All language subtitles for American.Addict.2012.1080p.WEBRip.x264.AAC-[YTS.MX]

You know. There are drugs in this country that are

classified as legal

and other drugs that are
classified as illegal.

And, for some people,
all it needs

to be labeled is legal

and if you have a doctor in place.

A doctor's an authority figure

who has the, you know,

ability to prescribe drugs.

A lot of people feel like,

"Well. If a doctor prescribed it,

it's fine."

But if we look at someone
like Michael Jackson

who is probably

the most famous person
on the planet

at the time that he died,

he was getting drugs

such as Propofol or Diprivan.

This is a medication that is
used in an operating room,

should never be used outside of
an operating room.

But he was taking pain pills.

He was taking pills for anxiety,

pills for sleep.

It's sort of an
interesting question why,

you know, are prescription drugs

less dangerous than alcohol
and cigarettes?

Sometimes.
But sometimes not.

We've turned the corner on

drug addiction in the
United States.

One of the most famous stars

in Hollywood history
is dead at 36.

Marilyn Monroe was found
dead in bed

under circumstances that

were in tragic contrast to her

to her glamorous career

as a comic talent.

♪ I'm gonna get it
'cause I'm a fiend

♪ sell the devil my soul

♪ to get me what I need

♪ get me a fix

♪ get me back into the zone
just one more... ♪

I said, "We need an
ambulance at Graceland.

Get somebody real quick."

Rigor mortis had set in. And...

I turned him over real quick.

I pulled up his pajama bottoms.

He walked in, said,
"Elvis is gone."

♪ tripled up on everything,

♪ I'm not breathing right

♪ it's got a hold on me

♪ and it might seize my life

Flowers. Candles. Notes.

These are items found

left outside of the
Manhattan apartment

where the body of

Oscar nominated actor

Heath Ledger was found.

Police say prescription pills

were found nearby.

An autopsy performed Wednesday

was inconclusive.

We have a--
gentleman here

that needs help

and he's not breathing.

prescription drug abuse

had been a problem for
Jackson for years.

Jackson family attorney

Brian Oxman tells us weekly.

"I warned them.

There is the misuse of

prescription medications by

people who were enabling him."

It all really started in 1972

when Richard Nixon coined

the phrase "The war on drugs."

But it's pretty clear

at this point that
we have lost that war.

And that war was really

dealing with illegal drug trade.

God bless you.

What a glorious day

for American seniors.

A strong and modern
Medicare starts today.

It took a lot of work
to get us here,

and it took the leadership

of President George W. Bush.

Law enforcement now
after 9/11

is locking down the border

and focusing on
terrorism.

But when you
lock down the borders

what's not getting in?

All of the illegal substances

that were coming in
from out of state

are significantly reduced.

So look at the statistics.

After 9/11, it looked like

we were winning
the war on drugs.

But the problem is,

no one addressed
the drug seeking behavior.

The supply was reduced of your

of your street level drug.

But the demand
was still there

for the misuse of drugs.

Whitney Houston was

pronounced dead at
the Beverly Hilton hotel.

Greg Giraldo, who died from

accidental overdose.

Brittany Murphy,
she died very suddenly.

Leslie Carter has died.

I was addicted to
Oxycontin and Opanas.

40 milligrams
a day along with

Dilaudid.

4 milligrams
six times a day.

I was taking Norco.

I was taking about
eight a day.

'co... Anywhere from two to--

Every two to three hours.

about six times a day.

Norco.
Eight a day.

And pretty much
every other

Opioid or
dangerous narcotic

that's out there.

He said he had
hurt his back

and that he was
taking it because

his back was hurting.

Oxycontin and
Roxicodone

and... Somas.

All prescribed at one time.

And this doctor
was prescribing him

medication for an illness
he didn't have.

He kind of lost his--

his drive...
you want to say.

And I went to work. And about

probably like, 10:00--
I don't... even the day...

the day is just
a mess for me.

I get a call.
And it's my mom.

She says:

"Something's wrong
with Joseph.

I went to wake him up

and there's this stuff coming
out of his mouth."

And I yelled at my mom.

I'm like.
"Why are you calling me?

Why aren't you calling the--

you know, the paramedics
or something?"

I ran out of work,
I left work.

And I prayed all
the way home,

tried to bargain with god

No bargaining with god.

I got here.

No paramedics.

Only police.

And so he was gone.

And from what the coroner says, he...

he only took one pill.

He took one pill.

And his body couldn't
handle it anymore.

And he went to sleep.
He didn't wake up.

And I guess they found out that.

Well, maybe it wasn't
just my son.

Maybe there's others.

So they started doing
their own undercover work.

They went in there undercover

and how easy it is to walk into

a doctor's office and say your back hurts

"My neck hurts,
my leg hurts."

and get a prescription for

A drug that is really for people

with, like, cancer or something

that's very--you know,
a very severe illness.

OK. My name is
sergeant Steve Opferman

from the Los Angeles
county Sheriff's Department.

I'm assigned to
our detective

division, major crimes bureau.

I supervise a
multi-agency Task Force

called HALT, which is the

Health Authority
Law Enforcement Task Force.

We handle over 100 cases a year.

We confiscate and destroy

probably $3 - $5 millions
worth of

confiscated drugs annually.

We've estimated we've probably

saved the government by

stopping, you know, a lot of

These illegal businesses about

$50 million in Medicare

and Medi-Cal claims.

This is an example of

medications that we seize from

what we call "a capper".

This is a recruiter that would

go around skid row and, you know,

find people with Medicare cards.

When we're talking about the

non-controlled substances,

when we're talking about

medicines themselves.
when we're talking about

medicines themselves.

There's a different black market

but the drugs are initially

acquired by the same means.

The main focus by government

is usually on supply.

If we reduce the supply,

that reduces the problem.

Well, not true.

If you have drug seeking behavior

and you reduce the supply,

it's like squeezing the

End of a balloon.

It just blows up somewhere else.

And you see this tremendously

with drugs, whether it's illegal

drugs and legal drugs.

The model of sort of optimizing

control and profits on drugs

is, to me,
very much one model,

because the economics of both

the illegal and the legal drugs

are very integral from a--

from a policy and
governance standpoint.

I'm pleased that all of you

are here to witness
the greatest advance

in health care coverage

for America's seniors

since the founding of Medicare.

This social phenomena is now

growing with the misuse of

pharmaceutical drugs.

Everybody, including
their parents,

their brothers,
their sisters

their grandparents,

everybody's popping pills.

♪ I'm feeling shitty now

♪ my pills are gone

♪ I done popped all my vicodin
♪ my pills are gone

♪ I done popped all my vicodin

♪ the other day

♪ now that my meds are done

♪ I'm paranoid

♪ but I'm get high

♪ in some other way

♪ I must get high

♪ in some other way

♪ I got to get high

♪ to get through the day

♪ I must get high

♪ to get through the day

♪ I must get high

♪ get high

♪ I must get high

♪ getting in it now

Prescription drug abuse is

rising in all categories in the

United States and
all age groups.

But unfortunately,

12- to 17-years olds are

the fastest growing
segment of everybody,

growing faster in terms
of drug abuse,

prescription drug abuse.

The state of Florida
is now experiencing

up to seven individuals a day

dying from the misuse

and the abuse of

pharmaceutical drugs.

We have three times as many

people die every year from

prescription pills versus

heroin, cocaine, and
methamphetamine combined.

They started going to
physicians' offices.

They started getting drugs
from "legitimate sources."

And all of a sudden
you can see the influx

in pain management clinics.

You can see the influx

In legalized drug dealing.

Broward, which is the
Fort Lauderdale area,

is the epicenter of
this pill mill epidemic.

And what we saw was that, in the

first six months of 2008,

67% of the Oxycodone
nationwide

that was put out by
dispensing practitioners

came out of
Broward county, Florida.

The entire mid-eastern quadrant

of the U.S., all those states

had a prescription drug
monitoring program.

Well, what that did
is started to drive

drug seekers--and I'm not
gonna use the term "patient",

it drove drug seekers
from those states

into the state of Florida.

