Cover 2 Resources

In October 2018, the Justice Department's Criminal Division created the Appalachian Regional Prescription Opioid (ARPO), Strike Force. This team consists of federal agents, prosecutors, and specialists from different government departments. Together, they combine data analytics and law enforcement to spot dangerous prescription patterns and quickly remove bad actors from the Application Region. In its early operation, the ARPO Strike Force brought charges against 60 individuals. Combined, those charged wrote 350,000 prescriptions, supplying 24,000 patients with 32 million pills. With their collaboration, the ARPO Strike Force has streamlined several years worth of traditional work, in a matter of months. Joining us today is Joe Beemsterboer, Sr. Deputy Chief of the Fraud Section of the Department of Justice. Together we discuss the inner workings of this data-driven program that gets results. Tune in this week for a detailed look at this revolutionary program, dedicated to ending the opioid epidemic as soon as possible.

Last February, I interviewed Evan Ratliff, author of The Mastermind. The book tells the story of how lone programmer Paul La Roux, built an online drug empire responsible for dumping millions of pain pills into the U.S. La Roux enticed hundreds of doctors to take part in his scheme and wasn’t caught until 2012. During my interview with Ratliff, he speculated on how La Roux’s cooperation with the government to bring down the people in his organization would affect his sentencing. Last month we finally got our answer, as La Roux went before Judge Ronnie Abrams for sentencing. Today, we revisit our story on The Mastermind and talk with Evan Rattliff about the bizarre twists in the La Roux proceedings. For more on the Paul Le Roux story, and the fate of the mastermind, join us on this week’s PPT podcast episode.

For the last few months, I’ve been covering COVID-19’s impact on the opioid crisis. With overdoses up 42% in May alone, it’s projected 75,000 additional lives will be lost to alcohol and drug overdose because of the pandemic. One resource that could help prevent this is a methodology for addiction treatment that has existed for over 45 years but has been relentlessly shunned by the medical establishment. This unique, non-pharmacological treatment is called Neuroelectric Therapy (NET) and I first learned about it last month, after receiving an email from 1A Productions. They had just released “The Final Fix”, a documentary following 5 victims of long-term OUD as they trial NET, in hopes of reclaiming their lives. Joining me on this episode of the Cover 2 Podcast is: The CEO of Izaiah House, Mark LaPalme. One of the five participants in the NET treatment study, Robert Capley. Treatment specialist and NET doubter turned believer, Matt LaRocco. And producer of The Final Fix, Norman Stone. Together, they take me on a deep-dive into Neuroelectric Therapy and the differences between NET and other treatment methods. We also explore why, even after 45 years, NET is still little known. For answers to these questions and more, join us for this week’s episode of the Cover2 Resources PPT podcast.

Over the last 90 plus days, much has changed in our world. COVID19 has forced many of us to endure unfamiliar hardships and inconveniences. But our most vulnerable populations, such as those struggling with OUD, have been hit particularly hard by the coronavirus. To better understand the impact of coronavirus on the opioid epidemic, we teamed up with some of the nation’s top opioid epidemic experts and former guests of the podcast: The Co-Director of Opioid Policy Research at Brandeis University, Dr. Andrew Kolodny. New York Times Editorial Writer and Bestselling author of Dopesick, Beth Macy. Former Clinton White House aide, author of American Fix, and recovery advocate, Ryan Hampton. Together, meeting online for last week’s live webinar, we discussed some of the most pressing questions on the current state of the Opioid Crisis: How has COVID-19 affected those struggling with OUD? How has the pandemic changed the way we treat opioid addiction? What has the struggle against coronavirus taught us about fighting the opioid crisis? For answers to these questions and more on our conversation, join us for this special episode of the Cover2 Resources PPT Podcast.

In 2018, bestselling author Ryan Hampton spoke with me about his struggles with heroin addiction while working as a White House aide and how he become a national advocate for those in recovery. We hope you can join us on June 25th for a special live webinar to discuss the pandemic’s impact on the opioid epidemic and the odds of recovery in America today.

Late in 2018, Beth Macy, best selling author of "Dopesick", shared the story of how Virginia became the canary in the coal mine for the opioid epidemic in her 5 part series with me. We hope you can join us on June 25th for a special event to discuss the pandemic’s impact on the opioid epidemic and the odds of recovery in America today.

