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tv   KQED Newsroom  PBS  May 12, 2018 1:00pm-1:31pm PDT

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tonight on kqed newsroom, the opioid crisis. what bay area is doing to tackle dependency and overdoses. the iran nuclear deal, we get an expert's take on what this means for foreign relations. plus, how three u.c. berkeley students are using their expertise to combat terrorism. i'm thuy vu. we begin with the opioid crisis. marin county will sue a dozen companies for highly addictive opioid medications. they're suing drug companies to recoup tax dollars they spent responding to the drug crisis. they include prescription painkillers and illegal drugs like heroin.
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while opioid prescription rates have declined, overdose deaths continue to rise nationally. in california more than 2,000 people died from opioid overdoses in 2016 according to the state department of public health. joining me now to discuss different strategies to tackle this crisis are dr. scott zieger, an associate professor of medicine and kqed laura kleinman and brian washington. welcome to you all. >> thank you. >> dr. steiger, let's begin with definitions. what types of drugs are categorized as opioids? >> they're divided into two main categories, opiates which are derived from the poppy plant, so that includes things like morphine, codeine, heroin and the more generic synthetic like oxycodone, fentanyl, hydromorphone, those are in the broader category of opioid. >> how do legal prescriptions
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fuel this crisis? don't people need the drugs to manage their pain? >> so in the mid '90s with the introduction of long acting oxycodone brand name oxycontin, the number of prescriptions for opioids for pain increased dramatically, and that continued until about 2012 at which point there's -- since then there's been a decrease in the number of prescriptions. the problem was that too many people had too many opioids and too many brains being exposed to that addictive substance led to some problems, namely that people became addicted to those things and needed to make sure that they were able to obtain that opioid, that chemical. the problem is that if the doctor no longer prescribes it or they no longer have access or the doctor is not available to give the prescription, the person still is physically
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dependent upon the substance and needs to figure out a way to have that happen. >> and that's what's led to the crisis we're seeing now nationally. i know, laura, you've been looking at this issue in the bay area. how big is the problem in the bay area and in california as a whole? >> as you mentioned, the number from 2016, it was over 2000 deaths in california but when you look at the country, our rates of opioid deaths, they are not high -- not quite as high as the eastern states but then you look at california as a state and you break it down by county. our rates in the northern more rural counties, they are in the same category as some places in west virginia. so they're quite -- it's quite bad. the san francisco bay area is not that. in 2016 we had just under 100 deaths in san francisco. >> i know that brian washington in marin county, you have now filed a suit against opioid manufacturers and distributors accusing them essentially of falsely promoting the safety and
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efficacy of their painkillers. this comes after 30 california counties decided to join a similar but separate suit. what is your legal premise behind all of this? >> thank you. the core legal premise is that the distributors and the manufacturers misled physicians and the public that prescribing opioids was safe for use for general chronic pain. they indicated that people only became addicted at about a rate of 1%. turns out now current estimates are that addiction rate is about 50%. >> are you basically saying the companies knew about this, they saw the problem coming and they chose not to do anything about it? >> that's correct. they relied on false evidence in distributing and marketing these drugs widely. >> and so there are many lawsuits on this now across the country, right, involving hundreds of cities and counties nationally. what do you -- what is the scope of this? how large could it get? we saw, for example, in the 199 o 5 -- 1990s a lot of companies
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were engaged in litigation for tobacco company. could it reach that scale? >> we hope so. we hope that's a good comparison, the tobacco litigation. we have over 400 cities and counties and states involved in the litigation and we think the public health problem is of a similar magnitude and it deserves a similar solution. >> and so, laura, california is also taking legislative action on this. this week the state assembly passed a bill that basically limits doctors in most cases from prescribing more than five days worth of opioids to minors. that bill now goes to the senate. what's been the reaction on this from the california medical a soesh yags and other doctors? >> the california medical association is opposed to it. doctors i've spoken to, one feels it's too little too late. >> why is the cma opposed to it? >> my understanding why they would be opposed to it is because it is getting into the
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territory of what a doctor is doing in their doctor's office. the doctors i have spoken with, they feel it's too little too late. regulation around prescription opioids, that's the first phase of the opioid epidemic. now people have moved on to heroin, fentanyl and those are deadly forms of opioids. so there's that view. and then also doctors who are prescribing opioids to kids, they have gotten a lot of this education at this point and so they're doing it in really severe cases. so these might be kids who are in hospice, kids who are experiencing extreme amounts of pain. one doctor said if you limit what we can give folks, it could have a really negative effect similar to what dr. steiger was saying, they have a dependency, they need to fulfill it elsewhere. he's saying, yes, let's get rid of prescribing in the way we do, but it needs to happen slowly. it can't be legislated out slowly. >> dr. steiger, do you agree
