Opioids in America: Part 2

TOPICS DISCUSSED

  • Gun Violence 

  • Opioid Crisis and Fentynal 

  • Outside of Politics: 10 Things to Tell You with Laura Tremaine

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

OPIOIDS IN AMERICA: PART 2

TRANSCRIPT

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

Beth [00:00:08] And this is Beth Silvers.  

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

[00:00:25] Welcome to Pantsuit Politics. It's been an excruciating week of gun violence in America, where young people were shot for knocking on the wrong door, turning around in the wrong driveway and opening the wrong car door. We're going to process that here together today as well as continue our conversation on opioids in America. We're talking about the fentanyl epidemic. And, as always, we try to redirect our energy at the end of the show by talking about what's on our mind Outside Politics. And today, we're going to share a small piece of our conversation with Laura Tremaine on her podcast, 10 Things I Have to Tell You About Our Friendship.  

Beth [00:00:57] I love that conversation with Laura. It's one of the few where I thought, I wish this could last longer. And her book has come up in my parenting more times than I can count since I read it. So, it is such a gem. Next week, we are heading to Fort Wayne, Indiana, to speak to the community there about difficult conversations and finding connection through conflict. We have spoken this spring with colleges about their relationships with the surrounding community. We have spoken with corporations trying to motivate their employees post-COVID. We've talked to church congregations trying to heal after some tough theological divides. And we love this work. We take it very seriously. We spend a lot of time speaking with organizers to figure out what's most needed in a space and how we can create a space that allows people to process and find some vocabulary for moving forward. So, if you would like to have us come speak to your organization or company or community, we have three spots left for this fall and we would love to come see how we can help. Please email Alise@pantsuitpoliticsshow.com or send us a message through social media and we will respond. And I also want to say we learn from these conversations as much as we give to them. And as you hear us talk, especially in our conversations about gun violence and addiction, on today's episode, you're going to hear influences from those communities that we've been and the people that we've spent time with. You are always working on us and it is a real honor for us to get to be in these spaces.  

Sarah [00:02:23] Up next, we are going to talk about the latest incidents of gun violence in America. There is a lot going on in the world right now. We have the Dominion-Fox News settlement, the approaching debt ceiling negotiation, and we're going to get to all of that. Don't worry. We've got entire episodes planned on both of those topics coming up in the next few weeks. But we decided to talk about these shootings because it's all we can think about and it's all we're seeing our friends and neighbors talk about and something about this particular set of events, this particular combination of events felt different to us and we wanted to process that here together. So, let's review what happened. On April 13th, which was a week ago as we're recording here on Thursday, Ralph Jarrell, a 16-year-old black boy, was shot and wounded after ringing the wrong doorbell in Kansas City, Missouri. He was attempting to pick up his twin brothers. And I think I read they were at 115 Terrace and he went to 115 Street. So he's at the wrong house. Andrew Lester, an 84-year-old white man, answered the door and shot through his glass door and shot Ralph in the head. He fell and he shot him again while he was on the ground. He was charged in connection with the shooting-- after being initially arrested and released. He was charged with an armed criminal action of first degree assault, which is the equivalent of attempted murder in Missouri. Three days later, on April 16th, 20 year old Kailyn Gillis was shot and killed in Hebron, New York after the car she was in turned around in the wrong driveway. Sixty five year old Kevin Monahan was arrested after a standoff with police and was taken into custody where he was charged with second degree murder. I was struck when reading about this particular event that the police also turned around in the wrong driveway while responding to the 911 call. And then two days after that, on April 18th, two Texas cheerleaders were shot. One of them, 18-year-old Payton Washington, was critically injured. The girls mistakenly got into the wrong car in an H-E-B parking lot. Pedro Rodriguez, who's 25-years-old, was charged with deadly conduct, a third degree felony. Payton is still in the hospital. I heard she was only born with one lung. Her father described her as a survivor. She said to have her spleen removed and is still in critical condition.  

