Fentanyl: Actually As Dangerous As They Say

Guaranteed human. - Two percent.

“That's the number of people who take the stairs”

when there is also an escalator available. I'm Michael Leister. And on my podcast, two percent, I break down the signs of Neville toughness, fitness, and building resilience in our strange modern worry.

Put yourself through some hardships, and you will come out on the other side a happier, more fulfilled, healthier person. - Listen to two percent. That's TWO percent on the eye-heart radio app.

Apple podcasts, or wherever. You get your podcasts. - When a group of women discover they've all dated the same prolific con artist. They take matters into their own hands.

- I vowed, I will be his last target. - He is not gonna get away with this. - He's gonna get what he deserves.

- We always say that trust your girlfriends.

- Listen to the girlfriends. Trust me, babe. On the eye-heart radio app, Apple podcasts, or wherever you get your podcasts. - Welcome to Stuff You Should Know. A production of "I Heart Radio."

- Hey and welcome to the podcast. I'm Josh and there's Chuck and Jerry's through two, and this is Stuff You Should Know. - A big bummery dish. - Yeah, not very joky,

because we're talking about Finth and L. And while a great painkiller, a very effective painkiller, it has sadly become the most deadly street drug in the United States. And we're gonna tell you how that happened.

- Yes, but there is a slight silver lining. It is possible that it is so deadly and so dangerous that it's actually created a decline that's used at the very least a decline in deaths from it has taken place.

So it is on the decline, at least deaths. And we'll talk about possibly why that is later on. But yeah, we'll talk about the origin of fentanyl. For those of you who don't know, it's a synthetic opioid.

First there was morphine, which is,

“I think, basically 100% processed natural opium.”

Heroine is a kind of a combo hybrid between synthetic and natural. And then fentanyl is just straight up like a dirt, like it just made up, it's an analog. And it's way more potent than anything anyone had ever seen

before when it came on the scene. - Yeah, like 100 times more potent and morphine, 50 times more potent than heroin. Created by gentleman named Paul Jansson of the Jansson company in Belgium, and it was originally developed

as an intravenous anesthetic for surgery. And they started out with a synthetic opioid as the base called Meperidine, Meperidine, I guess. And that was developed in the 1930s. And so they had this sort of Meperidine as the base.

They changed it around a little, all sort of the chemical structure a little bit because what they wanted was something that had fewer negative side effects, something that was safer to use.

And they were able to do that with fentanyl. I mean, it initially worked great. It was had a very fast onset, had a very high therapeutic index, which is how they measure like the ratio

between how effective a dose is and how you can get to a toxic dose. So if you've got a high number and a greater difference, then that's good. - Right, and one of the things I just wanted to say

that they messed around with molecularly to make fentanyl, they increased its fat solubility, which sounds like who cares. But that has two really important effects that make fentanyl what it is.

One, it allows the drug to cross the blood-brain barrier faster, which means fentanyl has a much faster onset than heroin or morphine, right? It just hits you much faster. And then it crosses back through the blood-brain barrier

more quickly, so the duration of the high that you get lasts a shorter time. So just that one little quick fat solubility made this drug what it is, because faster onset makes it addictive,

“shorter duration means that you need to do more.”

- Yeah, and then I don't think I mentioned it, but it was 1960.

It was when it first came on the scene,

Europe started using it in '63, came to the US in '68 and approved by the FDA, only by combining it with a tranquilizing drug called Drop Parodall, because they said, that combination makes it even a lower potential for abuse.

So you have to use it with that. But over time, that kind of waned in those limitations were lifted little by little

when they had cheaper generic versions available.

“And it was pretty commonly used in surgery”

and post-surgical recovery with skin patches and Los Angeles and stuff like that remain management. - Yeah, I think still today, it's the most common opioid used for anesthesia during surgery. And it's ditches sounds like madness

when you're familiar with fentanyl, the street version. But in the hands of a really well-trained anesthesiologist with hospital grade equipment, it's actually very safe. It's the fact that the stuff that you buy in the street has a very uneven, like dosages.

It means that's why it's just so deadly because you're not a trained anesthesiologist. You're not using hospital grade equipment. You're shooting up something that some dude sold you. And it's just not trustworthy in it can kill you.

Because it takes such a small amount to create a toxic dose. - Yeah, it will produce relaxation feelings, pleasure, sleepiness, you can also get nauseous, dizziness, confusion, vomiting,

urinary retention, breathing issues,

as we'll see later on, that's basically why you usually OD

is because of breathing issues. And besides the overdose risk, which is great, you could also have a heart attack, heart failure, mood disorders, immune system problems. For all these reasons, it's a schedule to narcotic

with a high potential for abuse. - Just a reminder, marijuana's schedule one. - Yeah, exactly. And most of what we're gonna be talking about is sort of the illegal illicitly produced market.

But there are fentanyl users that do get like the real stuff from, I'm not sure how they get it, whatever connection they have. And they'll just have to, you know, it's not like in a pill or a powder.

So it'll be like a patch or something that they might freeze and hold in their mouth or they might remove the gel and then eat it or inject it or something like that. But usually what we're talking about,

the really dangerous stuff is the powders and the pills that are being made illegally and either brought into this country, or being made in this country, but usually brought into this country. - Yes, and there's different kinds,

different analogs of fentanyl. Everybody just kind of puts under the umbrella of fentanyl when you're talking about illicit fentanyl, but two of them that stand out that aren't actually illicit, but they're used in the drug market is car fentanyl,

which is used, if there's no use for it in humans, they use it to sedate rhinoceros and elephants.