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that legislation is not an effective way to address this? >> it depends on the legislation. in this particular piece i don't treat kids so i can't really speak with much authority about who needs pain relief through opioids or not in that -- in that particular clinical setting, but i can say it has not yet proven to put a curve on the number of overdose deaths on a national scale or in california and so it seems like maybe other ways of -- other kinds of legislative interventions are -- would be more important for curbing the tide of death. >> in marin county aside from the lawsuit, it's been pretty active in stepping up and finding a community-based solution to this. can you talk about that? >> that's correct. i can talk a little bit about it. our public health department is leading an innovative program called rx marin working with the public, physicians, nonprofits
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to make sure we're rachetting down the level of opioid prescriptions. that's been a successful effort the past few years. >> pretty innovative. it's a whole collaboration between law enforcement groups, doctors, pharmacists, intervention specialists, right? >> that's correct. it's a problem that spans many disciplines and everyone's got to get involved in solving it and that's what rx safe marin is about. >> laura, i know you've been following up on treatment programs. what types of treatments are available out there? >> there are a variety of treatments available. the most common are methadone and bup prey morphine and methadone is something that has more regulation around it. if someone is getting treated that way they would go to a methadone clinic. b buprenorphine could be more effective in rural counties for people that can't take that bus ride that's an hour and a half to a methadone clinic that's
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hard to reach. another thing i've been following is the efforts in san francisco which are really amazing around harm reduction. so this is something for folks who are not yet ready to maybe transition to treatment but in san francisco these things mean you can go to a needle exchange and you can get clean needles, clean syringes, you can even get little strips that test a drug to see if it has fentanyl in it. someone will probably still do that drug, but maybe if they know there's fentanyl in it they will use less of it. they will use it with people around. another thing that we're doing in san francisco and other places around the state is distributing narcan, which is the opioid reversal drug. i went with one of these harm reduction individuals and she trained bartenders and people who work in clubs. that is totally unique. so next to their first aid kit they are going to have a little nasal spray injector of narcan. >> interesting. dr. steiger, with all of these options out there, is there a
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particular treatment strategy that works the best in your experience? >> well, i'm biased because i work at a methadone clinic so i think it's the gold standard. it's been around for over 50 years. we know it works. it -- it is incredibly highly regulated, however. if you're trying to reach people who don't have access to it, you're going to have other tricks up your sleeve and that's where buprenorphine is very effective, almost as effective. i think the key thing to know is not being in treatment is extremely risky. you have three to four times the risk of death, all cause mortality, mostly driven by overdose, but all cause mortality goes up if you're not in treatment for opioid use disorder. we'd like to say that people can do really, really well without any medication, but that doesn't happen that often. >> you can't quit cold turkey nkts you can't quit cold turkey. >> much of the attention has
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been focused on medical doctors prescribing these drugs, but what about other medical professionals like dentists? are we overlooking those other specialties in the fight against opioids? >> at the end of the obama administration there was legislation that allowed nurse practitioners and physicians to prescribe buprenorphine. they should be able to talk to people to reduce harm from their use. >> we will have to leave it there. dr. scott steiger, laura kleiver and brian with marin county council. on tuesday president trump announced he will withdraw the u.s. from the iran nuclear deal signed in 2015. this was one of president obama's key foreign policy achievements. it requires that iran never builds nuclear weapons. in exchange, the u.s. would lift sanctions that have severely
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stifled iran's nuclear growth. to discuss this i'm joined now by professor abas maladi from stafford university and a fellow at the hoover institution. professor malani, nice to have you here. >> nice to be here. >> on thursday tensions between iran and israel escalated as israeli war planes attacked dozens of iranian war targets inside of syria. what role would you say the u.s. pulling out of the iran nuclear deal played in that? >> i think it's what part of the same dance, a complicated dance that i think was coordinated between israel and the united states. it began with benjamin netanyahu's conference or show where he talked about all the new intelligence that they had found in iran indicating that iran had lied about its military component, the nuclear program in the past, something that mr. trump quoted in his decision
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talk and i think behind the scenes mr. trump has given israel the green light to go at iran in syria. >> but didn't iran, you know, fire first? you know, fire some missiles into golan heights? it wasn't like -- and that happened before the u.s. announced its decision to withdraw from the nuclear deal. >> right. iran certainly has taken aggressive actions in syria, and it has taken aggressive actions against israel in lebanon. iran has now placed about 200,000 missiles right on the neighborhood, right on the border of israel. israel is clearly worried about all of this. the immediate action that seems to have begotten the israeli attack is the firing of some 20 missiles into the golan heights. they hurt nobody fortunately. they destroyed very little but israel decided to respond massively and make the point.