Medication-Assisted Treatment (MAT) is considered the gold standard for treating opioid use disorder. But it doesn’t work for everyone, and for those unresponsive to MAT, the next use of illicit street drugs could be their last. This month, Staff Sergeant Conor King introduced us to SaferSupply, a program for those who are either not ready for recovery or just unsuccessful with MAT. As a drug investigation expert for the Victoria Police Department of British Columbia, King shares his expertise to break down this game-changing program. Join us on this week’s episode of the Cover2 Resources PPT Podcast, where we explore the potential impact of pharmaceutical-grade drugs on drug-related crime, homelessness, and overdose deaths.

On May 14th Greg received an email from Elaine, a Montgomery County Maryland Resident. She shared the story of her brother Alan who had struggled with addiction, recovery, and relapse for much of his life. Less than a month ago, his unexpected death came as a shock to Elaine. But, she was more surprised to learn that Alan had overdosed many times before, and his history of close calls was well known by several friends. Hoping to stop others from making the same discovery too late, Elaine shares her brother's story on the latest episode of the Cover2 PPT Podcast series. For her full emotional story, join us on the Cover2 Podcast. If you know someone who’s overdosed, make it your business to tell their family. You might save a life!

In today’s episode of the Cover2, PPT podcast, we continue revisiting some of the People, Places, and Things we’ve profiled in earlier episodes. We’re touching base to see how the Coronavirus has changed the way they’re making a difference in the opioid epidemic. Today we’re joined by Angie Ferguson, the Executive Director of Drug-Free Clubs of America (DFCA). This student-lead, in-school, prevention program, rewards students who pass drug tests, become card-carrying members and remain drug-free. We were first introduced to DFCA at a launch rally in Chillicothe, Ohio, back in 2016. There, 1,500 students marched from the gym to the courthouse to show their commitment to being drug-free. Join us on today’s podcast as returning guest, Angie Ferguson, share how COVID-19 has affected Drug Free Clubs of American and its student leaders.

Three years ago, we profiled AnchorEd, an innovative initiative, developed in Rhode Island. This program enables peer recovery coaches to meet with overdose victims before their release from the hospital. In March, the coronavirus (COVID-19) pandemic sent everyone into lockdown. To continue helping people with recovery, these programs had to adapt to the new normal of social distancing. As we pivot into a new phase of the pandemic, with communities across the country planning to open up, those in recovery will face new, never before seen challenges. Changes to Ohio TeleHealth guidelines enabled peer recovery coaches to continue connecting with their patients during the lockdown. Brian Bailys, the founder of Thrive Behavioral Health Center, shares how his peer recovery network adapted their services in response to the coronavirus.

Last week, a STAT News article titled “Covid-19 will worsen the opioid overdose crisis if we don’t prepare now,” stated that, “Missing from the national discussion on the coronavirus has been another vulnerable group: patients with opioid use disorder. Despite ongoing public health efforts, the opioid overdose crisis does not appear to be slowing down. The emergency of Covid-19 could worsen it if we do not preemptively develop and implement response plans now.” As we know all too well, social isolation is a key measure for preventing infection and curbing the spread of the virus. Many patients taking medications to treat their opioid use disorder — methadone or buprenorphine — aren’t able to stay home. Government regulations limit how these medications are prescribed and dispensed, often requiring inpatient treatment. Here to talk about what’s being done for those in SUD treatment is Dr. Rick Massatti, the State Opioid Treatment Authority at the Ohio Department of Mental Health and Addiction Services (OhioMHAS). Dr. Massatti currently oversees the federally licensed opioid treatment programs (OTPs) and has over sixteen years of experience working on substance use and mental health research policies and programs. As our state and nation pivot to address this crisis and vulnerable population, Dr. Massatti brings his expert understanding to this week’s podcast. Together, we shed light on the COVID-19 and the opioid treatment guidance policies, changing rapidly across the country. Join us on this week’s podcast for eye-opening insights into COVID-19’s impact on the opioid epidemic and the rapid response policy changes saving lives as the coronavirus pandemic evolves.

In its latest Strategy Report, the Office of National Drug Control Policy (ONDCP) shared its strategy for building a stronger, healthier, drug-free society. To reach this goal, the ONDCP details three tactics for fighting the opioid epidemic. First, continue to prevent new substance abusers through education and evidence-based prevention programs. Second, improve access to long-term addiction recovery treatment services. Third, reduce the availability of these drugs in our communities. By achieving these goals, the ONDCP will dominate the drug environment, reducing future lives lost to substance use. Today, we're joined by the Director of the ONDCP, Mr. Jim Carroll, the man in charge of executing this strategy. Together, we discuss the highlights of the latest Drug Control Strategy Report. Join us on the latest episode of the Cover2 Resources Podcast for a deep dive into our nation's plan for fighting the opioid epidemic.