Beth [00:04:54] And as we're recording, police are looking for a man accused of shooting several people, including a six year old girl and her parents in Gastonia, North Carolina. The details are a little fuzzy on this. It sounds like the incident stemmed from a neighbor upset that a basketball rolled into his yard. These events are hard to digest, and I think the reason that they are consuming most of my conversations right now is because we've all done all these things. I've pulled on the door of a car that's not mine. I've turned around in people's driveway more times than I can count. I don't even think about it. I just assume that we are allowed to turn around in each other's driveways. I've knocked on the wrong house door. I've knocked on doors of people who don't know me to say I found this thing of yours, or is this your mail or whatever. And so, I think all of us are just feeling this constant pull of what places are safe, what people are trusted, where do we give each other the benefit of the doubt? I've been thinking a lot about the legal concept of an easement. In property law, there's the notion that a piece of land can be owned by someone but available to others legally for certain purposes. I love the word easement. The idea that we loosen our requirements on this space to make something easy for someone else. That's not exactly how it goes in the law, but that's how I like to think about the verbiage. And I have always assumed a certain set of, if not legal, then social easements that, of course, we knock on the doors of people who are strangers sometimes. Of course, we sometimes are in a driveway that doesn't belong to us. Of course, sometimes I mistake the 9000 other white SUVs in the Kroger parking lot for mine. Of course we do that, and we should have permission to do that and to be assumed to not be a threat. And that's what I think is so insidious about this. It shows that we are all perceiving each other as threats and that those social easements are eroding. And I don't know how you have a functioning society without those social easements.  

Sarah [00:07:06] I've knocked on 5000 doors when I ran for the city commission. So, I've been in these driveways. I've seen the mats with the guns that say various assundry threatening messages. I've seen the signs in the driveway and I've knocked on the doors anyway. Sometimes I chose not to knock on the door, but I've definitely been in all these situations. I was struck in one of the reportings, they described Kevin Monahan as a sour character. And I thought, yeah, I've had interactions with sour characters in my neighborhood who were mad that my dog was running the street. My stepdad got into it with one of our neighbors about dogs in the street. He was driving and the person sort of yelled at him for driving too fast and he got out of the car. And I literally made him at our dinner table repeat back to me, "I will not get out of the car again." I said, "You cannot do that anymore. Ever again. Ever, ever again. You cannot get out of your car." And I can't promise you won't get shot even if you don't get out of your car. But you most certainly cannot get out of your car because there is a part of this that is not unsurprising, but I can recognize it. I recognize the sour character. I've seen those driveways. I've driven down those driveways as a CASA worker where I thought, I hope they know I'm coming, because every sign says, "Do not come down this driveway." And I've definitely opened the wrong door and I've sort of seen people and thought, don't cross their path. Like, you have those sort of tingly moments. And I think what's so heartbreaking is that all of these people involved were so young, and you develop that spidey sense about sour characters and driveways and you pay attention to welcome mats and all those signals as you get older. And I think that because of the massive amount of guns, I'm just going to get a tattoo across my forehead that says there are too many guns. That social easement that allows you to learn those lessons without getting shot is decreasing. And I think it's decreasing because of the presence of guns. I think it's decreasing because of these polls were saying the number one agreed value among Americans is money. We don't have those like social institutions that are drawing us together. And even the decrease in religion. I don't need people to go to church. I just need people to gather. Honestly, I don't care what you gather to do. I don't care if it is a coven. I don't care. I just need people to gather and talk about how to be a good and loving and kind human. There's something about that that our brains desperately need, and I think it's the decrease in that and the increase in guns. And it is manifesting in wholly expected ways. No less terrifying, but wholly expected.  

Beth [00:09:53] I want to talk about the spidey sense for a second, because in many ways a lot gets baked into that that's terrible. And that produces this problem too. A lot of our biases, our racism, our classism gets baked into that sense of like, ooh, this is a bad situation for me. It's a beautiful thing that our young people don't have that. And a lot of what I've read about this week, I don't think I would have had a sense that kept me out of these situations. If I thought I had an address where kids in my family were and I was picking them up, I would go there no matter what. There's just so much to think about here. And it makes you question yourself in every dimension. How do I just take the people around me first as people instead of as something to be afraid of? And how do we get out of a situation where it seems like the predominant emotion we feel about people who are strangers to us is fear? This is where I just have to reach out to my friends who are gun owners and who believe so strongly in gun ownership to say, "You got to help with this problem. I can't. This is not my posture in the world." We were talking before we started recording. We both grew up in houses where you didn't lock the door because our posture in the world was not to be fearful of others or to believe that anyone was intrusive. And, in fact, they were open door houses in the sense of like, you don't have a place to go for Christmas, come eat dinner here. Somebody got hurt? Everybody comes in from the community to say, how do we help? How do we bring food? How do we support each other? So, I don't look at the world from this defensive standpoint. I need people who do to talk about this and to say before you decide to buy a gun for self-defense, ask yourself, "Do I trust me with lethal power?" Not in general, but at my most vulnerable moments. Do I trust me, late at night awakened from my sleep, with lethal power to use this in a way that is safe for me and for everyone else and that I can live with the next day? And that message has got to come from people who view the world similarly, I think.  