Prescription drug abuse is rising.

But the innocent victims

are the infants born exposed
to opiates in utero.

Broward county Florida has
seen a quadruple increase

and more than
half of the people

taking prescription drugs
are women.

They're--over the last
several years,

there has been
no regulation whatsoever

in terms of patients

being able to go to
different offices

and get prescription pills.

And because of that,

you have an influx of people

actually coming from other states

to get these medications.

So as the number of adults and

women rise taking these

prescription pills, it's no

surprise that they're having

babies that are dependent on

painkillers.

Yeah. There you go,
Ok, look right there.

He's making a buy

with the guy in the brown.

He's got his money in his hand.

He's showing him something.

The drug dealers, when they're
dealing with prescription drugs.

Get the insurance companies.

Medi-Cal or Medicaid.

These programs pay for these drugs.

And then they're resold.

It starts with people that
we call "cappers"

that generally

drive around indigent

neighborhoods,
anywhere where people

are receiving government

benefits, primarily Medicare.

They're usually never
seen by a doctor.

Somebody in there
will write a prescription.

Then they'll pay that person to

go to a pharmacy and
fill that prescription.

And then they'll

give those drugs back to what we

call a capper.

They will take those drugs to

somebody that's generally

involved in organized crime

here in L.A.

They'll take them back to

retail pharmacies that they own.

They'll take them back to what

They call closed-door pharmacies

that they own. Use that as part

of their inventory.

So now they're able to
bill again Medicare

for prescribing these drugs to,

say, an elderly patient
in a nursing home.

That person never receives those

drugs even though there's

a paper trail and a billing

trail created so they can

continue billing.

Then when those drugs expire.

they're gonna package them up.

and they're gonna take them to

out-of-state to a wholesale

repackaging business.

If you automate all the

records in the state, all the

controlled substance records,

and a physician accesses your

file through the PDMP, he can

see whatever physicians you've

been to, what quantities you've

been prescribed.

And if he's checking the system,

and you've received a controlled

substance from another doctor.

he's not going to prescribe,

because that's a threat to his

license.

That would be a legitimate

doctor identifying drug seeking

activity.

So our bill, our original

bill last year would've charged

1/4 cent per prescription

drug -- pill, I should say --

to go into a fund, to collect

a few million dollars, so that we

could develop the capacity to

get everyone who writes

prescriptions--175.000 people

who are legally able to write

prescriptions in California--

to be electronically
on this database.

So in real time, the
Department of Justice

and the doctor
prescribing the drug

can see who's
prescribing what drugs.

And on the other hand,

the Department of Justice can see

that if there are physicians or

anyone who's allowed to write

prescriptions are abusing it

and basically taking the trust

the public puts in them
as physicians

and abusing it

by making profit money
by selling

opiates, painkillers to people.

They found a prescription

receipt in his car,
and I guess.

The coroner called the doctor

asked him: "What did you
give this boy?

What did you give this boy?"

The doctor said
"Well, why?"

"Because he's dead.

He's dead.

He's 25 years old.
And he's dead."

Then he told him what he
prescribed to him.

And it was

The roxi...
No, Oxycontin.

It's... the form of it was

the kind that does not...

it doesn't time release
or something like that.

It's just
instantaneous pain relief.

So systematically from 2001

up to approximately 2009.

the state of Florida fought for

a PDMP in the legislature.

Bills were introduced.

And it was fought down
every year.

Purdue Pharma also
stepped up to the plate

and most recently
as of a week ago,

offered $1 million to support

the state of Florida
in a PDMP program.

and to pay for the PDMP program
for the state of Florida.

And this is where politics
comes into play.

The governor of
the state of Florida

declined and does not

see fit that a PDMP

be implemented within
the state of Florida.

He cites that it's
a violation of privacy.

I met with the
pharmaceutical industry

I was right upfront with them.

I told them: "This is
what I want to do.

It seems to me
it's in your best interest

to help us do this.

It's not in your best interest

to read about
people dying from

abuse of your legal product."

And we had some
good meetings

but when the bill actually
went to Committee

and, obviously, had to get

passed out of Committee
in a majority vote

to get here to
the floor of the Senate,

I couldn't do it.

I couldn't do it twice.

The first time,
I came out of

the hearing room,
and I could

see some lobbyist talking with

a couple of my colleagues.

And these are
democratic colleagues

who I thought I had their vote.

And when the roll call
was taken,

I didn't have their vote.

If we are seeing

rapid acceleration of

prescription drugs
that are being given

to more and more and more
people including children

over the years in the future,

we are also looking at

a corresponding increase
of diagnoses by doctors.

What was once a diagnostic

manual that was paper thin

is now a huge book
with hundreds of

diagnoses in it that grows
and grows and grows

to the point where people are

being sliced and diced

where there is nothing
wrong with the person,

but something is being said

to be wrong with that person.

It gets into that area
in this country.

We have created
illnesses for drugs.

So, in other words,
I've seen, you see,

people have seen the commercial
"Restless Leg Syndrome."

Most people had
never heard of that.

But once that commercial
started playing,

the number of diagnoses

for restless leg syndrome

went through the roof!

Fortunately, there's Mirapex.

Mirapex is a prescription medicine

that helps relieve the
frequency and severity of many

R.L.S symptoms.

Just recently, I saw

a commercial where
there is a guy

mid-40s, early 50s,

and the narrator is like:

"You can't hit the golf ball

as far as you used to.

You don't have the
energy level you're used to,

You're not the same guy
you were in the bedroom."

And it says, "Maybe you're

suffering from Low 'T'."

And then I'm like,
“What is low T?"

And then before I can
even say that to myself,

the announcer says,
"Low 'T' is low testosterone."

Testosterone levels drop

normally in men
as they get older.

It's not necessarily a problem.

But they're creating a problem

because there is now
a new treatment,

a new pill for it.

Critics, anyway, of
direct-to-consumer advertising

say that it leads to
a lot of problems.

that it, number one,
over-medicalizes things

in society that are really
not medical problems

like..., an example
of that is anxiety,

so... "Social Anxiety Syndrome"!

Another example is
premenstrual symptoms.

And my doctor told me,

"That's not PMS;
that's PMDD."

Unlike PMS, Symptoms of PMDD

are severe enough to
actually interfere with your life.

Things like this, that are
kind of normal for humans,

are turned into a disease,
and people

subsequently request
medication treatment

for these things that may not
even be a disease at all!

So that's been a criticism of
direct-to-consumer advertising.

Attention Yaz, Yasmin,
and Ocella users.

The FDA says these drugs
may cause blood clot

and serious heart
and health problems.

There are a lot of
direct-to-consumer

advertisements of
anti-depressants.

And typically,

people will come in
if they're depressed,

asking for those
particular drugs

as opposed to
older alternatives.

And interestingly, one of the drugs

that is currently being
marketed for depression

is actually a drug
that's used for psychosis,

for things like
Schizophrenia.

But that it... it is useful

as an adjunct to
depression medicines

in cases of
very severe depression.

And we saw a lot of ads.

In our review of direct-
to-consumer advertisements

we saw a lot of ads
for this particular drug.

And I have had a lot of
patients asking me for it

even though it is actually
completely inappropriate.

Abilify treats depression in adults

when added to an
anti-depressant.

Some people had
symptom improvement

in as early as
one to two weeks.

Adding Abilify has made
a difference for me.

I mean. The ads don't say

that it's a first line agent
for depression

but because it's advertised and
the people in the ads look happy,

you know, patients
who are depressed

want a drug that's gonna
make them happy too.

And it's been very interesting,
people are asking for this drug that

they really don't want to take.

The most successful
PR campaign

in the history of the world

was Eli Lilly PR-ing that

depression is caused by
a biochemical imbalance

and that Prozac could fix it.

There was some interesting

research done looking at the

group for the diagnostic manual

that made up the diagnoses for

psychoses and for mood

disorders which are some of the

main places that the drug

companies make money from.

