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Apr 19, 2017

Three out of four people addicted to heroin probably started on a prescription opioid, according to the director of the Centers for Disease Control and Prevention. In the United States alone, 16,000 people die each year as a result of prescription opioid overdose...

...but perhaps the most frightening aspect of the prescription drug epidemic is that it’s built on well-meaning doctors treating patients with real problems. In the new book "Drug Dealer, MD: How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop", my guest on this podcast Dr. Anna Lembke uncovers the unseen forces driving drug addiction nationwide. Combining case studies from her own practice with vital statistics drawn from public policy, cultural anthropology, and neuroscience, she explores the complex relationship between doctors and patients, the science of addiction, and the barriers to successfully addressing drug dependence and addiction. Chock full of extensive interviews with health care providers, pharmacists, social workers, hospital administrators, insurance company executives, journalists, economists, advocates, and patients and their families, this podcast and book is a must-listen for anyone whose life has been touched in some way by addiction to prescription drugs. Dr. Lembke singles out the real culprits behind the rise in drug addiction: cultural narratives that promote pills as quick fixes, pharmaceutical corporations in cahoots with organized medicin e, and a new medical bureaucracy focused on the bottom line that favors pills, procedures, and patient satisfaction over wellness. Dr. Lembke is Assistant Professor at the department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine. She is the Program Director for the Stanford Addiction Medicine Fellowship and Chief of the Stanford Addiction Medicine Dual Diagnosis Clinic. She received her undergraduate degree in Humanities from Yale University and her medical degree from Stanford University. She completed a residency in Psychiatry, and a fellowship in mood disorders at the Stanford School of Medicine. She is a diplomate of the American Board of Psychiatry and Neurology, and a diplomate of the American Board of Addiction Medicine. She has published over 50 peer-reviewed articles, chapters, and commentaries, including in the New England Journal of Medicine, the Journal of the American Medical Association, the Journal of General Internal Medicine, American Family Physician, and Addiction.

During our discussion, you'll discover:

-The shocking truth Anna discover when treating patients for substance abuse regarding where were most of them getting their actual drugs...[9:10]

-What happens to a brain's reward circuitry over time when using something like a painkiller...[15:12]

-How activities like hard exercise, cold, heat and even neurofeedback can be used to "reboot" the body's dopamine response...[24:10 & 26:35]

-Why pain is good and why you shouldn't try to constantly shut it down...[25:15 & 29:00]

-How people around the world are using something called "Pipemania" to get their hands on new drugs...[30:40]

-Why we can't blame this all on big Pharma, and who is really responsible for the extreme surge of pill-taking in America and beyond...[43:30]

-The 12 different strategies that drug seeking patients use to get drugs from their doctor...[56:30]

-The growing problem of "pill mills"...[60:35]

-What an RVU is and why it keeps a doctor highly motivated to do a "procedure" or "prescription"...[63:25]

-Why something called "42CFR Part 2" keeps doctors from even knowing or having access to a patient's electronic medical record...[66:30]

-How we can stop the cycle of compulsive prescribing...[70:20]

-And much more...

Resources from this episode: -Kratom as a natural, non-addictive painkiller -The Peak Brain Institute to "rewire" the brain for tolerance to things like alcohol and weed

Do you have questions, thoughts or feedback for Anna or me? Leave your comments at and one of us will reply!