Sarah [00:12:14] Yeah. To a certain extent, I think some of this is like personality driven. I think there is just a personality that is highly attuned to threat. And it's not always bad. I was listening to a CASA training. There is a caseworker who was doing the training and she said, "I learned this when I worked at the penitentiary. I'm going home. I have a high survival rate, I'm going home." I'm not mad at her for feeling that way based on her career experience. Yeah, I mean, because we send social workers out there with a damn clipboard. There's a part of me that's I think some of this is personality. I think some of it is experiential, and then I think some of it is loneliness and just a soaking in your own sadness that sees everyone as a threat. And I think there is a gendered perspective to this. Obviously, all three shooters were men and absolutely with Ralph Jarrell, we cannot continue this conversation without talking about the racialized aspect of this, this racialized gun violence. And, look, I've said this on the show before. I'm the mother of three boys. I have a real soapbox about the teenagers are not grown. They are not grown. And there is a gendered perspective of this. And there is a intersection of gender and race that young black boys sit at the bull's eye. And I'm using that word deliberately of in such a dangerous, awful way. And it makes me so angry. And you see it all the time. Even I heard that the 85-year-old articulated, "Well, he was so tall." Well, he can't help that. And you even hear it talked about with parents. And I feel this with Felix, like when little boys are just bigger than we expect them to be, then they're punished for their behavior not aligning with our expectations because people think they're older. And so, they're acting young because they are. I mean, it's just bananas how we do this and how it is so, so dangerous and manifests in such violent ways, particularly with black boys. And I'm just so relieved that he wasn't killed. But this poor child has a traumatic brain injury. I'm glad he got to talk to the president for an hour, but he still has a traumatic brain injury. It's just so ridiculous.  

Beth [00:14:44] And we have a young woman who is dead. And who knows how much more of this we're going to hear about. The one positive to me is that these stories are being reported faster on a national scale than they've been before. That has a risk accompanying it because we're in this loop now where the news just tells us you're not safe anywhere. You're not safe anywhere. And if everybody who hears I'm not safe anywhere thinks, well, maybe I need a gun too. I don't know where that takes us. It makes me want those suits that they have in Dune where everybody's just walking around bulletproof now because there are so many guns that's what we have to do. I worked really hard when I worked at the law firm downtown in Cincinnati and walked to a parking garage every evening to deprogram that sense in my brain that everyone who is physically large and male is menacing to me. I definitely had just a hard wired feeling. I would walk faster. I'm sure I clutched my purse and my keys. And honestly, I didn't see a lot of black men in that parking garage because of where I was in Cincinnati and the demographics of the location. I did not see a lot of black men in that garage, but I saw a lot of men who were larger than me. And I really had to work on relaxing my posture, presenting myself with confidence and allowing my brain to just rest from that threaten mode as a young woman in a building like that. I thought about carrying pepper spray and Mace, and I decided that those things would make me more fearful and that what I really needed was to come out of that mode. And it took a lot of thought. It's like a level of consciousness to say, "Oh, I recognize that I'm feeling this way about other people. How do I let that go?" And that is the conversation to me that we're going to have to have in lots of spaces right now. How do we let this go? Because I don't know anybody who thinks this is good or healthy or okay. I really don't.  

Sarah [00:16:46] Now, it does seem to have broken through in a way that people who even don't pay that much attention-- because that's who I feel like we have to reach. That's who I think about all the time. I don't think about gun owners. I think about the people who say, I don't want to talk about politics. Politics is not my thing. And gun control is a political issue, and so they just tune it out. That's the people that I want to reach to say, "Do you get it? Do you want to live in the Wild West?  Do you want to live around gun battles all the time?" Because that's where we're headed. And if you care, if you don't want that, you are going to have to engage on this topic at least. We are going to have to reach a critical mass of people because of the Second Amendment. You guys, this is not going to be an easy fix. This is going to be like a big, big change. Now, we can get there with some gun control measures. Michigan just passed one, but there are so many guns. The only hopeful thing I've heard about this, (and this is one of my friends who I feel is pretty clear-headed on this issue, one of the most clear-eyed political operators I have in my life actually) and he was like, the thing is, there's a lot. But if people stop buying them on such a mass level, they don't last forever. I think there's a thing that I feel like if there's a gun, there's a gun forever. And he's like, no, they break. You don't use them, then you can't use them. Or people run out of bullets. We stop making as many bullets. And that kind of made me feel better just logistically about the number of guns that are out there. I would like to see some buyback programs. I'd be great if we could get on that train. But it's going to take everybody. There's going to be, I would say, 10 to 20%-- I don't think it's that high of a number-- of Americans who own an enormous amount of guns and who are unpersuadable on this issue. But I think that there's just a bigger number of people who recoil from anything related to politics, particularly controversial issues like gun control, who are going to have to engage.  