And every single member of the

Psychiatric Association's

Committee was involved with drug

companies, getting money from

drug companies, all of them.

About six years ago

my father passed away.

My parents had been married over

45 years. And my mom--

very healthy, in her 70s,

on no medications--went to her

doctor for regular checkup.

And the doctor looked at her

and said, "You know, Miss Smith,

you just don't look like your

usual self," and she went ahead

and told the doctor, “Well, my

husband of 45, 50 years just

passed away."

So before my mom could even

finish saying anything, he was

writing out a prescription.

So he handed her a prescription.

and my mom said, “What is this?"

and he said,
"It's Prozac for Depression."

And my mom looked at him and said

"I'm not depressed,
I'm just sad."

And I think this is really

a microcosm of what is going on

in this country at this time.

People have a problem.

And instead of asking them

“What is the problem?"

here's a pill for it.

Now, think about how bizarre it is

to sum up a person's life

struggle with a diagnosis like

bi-polar disorder.

Think about Lincoln,

there have been
innumerable books

studying Lincoln,
trying to figure out

"Who was Lincoln?
What made Lincoln tick?"

But a psychiatrist says
"Bipolar disorder"!

It used to be that a young

sophomore in college struggling

with his angst and his sadness
and his depression

would read Kierkegaard

or read some other really
deep and brooding book

to find some solutions to life.

Or he'd study philosophy,
maybe read some Freud,

maybe get some therapy,

But he'd view himself or herself

as struggling with life issues.

Now that same college sophomore

has already read in textbooks

that all the anguish
that people feel

is about biochemical imbalances

And with that, all the learning

of western civilization
is thrown out.

People are addicted
to the idea of drugs.

There's lots of addiction.

They believe that
drugs will help them.

People are overusing this thing,

these products that were
created to ease their pain.

And it's creating more pain,

I mean, that's the irony of--

and that's--and everything
endemic in our culture is like

“Well, get rid of my pain,"
you know,

"just get rid of it.
I'll pay anything for it."

But it's not getting rid
of anything.

It's making things worse.

This is an outrageous
societal phenomenon.

And it indicates a culture

losing touch with empathy
for itself as individuals

and empathy for
other human beings,

a culture that has just
gotten caught up

in the end product and
efficiency and work

and not at all thinking about

“What is life about?

Who am I?

Who are my children?

Are my children gifts from god?

Are they to be treasured?

Do they require that
I change my life

to bring them up better?

Or are they objects to be
tinkered with and given drugs?"

Talking with my doctor, he
diagnosed me with ADHD.

And I told him at that point

that my children
were taking Concerta.

I said, You know,
"Is there reason to think

that it would work for me?"

And he said, "Absolutely."

♪ And I’ll probably

♪ never change

♪ the more I try

♪ the more I stay the same

♪ I hate to look in the mirror

♪ 'cause all I see

♪ somebody sprung

♪ that looks me

♪ I hate to look in the mirror

♪ 'cause all I see

♪ somebody sprung

♪ that looks like me

♪ and I can't break my habits

♪ I'm an American addict

The point man in my
Administration on this issue

was Secretary Tommy Thompson.

And he and his team

did a fabulous job

of working with the Congress

to get this important piece
of legislation passed.

Tommy, I want to thank you
for your leadership.

This bill passed the Congress

because of the strong leadership

of a handful of members.

Starting with
the speaker of the House,

Dennis Hastert.

The speaker was joined by

Senator Bill Frist, Senate
Majority leader of the Senate

in providing the leadership
necessary to get this bill done.

I want to thank you both.
in providing the leadership
necessary to get this bill done.

I want to thank you both.

I appreciate the hard work of

the House Majority leader
Tom Delay

to see that this bill was passed,

Committee chairman Bill Thomas
for his good work.

Senator Chuck Grassley
did a noble job.

Senator Max Baucus
of Montana

and senator John Breaux,

Mr. Billy Tauzin of the House
of Representatives

did great work on this bill.

Senator Orrin Hatch from Utah

made a significant contribution.

Nancy Johnson,
the House member

from Connecticut did a great job.

Mike Bilirakis from Florida

worked hard on
this piece of legislation.

I want to thank
all the other members

of the Congress and the
Senate who have joined us.

Thank you all for taking time
out of your busy schedules

to share in this historic moment.

The Bush Administration
did Medicare part D

to help the elderly alright,

the elderly owners in the
Pharmaceutical industry,

the people who are the CEOs,

the people who are
the major stockholders.

When I worked on Wall street
or when I worked in Washington,

We would never ask the question

on how do we make money
on something,

so much as
the question would be asked:

“Where do we want
the world to go

and then how do we
engineer things

so that it will go that way?"

I left Wall street, and
I went to Washington,

and then I left Washington
and moved to Tennessee.

And one of the things
I struggled the most with was

explaining to my
family and friends

how the economic model

that America works on
really works.

And I finally--I finally decided

to write a case study.

It's called "Dillon Read & the
Aristocracy of Stock Profits."

And it tells the story of

how Wall street made money on

helping financing private prisons.

And I-- I wrote it
because I wanted

people to understand that

a very fundamentally
non-economic activity

can become very profitable
for many people.

What Medicare part D did was

it gave the drug companies

the ability to name their price
for Pharmaceuticals

and to get it, and have
the government pay for it.

What you'll often see is
sort of a combination

of an industry making money

and government engineering the
incentives and the economics

so that, whether it's the
consumer or the taxpayer,

they also make money
going in that direction.

Now this is an industry,

from my understanding and
from some amount of research,

that has really changed
in the last 20 years.

At least people will opine that

there are venture capitalists

who did a good deal of research

to see who Americans trusted.

And Americans used to and still

do put a lot of trust in people

in white smocks, pharmacists,

doctors--as they should--

and in pharmaceutical companies.

Unfortunately, in my opinion,

like a lot of things in the

investment world, there were

people who went in and took

companies over and what

companies used to pride

themselves on Research

and Development and providing

a product to the United States public

that would lengthen your

lives and make them healthier

lives somewhat got corrupted

and got driven more about

Profitability, Return on

Investment.

If you look at the amount of

money they spend on lobbying in

the last cycle, it was about

$272 million.

I mean, they have more lobbyists

active than there are members of Congress.

There's $64 billion in profits

last year. And that's on

revenues of about $254 billion

for the top 12 pharmaceutical companies.

So you're talking about
an enormous economic impact,

an extraordinary lobbying impact

and a real political impact.

We have something in this country call

a medical cartel.

A cartel is basically

interlocking interests that form

either a monopoly or
something close to monopoly.

We're talking about
companies, corporations.

In this case, we're talking about

pharmaceutical companies,
medical schools,

government agencies like the FDA.

And I went back to Harvard
for my first year of residency

right at the time that

the politics of psychiatry
was changing.

When I interviewed for Harvard,

I was interviewed by a family therapist,

and I met people who were
doing family therapy

and psychoanalysis
and social therapies.

One year later, the program had

changed into a biological

psychiatric program where you had
limited time with your patients

and spent most of your
time doing medication,

managing wards, giving ECT.

This transformation was
not through science.

This was a decision
by political psychiatry

that the future was with

selling biology and drugs

as the solution to
human suffering

if psychiatry was
gonna keep its power

and its status.

Well, originally,
modern medical schools

were mainly funded by

huge medical non-profit foundations.

Those foundations had
a particular view of medicine

that was leaning toward
what has become

modern pharmaceutical medicine.

And so to honor these grants

the medical schools were
funded and even established

to teach that brand of medicine.

Many people, when they
look at a university,

see a university, see a school.

That's not what I see.
I see an endowment,

and a lot of
intergenerational capital that

finances corporations

is sheltered from taxes

by managing it through endowments,

often for universities.

So everywhere you go, there's

the psycho-pharmaceutical complex.

And its tentacles reach

deeply down into
our educational system.

We--we now have a situation

where the drug companies
are sponsoring

programs to go into our schools

to monitor our kids

and find out who may
be having a problem

so that they can be
evaluated psychiatrically

and sent off to clinics where --
guess what they'll get?

