Dr. Phil on the Opioid Epidemic | Joe Rogan

And when you see, you know, all these folks that are on medication today, I mean, how many of these people do you think legitimately should be on medication? I mean, is it something you can assess? You know, I can't answer that in terms, I mean, I'm sure there's research of people, how many people are on medication. But in my personal experience, most of the people that I see on medications, in my opinion, don't need most of the medications they're on. Now that's just anecdotal, that's my opinion. You asked me to hand you a research survey or study to support that. I can't hand it to you or I can't point you to one. I can just tell you, after 45 years in this experience, I see people that are on medication, they've usually seen someone for six or eight minutes and said, you know, I'm really feeling kind of down a group. Here's some Prozac, here's this, here's that. They give it to them and they don't even really ask why. And they just give it to them because medicine has become a high volume business. That's not necessarily the doctor's fault. I mean, the way that it's now funded and Medicare and Medicaid, you got to turn them and burn them or you can't stay in business. And so it's a high volume business. And so they throw pills at them because they don't have an hour to sit down or don't take an hour to sit down and talk about it and say, well, let's find out what's going on. Is there a reason? Like I said, if this guy's got five parts of his life that have gone down or a woman has got, you know, three or four areas of her life that have really gone down in quality, then they should be having poor mood. So why mask that? Let's come up with an action plan and change it. So most of the people I see on medication, not all, but most of the people I see are on too many medications in too high a dose or either don't need it at all. And I am really bothered by polypharmacy. That's where I really get frustrated. Darrell Bock Yeah. This is – what you're saying is a very common sense approach, but it's not the norm today. It seems like more people are treating this air quotes depression issue as if it's a medical disorder like diabetes or something where you need medication. Darrell Bock Yeah. And look, for a lot of people it works. I mean, you give people a mood elevator and they say, hey, I feel better. Darrell Bock And then maybe they change their life. Maybe they move their life into a more positive direction. They can wean themselves off of it. Darrell Bock Because one of the things about depression, for example, you use that as an example, is you get what's referred to as psychomotor retardation. There's a lessening in activity level. And I think old sayings get to be old sayings because they're profound. Like you're not going to get a hit if you're not swinging. Well, if you're depressed and so you think slower, less actively, you behave less actively, your chance of getting rewarded goes down, right? You don't get out there and you don't mix it up socially as much. You don't apply for jobs as much. You're not as productive on your job as much. So you're less likely to get strokes. You're less likely to get rewarded. Well, maybe you go take a pill and it lifts your mood up so you get more active. And so now you start getting pats on the back. You start getting people to engage with you more. So that lifts your mood and that takes care of it. So you took the medication short term, you're lifted back up and you're okay. Short term, it can be an alternative. But I've seen people on everything from opioids to mood elevators for years. And that's where you lose me. I just don't get it. Yeah. I know people that have been on things since they were five years old and they're in their 40s. And then you have waste basket diagnosis like ADD and ADHD where what used to be a spoiled brat is now ADD or ADHD. So they start prescribing these... Ritalin. ...neocortical stimulants like Ritalin. And if you give a kid that does not need a neocortical stimulant, a stimulant, you're really going to throw them off the charts now because you've got a normally active brain that you're now making hyperactive. So you're creating a problem that didn't exist before you gave them the medication because you didn't do the proper diagnosis. Yeah. I had my old neighbor had a situation like that. They had a kid and the kid was just had a lot of energy and they weren't paying attention to him. So they started medicating him. It's insanely common. Yeah. And you cannot chemically babysit your children. And who knows where these kids are going to be 20, 30 years from now. I mean, we're just looking at this rash of people being treated with these ailments, air quotes. And then we're not seeing how this all turns out in the long run and how much damage we're doing to these people. No. And in fairness, on the other end of the continuum, I have seen some people that are clearly psychotic, schizophrenics, delusional, that without medication are absolutely impossible to manage. But if you put them on antipsychotics and so you can lower their delusional behavior, their hallucinatory behavior, so you can now have a meaningful conversation with them so they can respond to talking therapies. It makes all the difference in the world. And without those antipsychotics, you would be lost without them. So there are some medications for some disorders