Guests

03/02/22 Doctor Richard Andrews

Program
Cultural Baggage Radio Show
Date
Guest
Richard Andrews

Dr. Richard R. Andrews is a family medicine doctor in Houston, Texas. He is a conscientious objector to drug war who works daily to save the lives of drug users. He received his medical degree from University of Connecticut School of Medicine and has been in practice for more than 20 years.

Audio file

02/12/20 Richard Andrews

Program
Cultural Baggage Radio Show
Date
Guest
Richard Andrews
Organization
Andrews for Senate

Doctor Richard Andrews discusses needle exchange, safe consumption, opioids, overdose, Hep C & his run for Senate, Dist 13 in Texas + "Chief" Clarence Bradford & UH Professor Sandra Guerra Thompson discuss bail bond & protections against arrest

Audio file

TRANSCRIPT

CULTURAL BAGGAGE

FEBRUARY 12, 2020

DEAN BECKER: I am Dean Becker, your host. Our goal for this program is to expose the fraud, misdirection, and the liars who support the drug war which empowers our terrorist enemies, enriches barbarous cartels, and gives reason for existence to tens of thousands of violent U.S. gangs who profit by selling contaminated drugs to our children. This is Cultural Baggage.

This is Cultural Baggage and I am Dean Becker, the Reverend Most High. I have a wonderful show lined up for you. Put your ears on.

MALE VOICE: I am Dr. Richard Andrews. I am a Houston-based family doctor but at this point I mostly treat Hepatitis B and Hepatitis C and I am moving in to the treatment of opioid addiction.

DEAN BECKER: This is a necessary thing in this day and age to move in to the opioid addiction. I certainly want to get in to that here in just a moment. You are also running for office here in the state of Texas.

DR. RICHARD ANDREWS: I do happen to be running for office. I decided that since there are a number of what I would call public health crisis in Texas based on what I think is inappropriate policy – sometimes policy can be the thing that is hurting us – and I decided with so many people having medical issues driven by or at least affected by policy that I needed to step outside of the exam room and see if I could have an impact on how policy is made in Texas.

DEAN BECKER: I was lucky that I went to your office and took the test and it was determined that I don’t have Hepatitis C, but a lot of us Boomer’s (I guess that’s what we are) experimented back in the 60s and 70s and many of us had the likelihood of contracting Hepatitis C. It would be a good idea for folks to at least find out, wouldn’t it?

DR. RICHARD ANDREWS: It sure would, especially these days. We have had the ability for several years now since the 1990s at least to cure Hepatitis C but the drugs that were previously used while sometimes effective, they were usually not effective and required very lengthy therapy – sometimes as long as a year. You may not know until the end of that therapy whether you were one of the lucky ones who was able to be cured. The real problem with those drugs apart from what I mentioned is that the side effects were usually terrible and although a number of people were cured a larger number of people suffered severe side effects and were still not cured. Nowadays we have excellent drugs that are much better at curing the infection and for most patients will only take two or three months with minimal side effects with just a single pill a day in some cases three pills a day. Once you are cured of Hepatitis C unless you re-expose yourself the infection will not come back by itself.

DEAN BECKER: Again, we are talking with Dr. Richard Andrews who specializes in this arena. I am sure there are dozens to hundreds of doctors in Houston that could help you in that regard in you were to ask.

I went to Europe a couple of years back and I have been to Bolivia, Canada, and Mexico. I have toured 30 of these United States doing seminars trying to educate myself insofar as drug policy with regard to what is new and what is happening on the horizon and what we need to do to adapt and adopt. You have done much of the same. You had a fairly recent trip to Canada. Tell us about that, would you please?

DR. RICHARD ANDREWS: Sure. That was in September of 2019, and that was in connection with a conference that I discovered a few years ago and which I now attend every year and the organization that puts on the conference is called The International Network of Hepatitis and Substance Users Conference or INHSU for anybody who wants to look that up. There are conferences that focus only on Hepatitis and there are other conferences that focus on the illnesses associated with Substance Use Disorder, or addiction. This is the only conference that I know of at the international level that focuses specifically on Hepatitis and substance users – mostly Hepatitis C, but Hepatitis B is also an issue.

DEAN BECKER: Dr. Andrews, one of the things that I have had on the back burner and wanted to put on the front burner is to emulate or copy what they have done in certain cities there in Canada. I first went to Vancouver to the InSite facility there where they have a safe injection facility, safe consumption facility they are wanting to use these days to take away some of the oneness. I learned there that they have saved thousands of lives and never lost one overdose to these new opioid products. We have between 68,000 and 69,000 deaths from these opioid drugs and you and I want to do something about this here in Houston, don’t we?

DR. RICHARD ANDREWS: We sure do. There is so much that can be done. In fact I was just reviewing one of the best medical articles that summarizes what can be done and what shouldn’t be done. This is a 2016 article in the Lancet which is considered by many to be the most prestigious medical journal in the world. The article was written together with the School of Public Health at Johns Hopkins University which is considered by many the most prestigious school of public health in the world, and one of the oldest if not the oldest. Together they put together a commission on drug use policy around the world and the impact that has on health. This article is evidence based. It looks at a large amount of evidence and has a large number of authors that are very knowledgeable about the subject from all over the world and they concluded that drug prohibition tends to have a very negative impact on several different aspects of public and individual health.

DEAN BECKER: I have preached that sermon for the last 20 years and that it ensures a deadlier consequence. They want to smuggle in the most potent product in to the country that they can and then it is cut with everything from rat poison to levamisole, the cancer causing wormer that they put in the cocaine to make it so shiny. We just shoot ourselves in the foot by believing in this prohibition, do we not?

DR. RICHARD ANDREWS: Absolutely not. In this case as a candidate there is no getting around being political when you are a candidate, which is the very definition of being a candidate. Political means you want to impact policy. I really try both as a candidate and a physician to be as evidence based as I can. Everyone deserves to have an opinion and often we have very strong opinions. I am really less concerned about what somebodies opinion is – although I want to know that as well – but I want to know if you have a strong opinion about something for example what drug policy should be. Should we be putting people in prison for simple drug use and possession? Can you show what the outcomes of that policy are? If you can show actual data that was gathered and analyzed objectively and you can show the jurisdictions in countries or states that have done that and had better outcomes; then I am interested. By the same token if a careful analysis of these things shows declining Hepatitis C and HIV infection rates with regard to new infections in people using drugs then we have to take a look at what the policy should be. As long as that data is gathered and analyzed objectively then we should take a look at how that should influence policy.

DEAN BECKER: Dr. Andrews, one of our goals will be to educate, encourage, and motivate the district attorney, the sheriff, the police chief, city council, the county commissioners, and the state reps to take another look and reexam this policy and look at it scientifically as you were just eluding to in order to see that there is a better way. I was reading the other day that Chicago is wanting to open some safe sites for drug users and that there is already a makeshift network there. I think we may have a makeshift network here as well. Without going in to too much detail, are you aware of any inclinations in that regard?