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>> so the big question now is with the u.s. withdrawing from the iran nuclear deal, does this raise the likelihood of war? >> i think it does. i think it raises the likelihood of much more serious confrontation between iran and israel and syria. i think it raises the likelihood of more serious confrontation between iran and saudi arabia and yemen or other places where they are engaged in a proxy war. what i think mitigates against the possibility of a war is that i think that iranian regime doesn't really want a war right now. i think there are very few economic conditions. i think israel knows this, i think the trump administration knows this, i think everybody else in the region knows this and when you have as much of the economy as iran has and you have as much of a disgruntled
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population as the regime in iran faces, the idea of picking a major battle with israel or the united states is not happy news. >> what do you make then of israel's -- iran's position, rather, its assertion that it is ready to restart its nuclear program if this deal falls apart following the u.s. pulling out of the deal? is that just a scare tactic at this point? >> i think it was a scare tactic. it was trying to tell trump administration not to rock the boat. they said we will restart our nuclear program full force. we will do things you don't know yet kind of clear language, but actually once trump pulled out, they said we're going to stay in the deal. we are now going to try to make it work with the europeans, with russia, with china, with the u.n., with the iea. all of these forces and institutions want the deal to continue, and this puts the united states as the odd person out. >> doesn't the trump administration though have a
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point when it says this deal is flawed? for example, it did not address a number of issues, including iran's role in syria? >> i think the trump administration on that point is right. i was one of those people who thought that this deal is the least bad deal, but it was a -- the least bad deal possible and the least bad deal possible was clearly better than no deal. and the way you fix a bad deal is not walking away from it. you would have a lot more leverage, the united states would have had a lot more leverage if it had stayed in the deal and tried to get the europeans, tried to get russia, tried to get china to bring some pressure on iran to make the concessions that the trump administration needed. to walk away from it essentially gives the iranian regime someone to blame for their economic failures. it gives the iranian radicals an excuse to clamp down on the people and they've already begun
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to do that. it weakens the very people who are the only viable force who can make a regime change in iran. the iranian people are the only people who can make the change that we all need, more democratic iran. united states can't dictate that and to weaken the israeli forces by walking away from it so unilaterally and so unreasonably, well, to me was the worst way to fix the flawed deal. >> we have about 30 seconds remaining. i have to ask you this though. we have north korea looming. we have the talks now. it's been announced that that meeting between the u.s. and north korea will take place in singapore next month. what impact could this withdrawal from the iran deal have on those talks with north korea. >> one way for north korea to think that if the united states can walk away from a deal that everyone else says is working, why would i want to make a deal
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with them? why would i want to trust an administration that walks away from such a good deal? the other option is for them to think, trump is not very -- >> not trustworthy? >> trustworthy. trust is not very predictable, so the mad leader theory. play the mad, scare everybody into doing what you want them to do lest you do something even more unexpected. >> we'll have to leave it there. professor abas malani, thank you for joining us. >> my pleasure. turning now to tech. a group of u.c. berkeley students are using their tech skills to fight terrorism. they created archer, a nonprofit that builds tool to track connections between terror organizations and sanctions violations among other things. the inspiration behind their nonprofit is personal for these students. in 2016 two fellow u.c. berkeley classmates died in terrorist attacks, one in france and one in bangladesh.
