In this edition of Scheer Intelligence, host Robert Scheer dives into a critical discussion with Dr. Charles LeBaron, a distinguished physician and CDC veteran, who has authored a compelling and essential book, Greed to Do Good: The Untold Story of CDC’s Disastrous War on Opioids. Dr. LeBaron offers a unique perspective on the opioid crisis, drawing from his extensive experience and personal encounters. Through his well-crafted narrative, he sheds light on the complexities of pain management, the challenges of public health policies, and the human stories behind addiction.
Credits
Host:
Executive Producer:
Video Producer:
Transcript
This transcript was produced by an automated transcription service. Please refer to the audio interview to ensure accuracy.
Robert Scheer
Hi, this is Robert Scheer with another edition of Scheer Intelligence, where the intelligence comes from my guest and no question in this case, somebody here who went to Princeton and Harvard Medical School and published 50 scientific articles. And I’m building up his credibility because he’s written a really important, mercifully short book, I want to say, as somebody who reads books all the time.
And that is not getting the attention I think it deserves. And I read his book at my producer Josh Scheer’s suggestion. I’m happy for it. Because it’s about time I thought about not only the opioid crisis, but thinking about the CDC where Dr. Charles LeBaron, I hope I got it right, worked for 28 years.
And his view of the official medical agency and what it does and how it sets out guidelines is really powerful. But what adds force to it is at one point where I got really hooked on this book, one of the requirements at the CDC is you had to do some real life experience out there and he worked in a jail prison.
And that I found is a very moving part of the book. And then you worked on an Indian reservation where you actually functioned as a doctor there, not just as the epidemiologist studying these things as you had done, I shouldn’t say not just, but getting into the field. And what I found fascinating about this book is, first of all, it’s a page turner. Usually I think of doctors as people can hardly write a prescription, legibly.
And it’s very well written. But what really makes it so important is you really care about the outcome, know, not the statistics, but the pain, the health, does it work? Don’t kill the patient, don’t harm the patient, and so forth. And I don’t want to put words in your mouth. The title is Greed to Do Good. What is the subtitle again?
Well, I wrote it down before. The Untold Story of CDC’s Disastrous War on Opioids. Tell me about the greed to do good, this overview that you bring to it.
Charles LeBaron
Well, it’s a sort of tale of good intentions gone wrong twice, actually, the way the good intentions went wrong back in the late 90s and early 2000s, was everybody decided that nobody should be in pain. No one should have any pain whatsoever. And there were pain scales going around. And the idea is you walked into a doctor’s office and you experienced any pain, it would be basically criminal of the doctor not to prescribe something to relieve you of your pain.
Which is a little curious because in medicine you’re supposed to go after the cause of the pain rather than the effect. However, that was promoted very actively by a bunch of folks who make money off selling opioids. And that story is relatively well known that opioids were overprescribed and they were prescribed to the point where 80% of opioids
were being consumed by the US in a global sense where we only have about 5% of the population. You’re getting opioids at a rate of about 90% for operations where in Europe, for instance, only 5% people got opioids. And the result of this, you might call well-intentioned on some people’s part to reduce the number of people who are in pain, resulted in a large population of people who became, in essence, legally addicted to opioids, whereupon, as you might imagine, the number of overdoses also increased in parallel to the amount of prescriptions of opioids that are going on.
And people finally scratched their head at CDC and said, what are we going to do about this? So they slammed the door shut on people getting legal opioids. Well, you can imagine what happens if you’re opioid addicted to legal versions of opioids and they slam the door shut on that. There are a bunch of entrepreneurs south of the border who said maybe there’s a market share we can grab here.
And they said we can construct some really powerful opioids with some materials coming from China and they start importing fentanyl and other comparably lethal drugs, whereupon, as soon as CDC had decided to slam the door on legal opioids, there was an explosion of overdoses to the point where it quadrupled in about seven years, reaching to the point where there are 100,000 deaths per year.
And over the course of the first two decades of the 20th century, a million people had died of overdoses. And so again, these were two in a sense, well-meaning, but misguided interventions. One was to reduce the amount of pain in existence to zero. Well-intentioned, but misguided. And the second was, we’re going to eliminate addiction and overdoses by slamming the door on safe versions of opioids.
And in each case, matters went south. And here we are.
Robert Scheer
Well, as you point out in your book, there wasn’t only and maybe with the CDC, it was agreed to do good, but also there was a greed to make profit by pharmaceutical companies. And obviously, when you get into the illegal, even greater profit, perhaps. But I want to start with the pain, because actually I found that the book is divided into four sections. And I like that way of treating you because you put yourself in the position of the patient.
And the first part was about your back pain and your illness and so forth. And it’s really compelling because you’re getting it not from a doctor saying suck it up and live with it. You don’t want to make the cure worse than the illness. But you experience the pain. You write about it very movingly, trying to struggle with it, the temptation to take more and so forth. But you gained a lot of wisdom about it and having to manage pain.
So why don’t we begin with chapter one and then we’ll go through, I mean, section one and then go through the four themes of the book. Because I think there’s, I want to tell people, this is like 150, think 140 page book. Then there’s about another 60 pages of citation, good information. It’s very solid. But I just found it about the best way you could spend part of an afternoon reading it, you know. And on this show I reviewed books and things that take me up a week or two weeks to read. So I was grateful for that. But you, as I say, you have a real gift, I think, with the writing. And I haven’t read another book I saw by you on your first year at Harvard Medical School, but I’m going to get a hold of it after we’re done here. I’d like to know what that was like.
Charles LeBaron
Also short, also in that zone where an afternoon will do it for you.
Robert Scheer