DR. RICHARD ANDREWS: I am aware of those networks and I think having an informal network is better than not having a network at all where there are people who happen to be using drugs. We have to remember that it isn’t simply injecting drugs that can sometimes cause Hepatitis C. For example, if somebody is sharing a cocaine straw that can also transmit Hepatitis C. Sometimes people don’t realize that it isn’t simply the sharing of needles that can cause these issues. We don’t want to encourage people to use drugs but for those people who are using drugs they should be in a position to use them safely. These are sometimes people with depression and other mental health disorders that are simply self-medicating and could hurt others. If we have a larger burden of Hepatitis C and HIV in the population, then more people are at risk including younger people and older people, I think it would be better and the evidence shows this, to have formal networks such as a health care system and health care infrastructure in which people have a safe place to go to use their drugs. You eluded to the place I visited in Montreal, Canada in September of 2019. I had read about these safe injection sites before but had never visited one. I had that opportunity in September to visit a Montreal site. Canada now has well over 20 sites, with the first one as you know, in Vancouver. One of the doctors that cofounded that site is also the head of the Provincial CDC – the equivalent of the U.S. Centers for Disease Control there in Canada. They gathered excellent data and were trying to do harm reduction. The first was in Vancouver and it existed on the sly for many years. The police would shut it down and then they would open it back up and eventually as you know, the Canadian Supreme Court unanimously ruled that it should be allowed to stay open. After that you started to get a number of other sites around Canada. The Montreal site that I visited was amazing. It is open roughly 12 – 14 hours per day and paid for by the Montreal City Government. It is a clean, welcoming site with non-judgmental perspectives. If a person comes in off the street with their drug that they acquired on the street and as you point out on your show all of the time, they don’t know what is in that bag. One of the first things that the staff at this site does is test if for fentanyl. So before the person even uses the drug, they know if it has fentanyl in it or not. They are also given clean needles, syringes, and paraphernalia in general with which to use the drug. Again, the person is making their own decision about using or not using the drug. The staff is there to make sure they do it in the safest way possible and they are also given health education. There are two registered nurses there onsite the entire time the facility is open and they know how to recognize opioid and other overdoses. If they see an overdose they can immediately administer naloxone, which is the opioid overdose reversal drug and it is highly effective when used properly. They have occasional overdoses there as you would expect, but they do not have overdose deaths and I think this is a much more reasonable way to approach things than the high rate of overdose deaths that we see in this country.

DEAN BECKER: Sure. Thank you for that, Dr. Andrews. Speaking of Canada and Vancouver there was a recent headline entitled, ‘Vancouver Business Association Calls for Safe Supply of Drugs to Prevent Overdose Deaths’. You were talking about the drugs being tested for fentanyl so people don’t immediately overdose. Under prohibition drugs are suspect across the board for contamination as you indicated or quoted me that you don’t know what is in that bag.

I don’t know if you know Charles Gauthier. He is quoted as saying, “A safe drug supply is what’s needed now to truly make a difference”. That is moral from my perspective and it is human and that is compassion, is it not?

DR. RICHARD ANDREWS: I would say so but at the same time, I am evidence based and because this particular move in the area of drug policy it is a somewhat different yet relevant question in the notion of having safe injection sites. Do we want people using clean needles, or do we want them using dirty needles? Do we want them robbing people’s homes to get the money to buy a scarce commodity? It is certainly a question that should be asked and as a medical, clinical scientist I will be looking for the data on it. I don’t really have an opinion in favor or against it because I want to see what the outcomes are. If the outcomes show that you have markedly improved rates of disease and that people and society overall are healthier, than I think that should be looked at as another possibility. On the other hand, if it shows that it is not so effective or maybe even has adverse consequences then we could consider not doing that policy.

DEAN BECKER: Fair enough. I appreciate your concerns. Dr. Andrews, there is a story coming out of New Haven, Connecticut. The police up there are now going to distribute crack pipes and syringes in the hopes of keeping addicts safe. As you indicated, even the straw can communicate or transmit a disease to the next person using it. I was reading that the Houston Police Department and the sheriff are now giving people who are opioid addicted a drug named Suboxone if I am remembering correctly, to alleviate their cravings and the effects of their addiction while they are in the jail and when they leave they are given a carton or a sample of naloxone so that when they are out there on the street they won’t immediately kill themselves. You are well aware that people who have been in jail for a long period of time think they can do the same dosage or use the same amount that they were using before they were jailed and a lot of times that will kill them. Your thought there, please?

DR. RICHARD ANDREWS: Absolutely. In fact, you are the one who forwarded me some of these articles and I am so excited to see the intersection of the law enforcement community – of course you remember the law enforcement community yourself. The intersection of the law enforcement community and the public health community is a radical way of looking at things and it is so encouraging because it is not only compassion-based; it is outcomes based. We know that when the police view the drug user as somebody that may need assistance – not all drug use leads to health problems. In fact most drug use, according to the data and evidence is non-problematic but where there are people that are using drugs in an unsafe way, or who have Substance Use Disorder then we have to have policies including at the local level and the individual law enforcement officials where they are trying to look at what is most affective. Are we going to keep putting people in prison for this stuff? As you point out, they come out of prison and go back to their old habits because the infrastructure and support people who promote having a healthy lifestyle just aren’t there. I think that is a tremendous change and one that I am very encouraged by.

DEAN BECKER: I am as well. Again, we have been speaking with Dr. Richard Andrews. He is my doctor and he is also running for public office here in Texas. Please tell them about your venture in to politics.

DR. RICHARD ANDREWS: Okay. I realized that your show and the radio station can’t endorse me as an individual so I am not seeking that. I am running for the Texas Senate for District 13, which is in the Houston area including Harris County and Fort Bend. I encourage people to become informed about all of the candidates in the race – not just myself, and may the best person win coming up. The Democratic Primary is on March 3rd, and the General Election is on November 3rd, 2020. I encourage people to find out more about it and see who they want to support.

DEAN BECKER: What is the website where they can find out more?

DR. RICHARD ANDREWS: That is at: www.andrewstexassenate.com.

DEAN BECKER: This week instead of Name That Drug By its Side Effects, we have this very recent production by CBS Houston. The following is courtesy of KHOU-CBS Houston:

MALE VOICE1: It’s called “Gray Death”, it sounds scary and the DEA says it is.

MALE VOICE2: It’s like playing Russian roulette and you put your lives in these drug dealers’ hands.

MALE VOICE1: It’s a new super drug that looks like small chunks of concrete but can be powder-like, too. It’s made of heroin, fentanyl, and other deadly opioids. The mix makes it even more dangerous for users. This drug is being made in clandestine labs by a person with no chemistry background and with no oversight, rhythm, or reason in what they are putting in this drug.

Gray death is 10,000 times more potent than morphine. The DEA warning folks across the country after law enforcement in Louisiana discovered it just last week. Law enforcement in Houston say that it is already here, too.

DEAN BECKER: You would think after a hundred years they would quit trying to escalate the drug laws and realize it’s just not working.

A week ago a seminar was held in the city of Houston to talk about lowering the penalties and taking away the need for so many bail bondsman.

MALE VOICE: My name is C.L. Brad Bradford, I served 24 years as a Houston Police Officer, seven years as Houston Police Chief, and was on Houston City Council for six members as an At-Large Councilmember. I serve as a Special Prosecutor and Law Enforcement Liaison in the Harris County District Attorney’s Office.

DEAN BECKER: I think you are Kim Ogg’s Number One, if I am not mistaken – certainly up there near the top of her subordinates that she turns to when she needs advise. We are here today to talk about bail bonds and releasing folks on lesser charges with a ticket. Tell us how that is going to work if you would?