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today nearly 2 dozen u.c. berkeley students donate their time. they're using data to fort worth human rights abuses, corruption and money laundering. joining me are the founders of archer, tyler hines is a junior and alice ma who graduated last year from u.c. berkeley. welcome to you all. alice, let's begin with you. you founded archer along with tyler and angelie. what is it and how does it work? >> archer builds data analysis software for investigators who look at corruption, terror finance, war crimes and human rights. it's a subset amongst a larger set that we find systemic and criminal. we do this in a dual approach. the first is to our flagship product architect which tyler will have some thoughts on and the second is through the partnership's model where we talk to experts who know how to generate insights from data that are trying to investigate these issues already. >> i think we choose our
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partnerships really, really carefully. in particular we'll have the human rights center at barkley. they're holding bad actors accountable for the atrocities. >> how are you doing that? you're looking at a lot of data and putting it into a format that's easier for organizations to read and analyze? >> we do have a partnership like this but we have one major flagship product. we call it architect. this is a big data analysis platform and it organizes different critical public datasets into an intuitive network analysis view so investigators can sort of explore connections between individuals and organizations across borders and these are sort of just one big example of the type of tool that we build. >> and so, tyler and angelie, i know you were both in east france when the 2016 terrorist attack happens. tyler, can you describe that experience for us? >> i'd rather not talk too much
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about nice itself but it was the first time i was exposed to a problem this real, this impactful and serious. it changed the way i look at the way i spend my time and prioritize what i spend my time on. there are much more important things that i should work for than like building apps or worrying about classes. archer is something i should start and take forward. >> angelie, what was that experience like for you? >> for me it was slightly different because the student who passed away was one of my best friends so i was kind of already introduced to what it would be like to experience something like this. but i think for me as well it just made it really clear that like i can no longer ignore issues of systemic security risks or human rights violations. it became urgent that i participate in combatting that, yeah. >> as you try to build these tools to help, you know, make the links between various terrorist organizations and who are the sanctions violators and
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how they're related to each other, alice, what challenges do you encounter? >> so i think the challenges that we encounter are twofold. there's one on the side of -- there's literally just so much public data that's out there and the data has been exponentially growing in the last ten years. i think that's a broader context behind why archer exists and why it's impactful, because we discovered that the newsrooms or the analysts or the nonprofits that are working on these issues are no longer able to keep up with the information that's out there. so that's kind of how we are like making an intervention in the space, i guess. and that's extremely challenging because of just how much data is out there and how messy it can be. even with the shared manpower required to kind of gather it altogether and integrate it well, i would say that's one major challenge on a more thematic side for us. i guess it's something we've overcome thanks to like the ingenuity of the berkeley
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students on our team. besides ourselves, there's 19 other students that dedicate their time to this effort. and that actually brings me into a second challenge that i think is really important, which is like making an impact in this space when we're students. people always ask us, oh, you're a student so do you -- what do you do? like does it actually work? and, you know, how much time do you spend on it? and i think we've overcome this as well with the help of our team and just being completely dedicated and building a product that speaks for itself. >> you're all volunteering your time and you've in some ways devoted more than a full-time schedule to this. tyler, when you were developing these tools, what surprised you the most? what did you learn from it? >> what really surprised me is that there are all these different atrocities happening in the world and there's so much information collected about them. however, there's so little work being done just because of the tools and the accessibility isn't out there for news rooms,
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journal lists, for people who are involved in civil society. >> human rights organizations. >> human rights organizations. there's no way for people to analyze organizations in this way. we're trying to bring about tools to change that. >> i think what surprised us, too, is the fact that we were trying to do something about it is quite daunting. the three of us didn't really care but getting people -- we thought it was going to be hard to convince people to donate their time essentially. they were getting six figure offers or whatever. it's been really easy. we have kids who are like taking their finals this week and also on client calls and also spending 40 plus hours so that was a nice surprise. >> and who is using your tools right now? and have you been able to connect with any federal agencies? >> so -- >> okay. so the product that we just launched a month ago is called sanctions explorer. it makes u.s. treasury data accessible and inciteinciteful. the users are journalists, people that work at academic
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centers that work on nonproliferation issues. analysts that work on illicit finance or sanctions evasion to north korea. these are a subset of our users. i think we have reached out to the government, like the u.s. treasury regarding this particular tool many times. we haven't, you know, been actively engaged there honestly. we visited them last spring before we started archer because we demoed several projects that we had built to the department of treasury, and they were very excited about it but i guess we just kind of fell out of touch. >> so does that lack of contact change anything for you? are you still hopeful that this is an opportunity to bridge the gap between the bay area's tech epicenter, what you're doing, and policies being made in washington, d.c.? >> i think, yeah, the day that we launched i was sitting in class and our twitter was just i guess blowing up because of all the people -- like all the
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people who were really excited that this existed for them. so it hasn't been like discouraging or anything. like we really understood in the immediate 24 hours after we launched sanction explorer like we can have a considerable impact. >> i know you're attending rights con next week. in the meantime you're looking ahead, tyler, as you're volunteering on this. where would you like to take archer from here? >> so over the next few months us three are going to be going full time. that's a big jump for us going from students but we're going with the full commitment, going to this conference and our big focus is to get our products in the hands of as many impactful users as possible and to learn about their problems and impacting that. >> scaling and making money? >> yeah. so a big focus for the next couple of months is also architect, our flagship product, which integrates different
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critical public datasets and makes them connected so that's what we're focusing on. >> all right. good luck to all of you. alice ma, tyler hines and angelie, thank you. that will do it for us as always. you can find more of our coverage at kqed.org. i'm thuy vu. thanks for joining us.
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