Pills.

People will be much less

prone to slip through the cracks.

Because we have
forces operating

on the family,

on the schools,
the workplace,

to guarantee, in a sense,

that the over-medicalization
of society takes place.

The government money, and the

government rules and regulations,

program to develop the model

where they want to go.
So, for example,

when I first moved to Tennessee,

I had a friend who had just
retired from teaching.

And so many parents
would lobby her

to put her... to say that the
children needed Ritalin.

And the reason was, if they
got the kids on Ritalin,

they could get a disability
payment from Social Security.

It was an overnight
transformation at Harvard

because Harvard was cutting edge.

And in psychiatry, we see this

phenomena that
the best is the worst.

That the most cutting-edge
psychiatry, like Harvard,

to this day, is

the psychiatry that takes the most
money from the drug companies

that has the most
intimate relationships with

the federal government.

But there'll be someone
at a medical school

teaching medical school
students, teaching residents,

but pocketing $50,000
or $100,000 a year

for being a consultant
to the drug company

and giving talks.

Well, they're not gonna
be a consultant

and they're not gonna get paid to
give talks unless they are known

to be favorable to that
company and its product.

So that there are a number of people

in academic medicine

doing teaching,

being "prestigious"

who are influenced

by the vast amounts of money
that they think they need to get

from the drug industry.

For example, at Harvard,
it's Joseph Biederman

who personally caused a revolution
in the treatment of children

by defining more and more
children as bipolar

so that these kids
would be given

psychiatric drugs

that were suitable only for adults,

such as Lithium and Abilify
and Seroquel.

"Pills, pills, pills for children"

is the theme that comes out of

Harvard's
psychopharmacology program.

I blew the whistle
on Biederman years ago

as someone getting huge money
from the drug companies.

But it took a while for the
whistle to reach Washington.

And now there have been hearings.
And it's been discovered that

Joseph Biederman was getting
a lot more money than he admitted

from the drug companies

to push drugs on America's children.

There was a professor at Harvard

last year who had gotten
more than $100,000

in the previous year
from the drug industry.

And Harvard instituted
a rule that says

you can't be in the faculty

and get that kind of money
from the drug industry.

So he said, "I want my $100,000,

so I'm leaving the Harvard faculty."

I went on, to the National
Institute of Mental Health,

spent two years there.

And I was there as the
transformation was hitting NIMH.

When I arrived, the National
Institute of Mental Health

was basically a psychosocially
oriented institution in 1966 and '68.

But it was the beginning
of the transformation

of NIMH into an arm
of the drug companies.

We would later discover

that the drug companies actually
had conduits for giving money

to NIMH to do research on
the drug companies' drugs.

It's all very, very intimate

and tied together.

The profession was
moving hell-bent

to being literally an arm
of the drug companies.

Why have regulatory
agencies been co-opted

by vested interests that is
mostly industry interests?

And that's because the
industry is-- is ever-present.

I don't have to document the fact that

industry lobbyists
lobby Congress every day

and very powerfully. And
they give money to campaigns.

In turn, Congresspeople influence
the regulatory Agencies.

I think when you have
people that are lobbying

that have a lot of money
that they can throw around,

they get face time,
and that's important.

They get face time
with the decision makers

because they're able to

do certain things from
a financial standpoint.

The Congress has seemingly

reflecting the public interest...,
although I'm not sure

the public has
really weighed in on it.

Deciding to underfund the FDA,

leaving the FDA at the mercy
of industry funding

so that companies pay large
fees like $1/4 million that...

when I say a fee, I mean
a lot of money for the

for the regulator
to review its own drug,

which is a
bald conflict of interest.

I mean, the drug industry
has greatly

replaced the tobacco industry as the
most powerful lobby in Washington.

They pretty much get their way.

To a point where the consumer
doesn't have much of a chance.

So the power is virtually
completely one-sided

on the side of the market.

Anti-regulatory let the doctor do

what the doctor wants to do
because the doctor knows best,

when, in fact, there's no way the
physician can know what to do

because there's so much
knowledge out there

that they're very vulnerable to
pressure by industry lobbyists.

So it's in the nature of the beast.

It's in the nature of
the growth in knowledge,

the growth in information
systems, which can be distorted

by people who stand
to earn a lot of money.

Mount Sinai had a
prescriber education grant

through the Attorney General
of the state of Oregon.

And these grants were funded

to teach physicians about
the pharmaceutical industry.

And the money came from a
class-action lawsuit on behalf of

Medicaid organizations from
a bunch of different states

related to the
improper marketing of

Neurontin or Gabapentin,

which is a drug for...
used for seizures and pain.

The drug Neurontin was
illegally marketed

for unapproved uses,

including treatment for
bipolar disorder.

Neurontin has no proven benefits

for this condition, which left
those taking this drug

essentially untreated.

And it was found that
the company

basically inappropriately marketed.

And they settled with
a lot of money.

And part of that money was used
to fund educational projects.

So that's how I first became
interested in this issue.

As an offshoot of that grant,

we, my colleagues and I,

did a research project
looking at the adherence of

print advertisements
to FDA guidelines.

The breadth and depth to which
companies are involved

in training and education,

and some of it is quite indirect,
and some is quite direct.

Yeah, because it supports
a lot of academia.

And there have been many, many,
many writings on the fact that

physicians have been paid
to go to meetings,

have been paid to say
certain things at meetings,

to not say certain things
at meetings.

I myself have been
disinvited from meetings.

There was a study
not too long ago of

how companies use the high
gross profits from their high prices.

And it included documenting

371,000 professional meetings
a year for doctors.

Now there are only 1/2 million doctors
who are active in the United States,

so that is an
awful lot of meetings.

The branch of the FDA that
regulates marketing materials

had a budget in 2008 of
$9 million, approximately,

and that compares with
the marketing budget

of the pharmaceutical industry
in the United States

is, depending on
how you calculate it.,

on the order of $30 billion
to $60 billion per year.

And the stakes are so high and
the gross profits are so great

because American prices

are by far the highest in
the industrialized world.

So this is big, big business,

and they just put out
a lot of advertising.

And increasingly so on the web.

And they have, you know,
web banners and sponsored links.

So the public doesn't know
that they're actually

subsidizing 39% of all the
R&D that companies do

through tax deductions and
tax credits and tax subsidies.

It's our own taxes and
our own retirement savings

which are financing a system
which is literally lethal to our health.

Not to mention another major source,
which no one's tried calculating,

which is the billions of dollars

that companies accumulate
overseas in tax havens

to avoid paying U.S. tax.

These are companies that
consider themselves very patriotic!

They evade American taxes by
harboring billions of profits abroad.

And then, every five or six years,

the business has gotten
so large in these tax havens

that the Congress gives them
a tax holiday.

I once helped a reporter write
a wonderful story about

Novartis, who is
the maker of Ritalin,

and literally how much money
their stock would go up

for every child they got on Ritalin.

♪ I am rich

♪ beyond belief

♪ for this love

♪ you have given me.

There was an idea that

the new neurotransmitter
had been found

called Serotonin.

So Eli Lilly immediately went

to study rats to find a pill

that would do something -- change,

that is -- cause a defect

in the neurotransmitter system

so that it could be
claimed to fix it!

And they came up with Prozac,

which blocks the effective
functioning of the system

by stopping the removal
of Serotonin

from its active place in the brain

and flooding the brain with it.

They found quickly that Prozac

caused so much
agitation in patients

that they had to give
the patients tranquilizers,

or they'd drop out of the studies.

Well, when it came down
to approving the drug,

they couldn't find
a beneficial effect

unless they included
the tranquilized patients.

So the FDA forgave
Eli Lilly for cheating

and approved
Eli Lilly's drug Prozac

when they really were approving
-- they didn't tell anybody this --

really approving Prozac

with its agitation covered over by
addictive tranquilizing drugs.

So, as the medical expert,
we finally had our first trial.

Now, I wondered why...

why would this be the first trial
that we would bring out of 150.

Because it was
a very difficult case.