C.L. BRADFORD: I think the short answer is that our society has decided that offenders who commit nonviolent offenses where they pose no threat to the community and there is not a flight risk should be allowed to be released to await their time to show up in court in that they haven’t been convicted as a presumption of innocence. At the same time, in the criminal justice reform model you have to measure that with public safety. There are some people that do pose a risk to the community and those people should be held pending the adjudication of their particular trial. Low level offenders who are too poor to pay should not be held in jail awaiting trial simply because they are too poor and even some of them after conviction there are ways to hold people accountable other than locking them up where they lose their jobs, the ability to support their family, they lose their home or apartment. There are ways to hold people accountable other than locking everybody up. We have to keep those violent offenders confined.

DEAN BECKER: One of the more desperate situations that does develop with those jail stays is that the car gets towed and impounded and the fees are sometimes beyond the value of the car which really complicates their life. Am I right, Sir?

C.L. BRADFORD: Yes. We have people who make a mistake and commit a low level offense, get themselves incarcerated and they can’t make the rent or house note, the car note. As you mentioned, the car gets repossessed, the fees stack up and they can’t pay the tow and storage fee and they lose their car. Now they can’t get to work, they can’t pay rent, they can’t pay child support, and they can’t support the family. We don’t want to do that to them. That is not the right way to rehabilitate people.

DEAN BECKER: This falls on the heels of the Misdemeanor Marijuana Diversion Program, which has provided similar bits of relief from those same circumstances, right?

C.L. BRADFORD: Yes. Someone who is using marijuana, in many cases, need assistance if in fact they have a habit they would like to rid themselves of the diversion program allows them an opportunity to enter a structured program and we help get them back on the right track. The program is designed to help people whether it is counseling, treatment, etc., as opposed to just locking them up. Guess what you are going to find when you get locked up nowadays? The marijuana is in the system that you are locking them up in – it is there, too so let’s be serious about that in that you are not getting them any help at all. Let’s get people counseling, treatment, and help them get their lives back on the right track.

DEAN BECKER: I call you Chief Bradford because that is kind of where we met up and I thank you for your time, Sir.

C.L. BRADFORD: Thank you, I appreciate it. I don’t mind being called Chief, I have whelps on my back from that job and I earned this title.

(LAUGHTER)

DEAN BECKER: Thank you, Chief.

FEMALE VOICE: Sandra Guerra Thompson, I am a Professor at the University of Houston Law Center.

DEAN BECKER: We are here at the Talento Balingue de Houston and we are going to be talking about bail reform and lessening the penalties and not locking people up for minor crimes. What are you going to bring to this conversation?

SANDRA GUERRA THOMPSON: I plan to talk a little bit about the pretrial process and how it is that we ended up having a lawsuit in Houston and what the settlement will mean.

DEAN BECKER: Give us a snapshot – what is it going to mean?

SANDRA GUERRA THOMPSON: There are a number of things going on and one is that this lawsuit only had to do with misdemeanors so it has to do with the lower level offenses and under a new rule that the judges implemented, when people are arrested on these low level offenses will be released without having to pay a money bond like they used to have to pay. With a couple of exceptions where people might be detained a little bit longer if it is a second DWI, if there is already a warrant out for them, or if it has to do with family violence.

DEAN BECKER: That makes a lot of sense. Does this mean that they will be brought to the jail and then released from there or will it be a ticket on location?

SANDRA GUERRA THOMPSON: This is not cite and release but they will be released very quickly and my understanding is that most people will not be taken downtown to the jail and that they will be released from other facilities in the area.

DEAN BECKER: Now do you know when this has or will take effect?

SANDRA GUERRA THOMPSON: It is in effect now. I don’t know the exact date that it started but it has been in effect for a while now.

DEAN BECKER: Okay. Are there any closing thoughts that you might want to share with the listeners? It is a bit of progress but there is a long ways to go, is there not?

SANDRA GUERRA THOMPSON: There is and part of what is going on with the settlement is that there is a lot of data that is going to be collected and studied so there can be issues that come up that there may still be room to negotiate to make improvements. This is part of a larger movement, if you will, around the country to try to address a serious problem of people being held unnecessarily and having their lives ruined. All the affects that has from taxpayer cost to increasing criminality because when people are stuck in jail the statistics are very clear that they are more likely to commit crimes in the future.

DEAN BECKER: Yes. Well thank you for your time.

SANDRA GUERRA THOMPSON: Thank you.

I am the Reverend Dean Becker of the Drug Truth Network standing in the river of reform, baptizing drug warriors to the unvarnished truth. www.drugtruth.net.

That is going to wrap it up for this week. This might be our 8,000th program, which you can reach at www.drugtruth.net.

Once again I want to remind you that because of prohibition you don’t know what is in that bag. Please be careful.

Drug Truth Network transcripts are stored at the James A. Baker, III Institute for Public Policy. More than 7,000 radio programs are at www.drugtruth.net, and we are all still tap dancing on the edge of an abyss.

11/06/19 Richard Andrews

Program
Cultural Baggage Radio Show
Date
Guest
Richard Andrews
Organization
Dr. Richard Andrews for Texas Senate Dist 13

Dr. Richard Andrews is running for the Texas state Senate seat Dist. 13, Chicago to follow Oakland and Denver re Psychedelics? - Dr. Albert Hoffman speaks fondly of his child LSD

Audio file

TRANSCRIPT

CULTURAL BAGGAGE

NOVEMBER 6, 2019

DEAN BECKER: Broadcasting on the Drug Truth Network, this is Cultural Baggage.

MALE VOICE: It’s not only inhumane; it is really fundamentally un-American.

CROWD CHANT: No more drug war! No more drug war! No more drug war! No more drug war! No more drug war!

DEAN BECKER: My name is Dean Becker, I don’t condone or encourage the use of any drugs; legal or illegal. I report the unvarnished truth about the pharmaceutical, banking, prison, and judicial nightmare that feeds on eternal drug war.

Hi folks! Welcome to this edition of Cultural Baggage. I am your host, Dean Becker, the Reverend Most High. I am looking at a letter dated July 10, 1937. It is addressed to the Honorable Pat Harrison, the Chairman of the Committee on Finance at the United States Senate. It starts out, “I have been instructed by the board of trustees of the American Medical Association to protest on behalf of the Association against the enactment in its present form of so much of HR6906 as relates to the medicinal use of cannabis and its preparations and derivatives”, and it is signed by Dr. William C. Woodward. Later, Dr. Woodward came before the Congress and they told him that if he didn’t have anything positive to add to their efforts that he needed to leave the chamber. With that they then passed the 1937 Federal Marijuana Tax Act. Since that point in time doctors have hidden from the challenge over the decades but in recent years more and more doctors have stood forth. More and more family doctors are standing for their patient’s right to use medical marijuana. With that I want to welcome our guest for today which is my doctor, Dr. Richard Andrews, who is running for Senate here in the State of Texas. Hello, Dr. Andrews.

DR. ANDREWS: Hello, Dean.

DEAN BECKER: Thank you for taking the time to speak with us. It was protested by the American Medical Association back when they passed the marijuana laws and would you agree that more and more doctors are beginning to stand for the rights of their patients to use marijuana?

DR. ANDREWS: Absolutely. We are seeing quite a trend with younger doctors especially but also with some old farts like me. Now with several states that have legalized medical and recreational marijuana I think it will be increasingly normalized in the medical community.