that are absolute miracles that without them you wouldn't be able to do the work you need to do to get the person back where they need to be. Yeah, unquestionably. I mean, there's definitely a lot of great pharmaceutical drugs that help a lot of people. Do you get pushback from a lot of these positions from the established medical community? You know, sometimes, but mostly when you talk to people about it thoughtfully, they agree with what I'm saying. I mean, most people will agree that you need to be thoughtful about prescribing medications and that medications are too readily administered. I mean, that's certainly what we've seen in the opioid epidemic right now. Opioids are so readily prescribed right now that there are enough opioid prescriptions for every man, woman and child in America to have their own bottle. And if you renew that prescription one time, one time, if you are taking those opioids at the seven day mark, your chance of being addicted at one year is one in 12. And if you renew it at, if you're still taking them at 30 days, your likelihood of being addicted is one in three. And these things are getting written with way too high appeal count. And so the addictions, we're seeing a whole different kind of addiction now coming out of the suburbs and they take them for a while and they're very expensive. And after they take them for a while, heroin's cheaper. So they dump the opioids and start taking the heroin. So you're seeing soccer mom heroin addicts that you weren't seeing 10 years ago because they get started on prescription opioids and then they can't afford them. Or finally the doctor cuts them off, but they're addicted and so they start taking heroin because it's cheaper. Now, this is obviously a very disturbing pattern, but where do you see this going? Like when you look at the future, I mean, it looks bleak in that regard. I mean, I've known several people that have had real problems with pills. Yeah. The problem that I think people have is they think because a doctor gave me this because it's on a prescription pad that this is safe. Your body doesn't know whether you got that in the back alley or you got it from a doctor. It still has the same addictive quality. And I think it is at an epidemic level. I've testified before Congress about this and I think there are several levels of accountability at the manufacturing level and at the prescription level and at the educational level so people understand. I think everybody has to take part of it and I'm doing everything I can to raise the awareness about it as well. When you testified before Congress, what was the reaction? They're very much aware that this has become a serious, serious problem because the cost as you see the lost labor in the workforce is in the billions of dollars. You see the demands on the healthcare system that this is creating. Young mothers with children and babies born addicted to these opioids, the numbers are just going through the roof. It's putting a strain financially on the healthcare system that it just can't stand. You start costing money and it starts getting politicians' attention. They start saying, okay, now we've got to start doing something. They get it. They get that there's a problem. What could they do though? It seems like once that genie's out of the bottle. Well, clearly, you've got to start educating people and the manufacturers have to be required to start labeling this much more clearly. Physicians have to be much more conservative in prescribing. I just had this shoulder surgery and I took one opioid, one pill they gave me in the hospital. After that, you can manage it with Tylenol or something because the surgeons now are so good with the arthroscopic surgeries and stuff. It's so much less of an insult to the body that with ice and Tylenol and stuff, you can manage it if you just focus on it a little bit. I'm not saying if you've had surgery and you're having organic pain, for God's sake, get ahead of the pain and stay ahead. But as soon as you can get off of it, get off of it. Understand what's happening. Yeah, there's no sense in being like macho. We don't need a leather strap between your teeth and go have some surgery. I mean, shit, if it hurts, take the pill and get past it. Realize the minute you can get away from that, you need to get away from it. But they don't need to give you a 30-day supply. They need to give you three or four days and then you've got to go see your doctor again and if it's still a problem, discuss it. That's what I think needs to happen is just be a lot more conservative about what you're giving. The problem is these pharmaceutical companies make so much money. They don't want to back off that. They got private jets and yachts to pay for. Yeah, and they're starting to shut down some of these – they had some of these pill clinics and pain clinics in Florida where you could go in without an X-ray, without an MRI and just say you had back pain and there was a doctor there that would give you a 90-count prescription on the spot, no questions asked, 90. And you're out the door and you go down straight to the next one. Yeah, because there was no database. No database. And that doctor might be a foreign doctor that flew in from offshore, wrote all the prescriptions during the day, flew off again at night and now they're shutting that stuff down so the hammer's coming down. Well, one can only hope.