Beth [00:18:44] Well, and I think among gun owners more people saying, leave it in a safe, make it harder to get to. I think part of what breaks through about this is that you can see yourself on either side of these equations. I can't imagine taking a gun to the door when somebody knocks. But if I were a person who had something awful to me, let's say someone broke into my home once, or I had been the victim of a terrible crime and that is my space, I have a gun in my house for protection because I need it. When you read a story like this, you don't want to be these people. You don't want to suffer with having taken someone's life or health in this way. You don't want to suffer with the safety that you have taken from so many people because of your story, let alone the jail sentences that some of these folks will find themselves in. I believe we have these stand your ground laws, which are a whole other episode. But I hope that people listen to these stories and think, maybe I just need to put it in a safe so that there's space between me and my most fearful reaction.  

Sarah [00:19:58] I'm glad you said that because I read that Andrew Lester, the 84 year old man who shot Ralph Jarrell, was distraught in the police office and was worried about how Ralph was doing in the hospital. And I thought, well, you can't say that because you'll be accused of humanizing the attacker. And I thought, no, we should say that. We do want to humanize these people because they are part of the problem and therefore part of the solution. If we continue down this road of, well, this is just a monster and this is how they react, that's not helpful. That doesn't get us any closer to a solution, that doesn't help us unpack why people reach for a gun, why people buy guns. And I'm not saying we turn them into the victims, but there is a space between making them a monster that nobody can relate to and therefore we can't understand in order to unpack, and turning them into a victim. I don't want to turn them into a victim. I'm not interested in turning Kevin sour character Monahan into a victim. But I do think there is space here to say these were human beings and this is how we reacted. And what can we learn from that?  

Beth [00:21:04] You don't have to be a monster or a victim to be a product of the culture. And that, to me, is what is important to understand here. Every person here is a product of culture. We all are. And thinking through this, it is a different category when we're talking about guns and gun ownership than when we're talking about a mass shooting. I cannot stop thinking about that birthday dance in Alabama where so many people were killed senselessly. But we got a lot of people in this country who say that's a tragedy. It's awful. But bad people do bad things and they always have and they always will. And there's some truth in that. I can find some understanding of that argument. I don't believe that should mean we don't try to stop things like that from happening, but I can find the truth in that argument. These stories are not about bad people doing bad things. These stories are about what is happening in our culture that makes so many people believe not only that I need a gun, but that a gun happens to be my first response that I shoot before I even say, "This isn't your car. What are you doing?" There are no questions being asked here even. It is that the gun is the first solution. And we weren't born that way. You know what I'm saying? That is a cultural phenomenon that is absolutely worth asking a bunch of questions about.  

Sarah [00:22:24] Well, I'll take it a step further. It's that I have a right to respond this way. That's the problem in America. It's that I have a right to use a gun. And that's in the Second Amendment. People don't feel like that in other countries. They don't think they have a right to solve their problems even when someone is threatening their life with a gun. That is a uniquely American idea. I think it is a uniquely problematic idea as illustrated by the events this week.  

Beth [00:22:55] Well, and the other layer I would add, is that even if you left the Second Amendment in place, we've had it, you know, for much of our country's history. Our gun culture is orders of magnitude different than it was even when we were growing up as kids.  

Sarah [00:23:13] Yes.  

Beth [00:23:13] The come and take it shirt, bumper, sticker. The overtly aggressive members of Congress on Zoom with guns behind them. We're in a place now where it's not just that you have a right to respond this way, it's that that's the cool thing to do. And cool is not even the right word. It just shows my age too. But it's like that's who you are.  

Sarah [00:23:35] Well, we had an assault weapons ban.  

Beth [00:23:37] Yeah.  

Sarah [00:23:38] We had an assault weapons ban when we were growing up. The proliferation in the assault weapons culture did not exist when we were growing up because there was a legal ban in place. And I would say too the thing to remember is that it's not just a culture, it's an export. We're going to talk about fentanyl next.  

Beth [00:23:55] Yeah.  