DEAN BECKER: Yes, Sir. There are still those recalcitrant folks that stand in the way of the progress of ending prohibition against marijuana and I want to talk about a certain woman doctor who is also a senator in the State of Texas who stood forth proclaiming that marijuana was too dangerous for our Veteran’s to allow for medical marijuana. She stood forth stating that there was a study saying 70% of the overdose deaths of Veteran’s had marijuana in their system and it was part of the cause of their demise. Your response to that thought, Dr. Andrews?

DR. ANDREWS: Well I think an important aspect of what you just said has to do with the increasing tendency (which I think is a good tendency overall) within the medical field for there to be a reliance on data – what is called evidence-based practice. As evidence-based approaches are used increasingly then we will see an increasing number. It used to be that doctors and scientists were not even allowed to do studies on what the effects of drugs were so there has been a lot of mythologizing, and inaccurate pseudo-science regarding what the consequences of drugs are. Of course there can be consequences of drugs but that is the kind of thing that should be evaluated scientifically and then you put the data out there and it is peer-reviewed; in other words people can look at the studies that you did and contribute and then we will get a little closer to the truth I think regarding the consequences of using any drug.

DEAN BECKER: Yes, Sir. Now you are running for a senate seat in the State of Texas. This is not for this November, this is for November of 2020, am I correct?

DR. ANDREWS: Yes. The general election will be in November of 2020 that is right, then the democratic primary will be March 3rd of 2020. I am in District 13 in the Houston and Ft. Bend area, and in this particular gerrymandered district it has been heavily packed with democrats so really republicans don’t generally run in this district so I will be running in that primary and if you don’t make it past the primary then it is basically all over. It is mostly a primary battle.

DEAN BECKER: Yes, Sir. I want to go over some of the planks in your platform. I am going to read from them just a bit. Plank One: You are calling for the legalization, regulation, and taxation of recreational marijuana for adults with details to be determined a bit later which will parallel national models following a discussion with public input. Let’s talk about that a bit.

DR. ANDREWS: Sure. I was fascinated when I first learned about the different approach that Colorado and Washington took (you know all about this because this is your area). I was so fascinated by how the coalition in Colorado marshalled evidence that because marijuana is safer than people have said it should be legalized and regulated. Then Washington State’s coalition did the exact opposite and marshalled evidence that said that because it is so harmful it needed to be legalized and regulated. In a sense, they were both right. Certainly there is no such thing of a drug with no side effects and that includes recreational drugs as well and we shouldn’t be naïve about that. There are safe ways to use any drug, of course, and we want people to be educated on that and when things are either legalized or decriminalized the atmosphere that results in society makes it much easier to have proper health education and drug testing so that people are not getting Fentanyl in their drugs. I think that is just a much healthier climate for us to live in as citizens.

DEAN BECKER: You know, Dr. Andrews, coincidentally just today there is an Op Ed that is appearing in The Hill. It is by my good friend, Mr. Paul Armentano, he is one of the most knowledgeable people about cannabis. He is Deputy Director of the National Organization for the Reform of Marijuana Laws, but the title of his Op Ed is, Most Physicians Support Access to Medical Cannabis – Why Doesn’t the Federal Government? That is a pretty good question for you, Dr. Andrews, why doesn’t the federal government?

DR. ANDREWS: Well of course the history of anti-drug laws goes back so far and started with the Federal Narcotics Bureau or even proceeding that with the international laws that the U.S. was party to so after alcohol prohibition was lifted they doubled down on all of the other prohibitions and then instead of having the massive prohibition bureaucracy in Washington, those people had to find other kinds of work so they found it in the prohibition on other drugs and that has simply persisted. The Federal Narcotics Bureau then became the Drug Enforcement Agency (DEA) and although it has some beneficial aspects, to this day it is still the face of federal drug policy and their approach is frequently non-scientific and strictly police oriented. They will find a few doctors here and there to support their particular line but they really are not evidence-based in their approach to the whole thing.

DEAN BECKER: I have often used the parallel that it is like asking your barber if you need a haircut when asking the DEA about the drug laws because that is their Bailiwick.

DR. ANDREWS: Yeah. That is right.

DEAN BECKER: Now going back to some of the planks in your platform. Plank Two: You talk about legalization and regulation of medical marijuana, THC, and CBD for adults and I think that parallels with plank number one so I am going to skip to Plank Three, which talks about the decriminalization of all other recreational drug use and simply possession with details to be determined and that is kind of taking the Portugal model on, which I think is a vast improvement. Your response, Dr. Andrews?

DR. ANDREWS: I think when people first hear the idea of decriminalization of all drugs – in fact when I first heard the term it raised my eyebrows as well. Once people realize that what the word decriminalization means is that you are not going to put people in to prison for simple drug use and simple possession. As a family doctor and a public health professional, I have to look at what are the health consequences to the individual and to society of putting people in prison and of course there are huge implications for that. Of course it is mostly black and brown people that get put in prison for drugs and so really all you are saying with decriminalization is that we don’t think putting people in to prison is the way to go. There are roughly 26 countries around the world with Portugal being the best known, but there are 26 other countries that have decriminalized drug use including Spain which is right next door to Portugal. You and I have both visited Portugal and I have looked at their model. It wasn’t as simple as just decriminalizing; they decriminalized with a lot of public input. They took the resources that were going in to the police approach and put some of those resources in to enhanced health care, social services, and outreach. Since then their rate of new infections related to unsafe drug use from HIV, Hepatitis B, and Hepatitis C in particular have all dropped steadily in the 18 years that they have had that decriminalization policy.

DEAN BECKER: Folks, once again we are speaking with Dr. Richard Andrews. He is running for Senate in the State of Texas. Dr. Andrews, is there a district or is it just open voting for a Senate seat?

DR. ANDREWS: It would be great if other people in Texas could vote for me but no – it is District 13 here in the Houston and Ft. Bend area. It is a heavily gerrymandered district with weird boundaries. We need to get rid of gerrymandering as well, by the way. District 13 includes most of the main downtown area where all of the big buildings are as well as the entire medical center and a variety of other communities in the south and southwest portion of Harris County and nearby Fort Bend County.

DEAN BECKER: Okay. Just last month I went up to Oklahoma where they have just legalized medical marijuana and the have a great program. They are also doing something with is Number Four on your platform list; they are expunging criminal records for many marijuana users for simple possession because many times that stands in the way. It is a black mark; a means whereby you are denied credit, housing, education, a job. It is what drags people back to the black market, is it not, Dr. Andrews?

DR. ANDREWS: Absolutely it is. When people feel hopeless because they can’t get a decent job that is precisely the kind of disconnection that leads back to excessive and unsafe drug use. It seems perverse really not to expunge their criminal records once we have concluded that it is inappropriate for people to go to prison for it then it only makes sense that we would expunge those criminal records for these charges.

DEAN BECKER: Dr. Andrews, I agree 100% with that caveat. With regard to your platform, item Number Five: You are calling for significantly expanded state support for addiction treatment and I am all for that where it is needed but I think you are well aware that I also think there is a moral connotation that some people use these drugs without much if any impairment to their life and their lifestyle. Your response to that thought please, Dr. Andrews?

