History of the Opioid Crisis: How We Got Here

(1:06:13 - Q&A) Dr. Phillip Coffin talks about the history of opioid crisis and available medical treatments. Coffin is the director of substance use research at the San Francisco Department of Public Health and assistant professor in the division of HIV/AIDS at the University of California, San Francisco Recorded on 05/08/2019. [8/2019] [Show ID: 34790]
Everybody Hurts: How We Understand and Treat Pain and Addiction
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[@eguerrae75]

Doctor just said that 99% of people that enter treatment program come out and relapse immediately... I am proud to say that I'm in the 1% I was so hooked for years and I gave it up. I beat it...🙏 Hardest thing I've ever done

[@mariannebradley6905]

May I ask you if you did it by yourself or under supervision? By the main way, CONGRATULATIONS!!!

[@eguerrae75]

@@mariannebradley6905 I'm glad you asked no I'm a veteran and there's a lot of things they don't tell you when you leave the military and one of those things is at the VA is at your disposal so I got help to the Department of veterans affairs and I haven't looked back. I've lost a lot of guys or friends that I went into treatment with that's sad. Very sad

[@eguerrae75]

@@mariannebradley6905 thank you so much that means a lot Marianne 😘

[@XZITT]

one thing, you sound naive and a bit silly. since you think you're so special for beating addiction. first, you've beat it for today. addiction never rests and it never ends. congratulation on that, you've beat it for today. it's a great thing. keep it up. on my part, I said what I said, since I've had my share of fighting this monster a few times. the first time my sobriety lasted over 8 years, and I thought, I had it beat, took another 3 years to get my shit together. so never let your guard down. Keep it simple. and a day at a time. Lane Staley. RIP. is one of the great ones. Rest in Power.

[@timothysmith7080]

Thank you for sharing I'm very happy you're doing well. I've been fortunate that I never did drugs, but just a few different decisions, maybe a sports injury or if I had went to just one more party I too could be fighting this battle. Any one of us is in that same situation. Please stay sober, your life has so much value.

[@bobbyomari5500]

I wish doctors and people had more compassion and empathy for those struggling with pain and addiction. We need to treat everyone with dignity and humanely to start pushing things in the right trajectory instead of treating people like criminals.

[@claytonmorse2244]

These rehab facilities are not there to get you clean. Ask them next time their 'risk reduction facility' being prescribed an opiode to calm the detox and keep you from relapsing is what it does. But it was never meant to be used long term. The facility has no interest in you getting off their opiodes. So I understand having to take matters in your own hands after so many years. I congratulate anyone who can get clean but i have to say this. If you can get clean from 1 program the first time and be clean from than on in my mind you were never really a true addict. I also think thats where some people get the notion that addiction is not a disease because they did drugs and quit. No problem. That should tell you that you are not an addict. I have more to say but what's the point. Nobody listens on the internet. Too wrapped up in their own views and cannot admit when they may be wrong. Yada yada etc. Etc.

[@Scott-rz2vo]

@@claytonmorse2244 Well I would have to tend to agree w/u about how people are so wrapped up in theirselves & their own live's, children, problems, up's & down's, just Life in general ! It's freaking time consuming as Hell to get anything done anymore it seems. But back to what you were talking about, that's really an interesting subject or atleast I've always found it somewhat interesting. I'm an addict, I'm not in the throe's of addiction @ this point in my life so it's not like everyday is do or die like it once was. I mean I know I'm only a day away from being owned by the game again so I know I have boundaries to live by now or I lose that Freedom. Idk man, maybe I finally grew up ? Bout damn time, I'm 53 now but I've kinda been on the otherside now for almost 2 decade's. It's different for everyone, I can attest to that. Anyway man, I just wanted to let ya know that I appreciated you're effort's in trying to have some good, interesting & intelligent conversation. I will say this real quick too, as I've gotten older, I've found that I enjoy learning new thing's & reading more. As far as the whole Rehab thing goes, been there 20× & it never worked for me... Me & old Bill just don't see eye to eye on how to live life so.. Different strokes I suppose but I do know that it works for alotta people & I'm all about that for them. It just didn't take for me but I look at it like this, as long as we're going to the same place & we arrive there safely as well, then I can live w/ that. Anyways, didn't mean to run on like that on you Clayton, lol. Just wanted to let ya know there are some people out here who are listening & enjoy some good conversation. Take care & have a good afternoon Bro... 👣🐾

[@pouncepounce7417]

For an start we need doctors to treat addiction and not politicans or judges

[@tru2harris998]

@@pouncepounce7417 EXACTLY RIGHT!!!

[@pouncepounce7417]

@@claytonmorse2244 detox programs are the first step, they remove the physical addiction to an point the person is not under the influence. That is important, but it is the first step only, because the next step is replacing the addiction with healthy goals, removing the reason the addiction came to be or grow the person to choose better coping mechanisms. Sometimes that means putting the person on an healthier drug regime. They are not useless, they are useless if you do nothing else, but first you have to solve the physical medical drug addiction problem, then you can work from there, the useless part is detoxing a person and then tossing them back on the street with the reason they are addicted not adressed.

[@mariadavis3832]

I'm not in the medical industry but I do have a daughter that is addicted to heroin. This helped me to look at things in a new light.

[@dash2138]

I wish you the best

[@tabor503]

Please try to help her. It’s not safe out there anymore. Heroin doesn’t even exist. It’s all bullshit nowadays

[@j-s-m-rasmr5292]

Spirit of the living God let my ears hear only what you want me to hear guard my heart mind body and soul... Thank you for helping me thru almost 3 years clean from heroin and meth

[@tommyjames911]

🙏

[@jamesechevarria4813]

Amennn

[@JamesWoodWorker]

James 1:13. God didnt cause the evil nor can He be tried with evil. But the God of this World will cause suffering! Whos that? Read for yourself in 1John 5:19, 2 Corinthians 4:4 and Revelations 12:9. The God of this World. Jesus said be no part of this world. Liars are in charge. Like this guy!