In June 2017, Dr. Belma Andric, Chief Medical Officer of the Health District of Palm Beach County, Florida, joined Greg on the Cover2 podcast. She shared a unique pilot program that started Medication Assisted Treatment (MAT) for overdose victims right in the emergency room (ER). Unlike previous MAT addiction programs, the pilot program included 8 days of house calls to deliver medication and monitor patient progress. The success of that program inspired a new treatment initiative in Palm Beach County, an ER Addiction Stabilization Unit (ASU) specially designed for those struggling with substance use disorder (SUD). Since its inception, the ASU has treated over 350 patients. Similar to regional centers of excellence that address conditions such as heart, stroke, or cancer care, Palm Beach County now has the first center for evidence-based addiction care. Just two weeks after the ribbon-cutting ceremony officially opening the ASU, Greg met with Dr. Andric and her team. Together, they introduced this ground-breaking program that, through a public-private partnership, leading the way in overdose treatment, life-long addiction care, and reducing the stigma surrounding addiction and addiction treatment. Join us on this week’s podcast as Dr. Andric and her team share how they helped create the first ASU in Palm Beach County, Florida.

Since 1995, when the FDA approved OxyContin, igniting an opioid crisis, many bad actors have emerged willing to do almost anything to make a buck off the insatiable demand for opioids in our country. But none less known, and more destructive than Paul Le Roux. Born in Zimbabwe, Le Roux was a loner who became an expert software developer. Then, in 2004 he launched what would become the largest network of internet pharmacies in the world, supplying painkillers to millions of Americans each year. At the height of his operation, Le Roux was distributing up to 100 million doses of painkillers, roughly 25 percent of the annual volume of national drug store chains like Rite Aid. While LeRoux stayed largely under the radar, in 2014, he caught the attention of award-winning investigative journalist Evan Ratliff, launching his research into LeRoux’s little-known underworld. Over the next 4 years, Ratliff wrote: “The Mastermind: Drugs. Empire. Murder. Betrayal. The incredible true story of the decade-long quest to bring down Paul Le Roux—the creator of a frighteningly powerful Internet-enabled cartel who merged the ruthlessness of a drug lord with the technological savvy of a Silicon Valley entrepreneur.” Joining us on today’s podcast, Evan Ratliff shares Paul Le Roux’s improbable story and his influence on the opioid epidemic.

Between 2004 and 2011, opioid abuse and dependence among delivering mothers in Ohio grew by 491%. As a consequence, cases of neonatal abstinence syndrome (NAS), where opioid exposed babies experience acute drug withdrawal following birth, became commonplace. Babies who begin their lives suffering from NAS experience slower than normal development, and can suffer adverse effects from it for years. The Maternal Opiate Medical Supports Plus project (MOMS Plus) was developed to improve care and outcomes for mothers and their unborn babies through wrap-around services, care coordinators, and tailored counseling. The MOMS Plus program, launched in 2017, has already helped over 1,000 mothers get help for SUD and lowered the risk of opioid withdrawal following birth for their babies. Today, Dr. Michael Marcotte and Jennifer Terry from Cincinnati Children's Hospital join Greg to share the highlights of the program.

In 1996, pain became the 5th vital sign in medicine, prompting doctors to rely on opioids for pain treatment. As a result, opioid prescriptions spiked over the next 15 years, causing hundreds of thousands of opioid addictions. While many doctors were educated on opioid prescribing practices, what they didn’t know – and are still learning – were strategies for tapering patients off of these highly addictive drugs. Something Dr. Travis Rieder, a Bioethicist at Johns Hopkins School of Public Health, had to figure out on his own while recovering from a nasty motorcycle accident. Dr. Rieder recounts his experience with opioid dependency in his book, In Pain, and joins us today to share his story of opioid dependence, withdrawal, and recovery. Listen to today’s podcast for a first-hand experience of this medical knowledge deficiency, and what must be done to fill the gaps in pain treatment.