DR. ANDREWS: We know that the U.S. gathers large amounts of data in a well-regarded telephone survey every year for the last several years going back decades, really. Although the federal government does put that data out there, the graphics that they include are not very user-friendly. You and I would both encourage people to go to the Rice University’s Baker Institute on Public Policy which is at: www.bakerinstitute.org where they have made the data from those federal surveys on drug use much more user friendly and we can see that the data is very clear in that the vast majority of drug users do not show evidence of addiction. So the number of people with any given drug that actually get addicted to it; that is to say they have a dependency, and they end up having some problems with it. If perhaps on the order of 5% or less for virtually all drugs so the great majority of drug users are casual or intermittent users. However, for those people I recently got qualified to treat addiction and there are some people who genuinely would like to stop using a drug every single day because it gets in the way of things. That is why I think the small number of drug users who do get addicted should have treatment options for that when they request it.

DEAN BECKER: Yes, Sir. I think that ties in to your platform item Number Six: You are calling for mandates for adequate coverage of addiction treatment by public and private insurance in Texas, because many times when people hit that low spot they want to get in to treatment but there is not a bed available and they fall back in to the pit, so to speak. Am I right?

DR. ANDREWS: Yes, you are exactly right. I think it has gotten better honestly after the Affordable Care Act, or so-called Obama Care, but of course we all know what is happening these days with Obama Care in terms of efforts by the current government to restrict access to so many people which is a disaster.

DEAN BECKER: Yes, Sir. Platform item Number Seven ties in: You talk about monitoring and appropriate regulation to reduce or eliminate the widespread fraud and poor care seen in the private addiction treatment industry. That has gotten better over the last few years as well but it use to be a real hodgepodge with addicts treating addicts, did it not?

DR. ANDREWS: Yes. Of course one of the most famous aspects of that is the so-called “Golden Liquid”, as urine becomes incredibly valuable because they vastly overcharge for drug testing and will order drug testing on the urine even when it is not called for and then charge a lot of money for it. So that raises everyone’s premiums when it is private insurance or raises costs or reduces resources for the public forms of insurance so there should absolutely be appropriate regulation for that and not just to save money but to make sure people who need treatment are getting quality treatment and not just being charged money.

DEAN BECKER: Yes, Sir. Your platform item Number Eight: You are calling for an emphasis on harm reduction and use of evidence-based methods in addressing drug use and drug addiction rather than the 100 year old punitive approach that has been in place that just stigmatizes drug users and addicts and casts them aside so to speak. Right?

DR. ANDREWS: Yes. Absolutely. I was so struck when visiting Portugal and every year now I attend a medical conference which is fascinating because it is a medical conference on Hepatitis (I treat Hepatitis B and Hepatitis C), but it is not just a medical conference. It is the intersection of Hepatitis care in drug users specifically and there are people who attend this conference from all over the world. It is so fascinating to see all of the wonderful models from all over the world recognizing that people who use drugs and whether they are addicts or not. They are members of the community, they are neighbors, they are loved ones, they are parents, they are children, siblings and friends and they deserve to be treated with respect. We then need to implement policies that allow them to avoid harm. So when you have destigmatizing policies and environment then you can approach these marginalized communities with needle exchange programs, education on how to avoid using things in an unsafe manner, and screening for various infections. It is just a much healthier approach for everybody.

DEAN BECKER: Once again folks we have been speaking with Dr. Richard Andrews. He is running for Texas Senate, District 13. I should have said at the beginning of this program that Dr. Andrews is my doctor. I recently went to his office where we were determining if I had Hepatitis C or not. If so, we are going to treat it and cure it. That is a large part of his work as I think he just indicated. It also brings to mind that many people steer clear of doctors. I admitted to Dr. Andrews that I am not that trusting of the industry. I do the weekly Name That Drug By its Side Effects segment and I must fess up. I came in and had a blood pressure of 148/90, which is not good as I now understand and you prescribed for me these five milligram Lisinopril which seems to be working. I am down to about 125/78, which I think is a more normal number. The point I am trying to get to is that many folks have become untrusting of the medical industry because they have allowed for too long for these drug laws to run rampant on our country. I am just glad to hear that you, Dr. Andrews, are standing tall and doing good work, perhaps even keeping me around for a few years longer. Do you have any closing thoughts, Dr. Richard Andrews?

DR. ANDREWS: I just want to say that we need to make sure we address the overdose epidemic and we need to make sure that Naloxone (the reversal drug for opioid overdose) access is increased in Texas so that it is affordable. Most of the forms of Naloxone are extremely expensive; which is absurd when we are trying to save people’s lives. We can get to a point where overdose deaths are really rare which is the direction we need to move in so that people don’t suffer the ultimate harm from unsafe drug use and criminalization.

DEAN BECKER: Your response brings to mind one last question. It has been my focus, hope, and ambition to educate and embolden our city council, the mayor, the county commissioners and others to investigate the possibility of opening a safe injection facility here and at the very least a needle exchange program to help cut back on diseases and deaths that occur as a result in this prohibition. What is your thought on that, Dr. Andrews?

DR. ANDREWS: I am glad you mentioned that. In fact I just visited a safe injection site in Montreal, Canada just a few weeks ago in connection with going to this conference I mentioned and it was remarkable! They had two registered nurses there so when people come in off the street with their street-acquired drugs (which is a different issue of course), they can then do immediate testing of the drug that they bring in to make sure that it has no Fentanyl making it safer for them. In the event a person does have an overdose they are immediately given Naloxone to reverse the overdose. They do have occasional overdoses in situations like that but you virtually never have overdose deaths because you have professional medical care available immediately.

DEAN BECKER: It seems that the truth is being writ larger and larger. As we mentioned early in our discussion, more and more doctors are standing tall. They hear their patients are using cannabis and it doesn’t frighten or concern them very much because often times it is seen to have some benefit as well. Dr. Andrews, is there a website with contact information and any closing thoughts?

DR. ANDREWS: Sure. People are welcome to go to my website or the campaign, which is www.andrewstexassenate.com, we are adding to the website as we go along it is relatively new. You can also connect with me on Twitter where I will be making comments about this topic and others.

DEAN BECKER: Well that is a wrap with Dr. Richard Andrews, but I must say that following my discussion with Dr. Andrews, he got back the lab reports and it turns out that I do not have Hepatitis C. As he mentioned in our discussion it is rather easy to cure these days. We talked about the fact that there is a good chance I had it back when and that a lot of folks who quit drinking alcohol are able to cure it by themselves.

I was doing the wrong thing back in the late 60s and early 70s, sharing needles with all kinds of folks. I am just a lucky fella.

It’s time to play Name That Drug By its Side Effects! Works directly on the brain by interfering with neurotransmitters and dopamine levels. Because of drug prohibition this product is made with over-the-counter cold medicine, hydrochloric acid, drain cleaner, battery acid, lye, lantern fuel, and antifreeze. Times Up! The answer: Tina, Chalk, Go Fast, Zip, Chrystie, Crank, Speed otherwise known as methamphetamine hydrochloride.

The following is taken from Hoffman’s Potion, produced by the Canadian Film Board:

NARRATOR: In the 1940s, Dr. Albert Hoffman discovered a substance that had a profound influence on the way science viewed the human mind. Lysergic acid diethylamide (LSD).

DR. HOFFMAN: I think the possibility to have a psychedelic experience is inborn. These psychedelics have very similar compounds that are in our brain. A lot of the compounds that you find in the plant kingdom are so closely related chemically to specific brain patterns which we already have. We speak about the paradise of childhood when I have a vision and a beautiful experience as a child this is normal because we have these compounds already.