[@camplo777]

ALMIGHTY is good. Too bad this was all planned

[@giannafrigerio3924]

Good for you and your faith and strength 🙏🙏🙏🙏🙏

[@timothylogan1204]

I wish i had him as a doctor you can see he actually cares

[@chriscail20gmail]

Finally, someone who understands what an addict goes through.

[@icebreaker9006]

TURN TO GOD; REPENT OR PERISH, TURN FROM YOUR SIN OR YOU WILL GO TO THE LAKE OF FIRE, ALL SIN LEADS TO DEATH. READ BIBLE TO GET WISDOM, SEEK GOD.

[@heidiho5179]

Thank you so much! I’m in recovery from an opioid use disorder that started with an injury and a narcotic schedule. Later, I was abruptly taken off medication when the political winds changed, and went to the streets so I could still get up and go to work. I ended up losing my whole teaching career (K-12). After going to jail, I was referred to a treatment center where I found out about Suboxone, and was able to start rebuilding my life, in my 40s. Had I been referred for Suboxone by the doctor who cut me off pills, I would still have my career. I have to wonder if doctors don’t distance themselves from addiction medicine programs, so as not to be associated with the stigma. I’m glad that, at least, the fentanyl crisis has raised awareness about maintenance programs. I have always been very poor and was just starting in teaching when this happened. I’ve lived in the streets. So I can definitely relate to that aspect of your lecture, as well.

[@joannekerr3]

Congratulations on your sobriety! So sorry for your past trauma but very happy to hear you are rebuilding your life. It's never too late! Sending you my love and encouragement 💕

[@Luckyandkitty]

Me too I go to methadone clinic and I hate having to do so

[@Luckyandkitty]

Proud of you and every addict that even tries to attempt getting sober even if they fail they tried

[@margaretwebb6372]

Heidi, your voice speaks volumes! Thank you

[@edwigcarol4888]

Thank you Heidi for telling us your story. Love and support..

[@kimberlyvinson8386]

This is a dr that CARES! That's not an easy thing to find these days. A lot of drs (and others in the medical field) look down on chronic pain patients instead of trying to understand each patient individually. I love my pain mgmt dr but I have many, many health issues and overall I feel I get judged by other drs and medical workers. There are some who are great but they are few and far between. I wish every dr was as wise and empathetic as this dr. Absolutely wonderful, informative lecture. Glad I watched!!

[@cubrasa2]

I have stoped using fentanyl with help of testosteron and that is something that has to be examine. Withdraw is much more easier if you boost your testo in body.

[@soilmanted]

@@cubrasa2 That is not making a lot of sense. One of the "side" effects of opioids is a decrease in the body's production of testosterone. One of the effects of coming off opioids, whether slowly or quickly, is an increase in testosterone. The increase starts to become annoying when you get long-lasting erections at times when you normally would not, while at the same time you don't feel like dealing with them. Adding MORE testosterone? What for? The time to add testosterone iw when you are ON fentanyl, to compensate for the loss.

[@cubrasa2]

@@soilmanted body does not produce testosteron in withdrawal if this is true all women addicted to opioids would became man. I

[@cubrasa2]

@@soilmanted i use testo gel and i use one month before withdrawal so effects would be much better

[@soilmanted]

@@cubrasa2 It's the other way around. Opioids interfere with the production of testosterone, in men. When men stop using opioids, gradually their testosterones go back to normal. Women are not affected, or at least, not affected much.

[@beautifullife4255]

This is the best presentation on opiates, pain, addiction, etc that I have ever seen. He really covers all aspects of the challenges of each potential treatment and doesn’t act as if there’s a simple solution to the problem. I’ve been off pain meds for years but I felt understood by him as a would be patient. I’d be happy to have him as my doctor.

[@hellovicki6779]

Yes, very informative but I found it strange he says there were limited options during the 90's for terminal pain management. I worked in such settings during that time and there were lots of options eg. Fentanyl patches, oxycodone suppositories, morphine syrup and slow release MS Contin, sub cutaneous pumps and epidural catheters that were insitu. However, I am not from the USA so perhaps that is why.

[@fooddrugadministrator4079]

Ritalin is the solution for all addiction except porn addiction! Libido suppress appetite and cravings! Suboxone reduced withdraw symptoms only

[@icebreaker9006]

TURN TO GOD; REPENT OR PERISH, TURN FROM YOUR SIN OR YOU WILL GO TO THE LAKE OF FIRE, ALL SIN LEADS TO DEATH. READ BIBLE TO GET WISDOM, SEEK GOD.

[@claytonmorse2244]

@@icebreaker9006 thank God your not gay right 👍 what would you're beliefs do than...

[@gensaikawakami341]

Amen, too often when this subject is addressed the discourse quickly devolves into either 'pro' or 'anti' drug rhetoric which helps absolutely nobody and serves only to divide people on an issue wherein we should show the most solidarity. Much thanks for bringing some much needed clarity on the facts of the opioid issue, y'all are doing the Lord's work.

[@GregoryJWalters]

Wow! Dr. Phillip Coffin is a Wise and Compassionate Doc; Thank you for sharing your personal and medical experience. Your history of the opioid crisis in the US is as important as it is fascinating!

