do think like just this level of addiction forced us all to reckon with how ignorant our understanding of addiction had been for decades and decades and decades.  

Beth [00:32:56] And in some senses, when you try to do lessons learned here, you can make an argument for greater fragmentation of things. Some of this happened because our pharmaceutical industry is highly consolidated. There are three major distributors who control 95% of the flow of pharmaceuticals in our country. Some of it is because our industry associations for all the good work they do can also apply tremendous pressure on members of Congress who can then turn around and apply tremendous pressure on, for example, the Drug Enforcement Agency and the Food and Drug Administration. And you can have people in law enforcement jumping up and down and saying what's happening out there is criminal, it's wrong, it's killing people, we have to stop it. And the answer becomes we'll lose our funding if we go after these companies. So, in some ways, you look at it and you think we need to tear down these relationships and this system. And on the other hand, what does the treatment side call for? I'm aware of some situations where people have been in the throes of addiction and seeking help and unable to get the care they need because their driver's license is from a different state than the state they're in when they're ready to seek that help. There are too few beds. There are insurance obstacles. There are just scores of financial obstacles. And so, there's a part of me that thinks maybe the healing path is different depending on whether you focus it on preventing future addiction or treating the addiction that's out there. And we have to be able to do both at the same time. And it's just incredibly complicated.  

Sarah [00:34:49] I've talked over and over again on this podcast about Richard Reeves book Of Boys and Men. And I recorded a conversation with him for our show this summer that I can't wait to share. But he really convicted me during that conversation about how important it is to pay attention to gender imbalances and all kinds of statistics, but particularly public health. And so, I don't want this conversation to end without pointing out that seven out of 10 preventable opioid overdose death victims are male. And I think that gets to the complexity of what you're talking about, like moving forward and thinking through this. We talk about it at a really high level, but it breaks out so differently community to community, it breaks out so differently demographically. We're going to get into some of the racial differences on Friday show. And Beth got us started with a fantastic More to Say, you should listen to before that. But I think something is happening when seven out of the 10 deaths are male. And I think that's going to have to be included in the conversation and in a really important component of whatever we do, not only about treating current addictions but preventing future addictions.  

Beth [00:35:54] We're going to continue that conversation on Friday, and it won't be the last time we talk about this, because anything that causes 100,000 people a year to die affects our economy, our families, our workplaces, the way that children are growing up. There isn't a part of American life is unaffected by this epidemic. And so, we are going to continue to talk about this on Friday and probably well into the future. And we welcome (to the extent that you would like to share them) your stories. We know many of you have them, and so you are always welcome to reach out to us at Hello@pantsuitpoliticsshow.com because you are very influential parts of this conversation. Up next, Sarah is going to reflect on Felix's one year anniversary of being diagnosed with type one diabetes. Sarah, a year ago, we produced an episode called A Life Changing Diagnosis. And here we are another year later. And I know it's been a really intense year for you and your family, so I'm wondering what your reflections are.  

Sarah [00:37:06] Yes. Last year after spring break, Felix was diagnosed with type one diabetes. Fun fact, a lot of people diagnosed their kids over vacations. They call it sometimes the Disney diagnosis because they're just going to the bathroom all the time. You're like, why are you going to the bathroom all the time? And you don't see that it when they're at school. And when you have them sort all to yourself, you notice with a very undramatic diagnosis, which I'm still very grateful for and I think put us on the road to a easier and faster integration of this new diagnosis into our lives. But it's still been hard. It's a shitty disease, man. One star. Do not recommend. Approximately 1.4 of 5 million Americans have type one diabetes. And I was looking at statistics for this conversation and it's growing. The disease is growing at a rate of 2.9% per year versus the population growth of 0.8 percent. And so, I've welcomed a lot of listeners who heard that episode into the club this year. It is not a task that I enjoy, but I tell them that this has been a really hard year, but it's also been a really great year. We still went to Europe; we've been to Disney. We are now on an insulin pump which makes our lives infinitely easier. You were here in the very beginning when we were doing multiple daily injections, which was so hard and stressful. I've just sort of blocked it out from my memory.  

Beth [00:38:22] It was clear to me that it was so hard and stressful. And even still with the pump, watching you watch his numbers, it is a-- task is not the right word because it's bigger than a task. It's a whole section of your brain now that is always somewhere else. No matter where we are, what we're doing, a whole section of you is always writing those numbers with him. And I know that has to have been just an adjustment that I can't even begin to appreciate.  