I was walking on a beautiful May morning suddenly I stopped and I had the feeling everything had changed – the world was beautiful. Beautiful green and I had the feeling that somehow I got the feeling I saw the world as it really is. I got the feeling I would be included by it and a feeling of happiness I had never felt before. This gave me the security that if you have open eyes you may see the world in a different way; I mean you see it as it really is – wonderful.

DEAN BECKER: That was the voice of Dr. Albert Hoffman. Dr. Hoffman died a few years back but he was well over the age of 100 years old when he passed from this earth. If LSD was so bad for you well how in the hell did he last so long and remain so intelligent? It has now been reported that Chicago is thinking of following in the footsteps of Oakland, which became the second U.S. city to decriminalize magic mushrooms and other psychedelics falling on the heels of what they did in Denver. The truth is coming out; these drugs are safer than even marijuana and it is time to get over the hysteria and the bullshift.

Again I want to remind you that because of prohibition you don’t know what’s in that bag. Please be careful!

To the Drug Truth Network listeners around the world, this is Dean Becker for Cultural Baggage and the unvarnished truth. Cultural Baggage is a production of the Pacifica Radio Network. Archives are currently stored at the James A. Baker III Institute for Public Policy, and we are all still tap dancing on the edge of an abyss.

02/27/19 Richard Andrews

Program
Cultural Baggage Radio Show
Date
Guest
Richard Andrews
Organization
Marijuana Policy Project

Dr. Richard Andrews is a Houston family doctor who is co-chair of the National Task Force on Hepatitis B. He has a particular interest in the overlap between drug use, drug policy and hepatitis. + Matt Simon of Marijuana Policy Project regarding progress on drug laws in New England.

Audio file

CULTURAL BAGGAGE

FEBRUARY 27, 2019

TRANSCRIPT

DEAN BECKER: Hello, my friends, welcome to this edition of Cultural Baggage. I am Dean Becker, the Reverend Most High. This past Sunday I went to church, or rather to The Oasis to hear my doctor, Doctor Richard Andrews, give a talk about addiction.

RICHARD ANDREWS, MD: One of the definitions of addiction is that it's a chronic relapsing brain disease with compulsive drug seeking and use despite harmful consequences.

Now that's a key part of the definition, and typically that is in fact part of the definition, and so that kind of raises the interesting philosophical question: if you have compulsive drug use without harm, is that still an addiction?

And I'm not saying I have the answer to that, I've just -- it's something that I'm trying to figure out also.

Now, if you, sometimes it's highly contextual, though, you know, whether something is harmful or not is highly contextual. Whether you even are compulsively using it or not is highly contextual, and this has been shown extensively in the scientific literature, in fact.

But if you're rich versus poor, are you more likely or less likely to have harmful consequences? Well, again, it depends on the circumstances, you know, but, I would say that in general the poor are perhaps more likely to have harmful consequences.

And, in diabetes, is compulsive insulin injecting a disease? You know, it's an interesting question, and, so now here is, and I apologize for the slide being a little bit too busy and the letters are a little bit too small, but I'll review it.

So, and you see in parentheses there, or perhaps you can see it, the older terms for these phrases, in other words, loss of control, there are three different categories, loss of control, physiology, the effects on the body, in other words, and consequences. Those are the three areas in which you may have, you know, you can describe certain things about the person who has come to you for assistance with this.

They are using more drug than they intended, they're unable to cut down. Giving up certain activities that they used to enjoy, craving.

On the physiology side, experiencing tolerance. Now tolerance, unlike the tolerance here at Houston Oasis, in this case tolerance refers to the need to increase your dose of the substance in order to keep experiencing what you were experiencing before.

This is a natural phenomenon with some drugs, and with some people. Even with opioids, it does not occur universally. Sometimes it occurs and sometimes it doesn't. I've, you know, one of the most common reasons people go to doctors is for pain of one kind or another, and there are various different ways to approach pain.

I like to start with what are called non-pharmacologic approaches, which is to say, are you getting enough sleep? Do you need to get some more exercise? Issues like that.

And, but, you know, occasionally, the most effective medication to use is an opioid medication, and when used appropriately and monitored, they tend to be extremely safe, and I've had a number of patients go for years at a time on the same exact dose of an opioid and never change the dose, and they do fine, and it's still helping with their pain.

So, unlike what you might hear, it is not the case that everybody has tolerance with opioids and with other medications. That simply isn't the case.

Now, you do sometimes see that, especially in the case of euphoria, which is of course the most popular side effect.

And then you have withdrawal, in which you have the opposite effects on your body of the drug itself, when you're withdrawing from the drug, you know, instead of feeling calm and having euphoria, you'll have the opposite of euphoria, which is called dysphoria, or in other words feeling bad. Instead of constipation with the drug, you'll have diarrhea. Instead of feeling calm, you'll feel agitated. So that's withdrawal symptoms.

And then on the side of consequences, you may have unfulfilled obligations, interpersonal problems, or find yourself in dangerous situations or having medical problems.

The current definition, then, of substance use disorder is that you have two or more of the things listed, and you feel distressed or you have impairment. And all of those elements are important as part of the diagnosis.

So, why does addiction happen? Well, as you might expect, this is a complicated story that is still not all that well understood. But one of the ones that I wanted to focus on, because I think it's quite relevant and it's fascinating, is adverse childhood experiences, sometimes abbreviated, or the acronym is ACE.

PTSD is sort of, it can happen to an adult or a child, and it would tie in with the, at least for the childhood part of it, tie in with the ACEs or even just a lack of positive experiences, especially in your formative years.

And there was a fascinating study done a number of years ago by people from the CDC together with the Kaiser Group out in California, where they collected data on a huge number of their patients, and they looked at certain things. You can take the study, oh by the way, anybody who would like to have a copy of the slides you can email me at sciencelover@gmail.com, and I'll send you a copy of the presentation.

But if you had childhood trauma, neglect, or abuse, an incarcerated parent, there's a whole variety of different things that constitute Adverse Childhood Experiences, and if you have a certain number of these, and certain kinds of experiences, then that correlates quite well with certain problems, health problems, that people develop, including a risk of addiction or substance use disorder.

A lower income all by itself, you know, can predict a higher ACE score. A higher ACE score predicts earlier drug use and more likelihood of having a substance use disorder, and some studies indicate that a half to two thirds of illicit drug use is explained by a, again, that would be problematic illicit drug use, not necessarily non-problematic.

I'm fascinated by the idea of evidence based policy. Now, there's a nice Wikipedia article on that. Increasingly in medicine, and this did not use to be the case, increasingly in the medical field, if you don't present evidence for your position, your position is automatically deemed weaker.

Now, sometimes good evidence doesn't exist for certain things. If good evidence doesn't exist, then sometimes you do have to fall back on other things, like expert opinion, but it would be nice, increasingly, if we would have evidence based policy.

For roughly a hundred years now, we've had prohibition against drugs, you know, and so, and yet, drug use is not going down, problematic drug use is not going down, to put it mildly. Overdose deaths are rising, and so, despite a hundred years or more of prohibition against drugs, the evidence suggests that it isn't working.

Even proponents of prohibition admit that it isn't working, but they feel the solution is even more prohibition. So, I suggest that rather than having an emotional attachment to one view or another, we look at the evidence. Just like we do in the medical field, or at least the way we should.