[@ericainncca9771]

I absolutely love your outlook! I am a registered nurse with MS. When I was first diagnosed I was most definitely over prescribed opioids, quickly. I was 30 when I was diagnosed and devastated. I didn't argue with the meds because it was like a mini vacation several times a day. It was easier to zone out. I didn't ask to increase or add other meds but I was honest about my pain levels. In response the doctors just upped the dose or added a new meds. Now I know opiates don't usually provide relief for chronic pain. I will say I didn't have any problems with "stolen meds" or "lost" meds, etc. I eventually tapered myself off all of it one med at a time. Although, It was too late for many things Then my pain doctor asked why I did that. I said I need my life back. His answer was then to start me on a different opiate and then placed a pain pump. (Which I think is an excellent idea to manage some of the problems with overuse) As far as I go MS has made it very difficult to continue working. Each lost job meant a change in insurance. I have had to change my pain doctor 4 times in the past 5 years. For perspective, I have been with my primary care since 1999. I have had the same neurologist for 12 years. In the beginning I was happily married, raising 2 very busy teens, working full time, volunteering, with an outstanding income and amazing insurance.I have lost everything since my diagnosis. Now I am on Medi-cal(Medicaid). It's frustrating to see new doctors who definitely treat me differently than I was used to. The whole opioid crisis has been so devastating -as you know. It is very very refreshing to listen to you and your compassion shines through. Very informative! Thank you for doing what you do! ❤️

[@pinkbunny6272]

I deal terribly with pain, only take pain medication when in extreme pain. Otherwise I go hard, natural resource based: teas, hot drinks and meditation. And I have a addictive personality, so the family I grew up in, as a result of second cousin having drug abuse issues, gave me a good grip on how to deal with pain. I have to sit down, can't stand up too long and I'm 24 years old.

[@soilmanted]

Opium is a natural resource. It is simply the dehydrated fruit juice of the opium poppy, a flowering annual that grows about 4 feet high.

[@privateprivate1865]

I honestly think most people have addictive personalities, but i have no evidence, just my belief, but im sure theres some who dont?

[@fooddrugadministrator4079]

Ritalin is the solution for all addiction except Porn Addiction! Libido suppress appetite and cravings! Suboxone is for withdraw symptoms only

[@stj971]

Methadone is as addictive as heroin. It's ridiculous. It happens to be a very good pain killer.

[@stj971]

Chronic pain is a nightmare.

[@freakinfrugal5268]

I am amazed at how fabulous this explanation is. Totally fascinating!

[@danielnguyen8471]

Holy Shit!!! Alcohol doesn't get me drunk anymore.

[@jamesechevarria4813]

@@danielnguyen8471 if alcohol won't do it, then idk what will

[@m.a.g.ainfowarspatriot7777]

Wish every doctor was like this man God bless him

[@dondressel452]

It’s to bad that every doctor wasn’t like him He has empathy for his patients Most doctors only worry about losing their license because of prescribing opiates which is a valid point But to cut patients off cold turkey is heartless

[@berndmayer1765]

@@dondressel452 Heartless???? Murder! You know how many people commited suicide after being cut off and having no other Way of obtaining?? ( no plug to score)

[@Audiogeek-kf2ez]

This man, his insured , and his attitude is what what any chronic pain patient Needs

[@jessicadecoteau1178]

I almost didn't watch due to the lecture setting but so glad I did. So much great info and this Dr. Coffin has a heart of gold💯

[@abeltesfaye_]

I'm a legitimate chronic pain patient and have been for years. Issues like this makes it harder for me to get what I need to survive. I've had two hip surgeries, including a total hip replacement, and the hip replacement is now loosening. I also have chronic back pain bc I walked on a deteriorating hip for years. This caused me to get two herniated discs and scoliosis. I need medication and these people have made me go through hell every 30 days when it's time for me to pick up my medication as well as monthly when I need to talk to my doctor. This isn't fair - especially since I'm just one of MILLIONS who deal with this!

[@Randompotatoes-qs7bm]

But what is the solution?

[@johnsanchez6935]

@@Randompotatoes-qs7bm A pill that blocks the pain

[@Galworld761]

You get the pills every 30 days. What do you mean by hell? I need to see my doctor every 60 days for an allergy med refill.

[@stj971]

I can relate and it's totally unfair. No one should have to suffer like that.

[@brittscasualtoyreviews8245]

Nothing is worst than people making you feel like a drug addict cause your in pain. We have the power now that people don't have to live in pain/suffer, and yes I understand some people will abuse it.

[@loureed6504]

At present, 400,000-500,000 Americans are estimated to have died of opioid overdoses since the turn of the millennium, then all opioid-related deaths such as accidents, suicide, hepatitis, etc. are added, while the number of deaths in covid 19 is estimated at 87,000.

[@ronhicks1663]

I just spoke of this this morning. Let's compare money spent on drug treatment to money spent on corona since it started. Then let's compare od deaths to covid deaths in the u.s. I guarantee the opioid deaths are greater while money was spent on covid instead of drug treatment. Bottom line is politicians and big pharma want our money and they don't care who lives or who dies.

[@janiceferguson344]

This gives us understanding of what the medical profession has gone through. Thanks for the info.

[@c.a.greene8395]

Its nice to know there was a reason EVERYONE was kicked off their legitimate medications... I had many friends commit suicide when they were left to die a painful death without medication. Even I was kicked to the curb and my dr has written permission from the college of physicians and surgeons to give me whatever I needed, or requested to be comfortable as there is nothing more that can be done for me. There is a standing order on my file that says ' I can have as much and whatever I need when presenting to the emergency in pain ' the triage nurse showed it to me before coming around the table to put her arm around me and take me to a room, then she said she would be in every 15 minutes or so with an injection until I became comfortable, and that they wouldn't be wasting my time by making me see a dr. I began to cry, she held me and cried with me...too many botched surgeries, too much surgical mesh inside me falling apart... My dr still feared the pharmacist would report him...so I too lost access to my medication.

[@girumzemichael704]

@@c.a.greene8395 I truly hope you’re doing better by now. It’s heartbreaking and unbelievable what America did to itself 😔😡

[@c.a.greene8395]

@@girumzemichael704 the truth is this crisis was manufactured by our governments.... They saw legal opiate companies becoming filthy rich off the legal supply Our boarders have been locked down since 9/11 - who BUT the government could import ( or manufacture ) enough fentanyl to flood every street corner, back alley and barroom in every city, town, hamlet, backwater and rural route across the nation??? Previously these types of drugs could only ever be found in Port cities, or large cities...now places that can't be found on any map have addicts numbering in the hundreds!!! When those with pain lost their access they all went to the street to find their pain meds...many used their savings or retirement funds to pay street costs...some sold or lost their homes, everything they could sell or trade to the dealer, znd when they at last had nothing left - they made one last purchase - taking their lives and no one asked why? Or what happened? Just added their deaths to the drug epidemic numbers... Sad thing is here in Canada a junkie can have 16 × 100mg of morphine 4× a day, but someone like me is denied access.... IF we are going to exclude pain meds entirely because some people are addicted than by this same logic we must out law forks, knives and spoons because some people use them to eat food that makes them fat! It's nonsensical I truly believe this was done to make $$$ - greed znd greed alone

[@stj971]

The medical profession prescribes dangerous drugs all day long which are not opioids. They need to be better educated.