This man, Joseph Wesbecker,

had been paranoid and hateful,

threatening toward people at work
before he was put on Prozac.

That's not the best case.

But when he was put on Prozac,

within days he got psychotic,

and he killed a dozen people,

injured 20 at his place of work.

So I was gonna testify that it

wasn't that Prozac just caused this,

but Prozac tipped him over.

Well, I get ready to have the trial,

and my... the lawyer on
our side isn't preparing me.

He's not sending me
anymore materials.

I arrive in Louisville,

and the lawyer for our
side, who's suing Lilly,

is hiding documents from me.

I was thrown on the stand
with no preparation.

I gave the lawyer
20 or 30 note cards

before I went on the stand and said,
"You've got to ask me these questions."

He got mad at me.

Well, it was very hard to testify
under those conditions.

As it was, Lilly almost lost the case.

It was a 9-3 vote,
which allowed them to win.

One more vote against them
and they would have lost.

Big headlines:
"Lilly wins its case."

And all the other lawyers
started to settle

from the 150 or more
other cases.

Well, the judge figured out
that this trial had been fixed.

He called together Eli Lilly and

Mr. Smith, who was the
lawyer for the plaintiffs,

and said that,
“What did you guys do?"

And they said,
"It's none of your business."

So now the judge is up against
both parties on the trial.

So the judge investigates
and he finds out

that our side was
indeed paid off

in order to present a weak
case so Lilly could win.

And our side tried to
discredit me in court!

My own side tried to
discredit me in court

because Lilly needed to win the case.

And they needed to
discredit Peter Breggin

because I was their only real
opposition in the world.

♪ I need a bailout

♪ just like Citigroup

♪ I need a bailout

♪ don't forget AIG,

♪ Goldman Sachs

♪ I need a bailout

♪ what about the big three?

♪ I need a bailout

♪ it all ends with just me

♪ I need a bailout

♪ just like Citigroup

♪ I need a bailout

♪ don't forget AIG,

♪ Goldman Sachs

♪ I need a bailout

♪ bailout, bailout, bailout

♪ bailout, bailout...

Some doctors, including myself,

get frustrated with
the FDA sometimes.

Because there are
medications that work well

in Europe and other countries
that have been out for years,

but it takes another 10, 12 years
to get approved in this country.

So, in many ways,
they're very careful,

and the process is very slow.

But in other situations,
certain drugs are fast tracked.

So when you--when you look
at situations like Fen-phen,

a drug that was really popular
in the '90s for weight loss,

people--a lot of people
died from that drug.

A lot of people are still alive now

that are having long-term

heart problems from that--
from that drug combination.

They knew before that drug was
released that there was a problem.

People in that
particular company knew.

Information was suppressed

because when you go through R&D,
(Research and Development),

to get a drug brought to market,
it could take several years.

Tens of millions of dollars are
spent doing this process.

So when that drug gets ready to be released by the FDA,

it is a big deal if
it does not get released

because they've already
spent a lot of money.

And remember, pharmaceutical
companies are for profit.

They're not non-profit, good,
you know, touchy-feely corporations.

They are trying to make money.

I remember I told my son,

"Do you realize what
you're doing to yourself?"

"Mom, you know, I-- these--
they got 'em from a doctor.

A doctor's not gonna
give you anything bad."

So I don't know if they
have it in their head of,

"Okay, well, I'm not
buying it on the street.

I'm not buying it from the
drug dealer on the corner.

I'm not buying it from--
you know, in an alley somewhere.

I'm going into a doctor's office.
And I'm buying medication.

And it's fine.

Why would he give me something
that's gonna hurt me?"

The Food and Drug Administration

became responsible for

certifying drugs as being safe

and then, eventually,
for being safe and effective.

Which means that no drug--

no prescription drug,
no any kind of medical drug

can be licensed for
public use in the United States

without the prior approval
of the FDA.

Now that's a very strong piece
to have on the board,

a very strong position to have.

The FDA has built up
in strength and depth

each time around
a drug disaster where

a manufacturer has put a really
dangerous drug out there

and not withdrawn it quickly.

And that's led to congressional
investigations and then

a ramping up of
the regulatory body.

I think, at some times
in its history,

the FDA has been
very important

in the regulation and monitoring
of medications in the country.

Unfortunately, it, too, has been

co-opted by the industry,

has been happening gradually
over the last 20 year--

really, over 30 years.

A lot of times you have drugs that,

maybe, shouldn't even
be on the market at all,

get put on the market.

And people start dying.

And people start
having side effects.

But nothing really happens
until at least

they've recouped money,
made a profit.

Then the FDA comes riding in
on a white horse and

pulls the very same drug

that should never have been
on the market in the first place,

off the market.

The problem is that,

whenever a government agency
monitors an outside activity,

it is eventually bought and controlled

by that which it monitors.

So I think there are a lot of

very hardworking, conscientious,

highly trained people at the FDA,

especially the reviewers,

who are great public servants.

One pattern that we have found

in recent times (but goes back

to the '70s, I've found), is:

senior management overriding

worries and warnings by
their own reviewers,

basically approving a drug that

their own reviewers say
should not be approved

because it's too dangerous
to go onto the market.

It's somewhat difficult

for the FDA to get
physicians because

they do not pay
anywhere near as much as

most physicians would make
in an academic medical center

or, certainly, as they would
make in the drug industry.

They get doctors and there are
a lot of very dedicated

physicians at the FDA.

But, frequently,
the most dedicated ones

are driven out because

their decisions about the
dangers of drugs are overturned.

We did a study of physicians
at the FDA in 1998.

Between them,
they cited 27 instances

in which, a drug that they thought
was too dangerous to be approved

was approved over their head,
got on the market.

And in many cases, the drugs have
now been taken off the market.

So if you are going into
the government,

wanting to engage in
public health service,

being willing to take a lower salary,

and yet you're being thwarted
from your public health mission

because your bosses are
overturning you, partly because

they don't want to displease
the drug industry.

It's not a very welcome atmosphere!

And so tremendous
pharmaceutical company influence

has been exerted on the FDA

to approve drugs manufactured
by these companies

as safe and effective, naturally.

The rhetoric of the industry is:

"We need to do everything we can
to get life-saving drugs

to patients who need them
as quickly as possible."

And that rhetoric prevails.

That's what congressmen believe

and journalists believe
and so forth.

The reality is the following:

that several
independent review bodies

find that 5 out of 6 new drugs,
about 85% of new drugs,

are little or no better
than existing drugs

against clinical measures.

They can't be life-saving

because they're no...
they're little or no better.

And a few years ago
the industry was successful in

getting the time to review
of medications reduced

so that the FDA could go through
its review process more quickly.

And that's been associated with

a much higher rate
of approval of drugs,

a much higher rate of
approval of dangerous drugs.

The Vioxx disaster led

the FDA and Congress

and leading policy researchers to

become very seriously concerned
about how unsafe drugs were.

Vioxx is a drug made by Merck

that was touted as being
gentler on the stomach.

It's a painkiller.

And in their effort to prove that
it was gentle on the stomach,

the company, Merck,
did a study.

Half the people got Vioxx

and half of them got
another painkiller, Naproxen,

which has been on the
market for a long time.

The people that got Vioxx had
four times more heart attacks

than the people
that got Naproxen.

When that study was published,
we looked at the study.

It was published in
November of 2000.

It was no more effective as a
painkiller than a lot of other drugs

that didn't cause heart attacks.

It took the FDA several years

and yet another study showing

that it caused heart attacks to

get the drug
taken off the market.

Merck pushed the FDA
all over the place

to the point where they didn't
even put an adequate warning,

let alone take it off the market.

And it starts with something
the FDA is not attending to:

having companies
test their own products.

And they naturally want
to design those tests

to minimize evidence of
harmful side effects

and maximize evidence of benefits

so their drugs will be approved.

It's quite clear that

clinical trials that are
sponsored by industry

are far more likely to be positive,

to sort of find that the drug works,

as compared with
publicly funded studies

that are funded by the national institutes
of health or non-profit foundations.