Sarah [00:23:56] We spend a lot of time talking about fentanyl flowing over the border as if Mexico is the sole problem here. But we also export those weapons into other countries. We have a massive flow of guns into Mexico and South America, and that's on us as well. Before we move on to that conversation about fentanyl, I wanted to share something that was in Richard Moore's email this week. It was Ugandan theologian Emmanuel Katongole and peacemaker Chris Rice. It said, "Lament is not despair. It is not whining. It is not a cry into a void. Lament is a cry directed to God. It is the cry of those who see the truth of the world's deep wounds and the cost of seeking peace. It is the prayer of those who are deeply disturbed by the way things are. We are enjoined to learn to see and feel what the psalmist see and feel and to join our prayer with theirs. The journey of reconciliation is grounded in the practice of lament." That hit me so hard this week because that's what I feel when I look at these events. I just feel lament. That's what I felt when we talked about the shooting at Covenant School. I'm just crying out. This next paragraph where they talked about Rachel and how she refused to be consoled, and I thought, that's it. That's how I want to lament. I think that's why people have such a visceral reaction to thoughts and prayers. I don't want to be consoled. There's nothing consoling in this situation, and we need to see that and we need to cry out and we need to get others to see that as well, because that's the only thing that's going to change the situation.  

[00:25:40] On Tuesday's episode, we talked about the opioid crisis. We talked in particular about prescription drugs and heroin, and how the next phase of this crisis has involved fentanyl. Fentanyl is a very potent synthetic opioid that is 50 to 100 times more powerful than morphine and 50 times more potent than heroin, and is often used in medical settings for pain management. And it's been around a long time. It's been around since the sixties, but it was so expensive to make. Well, what happened is now the Mexican drug cartels can get these precursor chemicals to make the synthetic opioid from China, and that is what they are doing. And they are churning it out in massive, massive amounts and they're mixing it with other drugs. And so last week, the Biden administration, in fact, labeled FAX (Fentanyl Adulterated Xylazine) as an emerging threat. This is the first time any administration has declared a substance to be an emerging threat in the country. And it comes with all these response plans and increased resources. But it's just one manifestation of this crisis. It's been mixed with like animal tranquilizers and some really, really scary substances. And it's cheap. It's only 3 to $4 a pill. I thought this part was particularly interesting, that the effects don't last that long. The high is only about 20 minutes, so you need a lot more hits in a day. And because it's this combo of cheap but not a very long lasting high means it's highly addictive and highly lethal.  

Beth [00:27:09] When we talk about fentanyl being used in medical settings, we're talking about like cancer patients. It is severe pain that needs to be managed with fentanyl very carefully. Part of what is so incredibly heartbreaking and dangerous about the use of fentanyl right now-- you said this but I just want to underscore it-- is that so many people are taking it without knowing they're taking it.  

Sarah [00:27:34] Yeah.  

Beth [00:27:35] To the extent that you have any level of consent once addiction has taken hold, which I question, but to the extent that that's ever present, we have people who are trying to get other substances receiving fentanyl without their knowledge. And that is something that I think requires a different level of government analysis and response.  

Sarah [00:27:58] Well, I mean, the DEA has a faces of fentanyl wall of people that have died, and the youngest person on the wall is 17 months old and the oldest person is 77.  I mean, people are encountering the substance not even realizing what it is, not even attempting to take a drug. Some of them look like candy. The truest manifestation of this alarmism. We've always heard they're hiding drugs in the Halloween candy. Now it's like real this time, which is just so hard to think about. I mean, the DEA administrator came to Congress and she said fentanyl is the single deadliest drug that our nation has ever encountered. Overdose deaths went from 3000 in 2012 to 68,000 in 2021. I mean, that is just hard to comprehend.  

Beth [00:28:48] It is. And it shows how delicate all drug policy is, because in some ways fentanyl is a direct outgrowth of the opioid crisis, that we got all these people addicted through our health care system. And then our health care system said, oh, this is a crisis. We need to change lots of what we're doing here. Law enforcement comes and regulators come in. We make it much harder to access those drugs, even for people whose pain was being managed under a provider in a responsible way. And so, a bunch of people turn to a black market and dealers in that black market want to keep people addicted and here is a super cheap way to do it. To me, it highlights the thorniness of dealing in a space where you have substances desperately needed by some people and safe under some circumstances that gets out of control and then really out of control because it is turned over to a criminal enterprise instead of a system that is imperfect but at least able to be regulated.  