[@post-leftluddite]

At 3:00 he basically proves that as long as someone that is dependent has continual access to the substance, they don't display the symptoms of addiction. FYI drug dependence and drug addiction are two medically different things.

[@post-leftluddite]

@swag explain

[@chicofromph33nix64]

@swag yes.. explain plz

[@pocahontasprincess4197]

Please explain!!!!

[@mcu1fan822]

@swag We're waiting for an explanation...

[@kellyandersen3856]

Dr. Coffin...not the most comforting name for a doctor...

[@sibyllestr1980]

Kelly Andersen 😂😂 true

[@mplsmaven9404]

Right!?! 🤪😜🤨😂

[@ellep7689]

😂😂😂😭😭😭

[@ClareSw]

i am rolling hahahha, dr Ash

[@dondressel452]

As soon as I saw his name I thought the exact thing

[@threeballedtomcat9380]

Dr. Coffin, you have a 100% handle on the problem that plagues anyone that has a legitimate need for opioids. This "War on Opiates" has only hurt legitimate pain patients.

[@hhenrynice6843]

Agreed that legit need requires opiates. Buprenorphine sucks compared to the real thing for pain. It best use is for abuse. Stay with traditional opiods. Do not let them force taper you. Buprenorphine is better than ibuprofen but not good for chronic pain. Its weak! But even more addictive.

[@icebreaker9006]

TURN TO GOD; REPENT OR PERISH, TURN FROM YOUR SIN OR YOU WILL GO TO THE LAKE OF FIRE, ALL SIN LEADS TO DEATH. READ BIBLE TO GET WISDOM, SEEK GOD.

[@stj971]

ABSOLUTELY AND ITS UNFAIR

[@carl94-h9h]

Very informative, I learned a lot.

[@Kris10Ortego]

Such deep realizations on his part. He has expansive and such through knowledge. Appreciate this.

[@schrecksekunde2118]

I'm a consumer in Europe where we have an awesome treatment with the legal opioid of your choice (methadon, morphine, subuxone, Levo methadone) It's up to you and what you get along with which is a huge help because addiction is a very personal thing. The number of deaths in Austria for example went down from 500 per year to less than 20 plus the availability of needle exchanges reduced hiv to nearly zero. I can't say how grateful I am to all those who tried to make our lives worth living, those who made us humans again after having been reduced to a crime. Thanks for your support and help, you saved a lot of good people and a lot of families with them.

[@hellouser5498]

Morphine?? Thats like treating alcohol addiction with whiskey😂. You not being treated, you are being supplied

[@schrecksekunde2118]

@@hellouser5498 a supplied addict doesn't have to deal with 99% of the problems. and yes as a pain patient I'm being supplied. you never heard of accepting drug treatment i assume but i honestly hope you will as it's going to influence the lifes of millions of your citizens. wanna know what supplied addicts don't have to do ? sell their bodies, steal, lie, go bankrupt, destroy family relationships and hurt people and themselves. btw in Switzerland you can get Heroin. just imagine that! 😉

[@schrecksekunde2118]

@@hellouser5498 since Austria does it the number of hiv infections through consumption has gone to zero (!) and the number of drug deaths has gone from approximately 200 per year to less than 20. from the economy to the police everyone is agreeing that it's a vast improvement. if you want to insist on punishment and keep your drug dealers getting rich go ahead and continue your path

[@postscript5549]

I fell into this lecture by accident. I am interested in heroin because I've seen many addicts in my city. This podcast was interesting and informative. This Doctor seems dedicated and caring. Thanks.

[@claudiasc5871]

what a great lecture, and doctor. he really looks like he cares about his patients and what he is doing.

[@dustbunnycollector]

WOW!!!!!!! Where’s this Dr. he has a HEART 💖💞💝 larger then Texas. The man needs to be up on the hill educating the rock’H’eads running the country

[@post-leftluddite]

We got here because controlling what people what to do with their own bodies is always going to be ill fated. All drugs should be legal as all the worst parts of drug addiction are not caused by the substances themselves but by the laws prohibiting them. Also, how is their an Opioid crisis while simultaneously many doctors in scholarly journals report that we also have an epidemic of untreated and undertreated pain?

[@mypal3561]

how: pharma marketing inserts itself into the literature and there's no legislation to prevent it.

[@andreah6175]

We have the receptors for a reason and pre-existing plants. Some of us chronic pain patients ae simply endorphin deficient, its like a cure.

[@tabor503]

Amen

[@shawnsmiley5830]

This is an excellent lecture... its great for a drive ... great knowledge

[@nigelbrennan3816]

I tried to post this to F.B. ...the whole deal got shut down ....thought my laptop was going to catch fire . THAT IS WHAT YOU ARE DEALING WITH !

[@dondressel452]

Facebook is a joke That’s why I closed my account

[@carnevil5740]

Wow thank you so much.. definitely learned a lot.... very well done ❤💙💜

[@troytaylor4996]

This doctor is absolutely incredible!!! I wish I had him as one of my doctors!! At least he understands!!!!! Thank you Doctor

[@johnstoudt7476]

i love the way this man explains the whole proccess in step by step format and he explains everything so well and in great detail.i now have a very true understanding of how we got to where we are now in the history of the opiod crisis.its amazing to see through the years how the progression of opiods has led to this epidemic in this country.

[@MarcelAspenite]

Very informative, thank you.

[@daveparnell3886]

This is absolutely the first time I've ever even heard the blame for the opioid explosion point even remotely toward the ones responsible. The Dr. And yes I know from experience and my Dr. Was 100% to blame for my battle with dependency thank you.....