Those trials not only are
misleading in their results,

and therefore mislead
the review process,

but they don't provide useful
information to clinicians

on how to use the drug.

When these so-called drugs

are approved on the basis of
their randomized control trial,

they're used in practice
without any accountability.

There is no information system

that systematically looks for

the impact of these approved
medications on people's health.

So we're not looking.

We're not holding ourselves
accountable for what we're prescribing

in the field of medical care.

You have lobbyists.

You have people
who work for the FDA

who eventually go to work for
the pharmaceutical companies.

And some of them come back
and work for the FDA,

then move on to being

a vice president of, perhaps,

Regulatory Affairs
at a drug company.

Perfect position for
a regulator to go to,

from the company's point of view,

knows all the inside
byways and highways.

Increasingly, particularly since 1992,

most of the funding
for reviewing drugs

comes directly in cash payments
from the drug industry to the FDA.

It's a massive and almost
ludicrous conflict of interest.

But it's one that was
passed by Congress

as a way of balancing the budget.

They pay upwards of $800,000,
$900,000 per drug.

They have to pay the money whether
the FDA approves the drug or not.

But it creates a whole attitude,

a different attitude than
used to exist before 1992

as to how much policing
the FDA has done.

That inevitably is going to mean

that the FDA process
is going to change

because of the money that they get:

the size of the people who
are working in the FDA

on moving the approval
of drugs forward.

There are more people doing that,

and you have less people
who are involved in

monitoring marketing practices
of drug companies,

who are monitoring drug safety.

Basically, companies
through their lobbying,

got Congress to agree that
they would pay for the FDA.

They get quicker approvals.

That means they make billions
more in revenues and profits.

And in return, more people get
seriously ill, hospitalized, and die.

Because we've increased
the number of drugs,

we've increased the adverse
event rates from drugs

four times than we've increased
the prescription rate.

So that the adverse event rate
-- event rates for medications --

are getting bigger and not smaller.

And for some medications, we've
increased the adverse event rates

16 times what it was ten years ago.

So there's no question in my mind
that the evidence shows

-- strong evidence --
that adverse events

from medications are the
fourth leading cause of death.

I wrote an article

in the Journal of the American
Medical Association ten years ago.

Interestingly enough, the article was
originally submitted to another journal,

a very high-level, premier
journal, which rejected it

on the grounds that nobody
would be interested in it.

It was an article that
documented the fact

that the United States ranked
very poorly on health levels

with regard to other
comparable countries --

industrialized countries in the world.

And it also documented the fact

that we had a very high
rate of adverse events

from the use of various interventions
in the health care field.

And since that article was
published 11 years ago,

I have continued to get
requests for reprints.

I still get about five requests
for reprints every week.

The article has gotten
a lot of attention,

mostly, I think, from laypeople.

Almost no attention
from government.

I have never been
contacted by the FDA to

explain what I've done or to
explore the ramifications.

And I think that's because

people don't like to know

that medications can be harmful

and that they, in fact, may
account at least in part

for the fact that we don't do
very well internationally

in our health levels.

So how is the cartel going to
present itself as, really,

the one and only solution
to the problem of illness?

Through media.

Could you imagine a society where people advertised,

you know, heroin on television?

You know, "I got blue magic,
Da da da da da.

Call this number or, you know,
this website." You know, like...

That's funny, because
you couldn't imagine that.

But you now have pharmaceutical
companies selling drugs

through commercials on
television, billboards, and such.

The United States is one of
very few countries in the world

in which direct-to-consumer
advertising is legal.

And it's considered a free
speech right in the U.S..

And it's protected as a
free speech right here.

Proponents of direct-to-consumer advertising say that it helps

facilitate communication
between doctors and patients,

that it informs patients of things and

sort of helps them to be able to
talk about them with their doctors.

And there actually is some
evidence that that's true.

There's also evidence that it--

it increases prescribing of
advertised drugs. And, obviously,

you know, the pharmaceutical
industry are pretty smart,

and they wouldn't do it
if it didn't work.

There's no counterbalance to that.

So, in other words, when
a person is watching television

and they see this ad comes on,

and they say, "Are you not
getting enough sleep at night?

Are you restless? Are you anxious?

You having problems in the bedroom?"

Almost anybody watching
these commercials

can relate to some of these problems
at some point in time. And then...

all the while it's just
beautiful commercials rolling,

people in slow motion frolicking
through the forest, holding hands,

beautiful music,
you have a guy reading

in a very low voice of all
the potential side effects.

But our visual --
there's a visual disconnect.

We have the side effects being
read really low volume and fast.

And you have the people that look
like they're just enjoying their life.

And you have people that end up

going to their doctor's
based on a commercial,

asking for a pill. --
"Call your doctor if you have high fever,

stiff muscles, and confusion to address
a possible life-threatening condition.

Or if you have uncontrollable
muscle movements

as these could become permanent,

High blood sugar has been reported
with Abilify and medicines like it.

In some cases, extreme high blood
sugar can lead to coma or death.

Other risks include decreases..."

The FDA guidelines are
kind of legalistic.

But they're also very, very vague.

So they don't particularly mandate
the presence of important information,

they just mandate the absence of
overtly misleading information.

Because the FDA is so unable to

look at all of the marketing
materials that are out there,

we felt it was important to look at

the adherence of materials
to their guidelines.

So what we found in the case
of consumer-directed ads

is that relatively few of the
ads were clearly adherent.

But, most of the time, that was
because of incomplete information.

They're just was not the
information present in the ad

for us to even assess the
adherence to the FDA guidelines.

We also found that over 1/4 of the drugs that were advertised

in our sample had a black box
warning from the FDA.

So a black box warning is
an indication from the FDA

that a drug is
particularly dangerous.

If you are prescribed a drug, and
you get the package's insert,

you'll actually see a warning in
bold letters in a black rectangle.

Well, how do I feel about
the way this country has gone

over the... my professional lifetime?

The fact that it's falling further and
further behind in population health.

It's falling further and further behind

in people's satisfaction with
the health care system.

It's going further and further
behind in terms of cost control

and, in general, just simply not keeping
up with the necessary changes.

It's very disappointing. And
it makes me very unhappy.

Both from a professional point of view
as well as from a personal point of view.

I know that probably ever since

I started writing about primary care,
which was in the early 1990s,

I have been deliberately
shut out of

policy making groups
and consultancies.

And basically the only thing
that keeps me going

is the fact that I am well regarded
scientifically and professionally.

I think no one

has ever mounted a challenge
to my use of evidence.

At least I am not aware of it.

They certainly haven't done it
in professional media.

So I really don't have
much dissatisfaction

about the contributions
I've made to scholarship

and to knowledge about the way
health care should be provided.

But it has been personally
disappointing that

my work has not led to positive
change over my lifetime.

The Obama Administration's
health care policy

still left the insurance
companies in charge.

It was reformed within the
context of a for-profit system.

Insurance companies are still
raising their rates to the roof.

It also didn't do anything to touch
the pharmaceutical industry.

Because, essentially, with
Medicare Part D still intact,

the pharmaceutical companies
can continue to name their price

for prescription drugs and get it.

So the government, then,
has a dual burden,

which is: more pressure on the Medicare budget

-- through the pharmaceutical companies taking a big chunk out of it --

and greater pressure on the
entire health care system

-- through... about one out
of every three dollars

going for the activities
of the for-profit system

(corporate profits, stock options, executive salaries,

advertising, marketing,
the cost of paperwork).

I spoke about the urgent need
for health care reform

and what will be
required to achieve it.

And one of the things that will
be required, I said, was that

everyone in our
health care community

is gonna have to come
together and do their part.

In recent days,

Chairman Max Baucus, who's
been doing an outstanding job

leading the Finance Committee
on this issue...

What I'm holding is
a bottle of Zyprexa.

Zyprexa is an
anti-psychotic medication.

It's very popular and
it's very expensive.

This among some of
the others: Abilify,

Cialis -- erectile
dysfunction drugs --

are very commonly diverted.

The reason being is, again,
the medical programs

and insurance programs pay
a lot of money for these drugs.