“And I think it's something like 10,000 times more potent”

than morphine, you can get that on the street apparently, although I think it's fairly rare. And then Sioux fentanyl is five to 10 times stronger than fentanyl. So if you, like, people aren't like gets car fentanyl,

or Sioux fentanyl, you're talking about fentanyl. - Yeah, exactly, it doesn't necessarily mean it's the same exact chemical structure. It's just sort of a catch on, like pitbull. - Sure, the singer?

- No, no, no. - Pitbull, the dog breed, which isn't really a dog breed. - I didn't know that. - Yeah, there's all kinds of carriers that people just call pitbulls.

- Well, speaking of umbrella terms in different names, I think we should talk about some of the names the DEA says that this is called and the only one I could corroborate is the last one. - Tango and cash?

- Yeah, so apparently that's fentanyl and cocaine mixed together and or fentanyl and meth and fetamine, some sort of speed, that's the speed ball. And as we'll see, that's actually proving to be a really big problem that's created

like a new wave of opioid deaths. - Yeah, well, speaking of waves, there've kind of been three, and this is just sort of an overview of the opioid addiction crisis in the US

that's been going on for 10, 15 years.

The first wave was in the '90s,

and that's when you got prescription opioids from your doctor, those really rose dramatically because they do a really good job. But that's also in lockstep with fatal opioid overdoses. They doubled between 99 and 2010.

And 2010 was when things started to change for a second wave because the government was like, you can't be writing on these prescriptions like this to doctors and to manufacturers, like you got to change your formula,

it's like this stuff is way to readily abuse. So you got to do something. - Yeah, and this is really well portrayed in the Limited Series Dope Sick.

“Can't remember if it's on HBO, I wanna say.”

You saw it right? - I didn't see it. - Oh man, it is really good. But it's about the Sackler family in Purdue, Pharma,

hooking America on OxyContin. - Yeah. - And it's a really good series that just punches you in the gut, but it's really well done.

And it covers all that period.

“The problem was, and this is covered a little bit too”

toward the end, when you take people's OxyContin away and they're hooked on OxyContin and opioid, they're going to a lot of them are at least turned to whatever opioids are available. And that meant that a lot of people

who otherwise would have never tried heroin

took up heroin because they couldn't get OxyContin anymore. - Yeah, and that was the second wave and it's fatal overdoses of heroin because of that largely quadrupled between 2002 and 2013. The third wave is when we're kind of mainly

going to be talking about that started in about 2013 and mainly centers around illegally, illicitly produced, fentanyl and all the various harmful ways it can find your way into your body, sometimes even if you don't want

to be taking fentanyl. - So yeah, so that third wave, the fentanyl opioid death wave or fentanyl driven wave

“that vastly outstrips the death rate from the first two waves.”

- Yeah. - So I think in 1999, so this is when people are starting to take opioid prescriptions, there were two opioid overdose deaths per 100,000 people in the United States, that was 1999.

2013, the second wave is going on, that was up to eight.

By 2022, when the third wave is in full swing, it was 25 people per 100,000 people in the United States that were dying of overdose deaths from fentanyl. - Yeah, in 2022, deaths from fentanyl alone were 76,226 people or 69% of total overdose deaths.

- And 90% of the opioid overdose deaths. - Yeah, apparently. - So it was the problem. - For sure. - And apparently I was like,

well, what else is anybody doing on, it seems that meth has created a new epidemic of overdose deaths that everybody's like, what the hell's going on? - Yeah, well, fentanyl has hit such a high that it's actually had a real impact on US life expectancy.

It takes a lot to change a number like that, but fentanyl seems to have done it. And 2022 only opioid-related deaths resulted

in 3.1 million years of loss life,

because a lot of these users are young and if you OD it, 22, they calculate the average lifespan and do the subtraction and that's your number. So that, a lot of middle-aged white people without a college degree are the victims so much so,

and this is startling, but from that class, middle-aged white people without a college degree, they are dying earlier on average than their parents did. - Yes. - That's not how it's supposed to work.

- That's just not how it has worked unless the United States is in war essentially. And we're talking a lot about the US, but the UK and Europe, sorry, UK, tracks fairly closely,

although the numbers are lower, that it seems to be following a similar pattern, although I think in some countries, I think Estonia is one of them. Like you can't even get heroin anymore.

Everybody's just doing fentanyl. - Yeah, well, here's the deal, though, is researchers have looked at these numbers.

“I think they declared this a public health emergency in 2017.”

And what they're finding is, and this has been co-operated from other surveys and metadata studies and stuff, is there aren't more overdose deaths because more people are using it?

It's not just like, oh, well, more people are doing it, some more people are dying. It seems like it's because this stuff is more dangerous, it's getting in places that it shouldn't get, because usage has actually declined some

over the past eight years, right? - Yeah, I think the first two waves were driven by larger numbers, increases in people using prescription opioids and then heroin, so that accounted for it, but when fentanyl came on the scene,

yeah, people stopped using it as much, but their deaths just increased, which if you look at it from a distant outside perspective, like it's just because it's so potent, and it was rolled out or introduced to the drug supply

in a really horrific way as well. - Yeah, yeah, for sure. It also sort of goes and locks up with the income disparity in the United States, and the decline in fortunes for a lot of people

in this country. Overdosing is basically what the college is a disease

and when they're down or depressed,

“or having really hard times, a lot of times,”

drugs can be a distraction, or if you are a casual drug user or could get worse during that time, and they found in 2017, they studied counties in the U.S., and found that those with the lowest social capital, meaning networks that can help people

with financial security and achieving goals, they had the highest rate of overdose.