[@andreah6175]

Did you overcome it? Do you have chronic pain?

[@daveparnell3886]

@@andreah6175 I still have pain , but I have finally learned how to cope with it, with stretching and not doing anything too strenuous...

[@stj971]

Some pain is just not doable. THEREFORE LEGITIMATE PEOPLE WHO NEED PAIN MEDS. THEY ARE BEING DISCRIMINATED AGAINST.

[@NilodeRoock]

What an excellent informative talk. - THANKS. Many times over.

[@joebrown3759]

Brilliant lecture Dr!!! I wish every American could hear you. Thank you for your time, consideration, empathy, and giving an expert explanation to this pyght our world is in currently.

[@pleasedontfeedtheai2341]

That was fabulous, really enjoyed his insight!

[@TRAN_S]

Great lecturer and story teller

[@bigbadbruins1]

I lost a daughter and son to opioids.It’s a nightmare.

[@amy2770]

Hugs, can only imagine how devastating that must be so sorry for your loss. May God wrap his loving presence around you and give you comfort

[@thiphan6515]

Everyone should watch Dopesick, it explains this history very well. It’s extremely heartbreaking

[@BeautyQueenFL]

Even as a small child, I was aware my mother is an opioid addict. I never knew if she would live to see the next day. Every time I tried to confront her addiction she would severely abuse me. Her addiction began sometime before 1997 by stolen morphine from my great grandmother and still continues now(2021) with fentanyl , oxycodone, and an arsenal of others meds. I went no contact with her years ago and tell people she died. An addict sucks the life out of everyone who cares about them until they’re all alone with only their drugs. 💊 👿 ☠️

[@marynehra502]

Same with alcohol

[@susettesantiago5509]

This has devastate millions of families across the world……including mine………it’s disgusting to think these things are formulated………intentional affliction

[@cahyasatixoxo7207]

Well if she’s all alone no wonder she’s still using. You can’t abandon people who need help and expect that to fix them. Drug addicts are broken people who need help and compassion, turning them away from all they have left to care about is taking away any reason they might have to try and manage their life better. Speaking from experience as both the addict and the concerned loved one.

[@ThePolypam]

@@cahyasatixoxo7207 Did you grow up with an abusive, drug-addicted mother? She had people around her earlier in life, it clearly didn't help her get off these horrendous drugs and was dragging her own daughter down. How can you guilt her daughter? Good for the original commenter. She chose to save her own life, sanity and well-being.

[@smar544]

maybe u did the right ... opioid dependence (physical and mental) /addiction is probably the hardest to come off. From my past experiences; Agony of the withdrawal and lack of information about addiction treatment programs were my two main reasons for keeping this devil inside...

[@RaviSingh-xl3os]

This Dr is a godsend

[@ahunvodela7176]

excellent information and thanks for educating audience.

[@stregalilith]

Finally. Some informed and intelligent information from a compassionate medical expert! I bet just watching this has saved lives. following his plans and suggestions would save many more. And helping people to arrange their lives with stable housing, meaningful work and a loving supportive community could turn this whole thing around. Only then can mindfulness and the other modalities really help. We lose far too many people and that's a loss we all suffer socially and economically, landing orphaned kids into a broken foster care system putting them at risk for sex trafficking and creating another generation of addiction. Overdose prevention sites with clean needles, safe drug titration and patients being treated with respect is a first step and a vital one. This will bring back huge numbers of people into healthy life and into the economy which will, as they say, raise all boats. People who have managed a bad addiction and survived have enormous talent, skills and commitment and are assets once they are in recovery. Canada, Portugal, the Netherlands have proven the savings in mortality, productivity, and all other measure of quality of life for everyone, not just those addicted to drugs. Because none of the above therapies work on dead people.

[@dominivmurphy9687]

What a fantastic talk I. Great doc . What a mess we are in though....

[@Jackie-md8zs]

This is the best explanation on the opioid problem I've heard. Very well done! ❤

[@berndmayer1765]

WE HAVE TO TREAT PAIN AND PROVIDE OPIATES FOR ALL WHO NEED THEM. PERIOD!!!

[@Randompotatoes-qs7bm]

Awesome video. I learned a lot.

[@neatodd]

Very interesting talk - thanks.

[@alexallex7722]

Itś very well planned and executed,same like financial crisis in 2008

[@Jackie-md8zs]

Almost like the plot of a damn movie. Very well planned population control. Hope the pieces of shit responsible for in hell.

[@mplsmaven9404]

@@Jackie-md8zs wait for Big Pharma to tell the Government that EVERYONE NEEDS to TAKE the VACCINE for Bat Stew Flu aka COVID-19. Release the KRAKEN!

[@nicecutie]

people in severe chronic pain that need opiates and have been on them and take them correctly should not have such a difficult time getting them this is crazy stop the madness!

[@dondressel452]

I agree 100% I was prescribed opiates for my chronic back pain My doctor told me I was lucky to still get pain medication Then 2 months later I was diagnosed with cancer Now I have no problem getting my medication

[@TheTimgta]

@Eric Helminiak wtf are u talkin abt

[@lapislazarus8899]

I feel like I'm watching a game of tennis with this guy; going back and forth agreeing with and disapproving of what he's saying. This is the sticky, messy truth. People aren't easy, neither is medicine (is it an art or a science? Both or neither?) and let's not forget our liturgical society. Should law enforcement even be part of this equation? All I know is I and too many of my fellow citizens are suffering needlessly. American exceptionalism my ass!

[@kathryndeberry4673]

This dr is all over the place in his comments. He helps no one.

[@kellyraney4282]

AWESOME VIDEO

[@creditrepair1102]

Excellent Presentation

[@EfHaichDee]

What are the ethics of working with an industry that you know is taking advantage of people's suffering in order to make a profit? He talks about the responsibility of the medical profession to fix their mistakes, but this will only keep happening as long as they keep choosing to work with the pharmaceutical industry. If you know that they are doing the wrong thing, and their behaviour goes against your own ethics and values, why continue to work with them? Aren't you then knowingly complicit in all the future pain they cause? This is something I have never been able to understand.