Sarah [00:38:51] Yeah. Luckily, I'm not a very past oriented person, so sometimes I'll have a glimmer of, like, what was it like when we just ate? I don't really remember. That's a kindness my brain affords me. I have sort of moved on to another phase of life. I don't really have a memory of what it was like before. But, yeah, Felix wears a continuous glucose monitor, so we know his blood glucose about every 5 minutes. And I just think about Sarah sitting in that hospital room a year ago thinking, well, I'll just get this glucose monitor and the pump and we just won't have to really think about it. But that's such a joke. For one thing, they're never always functioning perfectly. The sensor is always a little wonky or the pump is mad and the sight is like sort of run its course. They're never really just functioning perfectly all the time. We'll get really good days. We had a 100% in range day the other day, which felt amazing. And Felix's A1 C, which is a measurement of how good his blood sugar basically is, is phenomenal. It's only one point higher than mine. And that's largely due to my amazing husband who really, I would say, is probably the primary diabetes caregiver. He's the one who gets up in the middle of the night with any low blood sugars. He watches his numbers even more closely. You think I watch the numbers? Listen, you should hang out with Nicholas for a day. I bet he checks it every 2 to 3 minutes. And we're working on that. We're working on having a healthier relationship with diabetes. I'll never forget our consultant saying, like, we really want you to have a healthy relationship with diabetes. And we both thought how? It's such a monster in our lives. But I think we're getting closer every day. The pump has been life changing.  

[00:40:21] We have the most incredible school nurse, nurse Leslie, and his teacher, Ginger Molina, who take exceptional care of him. My parents have really stepped up, and so it feels like now I don't feel like I have to be with Felix every second of every day. He actually is pretty good at managing himself. He has excellent awareness for when he's going low. And that's the ultimate thing, it's watching him just continue to thrive and grow and be funny and fierce in the face of all this, in the face of being eight years old and being told, no, you can't have that. No, you can't have that. No, you can't have that. You do really get resentful of the overabundance of sugar in our culture, but I'm really proud of our family. I'm really proud of how we've handled it and just incorporated it into our lives and moved forward and not let it slow us down. I was reading an interview with Ron Klain and he was quoting Biden, who was quoting Daniel Patrick Moynihan, who said, "To fail to understand that life is going to knock you down, is to fail to understand the Irishness of life." And I thought, that's great, especially as we're heading to Ireland this summer. Life is full of struggle. I believe that and I think you can either fight it or accept it and do the best with it that you can. And that's what we've tried to do with this diagnosis. And a year later, which I cannot believe it's been a year, I'm really proud of us. I'm proud of Felix. I'm proud of Nicholas. I'm proud of myself. I'm proud of all our friends and family. And I don't wish it on anybody. But it's sort of like the Stephen Colbert quote, "I love the thing I wish most had not happened." So, here we are one year later on our diversary.  

Beth [00:41:56] Well, it's fitting that we have been talking about follow ups today, including Felix's follow up. And that will continue to be a huge part of who your family is and a huge part of every aspect of your life. And so, we want to talk before we go about one more event that has reverberated broadly and for decades now. Today, Tuesday, April 18th, is Holocaust Remembrance Day. It is celebrated a week after Passover to honor and remember the 6 million Jews murdered in the Holocaust and also to acknowledge their resistance. So, we have a poem to share by an unknown author. But we know that a Jew in a concentration camp wrote this on the wall of a cellar during World War Two, and we thought these words would be the best way that we could leave you today.  

Sarah [00:42:45] I believe in the sun, even when it is not shining.  

Beth [00:42:49] And I believe in love, even when there's no one there.  

Sarah [00:42:52] And I believe in God, even when he is silent.  

Beth [00:42:55] I believe through any trial there is always a way.  

Sarah [00:42:58] But sometimes in the suffering and hopeless despair.  

Beth [00:43:02] My heart cries for shelter to know someone is there.  

Sarah [00:43:05] But a voice rises within me saying, "Hold on, my child, I'll give you strength."  

Beth [00:43:09] I'll give you hope. Just stay a little while.  

Sarah [00:43:12] I believe in the sun even when it is not shining.  

Beth [00:43:15] And I believe in love even when no one's there.  

Sarah [00:43:18] But I believe in God, even when he is silent.  

Beth [00:43:21] I believe through any trial there is always a way.  

Sarah [00:43:25] May there someday be sunshine.  

Beth [00:43:26] May there someday be happiness.  

Sarah [00:43:29] May there someday be love.  

Beth [00:43:31] May there someday be peace.  

[00:43:33] Thank you so much for being here today. We will speak with you again on Friday. Until then, have the best week available to you.  

[00:43:55] Pantsuit Politics is produced by Studio D Podcast Production. Alise Napp is our managing director.  

Sarah [00:44:00] Maggie Penton is our community engagement manager. Dante Lima is the composer and performer of our theme music.  

Beth [00:44:06] Our show is listener-supported. Special thanks to our executive producers.  

Executive Producers Martha Bronitsky. Ali Edwards. Janice Elliott. Sarah Greenup. Julie Haller. Helen Handley. Tiffany Hasler. Emily Holladay. Katie Johnson. Katina Zuganelis Kasling. Barry Kaufman. Molly Kohrs. Katherine Vollmer. Laurie LaDow. Lily McClure. Linda Daniel. Emily Neesley. Tawni Peterson. Tracey Puthoff. Sarah Ralph. Jeremy Sequoia. Katie Stigers. Karin True. Onica Ulveling. Nick and Alysa Villeli. Amy Whited. Emily Helen Olson. Lee Chaix McDonough. Morgan McHugh.   

Beth Jeff Davis. Melinda Johnston. Michelle Wood. Joshua Allen. Nichole Berklas. Paula Bremer and Tim Miller.

Maggie PentonComment