- Yes, so social capitals basically

the size of your local co-honest chapter. - I knew you'd get a joke in there. - So, yeah, this whole thing kind of rose in lockstep, opioid overdose deaths rose in lockstep, which is these financial crisis that the U.S. found itself

been over and over again since 2008. Job loss, loss of manufacturing jobs, just all of the hardship that the United States has gone through since then, opioid deaths kind of tracked with it, especially with people, basically more people turning

“to that kind of thing as a disease of despair.”

Which is just sad, it's just nuts that you can kind of connect those two things. - Yeah, should we take a break? - Yeah. - All right, we're going to take a break,

and we're going to talk about the rise of fitness right after this. (soft music) - Two percent, that is the number of people who take the stairs when there is also an escalator available.

I'm Michael Easter, an on my podcast, 2 percent,

I break down the signs of mental toughness, fitness, and building resilience in our strange modern world. All be speaking with writers, researchers, and other health and fitness experts, and more, to look past the in practical and way to complex pseudo science

that dominates the wellness industry. - We really believe that seed oils were inherently inflammatory. We got it wrong, many of the problems

“that we are freaked out about in the world”

are the result of stress. - Put yourself through some hardships, and you will come out on the other side, a happier, more fulfilled, healthier person. - Listen to 2 percent, that's TWO percent

on the I-Hart Radio app, Apple Podcasts, or wherever. You get your podcasts. (upbeat music) - There's two golden rules that any man should live by.

Rule one, never mess with a country girl.

He plays stupid games, you get stupid prizes. And rule two, never mess with her friends either. We always say that trust your girlfriends. - I'm Anison Field, and in this new season of The Girl Friends. - Oh my God, this is the same man.

- A group of women discover they've all dated the same prolific con artist. I felt like I got hit by a truck. I thought how could this happen to me. - The cops didn't seem to care.

So they take matters into their own hands. They said, oh hell no, I vowed. I will be his last target. He's gonna get what he deserves. (upbeat music)

- Listen to The Girl Friends, trust me, babe. On the I-Hart Radio app, Apple Podcasts, or wherever you get your podcasts. (upbeat music) - Hey, I'm Nora Jones, and I love playing music

with people so much that my podcast called Playing Along is Back. I sit down with musicians from all musical styles to play songs together in an intimate setting. Every episode is a little different,

but it all involves music and conversation with some of my favorite musicians. Over the past two seasons, I've had special guests like Dave Grohl, Lavey, Mavis Staples, Remy Wolf, Jeff Tweedy, really too many to name.

And this season, I've sat down with Olesia Cara, Sarah McLaughlin, John Legend, and more. Check out my new episode with Josh Grobin. - You even did the Phantom at that point. - Yeah, I was definitely the Phantom and that.

- That's so funny. ♪ Shall we stay with me tonight ♪ ♪ Each morning ♪ ♪ Say you love me ♪ ♪ You know I ♪

- So come hang out with us in the studio and listen to playing along on the I-Hart Radio app. Apple podcasts, or wherever you get your podcasts. (upbeat music) - So one reason we've seen a surge in overdoses

the Iron Law prohibition that was coined in 1986 by an economist named Richard Cowen.

And it's basically saying that, hey,

if you ban something that people like doing, something's gonna come along, and it's probably gonna be a stronger version. The reason they call it the law prohibition

“is because that's what happened when people were like,”

"All right, you're gonna take our beer, we're gonna start making gin and our bathtubs "and moonshine out and the woods." And the rise of crack in the 1980s, the same thing, and they're basically saying,

"Finternals basically the same deal." - Yeah, and not only more potent, but the fact that it's more potent means that less of it can generate just as much cash, which also means it's easier to smuggle, too.

And like you said, fentanyl tracks exactly the same way. It's really easy to make. I mean, apparently you just basically, if you have the precursor chemicals, you're just making a stew and a pot

that you're stirring, you dry it out and there you got a bunch of fentanyl. So it's easy to make. You don't require tons and tons of agricultural workers and tons and tons of acreage to grow poppies

that you process into heroin. And because the potency is so much more, there is a huge cost benefit. Apparently, it just accrues to the dealers though. There was a study in the journal addiction from 2020

that basically wanted to find out

why was fentanyl introduced? Was it users who were like, "Hey, heroin's great, "but we need something way dead, Lear." Was it dealers who were like, "Hey, heroin's great, "but this stuff I can heroin with."

And like, I'll make a lot more money or it was at a combination of them too. They didn't say definitively, but they made a pretty good case that it does seem to have been the dealers looking to cut costs

because those cost or those savings weren't passed on to users. - Yeah, it's not like, "Hey, we're making the drugs cheaper now, "so we're just gonna give you a break on this." There was one study that found between 2013 and 2021. The percentage of heroin that had fentanyl rose

from less than 1% to 40% over what is that? Eight years, and of course, that's gonna lead to a huge number of overdoses because you've got these batches that are coming out that the potency has got a pretty dramatic range from one batch to another sometimes.

“And then, for a long time, I think the word is finally out now.”

And we're gonna talk about that a little bit later, but people that were heroin users thought they were getting heroin and knew how much heroin to take safely. - Yeah, and one reason why is because these dealers were saying,

if I sell you heroin mixed with fentanyl, I have to use less heroin 'cause it's gonna be just a potner more potent, but it can charge you heroin prices, even though I'm paying way less for the fentanyl that I'm using here.