Sarah [00:30:01] I'm actually really interested with fentanyl on the supply side. I think it's a very unique case as opposed to definitely the prescription drugs-- but even heroin.  I'm going to put this out here because I feel like we will have an audience member who's like, "I know the answer." But how did China start producing the precursor chemicals? How did this production start? I don't actually understand hiding fentanyl and cocaine. Then you're killing your customer. My question with fentanyl is like, if you're hiding other drugs and you're not paying attention to the dosage, again, you're killing the customer. That doesn't make sense as a business model. Not to be coldhearted, but you do have to assess the business model of the supply side in order to undercut it. The Justice Department is doing its best. It's arresting members of these two main cartels that are involved in the fentanyl production. We have reached an agreement with Mexico who was like, "You're going to do something about these guns and we'll do something about fentanyl, but we're going to do it together," which I think is fair. I think it's fair.  

Beth [00:31:01] That's how you are a broker on the international stage. One hundred percent. 

Sarah [00:31:04] Well, how are you going to undercut these gangs if they're still getting a steady supply of weapons from our country. They're trying to battle gangs that have basically an arms deal with the United States. It's just a black market arms deal. I would like to know more about how that happened. Like, when did they start producing fentanyl? When did they start ramping it up? I have a lot of questions. I mean, it's in all 50 states, every county. It's everywhere. It's not like concentrated in the way previous drug waves were.  

Beth [00:31:38] I've been reading a lot about drugs and fentanyl. I highly recommend the book American Cartel by Sari Horwitz and Scott Higham from the Washington Post. But I've gotten in my head about the supply side, as you were saying, because I just keep thinking, is this a weapon? Is something different going on here than an industry? And it turns out I am not alone in that question. And there is a big movement among Republican attorneys general to classify fentanyl as a weapon of mass destruction. Now, addiction experts do not like this. Do you not agree with it. Do not think it's the right path to go down. And I certainly do not agree with the idea that we're going to combat this most effectively through our military. I think classifying these cartels as terrorist organizations and sending troops to Mexico, I think that is bad news. Mexico is our neighbor. We must cooperate with our neighbors. And I believe in conversations like we are going to work on reducing the flow of guns to your country and you work on reducing the flow of drugs to ours. Diplomacy, to me, is the tool here. But our diplomacy with China has broken down. And that's what made me wonder what is it about fentanyl flowing from China that we need to be paying attention to? There is a full court press, though, among Republicans to say this is a weapon and we need to bring those kinds of tools to this conversation. And our own attorney general in Kentucky has signed on to a letter to the Biden administration about this. And I think we're going to start seeing that conversation get bigger and bigger.  

Sarah [00:33:11] Well, and I also want to say we're talking about how it's everywhere. And it is. But it is hitting some groups harder than others. No group has seen a bigger increase in fentanyl overdoses than black men. Black men have now overtaken white men and are now on par with American Indian and Alaska Native men as the demographic group most likely to die from these overdose deaths. The death rate has tripled, rising 213%, and the overdose fentanyl rate for black women rose 144% between 2015 and 2020. And the indigenous community is incredibly hard hit. And what you're seeing and what I read a lot about in the research is that, you have a history of substance abuse, but you have so little history of receiving substance abuse treatment.  

Beth [00:33:58] Well, and also of pain being validated and recognized and treated in accordance with common medical standards.  

Sarah [00:34:05] I mean, this statistic took my breath away. Only one in every 10 American Indian or Alaska Native or Hispanic person has reportedly received substance abuse treatment. One in 10 and it's even lower. It's like one in 12 for black people. Research shows that black people have a much harder time getting into treatment programs. I saw this quote in an article, "If you are a black person and have an opioid use disorder, you are likely to receive treatment five years later than if you're a white person." I mean, it's not surprising that this is manifesting in racialized ways. I think we have a long way to go as far as-- we talked about this on Tuesday-- our understanding of how to treat opioid addiction. And there's lots of approaches we have. I thought the test strips, the testing the drugs to make sure they don't have fentanyl in them is very interesting. But then you read articles where they go to parties and they're like 3 to 4 people who've overdosed at these parties. There are dead on the ground next to test strips. So I'm not really sure how effective those are. And PSA still like not do it alone. But, again, you go to parties and more than one person has overdosed. And then of course, you have Naloxone and Suboxone, which are drugs that can reverse the effects of these overdoses.  