And should policemen, should cops be the ones who are dictating health and social policy? Again, I don't have a position one way or the other. We need to look at the evidence, and if the evidence suggests that that really was the best way to go, that putting drug users in jail for simple drug use, if that really was good, then I would be in favor of it.

When I spoke to the Portuguese police about this when I was over there, because I tried to find people who disagreed with the policy, and I, so I ended up talking to, I was able to arrange an interview with the top narcotics interdiction person in the country, and he said, look, when this decriminalization law in Portugal first passed, in 2001, I was opposed to it. A lot of my police colleagues were opposed to it.

But at this point, most of us support it. And he said, look, as a cop, I have to enforce whatever the legislature says the law is. I'm not the one who decides what the law is, that's what the legislature does.

And he said, but I'm also a citizen, and as a citizen, as a member of the community, as a neighbor, I support the law, because I have seen the benefits. And the cops, in other words, are frequently, they frequently discover that they really aren't enjoying being the, you know, the drug police.

You know, that, in other words, and I'm not talking about drug dealing, I'm talking about drug using here, but, you know, they're really not well equipped to handle addiction and overdose and stuff like that. And so frequently, police appreciate no longer being in that realm.

In Portugal, once you're deemed, if you're picked up with drugs in Portugal, and in some other places, once they determine, and they have criteria for this, once they determine that you're a user, not a dealer, then you're automatically shifted over to the health and social sector. Automatically, just automatically.

There's no decision made, all you have to do is decide user or not. If they're a user, they're automatically no longer a police issue. Drug crops are always far more profitable than any other crop, and so when you're dealing with a number of poor farmers, and they have a choice between feeding their family or not, then they're frequently going to choose the very profitable drug crop.

I remember when I went to a tobacco museum at one of the tobacco companies in Virginia, when I lived there, and I was fascinated to see a comment there that in the Virginia colonies, a few hundred years ago, you know, growing tobacco, because it was so profitable, was so popular among the farmers that the colonies started to starve to death, because no farmers were growing food.

And so the Virginia governor had to pass, they had to pass a law saying that the farmers had to grow at least five percent of their territory for food crops. They had to set aside at least five percent for food crops.

And, then, you know, in the middle of the 1800s, of course, you had the opium wars, which are fascinating on so many different levels, but, and that was England growing opium in India in order to sell it to China, and then China saying, well, we don't think that's such a good idea for our population to have all this huge amount of opium coming in, and so the Chinese tried to restrict it, and the British said, no no no, you can't restrict it.

And so England went to war with China to force them to continue to import their Indian opium, you see. And that's where -- that's why Hong Kong was in British hands for all this time, that was part of the loot from winning the opium wars. That's why it was British.

But what's interesting, too, if you go back even further than that, the reason England felt like they had to grow opium in India and send it up to China was because England got addicted to another substance, which was tea, right? The British love tea, as you know, to this day, and that's mildly addictive, and so the balance of payments with China was terrible, you know.

So China was, I mean England was buying all this tea from China, and so they decided to get another drug, and so the whole thing is interesting to me.

So, and then a little bit more, I mean, if you look at the stock market, you'll see all this, you know, breathless discussion of the best stocks to buy and stuff like that, including for the anti-overdose drug naloxone. There are a few different brands, which we'll talk about here.

Drug treatment is a huge industry, and then you have private prisons, of course, you know, one in five Americans are incarcerated because of drug use, and there's been a huge increase in private prisons and private inmates just in the last 20 years.

Very briefly here, I know I'm getting off track, is the first documented hypodermic syringe used was the guy who was the architect of Saint Paul's Cathedral in London, who apparently did a little bit of everything, and in the 1600s, he injected dogs with opium using an animal bladder and goosefeather quills, and I'm not sure if you went to this guy as your doctor, if you had to pay more for a clean bladder or, you know, or not, I'm not sure.

And then shortly after that, a German scientist tried injecting various things into humans, and that didn't go very well, and so, and since I grew up in Spain, I have to mention that the modern two-piece needle syringe combination was invented by a Spaniard.

I strongly recommend, if you're interested in this topic, that you look at the Rice University drug charts. There's a drug policy institute right here in Houston at Rice University, and that has some of the best data, I mean, it's data that is collected by the federal government, where the federal government every year collects survey data on about 120,000 Americans of all different ages, to find out how many drugs are being used and what's the pattern of drug use.

It's absolutely fascinating. I mean, you can go to the federal government website, but it's not as user friendly, and so that's why they are, they make them more user friendly here.

And so it turns out that the evidence is quite clear. This is some of the largest databases in the world for this. Turns out that the vast majority of drug use is in fact casual, occasional, non-problematic drug use.

How many people are addicted to heroin in this country? And there certainly is an increasing problem with all kinds of opioids, with unsafe use of opioids, but in terms of the actual percentage, and now this was up until 2016, was 0.3 percent of the young adult population, you know, one of the -- that's one of the key ages for addiction, is in your 20s, because the brain is still developing and what not.

And by comparison, Portugal before they decriminalized was up to around 1 percent of the population using heroin, or having used heroin, which is considered a huge percentage.

This is a picture of the opium poppy flower itself. There's actually a purely ornamental version of the flower [sic: even poppies grown in household gardens in the US are opium poppies], and opioids versus opiates, what's the difference? Well, opioids includes, is the broader term that includes both natural and synthetic products.

We have our own opioids, of course, every person here is producing opioids on a regular basis. If you twist your ankle, and then after a while you find the pain subsiding, that's your own opioids that are attaching to the parts of the brain that govern pain perception, and that's why the external opioids have an effect on our brain, is because our brain is already set up to experience pain reduction and to a certain extent euphoria.

The opiates in the plant itself, the opium poppy plant, include opium, morphine, and codeine, and as we've discussed, bagels and muffins. When you eat a poppy seed bagel, that really is from the poppy seed, from the poppy plant, and yet it does contain morphine. Okeh? That's why I asked earlier.

So sixty percent of you have had morphine in your bloodstream from eating a poppy seed bagel or poppy seed muffin, but don't worry, the amounts are tiny. Yes, it can cause a positive result on a drug test. Okeh, that's why you have to be a little bit careful about that.

And, semi-synthetic opioids include heroin and oxycodone. That's where you take the morphine molecule itself, from the poppy, and then you modify and create a different product. Heroin by the way was first created by Bayer corporation.

Fully synthetic products are methadone, fentanyl, and carfentanyl. Fentanyl and carfentanyl, because they're so incredibly potent, are causing a lot of the overdose deaths these days.

And, for medical opioids, are they safe or are they deadly? Well, a little bit of both. It's kind of like insulin. It's actually quite similar to insulin, in the sense that, if you're opioid naive, meaning you've never had opioids, external opioids, then a high dose or even a moderate dose can be quite deadly, because one of the effects of these drugs is that it reduces your respiratory drive, and then people stop breathing, and that's where the overdose deaths typically come from.

But if it's increased slowly, this is remarkable because there are very few medicines for which this is true. I remember once a few years ago I had a cancer patient come see me. Now, I wasn't a cancer doctor, I was going to help her with other issues. She was already seeing a cancer doctor, and she had cancer all over her body, as is very common.

She had a lot of pain. And, she was already on fentanyl, because her oncologist, her cancer doctor, had prescribed it, and a month earlier, the cancer doctor had said, you need to increase your dose of fentanyl.