And yeah, people were caught by surprise. The fact that it was duplicitous is just awful because it's like, hey, good luck getting acclimated to this, it's gonna be a rough transition. But if you look at it from a business standpoint,

the rollout of fentanyl into the American and European drug supplies had terrible marketing. Like it had zero marketing. It was just all of a sudden there. People started dying and it took the authorities

investigating what the heck was going on for people to figure out that it was fentanyl. That's how it was introduced. It was just so reckless. And I mean, I'm talking about heroin dealers

being even more reckless than they normally are.

“That's what happened with fentanyl being introduced.”

It just suddenly popped up. No one said anything about it first. - Yeah, and by the way, when I said, safely do heroin, I'm hope unclear

that there's doing heroin is never safe.

I just meant heroin users would know how much they can take without overdosing. - Right. - Okay, I just wanted to make sure people do what I was talking about.

- I think that was worth mentioning, yeah. - Okay, good. So the other, you know, problems with fentanyl is that it has a really intense rush when it's first used.

Apparently it's more of a head rush than a body rush. So it can be a little more. You can be a little more active as a user than maybe doing heroin and just like passing out in your couch for hours and hours.

It's also dangerous 'cause the high is only an hour or two. So, you know, heroin high lasts longer. So that short duration is gonna have people using more frequently. And every time you use fentanyl,

it's just another chance to overdose, basically. - Yes, it's a great point. Yeah, and that has to do with that fat solubility again. I said it before and I'll say it again. - Yeah, I mean, it can happen like a fentanyl overdose

can happen in seconds, right? - Yes, because the onset is so quick, which makes it, that's another reason that it's so deadly, too, is you don't have time to be like, oh man, there's froth around my buddy's mouth.

I better call 911 'cause there's good Samaritan laws in my state. It's like, oh, my buddy just injected fentanyl and now they're dead.

but compared to heroin it is.

“And yeah, I think it's measured in like seconds.”

- Yeah, it certainly can be. Oh, another thing that makes it more deadly is that people started changing how they used it. Among people who died from illegal fentanyl overdoses, the portion who injected dropped 42%

over just a two year period between 20 and 20 and 22. And they generally started smoking it, that jumped at 79% I believe people also can snort the powder, but just the fact that people aren't injecting it as much kind of, you know, if you connect the dots,

somebody might dive into using it a little quicker if they're like, hey, just snort this thing instead of, hey, shoot up this thing. - Yeah, 'cause that's a big barrier for a lot of people who are like, I like drugs,

but I'm not gonna stick a needle in my arm. That just seems like such a horrible road to go down

that it'll give people second thoughts,

but smoking something, geez, I like marijuana. I like smoking crack. Am I as well try smoking fentanyl?

“It's just much less of a barrier to overcome.”

- Yeah, and if you're smoking it or snorting it, it doesn't stay in your body as long as if you shoot it. So again, just another case of it, wears off quicker and you're gonna wanna use it again,

and that's just another overdose opportunity. - Yes, yeah, I mean, it's crazy if you think about it because most other drugs that you smoke, you could conceivably overdose on, but fentanyl, even though you're smoking it

and not injecting it, there's still a really good chance that you could overdose and die from just smoking it. That's kind of mind-boggling, but it's accurate. - Yeah, and we're talking about smoking it

and snorting it and powder in a bag kind of stuff. But the real danger now and the real problem, all of it is of course, but the real real scary thing is the fact that these are generally sold and the U.S. seizes pills.

I think by late 2021, more than a quarter of the fentanyl seized was in pill form. And a lot of these pills are they look like something else. You hear stories on the news about a kid that did not wanna take fentanyl

that thought they were taking something else and it ended up being either laced with fentanyl or largely fentanyl and they overdose without even knowing they took it. - Yeah, and it's kind of hard to wrap your head around

like why would somebody send you that? Like how evil could you be? But apparently, fentanyl pills are very frequently created to look like old oxycontin what are called M30s.

So it would be very easy for somebody to be like, oh, cool, here's an oxycontin. A fentanyl users know what they're doing but if you didn't or a fentanyl user and you just wanted an oxycontin,

“that's how you could buy of an overdose.”

Very quickly. And like you said, those are the stories that you hear on the news. I don't think it's a very frequent thing but when it does happen, it's just a horrific.

- Yeah, for sure. Or if you say you want to use some cocaine, you're like, hey, that's my thing. Do it every now and then on a Saturday night. I'm gonna get some of that stuff for the same reasons

heroin is cut with fentanyl cocaine can be as well. So that's not even the same kind of high. You're looking for cocaine.

You may never in your life have taken anything

like morphine or heroin. And all of a sudden, you're snorting fentanyl without knowing it and you're on the floor. - Yeah, just a reminder. Speedballs are what killed.

Not just Chambalushi, but Chris Farley as well. And apparently this is that fourth wave that we were talking about of speedball in fentanyl with cocaine or with meth. And it's not just where dealers are cutting it

and not telling their buyers, the buyers are seeking this out. - Yeah. - And apparently this fourth wave has kind of caught black Americans up into it more than the other previous waves have. - Yeah, really? - Yeah.

All right, well, I guess we can talk a little bit about where it comes from, a lot of it that's muggle into the U.S. was originally made in China. But in 2019, China said that you cannot produce herself fit in all anymore and some people stop doing it,

but a lot of manufacturers continue doing so sometimes through legit means that made it very easy to ship. But then they also turn to the black market to ship directly to customers in the U.S. in Europe. Or, hey, let's ship the stuff over to Mexico

and these cartels and they can just kind of put it together there and work as the distributor for us. - Yeah, so the cartels are getting these precursors. They're turning around and distributing the precursors to cooks who I read like a univision story on stuff.