Beth [00:35:18] I think that we all have to start talking more about harm reduction. And this goes along with destigmatizing addiction and recognizing that this can happen to anybody for a whole host of reasons. The other side of it is saying not everyone is ready for treatment. Not everyone is ready to get clean. It takes a lot to get there. And we still love those people and we care for them and we want them here. And so, we want them here, we will provide them with test strips. We will accept you are going to do drugs. How can we make it safer? How can we get you clean needles? How can we encourage you to at least be with other people? How can we just keep showing up for those people? I heard a story this week from a listener that really affected me about a beloved family member who was in the throes of addiction for years, and no one in the family could get through to this person to get them to start accepting some treatment. And another person in life who has like a very tenuous connection, just kind of miraculously shows up and becomes a fixture in the person who was the addict life and stays with that person. Like, left work for months to go to treatment with this person and just be there beside him. And that is how he got through it. And I want to be careful about the details and respectful to the folks involved, but accepting people where they are in their journey and not giving up on them is a societal mission as well as an individual mission and harm reduction. And allowing the use of medicine to treat addiction is part of us saying we want these people here and we want them to recover and we will tolerate that recovery happening not on our own schedule and still say, "How can we keep you as safe as we can in the meantime?"  

Sarah [00:37:10] Yeah, and I think we just have to keep talking about it. I've talked about it with my kids. I'm in conversation with some community members and moms and we're thinking about getting some naloxone that we just have on hand in the case of these sort of emergencies. And worth noting that Tuesday, May 9th, is National Fentanyl Awareness Day. I'm sure there will be lots of resources and statistics and a way to start these conversations in your own community and with your own family and friends. And that's an important first piece of the puzzle for a problem as big and complex as this one.  

Beth [00:37:42] And big shout out to the Food and Drug Administration for working to make Narcan over-the-counter widely available with good information about how to use it. Because I do think more of us keeping that as part of our first aid kits is a way to participate in that societal interest in continuing to care for people.  

Sarah [00:38:02] Thank you for sticking with us as we begin to tackle this incredibly difficult issue in American culture. Next up, we are going to share a piece of our conversation with the fabulous Laura Tremaine. Laura Tremaine has a new book, The Life Council: T10 Friends Every Woman Needs, that we both loved. And so, when she asked us to come talk about being battle buddies on her podcast 10 Things I have to Tell You, we were delighted and we are so excited to share a piece of that conversation here on our show.  

Laura Tremaine [00:38:37] That's one of the things that some of us never learn. I'm actually not great about this part, that if you go first, if you reach out, if you make the ask, if you extend your hand, if it's a no, it's fine. Like very few asks in our life do we make where the stakes are that high, especially in what we're talking about. Friendship, relationship, opportunities, whatever. If it's a no, walk it back to what's the worst that could happen there? If Sarah had been, like, "No, I don't take guest post." Well, okay, it's not personal. Or even if she was like, "No, we don't really align and that's not how I'm doing this project." Okay. From good person to good person-- and I think that the vast majority of us are good people and well-intentioned people-- even and no is not personal. It's not about people's worth. But I get nervous about that too. Like, I am trying to make new friends now a little bit. My daughter just started a new school, so it's like a whole new group of moms and parents. And I get nervous, like, if someone says no, that they don't want to get together or they don't text me back or whatever. Even if I give myself the self-talk that it's not personal, everybody's busy, everybody has their own life or whatever, you still think, "Well, I don't want to see them at the carpool because they said no to me," that it's not that big a deal.  

Sarah [00:40:06] It really isn't. I say all the time, if I can leave my children with one skill, it will be the ability to cold call. I think that if they can walk out of my house with the ability to cold call and public speak, the world is their oyster. The ability to just ask. My stepfather was a door to door insurance salesman. So, that was like drilled into me. The worst someone can say is no. That's the worst someone can say. But when you name that about-- or maybe we're just in a line, I'm like, "Oh my gosh, what if I had said that?" Like in my early twenties I think when I was very self-righteous about my own political views, I might have said, "No, I don't want to platform someone who votes differently than me." I think there's an alternate universe where Beth comes along later in my life post some dramatic changes in American culture and politics where I would say that again, I would say no. We think about that on our own show. Like, who do we want to give voice to? We have to be really careful about that. So, oh, my God, I'm so grateful in that moment. And I think for a lot of reasons we had had some conversations around natural childbirth, which both of us had that kind of built a little trust in the trust bank. But I'm so grateful that I didn't have that reaction of preciousness about my platform and what was I sharing it with, and did we align perfectly. And that I was just more interested in the fact that she felt differently than I did and I wanted to hear why.  

Laura Tremaine [00:41:28] And so, then did your relationship feel private? Because relationships are private by nature of that intimacy, or did it feel from the get go because you were doing this project? Did it feel public?  