[@alpineglow8848]

There's a surplus, one is tempted to say, an overdose, of ethical emptiness in every facet of the Pharmaceutical Empire. The nearly infinite abyss of ethical emptiness reaches it's Nadir with the notorious Sackler Clan, Oxycontin's Royal Family. It's with them that The Trail of Tears begins. I found the Doctor's message and compassionate motives to be entirely above reproach. Avoiding Big Pharma entirely would be the best choice in most cases. Sometimes exceptions prove the rule. This endlessly repeated line is too hard to avoid: "If you're not part of the solution, you're part of the problem".. He gives a not so subtle hint occasionally that he's not All In with Big Pharma's Loathsome M.O.: "The ~$400 million Purdue Pharma was fined was like.. One Day of their personal profits".. Message Received Sir. It's clear you're On Our Side.

[@jeep19]

Because it's legal, government gets a cut, and profits...

[@EfHaichDee]

@@jeep19 That doesn't explain why a member of the medical profession would be complicit in it. Who studies for years in medicine to worry about whether the government gets a cut of the profits from big pharma. They can't make money if the doctors actively try to avoid engagement and cooperation while carefully maintaining the health of their patients. This would set up a self-regulating system. Something is fundamentally wrong with the way we've set things up

[@dondressel452]

It’s all about money

[@c.a.greene8395]

@@EfHaichDee dr recieve gifts of gratuity from big pharma for every script they write... Some get sailboats, fur coats, expensive vacations, shares in the company and travelers cheques made out 'pay to the order of CASH ' so there won't be a paper trail... My girlfriend is a medical secretary and she says the dr in her office get several of these daily and many weekly. With every first prescription of something that 'could be habit forming ' they get 1000$ travelers cheque, for each person who is on these meds the dr also receives another cheque monthly with bonuses given annually... Its illegal, but what did the canadian government think would happen when they capped dr salaries and refused them item billing? ( our dr are supplementing their incomes because unlike the USA they do not get paid for what they do, they get paid according to their number of patients on their roster, with a ceiling on the max allowed amount. This made the possibility for corruption within our medical system. Now when a dr prescribes something for me I am left to wonder am I getting the #1 medication for this illness or the #1 medication to my dr financial benefit and for me it's the #3 or #4 best medicine to cure me

[@frankiachetta5200]

I think this doc should get an award. You can tell and feel how passionate he is about fixing this epedemic drug companies have unleashed on the world

[@Jackie-md8zs]

Agreed! I'm stunned by how far back this all goes.

[@jaybloc6485]

Yea cuz it's karma

[@Kim-Berly200]

Very insightful❣️

[@triztvnz6726]

Also a big reason that illicit opioids/non RX opioids got so big is because the powers at be didn’t want to be to blame for opiate overdoses, getting people hooked on opiates, and all the downfall of opiate prescription. So they helped the push of heroin and Fentynal into the drug game so it would take the light as the leading cause of opiate downfall.

[@JustT0m752]

The historic perspective was very interesting.

[@jeffcooper2200]

This doctor is truly amazing. when i hear a professional in the medical community speaking about the " opioid crisis" like he does it really excites me because you figure as advanced the medical community is in the United States you think great, they finally get it now they can start to mainstream this ideology into a new way to treat addiction for everyone. However then i see the date when this was video was published 2019 and we are in 2021 on the threshold of 2022. though there have been great strides made in the recovery and treatment community the fact is that not all medical professionals law enforcement politicians or society as a whole began to change its view on opiate addiction. i realize its not feasible for me to believe that because this information is out there that everyone's going to hear it and immediately be on board with changing their outlook on addiction. it would just make the world such a better place if we could change people from being judgmental to being compassionate. Much respect Dr. Coffin . As a long-time opiate addict myself it's great to hear a professional like yourself taking the time out to make it your professional career to help humanity with such a complex issue. Thank You.

[@kerranky]

I have had injections to block paid, helps a lot.

[@Sunnahiman]

This is very sad, thank for educational lecture, I am African American 66yr woman from NJ. I know the history of the heroin in the early 60s when it was delivered in my community. I was 13yrs old when the crisis of herion hit my community. I feel sad for anyone, no matter what nationality they're no poor or rich its a human being that died. The doctors, pharmaceutical, and presidents are responsible for allowing this to happen. Jobs overseas, welfare reform, high cost if rent, corrupt doctors are the cause of the drug epidemic. I am learning a lot from the current drug crisis.

[@ValerieBernard1]

Thank you after being clean for 32 years I was put on Morphine Sulfate 15 mg immediate and 30 mg extended I want to feel less pain but the knee shots really help and I want to reduce my dosage I feel I am taking more than I need and know how wonderful it was to be completely clean from all drugs for 33 years. As I got older Arthritis was in my knee and elbow. I can not walk without a cane and my soon need a walker or wheel chair. I want to get off this high dosage.

[@hollydancergirl5592]

Praying that you find a doctor who will help you feel better without giving you such a high dose. Sorry you have knee pain. Praying for you valerie!

[@stj971]

Makes no sense. You can regulate yourself what you take.

[@venusharris187]

Thank you

[@Travluminatii]

The opioid crisis has been blown way out of proportion

[@swampfoxIX]

Maybe. Maybe not. Still needs to be addressed and studied, though.

[@emmaseguin6051]

Very interesting, gives a good perspective on the whole mess, but it clearly was a number of factors that were aligned and created the crisis.

[@Penguin24766]

Broken system. Just like the war on drugs, a joke - how would the world be if the money used on hunting down drugs and users was used on educating and supplying clean drugs, needles etc for those who want to stop, and education for "beginners" so that they know the dangers of the drugs and how to minimize risks. The chronic pain patients : proper screening, yes some are drug seeking and not in pain as such, but help those and don't do a completly brainles action of hunting and punishing the physicians for prescribing what they find neccesary.