'Cause they just, I guess we're interviewing some random

It was like 320 year olds who were just standing out

on the woods under a black tarp with a pot on top of a fire just stirring it. Like it was really easy to make. And then that stuff goes back to the cartels to smuggle across the border and sell.

- Yeah, another myth we can kind of bust here as far as where it comes from is that in recent years there have been politicians that have tried to link the influx of fentanyl in the United States to illegal immigration.

And there was a poll in 2022 that found that 40% of Americans believed that most fentanyl entering the country was being smuggled by illegal immigrants basically.

“And that's not true. The truth is is that most of this drug”

comes through legal points of entry. And when it does, it is smuggled in in vehicles driven by US citizens. - Yeah, most often American women and I think the Kato Institute did a study

where they found 86.3% of convicted fentanyl smugglers are American citizens. So that seems to be totally untrue. - Yeah. - And apparently this is a measure of how bad fentanyl is

because I mean, Chuck, we're pretty fentanyl naive.

I've never done fentanyl.

I'm making a pretty good assumption that you've never done fentanyl and kept it as secret for me. So it's entirely possible that within this whole thing we've passed along some myth or exaggeration without being aware of it.

- Yeah. - And for that, I'm sorry. The thing is, it seems that the overall theme that fentanyl is incredibly deadly and on a level unlike any other drug

that's ever hit the US market. So much so that it's like just don't do drugs. It's too dangerous because of the presence of fentanyl.

“I think that holds and I think this supports”

that thesis in Cinelloa. The Cinelloa cartel has a ban on selling fentanyl in Cinelloa punishable by death. So if you're a drug dealer in Cinelloa and the Cinelloa cartel catches you selling fentanyl

in their state, in Mexico, where they're supplying the rest of the world with fentanyl, they'll kill you. I think that says just about everything you need to know about fentanyl.

- Yeah, for sure. Should we take another break? All right, we'll be back and talk about punishment in harm reduction, right after this. (gentle music)

- Two percent. That is the number of people who take the stairs when there is also an escalator available. I'm Michael Easter, an on my podcast, two percent. I break down the signs of mental toughness, fitness,

“and building resilience in our strange modern world.”

I'll be speaking with writers, researchers, and other health and fitness experts, and more. To look past the in practical and way too complex pseudoscience that dominates the wellness industry. - We really believe that seed oils

were inherently inflammatory. We got it wrong, many of the problems that we are freaked out about in the world are the result of stress. You're self through some hardships,

and you will come out on the other side a happier, more fulfilled healthier person. - Listen to two percent, that's TWO percent on the I-Hart Radio App, Apple Podcasts, or wherever. You get your podcasts.

(gentle music) - There's two golden rules that any man should live by.

Rule one, never mess with a country girl.

He plays stupid games, you get stupid prizes. - And rule two, never mess with her friends either. We always say that trust your girlfriends. - I'm Anison Field, and in this new season of the girlfriends.

- Oh my God, this is the same man. - A group of women discovered they've all dated the same prolific con artist. - I felt like I got hit by a truck. I thought how could this happen to me.

- The cops didn't seem to care. So they take matters into their own hands. I said, oh hell no, I vowed. I will be his last target. - He's gonna get what he deserves.

(upbeat music) - Listen to the girlfriends. Trust me, babe. On the I-Hart Radio App, Apple Podcasts, or wherever you get your podcasts.

(upbeat music) - Hey, I'm Nora Jones, and I love playing music with people so much that my podcast called Playing Along is Back. I sit down with musicians from all musical styles

to play songs together in an intimate setting.

but it all involves music and conversation

with some of my favorite musicians. Over the past two seasons, I've had special guests like Dave Grohl, Lavey, Mavis Staples, Remi Wolfe, Jeff Tweedy, really too many to name. And this season, I sat down with Olesia Cara,

Sarah McLaughlin, John Legend, and more. Check out my new episode with Josh Grobin. - You even did it in the Phantom at that point. I was definitely the Phantom in that. - That's so funny.

♪ Shall we stay with me tonight ♪ ♪ Each morning ♪ ♪ Say you love me ♪ ♪ You know ♪ - So come hang out with us in the studio

and listen to playing along on the I-Hart Radio App. Apple Podcasts, or wherever you get your podcasts. (upbeat music) (upbeat music) - So one of the things that's a little different

about the fentanyl epidemic is that it hasn't tracked closely or identically to past drug epidemics where the crack epidemic or cocaine epidemic, especially of the 90s, or the 80s or 90s, where if you were caught with it,

especially if you're a black, you're going to prison for possibly the rest of your life. This time around, it's been a little more, there's been a little more understanding that this is as much a public health crisis,

probably more a public health crisis than a crisis to be addressed by law enforcement. And one of the more cynical reasons why that's probable is because it's largely been viewed publicly as a white issue that it's mostly white people

who are overdosing and dying from fentanyl. - Well, let's say this.

“I don't remember anything growing up in the 80s”

that said, "Let's help these people addicted to crack." - No, you were just morally reprehensible and your kid was probably screwed up. - Throw away the key, is what you got. - So yeah, I don't think that's cynical.

I think that's absolutely the truth. So thankfully, they're taking a little bit different approach. We've gotten a little bit smarter about this stuff. And now we're trying to focus on what's called harm reduction techniques.

Basically, trying to keep people from dying.