Beth [00:41:43] I think that's such an interesting question. I think for me our relationship didn't start feeling private until we started traveling together.  

Laura Tremaine [00:41:51] Oh, say more.  

Beth [00:41:53] Well, our conversations were largely in public. We were not doing this professionally at the beginning. We weren't planning a bunch. We would get on the phone, what do you want to talk about? And we would do our best with it. And so, there wasn't as much of an off the mike relationship as there is now that this is our full time job. When we started traveling together, that's when we had the large chunks of time where friendship is developed. We were eating together, we're driving together, we're flying together, we're in the green room together before and after the show processing things. And I think it was in those moments when we really were alone, we weren't trying to create content, that we got to know who this other person was. Hearing Sarah talk to her husband on the phone is a key ingredient of understanding Sarah. And I didn't get that when we were just hopping on to record late at night and then passing out and getting up to be moms and workers and all the things the next day. It just took that investment of time and those unscripted opportunities to really see the fullness of who she was and who she is to me and who I am to her.  

Sarah [00:43:08] Well, and it's so funny because at the beginning it felt very private to me. Even when we weren't traveling, I really was just talking to Beth. I was not talking to anyone listening. I was talking to Beth. That's all I was doing. I was sitting down and being, like, "What do you think about this? Here's what I think about this." I would be lying to you if I said that was totally true anymore. There is no way for us to do what we do now without the awareness that thousands of people are listening. And so, there is more of a we're talking with each other than just to each other. And so, it was private and then it expanded. And then because of the business, there's like a branch that is private now, because we stay in each other's homes and we travel together and we understand each other's kids and all that. Then it's like it bifurcated in a way inside our relationship.  

Laura Tremaine [00:43:58] Okay. Do you think that's interesting? Because another thing that I talk about in the Life Council is that you can let friendships-- and these are important friendships to you possibly-- stay in their own lane. So, for example, business besties, (someone that you're working with or that you're in a partnership with, an important partnership with) it doesn't have to be personal. You don't have to stay in one of those homes when you travel. You don't have to do that part. Like, it can still be meaningful and deep or shallow however you choose and stay in its own lane and still be a friend, still be a life council member. It can-- and has with you-- bleed into these other parts. And that can obviously take a relationship to a much deeper level when you're staying in one another's homes, when you're hearing each other on the phone, when you're letting those things bleed over. But it doesn't have to.  

Sarah [00:44:56] Thank you to Laura for having us. Before we go, we love to hear from you and your feedback. It makes the show better. We wanted to share a message from Kieran [sp], a former pharmaceutical company employee, and she had feedback that we found really helpful. She said, "When people report on this issue, they often use the shorthand, the pharmaceutical industry to describe who makes or made these drugs. This sounds like it is a conspiracy of many, many companies. It is not. I worked for many years for two major companies, and neither one of them had any opioids. There were a handful of manufacturers who did make opioids approximately five out of a total of 100 plus pharmaceutical companies, with one major player, Purdue, who was responsible for most of the offenses. When people use that shorthand, it vilifies those companies who never got involved in those products and makes people unwilling to take those drugs that are needed, including those drugs who are most appropriate to treat mental illness." Good, interesting feedback.  

Beth [00:45:41] It's good feedback. And also it makes me wish for some more terms because it's not just the manufacturer, it's the distribution.  And the oversight within pharmacies. American cartel is really good on showing how each player has access to different forms of information and different levels of responsibility based on the access to that information. And so, I am going to take Kieran's feedback to heart and try not to use the pharmaceutical industry as shorthand in any context anymore. I do need some help with that supply chain side to make it clear that we've got lots of opportunities in the system to check in and ask questions and say, "Does this number of pills being shipped to this location at this frequency makes sense. Should we take pause here and ask a question instead of just cashing the checks and moving on?"  

Sarah [00:46:28] We covered a lot of difficult topics today. This is a good representation of the fact that we can't contain every experience in one episode, so we appreciate your grace and insight as we continue to tackle these tough topics. Thank you for joining us. We will be back with you on Tuesday. And until then, keep it nuanced y'all.  

Beth [00:46:59] Pantsuit Politics is produced by Studio D Podcast Production. Alise Napp is our managing director.  

Sarah [00:47:04] Maggie Penton is our community engagement manager. Dante Lima is the composer and performer of our theme music.  

Beth [00:47:10] 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. Danny Ozment. 
Beth Jeff Davis. Melinda Johnston. Michelle Wood. Joshua Allen. Nichole Berklas. Paula Bremer and Tim Miller.

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