[@dondressel452]

Your making way too much sense The government policies never make any sense

[@chicofromph33nix64]

1982:war on drugs (19 years later)2001:war on terrorism (19 years later)2020:war on germs... They give us this invisible boogie man that cant been seen or touched,but keeps the masses In fear.. they love to work with the cycle of the moon,every 19 years... covid 19/19 hi jackers...

[@thts.my_voic]

Doctors got paid big time, from the Pharmaceutical company's to write Rx's. The doctors did not tell patients, that these pain meds are habit forming. Shame on all of them!! I know because, it happened to me. I quit taking my Rx, after my Total hip replacement was successful. I was diagnosed with advanced osteoarthritis at the age of 36, I'm 50 now. I took the script the correct (13 yrs) way but, I was still addicted. I've been off Perk 10's for 3 yrs. Thanks to Suboxone. I was tired of the withdrawals. I know a bunch of people hooked on opioids. More treatment availability is needed.

[@truthxposed8975]

When you get sick of suboxone, call Advanced Rapid Detox.

[@truthxposed8975]

@Johnny Sinns 😂 people think if youre poor in America you dont get medical care. Thats hilarious. Hospitals here cant turn you away just because you dont have insurance. Thats the biggest misconception about America. If you are what they call indigent you get Medicaid and your treated through state and county services. Its the equivalent of Canada or European healthcare if you dont have insurance because its government funded. If you have good insurance you get class A treatment and its better than anywhere else in the world. Thats why wealthy people from all over the world come to the U.S for treatment.

[@truthxposed8975]

@Johnny Sinns good for you.

[@dondressel452]

@@truthxposed8975 my doctor was about to cut me off as he told me I was lucky to still get my pain medication He told me two other patients had committed suicide because he had to cut them off because of the pressure from the DEA Two months later I was diagnosed with cancer Now I get pain medication from my doctor with no problem It’s a screwed up system

[@truthxposed8975]

@@dondressel452 Don, you really need to get to a legal state and get some RSO oil. My uncle had esophageal (adenocarcinoma). RSO cleared it up and no evidence of cancer on his PET scans but he got surgery and chemo anyway. BTW, do NOT get Keytruda chemo because it only helps in the very early stages. Anything past stage 3 is a death sentence. Dont let them push you into that drug. He ran out of RSO and didnt tell me. Within 6 months it was back in his liver. He died 2 months later. When RSO kills the cancer, you have to keep taking preventive doses. Go to Caregivers For Life in Denver. I wish you the best, Sir.

[@dondressel452]

What is the policy here in California in regards to prescribing opiates to cancer patients I have prostate cancer in the bones It’s very painful as hell but I’m terrified that I will be cut off of my pain medication suddenly I do not abuse my medication in any way but the hysteria is out of control I do not drink at all and I’ve tried marijuana but it doesn’t work for me at all

[@sacrimonius]

Mono formulated. That’s the key. Abuse isn’t. People want to feel normal or just ok. Human nature.

[@louisasmith9388]

So much is super about this doctor and even how carefully he uses language about his patients. But HOW long does it take to get patients OFF of methadone or buprenorphene (etc, suboxene...)

[@louisasmith9388]

Edit: with Q 1 from audience member: these patients (or most) about whom you speak are long past getting “high” and just continue opioids and opiates to avoid getting “dope sick,” unless they find they can get off (or manage on lower doses of) the original meds. The same is true then for these substances like bupreprenprphine, suboxone, abd methadone (I’m not an MD abd haven’t looked up naltrexone bc I don’t have a strong reason personally or professionally fir research on that detailed level(. One hears from addicts who are on suboxone, whi say they will NEVER go off of suboxone, siny because they will get “dope sick” if they do. So isn’t it just substituting one drug for another but for one good overall social reason: ie to reduce the initial market in illicit sales of prescription grade populates/opioids?

[@lynnelee4390]

People say they are almost impossible to get off of, they wish they would have just went on and got sick and got 8t over with

[@shalexiadavis1530]

Wow. Interesting history lesson. This guy provided a lot of unknown and important facts. Back in the 1800's in America (remember the some of the Western movies), there was laudadum (which was a opoid) and opium dens.

[@ThePolypam]

Opium has been ravaging societies for many centuries. Opium dens came to the USA and the UK from China. China was flooded with opium by the East India Company. See Opium Wars.

[@susanlippy1009]

I like that he details the options that can be used. Sadly though insurance won't pay for much so those of us in pain that must continue to work are left with no options but working through pain. I durance in America is a scam, akin to robbers who take your funds and provide a defective product with no rights given to consumers.

[@rhmetademnur9717]

Thank u sir

[@soilmanted]

I'm sorry but despite what this man says, there seems to be very little scientific data supporting the idea that integrative pain management works. We only have anecdotal reports, such as that made here by Phillip Coffin.

[@staceymodisette1149]

omg so sorry for all

[@janekocorek3313]

PHIL COFFIN are you serious? Wonder if his middle name THE. Great guy, great doc, great presentation, great heart and intentions. But if I were him I would seriously consider changing my name.

[@bruzzgravely3470]

God was the only answer for me, Thank you God!!

[@nickf527]

How it escalated in my opinion is simple... HIV and Hep C rates skyrocketed because states weren't allowing users to buy or obtain free and clean syringes... Then when the DEA tightened down on doctors prescribing drugs like oxycontin, morphine, percocet, etc it made our citizens turn to the streets to find "alternatives" to their pain relief and their horrible withdrawals... So I personally think the DEA restrictions backfired and only made things worse...

[@soilmanted]

Mindfulness actually exacerbates my pain. If I have mild pain, it is the worst thing to do. The best thing to do for mild pain is to take my mind off of everything by, say, becoming involved in a very involving project, making something, fixing something, teaching a class in something or tutoring someone. For severe pain, there is nothing that helps. I can't even enjoy watching a movie. As far as accupuncture goes, there is no scientific evidence to support it. These "integrative medicine" people really piss me off. Massage can help some kinds of pain, but not others. I don't know about yoga but yoga was never intended to help with pain. It was created to help people yoke themselves to their creator, whatever the creator is.