A bunch of different things have been tried and a lot of it has been fairly effective as we're seeing like the numbers going down and overdoses, but distributing test trips. So if you buy a pill or if you buy cocaine or something

and you have a test trip, you can test to see if that drug has fentanyl before you use it or maybe your dealer even offers that service. - That's really something.

“- Yeah, I mean, if you want to be a, and again,”

I say reputable drug dealer with sort of scare quotes, but I would imagine that's a good thing to do is say, "Hey, this stuff is pure. I got a test trip here and you can test it to make sure that you can be a repeat customer

and not dead on the sidewalk." - Yeah, and I think that the test trips have helped a lot of people have not saved their lives the problem with them that I've seen is that all they do is show that there is fentanyl present.

It doesn't say whether it's a fentanyl analog, like car fentanyl, that's 100 times stronger than fentanyl. It doesn't say how much fentanyl is in there. So is it just a little bit or is it like a kill you sized dose?

But if you're like, "I don't do fentanyl, "those test trips are going to be quite a bit." I just want cocaine, stop putting fentanyl in my cocaine, those test trips are going to help you. And they're going to tick you off

'cause I mean, I don't think you can take cocaine back to the dealer and get your money back 'cause it had fentanyl in it. Although, who knows with kids these days? - Yeah, I mean, these newer generations

made demand return while-- - Restitution. - So another thing that they can do is, you know, there are safe places where people can go, use the drugs while people watch out for you,

the drug users themselves seem to have wiseened up a little bit, because of all the news and probably seeing their friends dive very sadly. But they may take, you know, dip their toe in the water

a little bit at first and take a smaller dose,

or they may, if they're with a group that's using, staggered the doses, so people can be standing by with that Narcan in case one of their friends passes out. - I wonder if they draw straws to see what order everybody does drugs in.

“Like how did they determine who's going to go last?”

- Any mini-mini-mini-mini-mini-mini-mini-mini-mini-mini-mini-mini-mini-mini-mini. - Okay, there you go, the age-old. - That's the traditional way. - Exactly. - But I did mention Narcan, and that is the brand name

for Naloxone, or Naloxone, and that can reverse an overdose

I don't know if it always works this way,

but one day, quite a few years ago, a car, just kind of pulled around the corner and parked across the street, and this dude got out of the car, and his girlfriend was like passed out, and it was clear that it was a drug thing.

Luckily, my cross-street neighbor's a nurse, he called 911 immediately. They showed up with Narcan, and dude, they injected that, and this girl was walking around and saying, can we leave now, like minutes later?

- Wow.

“- Yeah, I mean, it just reverses an overdose, right?”

- Yeah, but I don't mean, I don't know what happens after that. All I saw was the snapshot, where she was like, I want to get out of here, and I don't know what the laws are as far as that kind of stuff goes, but the ambulance, I don't think is allowed to call the cops on you

if I'm not mistaken. I think they're just like, okay, I guess you can go. - Yeah, I don't know the law in Georgia, or anywhere really, but yeah. - But those laws are called something, what is it?

- Good Samaritan laws. - Oh, okay, yeah, I guess it's it. - So you would be protected, but that wouldn't matter. It's more like if you're shooting up with your friend and your friend overdoses, and you have a bunch of heroin

or fentanyl on you, you can't be prosecuted for having that. I mean, I'm sure to an extent because you, just because you called for help to help your friend and the cops ended up showing up to you. - Yeah, and I didn't look this up, but can't you,

just buy Narcan? - Yeah, it's getting much more widely available. - Okay. - Yeah, but let's talk a little bit about overdoses, because there's some, one of the telltale signs,

I think it's not just with fentanyl, both heroin as well, or opioids in general, is it can produce fluid in the lungs, so that a telltale sign of an overdose is froth around the mouth or in the nose.

“What's that happens you need to act pretty quickly?”

And one of the things that they say to do first

is rub your knuckles on their chest kind of hard, 'cause it's a very uncomfortable thing to have done to you, and it can snap you out of the opioid stupor, even that. But if they don't respond, then it's your, you need to call 911 and/or administer in the lock zone.

- Yeah, I mean, in the brainstem, there are a couple of regions, the Medulla and the Ponds, and they control the depth and rate of breeding, but both of those have a lot of opioid receptors. So if you do fentanyl and they attach to those receptors,

which they will, they can change the behaviors of the cells such that they just stop working, and you just literally just stop breathing. Like, it's that simple. - Yeah, and it's even worse than that, actually,

because there's also opioid receptors in the parts of your brain that control voluntary breathing. So like when you're like, I need to catch my breath and you take a deep breath, or if you're meditating, when you purposefully breathe,

that is repressed as well. So you have involuntary breathing, involuntary breathing repressed, and this thing that detects rises in CO2 in your body, that gets repressed as well, right?

“- Yeah, so basically, if you want to take that deep breath,”

if you've since, like, you're in trouble, like, oh man, I gotta get a big breath of air here, you just do that normally, but little small increases in CO2, or since, and the corroded body, it's a little small cluster of cells in the neck.

They're gonna spur that increase in breathing to remove that excess CO2, but if that's not working, and that emergency sort of fail safe is switched on, then again, you can't even get that big breath to save yourself. - Yeah, so breathing, I think you said early on that,

that typically is where fatal overdoses derived from is just, you just stop breathing, stop being able to breathe. But there's other ways you could die, think you mentioned heart attack earlier too. - Another famous one with opioids is your gag reflex is suppressed.