Now, fentanyl, when it's increased slowly, there's a safe way to increase fentanyl dosage, and it's quite safe. But she was afraid, here she was with cancer all over her body, and miserable, and she was afraid to increase the dose because I might get addicted.

And so I increased her dose, I convinced her that it was okeh, she wasn't going to suffer any harmful consequences, and she needed to increase her dose. And so we did that. So, but I decided before, I had used fentanyl once or twice before, in my patients, in other words, and I decided to go back to the books, not that anybody uses books anymore, but I decided to go back to the references and reviewed safe use of fentanyl in terms of increasing the dose appropriately.

And I was reminded right there in the description of how to use fentanyl safely that there is no known upper dose limit. And this is true for opioids in general. In other words, when it's increased slowly, it's not clear, there probably is an upper dose limit, but because, when it's increased slowly and you're under medical supervision, it's a very, very safe class of drugs.

Obviously, if you're buying it on the street, as Dean Becker often says in his radio show, you don't know what's in that bag. If you're buying it on the street and it's not regulated, then you have no idea what's in the bag, and it may well contain fentanyl or carfentanyl, and that's where the deaths come from, because when people don't know what they're taking.

DEAN BECKER: Doctor Andrews went on for quite some time. We'll use some of it for 420s next week.

It's time to play Name That Drug By Its Side Effects! Agitation, paranoia, hallucinations, face chomping, lip eating, heart devouring, brain slurping, ecstasy, suicidality, zombieism. Time's up! The answer, according to law enforcement, from some crazy ass chemist somewhere: mephedrone, otherwise known as bath salts.

MATT SIMON: Yeah, my name's Matt Simon. I live in Manchester, New Hampshire, and I work for the Marijuana Policy Project, trying to make cannabis legal for adult use in New England.

DEAN BECKER: Now, and that's right, you're not just focused in one state, you kind of have a few, you're adjacent to a few states there and you're trying to maneuver things along in several states. Right?

MATT SIMON: That's right. I'm registered to lobby in five states this year, and I keep up with them the best I can. Really, the action so far has been really hot in New Hampshire, where I've lived for twelve years, so, so far that's consumed a lot of my time.

Committee I've been lobbying, the House Criminal Justice and Public Safety Committee, for 12 years, for the first time just recommended passage of a bill that would legalize cannabis for adult use. It was a 10 to 9 vote, but it was quite history making, and it's been a very difficult committee, so, that goes to the House floor on Wednesday, and it looks like it's going to pass by a good margin, and proceed.

So, we've got a lot stacked up against us in New Hampshire. Our governor is totally opposed to legalization. But, so far so good for this bill. It passed its first committee and goes to the House floor this week.

DEAN BECKER: Well, and I want to bring up the fact of the matter is, this is a result of not just work you've done this year, or last year, or, it's over the years. This is a cumulative effect, that you got, finally got 10 to 9, because those people in that committee are probably the hardcore proponents, or opponents, am I right?

MATT SIMON: It's been a very difficult committee for a long time. We've been fighting in that committee, trying to educate, for a long time, and as we've realized that some of them can't be educated, you know, some of them have been replaced over time.

So, it's an issue that's come up in this committee year after year, and through the efforts of, you know, a lot of people over a long period of time, people calling and mailing and, you know, helping turn the tide against prohibition.

We've won enough of them over to be able to get it out, with a positive recommendation, so ...

DEAN BECKER: And if I'm hearing you right, you have a governor who might be the blocker, who, and we have a similar situation in many states, Texas in particular, our governor and lieutenant governor are, you know, nineteenth century, you know, marijuana doctors, if you follow me.

I mean, they think they know everything, but, this is an example, though, that there is potential for progress, that your governor can just embrace the idea that it's good for the state. Right?

MATT SIMON: Well, our governor's not embracing that idea. It's incredibly frustrating, the governors of Rhode Island, of Connecticut, of New York, of New Jersey, of Illinois, are all asking their state legislatures to pass legalization bills, and Chris Sununu's going the other direction. He's actually invited Kevin Sabet and Project SAM to come to New Hampshire and fight us tooth and nail.

Kevin's going to be here later this week, actually. So, our governor's declared war on us, and the only thing we can do is try to override his veto in the state legislature. So fortunately we can do that, if we can get two-thirds of the House and two-thirds of the Senate, we don't need the governor's support. If he wants to be stuck in 1985, that's his business.

So, that's pretty much where we are.

DEAN BECKER: Well, folks, once again we're speaking with Mister Matt Simon. He's with the Marijuana Policy Project up there in New England. Matt, you say you, I guess, in the smaller states, you can work with three or four or five of them within a given year. Right?

MATT SIMON: Yeah. Yeah, I spend a lot of time in Vermont, over the years, and, you know, they passed the legalization of just limited cultivation and possession last January, and the Vermont Senate, this year, is going to pass a bill, this week, the House will -- sorry, the New Hampshire House will pass legalization on Wednesday, and then probably on Thursday, the Vermont Senate will pass a bill that would create a regulated market.

So, those two have been pretty busy, and then Connecticut, I think we're going to see get real busy in the coming weeks and months. You know, the legislature, the mood's really on to do this, and the new governor is very supportive, but, we haven't seen a lot of action just yet, but it's coming.

DEAN BECKER: And, this is, you know, I hear great news coming out of New York. I know that's, I guess, not your bailiwick, but the point there is that the governor and the mayor and all kinds of important folks are kind of standing tall for marijuana.

It's, I didn't know how to say this, that we can have this tide shift to impress or compel elected leaders like governors and mayors to stand forth, and others can just be so recalcitrant, and back pedaling. It's really puzzling at times. Your thought there, please.

MATT SIMON: Oh, it's certainly puzzling, and it can be incredibly frustrating, but, you know, we, we're not powerless in this, and especially as the polls continue to go our way, we have more and more leverage.

So, if we can't educate a governor or a legislator, we probably can replace that person, and, you know, it's, as long as people are patient and, you know, we're going to have rocks thrown at us, we're going to have lies told about our issue, about us sometimes, but we're right, and if we continue to present accurate arguments and data about how we're right, we will win hearts and minds over time.

And the people we can't convince, we might be able to replace. And that's how it's played out, one place after another. So, I think someday it will be obvious. Someday we'll have ended this crazy prohibition of cannabis and we'll look back and wonder why it took so long.

But, it would have taken a hell of a lot longer if it hadn't been for all the hundreds of thousands of people, hundreds, thousands, I don't know how many, but people who have written, emailed, called their legislators, people who've published letters and op-eds, people that host radio shows, people that do what they can to get the message out.

So, the tide is turning. The boulder has topped the mountain and is now starting to roll down the other side, but we've still got our work cut out for us, and particularly in state legislatures, where so many of the members are in their 70s and 80s, and just really need to be educated on this issue, in a way that isn't stuck in the 1980s.

DEAN BECKER: Oh, you're so right, and I like that thought, that the boulder has made it to the top and it's just starting to go over the edge, but it's going to pick up steam, and some of these politicians better get out of the way. That's for sure.

Well, once again, friends, we've been speaking with Mister Matt Simon, Marijuana Policy Project. Closing thought, website, Matt?

MATT SIMON: MPP.org.

DEAN BECKER: Just enough time to urge you to please visit our website, DrugTruth.net, and because of prohibition you don't know what's in that bag. Please be careful.