I'm a sales rep for
a pharmaceutical company,

been doing it for about a year.
I'm a sales rep for
a pharmaceutical company,

been doing it for about a year.

And my job is essentially to

sell our products to physicians.

You can be fired for talking to
physicians off-labeling.

Now, does it happen?

It happens often, and
it happens frequently.

Off-label promotion in English
means a drug company

attempting to sell a drug for a disease
that the FDA hasn't approved it for.

Let's say a drug gets approved
by the FDA for one purpose

and it doesn't sell very much.

So the company says,
"Hmm, maybe we can pretend,

by advertising and promotion and
buying up doctors to spread the buzz

that this drug is also good for the 2nd
and third and fourth and fifth disease."

Their marketing is ingenious.

It is so illegal. It makes the
Colombian cartel look like child's play.

Eli Lilly knows how long
it's drug is patented

and how long they're gonna charge
a premium price for that drug.

And as soon as
that drug goes generic,

they need another drug to
replace it to replace those profits,

because shareholders expect profits

and a return on their investment.

So Prozac is going off patent

and they need to replace those
profits. So they take Zyprexa,

and they develop
this elaborate scheme

to market Zyprexa to the elderly and
to the children, to anybody off-label.

This is a criminal act on
the part of a company.

If they do this, they're essentially
making it seem as though this drug

is safe enough relative to
its benefits to be promoted.

The fact is, if it hasn't
been approved at all

for that off-label or second purpose,

we don't know whether
the benefits outweigh the risk

or whether the risks
outweigh the benefits.

If there was enough evidence
of that, it would be on-label.

The FDA would get the evidence
and would approve it.

So the elderly that were
placed on Zyprexa

died terribly painful deaths.

Eli Lilly had psychiatrists
in their staff

develop a psychological profile

of the doctors prescribing Zyprexa.

They would direct the marker to say

"No matter how dumb your doctor
is, don't talk down to him."

Pharmaceutical representatives
are universally attractive.

They get recruited from places
like cheerleading squads

at big ten schools,
in the case of women.

And it's quite clear that
part of their hiring process

is the attractiveness of the people.

They don't particularly have
a lot of medical background,

you know, they are marketers.

But they go to sort of boot camp
to learn about their drug.

They're going to primary care
physicians, who are treating you and I,

and telling them how to manage their patients

who might just have
a sleep disorder.

And I guess the most
frustrating thing to me

to find out is that 20% of
the people getting Zyprexa,

at least in our claims data,

were people that were over 65,
for whom it was off-labeled.

Not only that, most of
these people had never,

in the data that we had,

had evidence that they were
Schizophrenic or bipolar.

They taught them to say,

"Doctor, well, don't you have any
people that come in and complain:

'Well, you know, financially, we're
doing--we're having a difficult time,

and I'm just stressed out right now'?

Anybody who says that, who uses these magic words like 'stress',

you can convert that word
into 'delusional', okay?

You can convert any anxiety they
have into a delusional behavior.

And as long as you put
'delusional' in your record,

then you can qualify for payment

by a government entity like Medicaid and Medicare."

The reason that drug companies
pray on Medicaid

is the same reason that
bank robbers rob banks.

That's where the money is.

And there's hundreds
of millions of dollars

in even a relatively
small state like Utah,

with its population of
2.5 million people.

"If you do that, we will pay you
to go on a speaking circuit

to tell other doctors
how effective this drug is

for your regular patients."

What qualifies as a speaker is,

if that doctor got on the phone and
talked to even one other doctor

who was scheduled to take part
in a telephonic conference,

they would get a check.

And there were doctors who were
getting a lot of checks for that.

I sue drug companies.

I sue them on behalf of
Attorney General.

I sue them on behalf of Medicaid.

I've been doing that
for about six years.

We were really
the first set of lawyers

to bring an Attorney
General case to trial.

We bought--brought
that case to trial in Alaska.

Two weeks into trial and shortly
before the jury out..., went out,

we settled the case
for $15 million.

I settled Utah's case against the
same defendant, which is Eli Lilly,

maker of the drug Zyprexa.

I settled the Utah case
for $24 million,

Idaho case for $13 million,

West Virginia versus Eli Lilly,
which settled for about $24 million.

Many of the Attorney
Generals turned us away

because it's unpopular for
them to sue big business.

Not only is it unpopular,
but it's very expensive.

The government purse was being
depleted in enormous amounts

by these drug companies
that weren't playing fair

and the government had
the right to recover that money.

The issue was--it's whether or not
there was excessive costs

or excessive inappropriate uses of
Zyprexa in the Medicaid population.

The FDA approved
the use of that drug

for people between
the ages of 18 and 65

only if they had been diagnosed with
bipolar disorder or Schizophrenia.

In other words, they had no
clinical condition in their past

that would indicate why
they should get Zyprexa.

Secondly is, is these people had an increased propensity

for getting diabetes.

I looked, then, at what the cost
would be to our program

and noted that, besides the pill costs,
I looked, then, at what the cost
would be to our program

and noted that, besides the pill costs,

there were additional
health care costs,

maybe up to $70 million
for our particular state

for the use of this medication.

These are primary care physicians
that they're selling Zyprexa to.

They're not going to psychiatrists

who are treating the people the
FDA has approved Zyprexa for.

Only psychiatrists are treating people
with bipolar disorder and schizophrenia.

The justice department that
prosecutes these cases

hasn't fined the companies
anywhere near as much as they should.

In other words, as much as they made.
Nor has anyone ever gone to jail.

If you just think about the
consequences of this criminal activity:

a doctor gets illegally promoted
by the company

to prescribe a drug that
the doctor may think

has benefits that outweigh the risk.

There isn't any evidence
for that at all.

The doctor prescribes
the drug, a person dies

because there really wasn't any
evidence that it even worked for that.

And there were--
there's evidence of dangers.

One company, Pfizer, one of the
biggest drug companies in the world,

sold $1 billion a year
of a particular drug,

and 90% of the sales
were for off-label use.

Illegal, they were criminally
prosecuted for it

back about five or six years ago.

But the fine they paid,

which seemed large
--hundreds of millions of dollars--

wasn't big enough to deter
them from doing it again.

And in September of 2009,
the same company

paid the largest criminal penalty ever
paid by any United States company:

over $1.2 billion for illegal,
criminal off-label promotion.

This was a deliberate scheme.

They know how defenseless
Medicaid and Medicare are

when it comes to paying
drug prescriptions.

There's such an elaborate
computer oriented system

set up for payment

of these millions and millions
of prescriptions across the country

by people on Medicaid and Medicare

that it can't be interrupted.

There's no way for
any watchdog to say,

"Oh well, you've prescribed
this to somebody

who has no business taking it."

Medicaid will pay

whatever it is they choose
to charge for their drugs.

So Zyprexa prescriptions

cost somewhere between $500
and $1,000 a month per person.

It's an extraordinarily
expensive drug.

When we looked at this,
we noticed that

there was a considerable
increase in cost.

In addition to the cost of
the medicine itself.

Now, this was particularly
frustrating to me

because recently there's been evidence that some of the older

antipsychotics -- (Antipsychotics had been around for 40 or 50 years) --

work almost as well as Zyprexa.

So here we have a
group of people over 65

who are getting a medication for
anxiety or to calm them down

for which the medicine
was not approved,

and it's costing a lot of money,

increasing the likelihood
that they'll have diabetes.

And in addition to that,
there are other medicines

that they could've used that
seem to work as effectively.

But the state is paying for it, so it
doesn't matter that it's expensive.

And it doesn't matter that there
are other things that are better.

It's sort of like a modern
form of lobotomy.

While the nurses
are complaining less

because the old people are
less active, it's killing them.

And it's extremely expensive.

Our look at the data said it's
extremely expensive to die.

So what happens is: Medicaid winds up
paying for the person's final illness.

So it's a win-win for Lilly
and for the doctors,

but it is a terrible losing
proposition for the state.