So if you're basically not at off, and you throw up,

say you've been drinking as well, you're not going to choke that stuff out, or spit it out, or throw it up out of your mouth, it can just stay in your mouth, and it can go down your lungs, and you aspirate, and/or choke on your own vomit.

That's another way you can die from an overdoses as well. - I was waiting to see if you were gonna come up with like a fourth way to say, "Puking." - How would did I say a bunch of different ways? - You said like three, you like spit it up,

or vomit it up, or choke, or, yeah, it up. I was like, "We get it, the blood chunks are done." Oh God. - So as far as treatment goes, it kind of goes and locks up with what they do for heroin.

It's called medication-assisted treatment, or matte, that's kind of the gold standard. We're talking about either methadone, or, how do you say that? - You pronounce it. - You pronounce it.

- Do you pronounce mean? If you get methadone, it's gonna be done in a clinic.

which means you have to go to that clinic. You've got to wait in line a lot of times. You've got to do it there.

“The other one I believe is given in the form,”

or I guess the brand name suboxone. And I think you can get that prescribed. But a lot of people are like, "Hey, you know, "go to drug rehab and just quit doing all this stuff "because you're still on another drug

"if you're going to a methadone clinic every day." - Right. A lot of people don't have access to the kind of doctor that's going to prescribe that for them. There's a lot of, like, even among medical professionals,

still believe it or not, there's still a lot of stigma associated with being an opioid addict. - Yeah. - Which is pretty rich considering that American physicians, a significant chunk of them,

got America hooked on opioids in the first place,

but that's neither here nor there right now. So I think there was a study from 2022 that the CDC conducted, where they said that of the 3.7% of all adults in the United States who need medication

“assisted treatment, I think only about 25% of that 3.7%”

were able to get it. - Yeah. - One of the other ways that you can get off of it is to go to prison where they are just like, good luck drying out.

- Yeah. - That's no way to kick. - No, and the problem with it too is not just like, that's, I can't imagine going through that, but if you get out of prison or say you're able to get heroin

or something or fentanyl in prison after you've kicked it, your tolerance has dropped. And we talked about this in our heroin episode in 2020, but your tolerance has dropped. And so your likelihood of an overdose

is through the roof compared to what it was before you kicked heroin the hard way or fentanyl the hard way. - Yeah, so we busted the myth about illegal immigrants smuggling this into the country earlier. There was another myth, apparently police departments

kind of spread this one, that touching, fentanyl at all,

“or inhaling just trades amounts can overdose you.”

Apparently that came from a 2016 USDA advisory to claim that was possible. But this is sort of annoying because it's not, you know, generally absorbed through the skin. They have those transdermal patches,

but it's not like helping someone, like shaking somebody on the ground or something can get it into your skin that way. Or inhaling enough to overdose you is like, there's no way you would accidentally inhale enough to overdose.

- Right, but there's cases

of like first responders and paramedics suffering

from exposure to very small amounts of fentanyl. And people are like, what the heck's going on. The best explanation is that it's what's called the culture-bound syndrome. This expectation that it can happen

it leads to a nocebo effect where the person essentially freaks themselves out into a panic attack and it's there like I just had, I just OD on fentanyl just from touching a little bit of it. - Yeah.

- That's the best explanation. It makes sense. The point is like interacting with somebody who's OD on fentanyl isn't going to give you a fentanyl higher overdose.

- Yeah, for sure. Another myth, I guess a final myth that we can bust is, if you hear somebody saying like, you know, all these unhoused people on the streets, it's all because of fentanyl.

They're out, they're at homeless now. They're in your neighborhoods and this is because of this epidemic. I'm sure that has happened where people can't pay the rent and they're on the street because of an addiction like that.

Sometimes people turn to drugs after the fact if they are on house, but if you look at it on a macro level, the data shows that the reason America has an unhoused crisis like we do now is mainly because of the cost of housing. It's not drug use, it's not mental illness,

it's not unemployment even. All those things are a factor, not saying they don't count, but it's the cost of housing. - Yeah, it's crazy. Look at all the morality we associate with drugs

like it's brought in by illegal immigrants. Drug users accidentally create overdoses

in first responders and paramedics trying to help them.

It's the reason for homelessness. Like it's all, there's all moral judgments associated with all of those things and you associate it with the drug and anybody who doesn't do that drug and loves first responders doesn't like illegal immigrants

and doesn't like homeless people is going to hate that drug from that point on. - Yeah, the drug that was okayed by the FDA and that wealthy pharmaceutical families in this country got rich off of.

- Yeah, let's just say again, fentanyl is perfectly safe

It's just outside of that when cartels become involved then it becomes a huge problem. But I said at the outset, there is a silver lining or at least some hope because the use is,

well, first of all, opioid deaths are declining.

“I think they peaked in 2022 with 108,000 opioid overdose deaths”

in the United States and the numbers are in for 2024, but they think the estimate is that it's going to be anywhere between a 15 to a 20% drop in overdose deaths from fentanyl and they say, "Okay, well, Chuck, why are these fentanyl deaths finally subsiding?

What's the deal?" - Yeah, I mean, it's probably most of these things combined when you look at it on a bird's eye perspective. A lot of people say the testing strips have made a big deal. That Narcan has made a big difference.

That mat treatment has made a big difference. One reason is because drug users have gotten a little bit smarter, like I mentioned earlier. Some people are trying to avoid it all together. Some people are, like I said, dipping their toe in the pond

or making sure their friends don't overdose.

One of the saddest possible factors

is that so many people have died off. They're just aren't as many active users anymore for that reason. - Yeah. There was a, yeah, you were saying that like younger generations might have been scared away from it.