[@TheRoark85]

Opiods have been in western society for hundreds of years but it has only been a problem in society since the 60s. I think culture has more of an impact on the problem than the drug does.

[@ThePolypam]

Perhaps in Western societies but it's been a huge problem in China for 5 centuries, so I am not sure if there is a direct correlation.

[@barbarabrown-daniels3273]

ere opiods sold on the street? Were opiods illegaly manufactured?

[@edwigcarol4888]

Very well explained how and why the opioid crisis is house made in the USA, and did not occur in Europe despite the same social and health issues. Each measure viewed separately, measure after measure, adding to one another to end up into a disaster. No global comprehension.

[@shalexiadavis1530]

A tragic incident is when a person is involved in a horrible accident, a victim of crime, or given a medical terminal illness diagnosis, not when u willing take and do drugs.

[@mplsmaven9404]

It’s All About Choices! Why addicts are coddled is beyond me and I quit drinking & go to AA. When I grew up and made good choices I didn’t have the problems I had when I was drunk & high.

[@thatwasprettyneat]

Finally, someone who can actually pronounce the word "fentanyl" correctly

[@flukeseawalker]

Psilocybin can break the chain of Opioid addiction.

[@louisasmith9388]

Consistent with audience Q#1, one hour and 8 minutes in, aren’t we just substituting the buprenorphene/suboxone/naltrexone, abd methadine, for the original RX’d opioids abd opiates? Long after any of these patients gets any “high”? So they will have to be on these aubstitutes for LIFE, correct? (My comment posted just a minute ago is unfortunately replete with typos, which I cannot fix just now.)

[@trentblume5998]

This had a commercial on it

[@scratch5191]

U.C. Davis was how I got hooked on them. Hahahahahaha

[@soilmanted]

Methadone needs to be provided by specialized clinics? I've had methadone prescribed for me by a physician, for pain. He wrote a prescription and I had it filled at the pharmacy where I had all my medications filled, my blood pressure pills, my high-flouride toothpaste, my antibiotics. Nothing special about the methadone supply method. This was in the US, New York State. I found that the long-acting effect was a problem because it would stop working for pain, and then hours later it would start affecting me again, and making me sleepy when I needed to be awake.

[@ryanworthington6346]

For opiate use disorder. Any dr can prescribe it for pain.

[@soilmanted]

@@ryanworthington6346 Well, he didn't say that, did he? And what is to prevent someone with "opiate use disorder" from masquerading as a pain patient? The whole system is effed up. We need to make opioids available over the counter just like aspirin and acetaminophen. With warnings on the label about its dangers, just like we do with acetaminophen and aspirin. About 450 people are known to die each year from acetaminophen-caused liver damage. I would not be surprised if many more people with liver damage that possibly contributed to their death, had their liver-damage caused or contributed to by acetaminophen, but no autopsy was done to find out.. And as with opioid deaths that are caused by a combination of alcohol and opioids, rather than by an opioid alone, we need to stop attributing damage that is caused by a combination of alcohol and acetaminophen, to acetaminophen alone. We need to start recognizing the risks of alcohol consumption. And we need to stop creating a climate of sensationalism around opioids - get them out of the ridiculous sensationalism of pulp-fiction. The opium poppy, from which they are all either directly derived, is a simple plant. It grow wild in some places, is feral is some places. Although it is very labor intensive to harvest It is easy to cultivate and recent archeological evidence shows that it may have been the _very first plant that was ever cultivated._ We don't know yet if it was cultivated for its high calorie, high protein, high lipid seeds, or the effects of its fruit on the nervous system, or both. But we have evidence it was cultivated 10,000 years ago, and other plants are only known to have been cultivated 8000 years ago. I said _may_ have been. It isn't certain.

[@ryanworthington6346]

@@soilmanted sounds good to me.

[@brannonmcclure6970]

Good work. America should have the opioid problem solved mostly now.

[@kathleen2920]

This world TODAY is seriously screwed up. Every day prices increase and the items we buy are cheaper and less amount. GREED GREED is the main issue, all life is about is who we can screw today! Life has turned off compassion..kindness..understanding..dignity.. WE ALL NOW have to live in this fucked up greedy screwed up existence. I feel for the kids today!!

[@brandyhuffman8672]

Yes its all about greed. And more greed.

[@blueskiesprods507]

My production company is working on a documentary focusing on California residents to end the stigma of substance abuse. I hope you will consider sharing your stories with us!

[@daveparnell3886]

I'm not from Cali I'm from Washington but would gladly share....

[@devasworld9839]

Would love to. Ex meth and morphine addict still struggling with heroin

[@erinarthur4787]

Kratom = harmreduction = staying alive

[@alexeichenauer]

Kratom didn't work for me

[@erinarthur4787]

@@alexeichenauer I am sorry

[@rkalkes]

It works.

[@rkalkes]

Taper down on your drug of choice. You can't go from slamming a gram or heroin a day to 3 tablespoons of kratom a day.

[@lynnelee4390]

@@alexeichenauer it takes a bit of experimenting to find the vein that works for u. Took me a few months. I have chronic pain. The red vein finally did the trick. Now they want to take it away

[@TurboRonin83]

Insurance companies in America are a joke. Making profits off people’s suffering? They should be punished severely.

[@johnnym4400]

All I can say is methadone saved my life I was addicted to Oxycontin in the early 2000's because of a serious back injury then my insurance lapsed so I had to put myself on the program and I haven't touched any pill in over 14 years. I just wish they would come out with a medication to get you off opiates without going through the withdrawal. I mean why is that so hard to come up with? I'm not a scientist or anything like that but I'm sure there's something they could do about the withdrawal

[@aaronmccarty8059]

How can anyone NOT know or think that cocaine is not a narcotic?

[@bigbadbruins1]

4 people were in audience.

[@epic6434]

I don't shoot up or know about the effects of all drug's