What we found out through
the Medicaid databases

of the states that we represented

was that over 50%
of the drug Zyprexa

was prescribed off-label for
uses unapproved by the FDA.

This is over 50% of the drug
just in the Medicaid population.

There's no doubt that at least
that much of the drug

was prescribed off-label for people
outside the Medicaid population.

All right, now we're gonna
get back to our earnings.

specifically drug earnings.

Eli Lilly beating analyst estimates
by two pennies a share,

not counting money set aside
for future legal settlements

linked to the
antipsychotic drug Zyprexa.

Joining us for a closer look
at the company's numbers

is John Lechleiter, Chief
Executive Officer at Eli Lilly.

He comes to us

from the company's headquarters
in Indianapolis this morning.

John, good morning. Good to
have you back on Morning Call.

Thanks, Carol, good morning.

So what are the highlights
from the quarter?

Carol, we had a very strong quarter.
We grew our sales 14%.

We grew our expenses
less than that.

We expanded our gross margin.

Our non gap quarter to
quarter comparison:

14% growth in
earnings per share.

Make it too expensive
to do it in the unsafe way.

If you say to the drug company,

"Hey, look. You can make

$4 billion worth of profit out of this
if you do it in the unsafe way,

but I'm only gonna
fine you $1 billion."

Well, that's $3 billion
worth of profit.

Well, it can't work that way.

It's got to be too expensive
to do it in the unsafe way.

The FDA, they don't have
the manpower. They never will.

They do it--they do the best job
that they can with what they have.

But as one of our experts said,

nobody can review a new
drug application at the FDA.

Because no human being
can read the whole thing.

You can hide the stuff in there.

But what the drug company
needs to know

before they ever submit
that application

is that if I hide things in there
and the truth comes out,

it's going to be more expense
than it is worth.

Otherwise, none of us are gonna
be safe from this behavior.

You can't let them make
a net profit on lying.

You make a net profit on
lying, you're going to lie.

And it's the
lawyer's fault, OK?

It's the lawyer's fault.
We invented corporations.

And when we invented it,
we didn't give it a conscience.

We didn't give it a soul.
You can't put it in jail.

It's not a human being. It's a
machine. It's a legal machine.

We invented it.
It's our fault.

But the only way to keep
that machine in check

is to make it too expensive
for that machine to do it.

Because that's all the machine understands.

And that'll solve the problem.

We--we are spending

for a level of health care

that we should be able to have it all.

Instead, what we spend
on health care

benefits the insurance companies
and the pharmaceutical companies.

I think we need to change
medical education.

We need to train medical
students in residence

so that they think about
adverse effects,

probably even before they think
about the desired effect.

Because adverse effects
cause problems in patients.

And that's counter to the principle
that we all have abided--

that we all have sworn to when we
graduated, that is, "Do no harm."

As much as I'm for small government,
we're gonna need a monitoring agency.

But we have to figure out ways
to absolutely insulate

the people who monitor from the
people whom they're monitoring.

We can look back as far as
people like Elvis Presley,

and Anna Nicole Smith
more recently,

and then graduating into Heath Ledger, Corey Haim, people like this dying.

And the only positive
that's come out of this negative

is that it's brought some attention
to the American public

that this is a problem.

And the reality is is that,
regular people, non-celebrities,

are dying every single day from
prescription pills--not from overdoses,

not from people taking it for fun,

but people simply
taking their medications

exactly how their doctor
told them to take it.

But the combination of sleeping pills
and anxiety pills and narcotics,

they go to sleep,
they don't wake up.

So how do we stop it?

The problem is, we have a nation
of addicts that are being ignored.

The answer to the problem,

in my opinion, is
not the government.

It's not other people.

It really starts with the individual
being responsible for themselves.

I think that every person should have
their own medical record, period.

You shouldn't rely on your medical
record to be at your doctor's office.

Maintain your own medical records.

If you have an MRI,
get a copy for yourself.

The best way to solve this problem

is to prevent it from
happening in the first place.

If a person has to have surgery,

then they're gonna need a pain pill after surgery....

You're gonna have an arthroscopy
of your knee, it hurts.

It's supposed to hurt. You're supposed
to take some pain medicine.

Most pain happens after surgery in the
first 72 hours, the first three days.

So it's fine to take a strong
painkiller for those three days.

But often what you see is,
doctors will give out 90 pills

or 60 pills or 120 pills

for a surgery

that's only gonna
really hurt the person

where they would need those pills
for maybe three or four days.

If you only use a few pills,

get rid of the other pills.

You don't want to throw
them down the toilet.

People say, “Well, I flush
it down the toilet."

We're contaminating
our water system.

So you don't want to
flush it down the toilet.

You want to take it back to
your physician's office.

And they normally have a
mechanism to get rid of drugs safely.

Don't look--don't accept
a pill for a problem.

So if you go to a doctor

and you tell the doctor

that you're having headaches.

And the first thing he does is
give you a pill for headache--

he doesn't even ask you
what kind of headaches,

when did they start,
why they start.

You first tell the doctor,

"Is there any alternative other than
this pill for my headaches?"

And if the doctor tells you no,
it's time to find a new doctor.

♪ You got to push in my hand

♪ that won't let up.

♪ No brakes, living fast,
not givin' a fuck.

♪ High stakes, I'm gonna get it

♪ 'cause I'm a fiend

♪ sell the devil my soul

♪ to get me what I need.

♪ Get me a fix,

♪ get me back into the zone.

♪ Just one more trip

♪ until my mind gets blown.

♪ Leave me alone.

♪ Prescriptions for the shit I'm on

♪ got me looking like the light's on.

♪ But no one's home

♪ check my heartbeat

♪ racing at the speed of light.

♪ Percocet or Vicodin
♪ racing at the speed of light.

♪ Percocet or Vicodin

♪ will set you free tonight.

♪ I tripled up on everything
♪ will set you free tonight.

♪ I tripled up on everything

♪ I'm not breathing right

♪ it's got a hold on me

♪ and it might seize my life.

♪ I ain't never give a fuck

♪ about shit

♪ except for corporate doctor

♪ trying to get me that fix.

♪ I got a drug cocktail

♪ to get me in the mix.

♪ Pop a pill, kneel

♪ and kiss my crucifix,

♪ I see that my

♪ problems never change

♪ the more I try....

I'm stopped taking the medication.

It had side effects that had

caused me numerous whole bouts

of personality changes that

caused a breakup with my fiancée.

I kind of just stopped everything,

and, for about 20 days,

went through withdrawals and
the worst feeling in my life.

I was an addict.

I was taking them all the time

for two years.

I was taking eight to ten a day.

and my body felt like I needed it.

I had no strength.

Like I was nobody.

I was really sad, crying.

Okay,

I started at one pill a day

for the first month or so.

and then it slowly progressed to two.

And then I ended up at the most--

I ended up taking about

seven to eight pills a day.

and I was sifting them onto foil.

And then I would smoke them.

Or sometimes I would sniff them.

And it just took me away.
It hit me.

It'd make you feel maybe--

maybe a little euphoric
or something.

But I always thought
I took them for the pain.

But I think I took them mostly

like they said, because I just
thought I needed them.

I never knew what
these medications were

or, you know, the
long-term effects of them.

It's such an easy thing to get
caught in this vicious circle.

Being given pills every month,

you know, ridiculous quantities,

is just like you're not even you.

You're just a zombie.

♪ Stuck on the mushrooms,

♪ hallucinating

♪ locked in the room

♪ going head up a second

♪ addicted to them pistols

♪ and running missions

♪ 45 the case

♪ and making bad decisions

♪ addicted to throwin' up

♪ my blessing.

♪ I was down to die

♪ for that shit.

♪ You can bet

♪ I'm addicted to this music

♪ that saved my life,

♪ helped me become a man,

♪ and get my shit right,

♪ and I’ll probably

♪ never can change.

♪ The more I try

♪ the more I stay the same.

♪ I hate to look in the mirror

♪ 'cause all I see

♪ somebody sprung

♪ that looks like me.

♪ And I can't break my habits

♪ I'm an American addict!