- Yeah, that's another reason. - Yeah, apparently, I thought you said that. So apparently, Gen Z is unlikely or less likely to use drugs.

“I think like 67% of 12th graders said that they abstained”

from drugs meaning that they hadn't taken any drugs in the last 30 days. And I was like, I wonder what that is compared to Gen X back when we were in high school. - Oh my God.

- And I was like, this is gonna be crazy. It is crazy, but it's the opposite way you would think. I can't remember what U.S. agency conducts this every year. But in 1993, high school seniors said that 81.7% said that they had abstained from drugs in the last 30 days.

So Gen Z is on way more drugs than Gen X was, which is very surprising to me. - Or Gen X is the generation of liars. That's entirely possible to, are you an arc man? - Yeah, I don't know.

I mean, I was a good boy growing up, but I certainly, I feel like all my friends were doing all the drugs. - I wonder if it really is, there is, it's just a lot more prevalence of drug use

because it's so easy to get it on the internet

“and it used to be hard back when we were in high school.”

- Four people, maybe. - Four people in high school. - Well, I mean, there's definitely improved international cooperation between the United States and other countries, just to reduce this supply,

that U.S. and Mexico has gotten together and they've been working together for a while now, trying to intercept those drug shipments and trying to, you know, mess up the cartel and what their activities, what the cartel is doing.

I think in 2024 last year, the amount of fitness crossing that border dropped by about 20%, so that's pretty good. - Yeah, I mean, that's pretty significant. What else?

- I got nothing else. - Well, I guess we should probably say before we end the episode Chuck, if you do fentanyl and you're addicted to fentanyl, please seek whatever help you can find to get off of it. And if you haven't tried it yet, probably you shouldn't start.

- Yeah, I'd say not even probably. Let's say definitely. - Okay. - Well, since Chuck corrected me from probably to definitely, as was foretold in 2008,

he has just triggered listen and mail. (bell ringing) - All right, there's another two-parter on disaster movies. Because we heard from two African-American listeners because I specifically asked,

like, how mad are you about the fact that black people get killed in movies and horror movies and disaster movies routinely? And that's just such a well-known trope. And we heard from a couple of faithful listeners.

Hey guys, you asked if it's still a thing

amongst black people about being the first

to die in scary movies. Yes, it is. Still a running joke, of course, but there's more to it now, I found. I'm finding as an African-American and Abbott movie

watcher, the new thing is the black person often dies in sacrifice of something or someone else. So yes, we still may go first in the film, but often for a noble cause, I guess that makes it more palatable, LOL.

That is from Serena, and then this is from Kevin. First of all, I'm a casual fan of this sub-genre and enjoy the exciting thrills that come with it. For years, it's become a common knowledge that black people will rarely lead or survive

to the end of those movies as well as other genre movies like for or rom-com and mainstream Hollywood. It doesn't make me mad, though, guys,

I just want the escapism of the movie.

“I don't want to think about the socio-economics”

behind everything. But I understand that Hollywood is catered to a white audience since the beginning, as they figure that this is a safe bet financially, and minorities are expendable.

My movie, watching friends, pretty much no, who will survive and who will hook up. And we just want to enjoy the show, but I am glad to live in a time where we are having more representation

behind the scenes to pull more strings in our favor. Keep up the good work, and that is, again, Kevin and then Serena. Awesome, thanks, Kevin and Serena. There reminds me of a point-on-one to make that I didn't have a chance to, in Earthquake,

Richard Roundtree, a K-A-Shot, he was in that, he made it to the end, and he was also one of the heroes helping save Genevieve Vujol, my senior name correctly. I don't know, but I know that Richard Roundtree

is almost always the hero.

Yeah, so yeah, he was like a motorcycle stuntman. So he was sadly an exception, but he definitely did make it to the end, which was great. Yeah, nice work. Nice work, Richard Roundtree.

“And if you want to be like Kevin and Serena,”

and want to share your thoughts with us, we love that kind of thing. You can send us an email, the stuff podcast that I Heart Radio.com. Stuff you should know is a production of I Heart Radio.

For more podcasts, my Heart Radio, visit the I Heart Radio app. Apple podcasts are wherever you listen to your favorite shows. - 2% - that's the number of people

who take the stairs when there is also an escalator available. I'm Michael Leister. And I'm my podcast, 2%.

“I've worked on the science of Neville Toughness, Fitness,”

and building resilience in our strange modern worry. With yourself through some hardships, and you will come out on the other side, a happier, more fulfilled, healthier person. - Listen to 2%, that's TWO% on the I Heart Radio app,

Apple podcasts, or wherever you get your podcasts. - When a group of women discover they've all dated the same prolific con artist. They take matters into their own hands. I vowed, I will be his last target.

- He is not gonna get away with this. - He's gonna get what he deserves.

- We always say that trust your girlfriends.

(upbeat music) Listen to the girl friends, trust me babe. On the I Heart Radio app, Apple podcasts, or wherever you get your podcasts. (upbeat music)

- Ready for a different take on Formula One? Look no further than no grip, a new podcast tackling the culture of motor racing's most coveted series. Join me, Lily Herman, as we dive into the under explored

pockets of F1, including the story of the woman who last participated in a Formula One race weekend, the recent uptick in F1 romance novels, and plenty of mishab scandals and sagas that have made Formula One a delightful,

decadent dumpster fire for more than 75 years. Listen to no grip on the I Heart Radio app, Apple podcasts, or wherever you get your podcasts. - This isn't I Heart Podcast, guaranteed human.