In February of 2019, we interviewed Palm Beach Post reporters Pat Beall and John Pacenti, about the trial of former executives from opioid manufacturer Insys Therapeutics. They’d been accused of racketeering, bribing doctors to prescribe their high-powered opioid fentanyl spray, Subsys, to patients who didn’t need it. A year later, the Insys executives have finally received sentences of 1 to 5 ½ years in prison. This is the first time big pharma execs have been convicted and sent to prison for racketeering. It’s arguable whether this sentence achieves justice for the 900-plus lives lost to opioid addiction that began with Subsys prescriptions. But, it does send a clear message to the rest of the pharmaceutical industry. To share their insight into the Insys sentencing, Palm Beach Post reporters, John Pacenti and Pat Beall return to the podcast. Together, we break-down what this case means for the rest of the pharmaceutical industry and the questions that remain.

Last July, Major League Baseball fans were shocked when Tyler Skaggs, a rising star pitcher for the Los Angeles Angels, was found dead in his hotel room. The toxicology report indicated Skaggs had oxycodone, fentanyl and alcohol in his system, causing him to overdose. The tragic loss of Tyler Skaggs left many people wondering how his drug abuse went undetected by Major League Baseball. But it quickly became a compelling motivator to change their approach to substance use disorder in the workplace. Last month MLB announced its new drug testing policy, which will include mandatory opioid testing for all players. The current MLB drug program tests players for performance-enhancing drugs like anabolic steroids, and other so-called “drugs of abuse”, including opioids, only if they had “reasonable cause”. The new MLB testing policy shifts way from solely punishing drug abusers, to getting them the help they need, a refreshing change in policy that has never been attempted in professional sports before. To help us better understand the new MLB drug testing policy, joining us is journalist Jared Diamond of the WSJ. His in-depth reporting on this issue provides an insider’s perspective on MLB’s sweeping changes to their drug testing policy.

In 2006, Purdue Pharma was under fire for falsely advertising the addictiveness of its opioid, OxyContin. Many families believed that handcuffs were the only justifiable punishment, and the Department of Justice (DOJ) seemed to agree. Yet, somehow Giuliani Partners LLC managed to reach a settlement for Purdue Pharma and it’s top three executives. Effectively telling all of Big Pharma that the deaths of thousands of Americans were just the cost of doing business. However, in August 2019, The Weekly, a New York Times documentary TV series, released an episode profiling a leaked prosecution memo. The memo detailed that government investigators believed Purdue Pharma knew OxyContin was fueling a rise in addiction and had damning evidence to prove it. Why did this memo take more than a decade to come to light? Had its contents been exposed, would it have mitigated the opioid crisis? Who was behind the decision to settle with the drug manufacturer responsible for igniting our country’s worst health crisis in history? We’re joined today by Paul Pelletier, the former Deputy Chief of the DOJ’s Fraud Section of Criminal Division, and by returning guests Dave Aronberg, State Attorney of Palm Beach County, and Chris McGreal, award-winning author of American Overdose, and opioid crisis expert. Together, we explore what really happened with the proposed indictment of Purdue Pharma and their three top-ranking executives, and the lost opportunity to make them pay. Tune in to our PPT podcast for an inside perspective on NYT’s leaked prosecution memo, and the many unanswered questions left by the 2006 case against Purdue Pharma.

In 2019 we released 45 new podcasts covering books from best-selling authors such as Dopesick from Beth Macy and American Overdose from Chris McGreal, to important developments such as the MDL and the J&J Oklahoma trial and people making headlines such as Joe Rannazzisi, former head of diversion control from the DEA. As I look back I realize how many amazing people, places and things we were lucky enough to profile on our series in 2019. The one that stood out for me, was episode 250, with Dr. Andrew Kolodny. Dr. Kolodny’ s candid insights into the policy missteps at the FDA that enabled an epidemic to grow out of control for over two decades were a revelation to me and I hope, to our listeners as well. So, as we close out 2019, we’re pleased to re-release an abbreviated version of our interview with Dr. Andrew Kolodny. Today’s guest, Dr. Andrew Kolodny, is an authority on the opioid epidemic. As a Senior Scientist and, Co-Director of Opioid Policy Research at the Heller School for Social Policy and Management, Dr. Kolodny has a deep-rooted interest in public health. He began his career working for the New York City Department of Health and Mental Hygiene, helping develop and implement multiple programs to improve health and save the lives of New York City citizens. These initiatives included: city-wide buprenorphine programs, life-saving naloxone overdose prevention programs and emergency room-based screenings, and brief interventions and referrals to treatment (SBIRT) programs for alcohol and drug misuse. Using his expert knowledge and vast experience fighting the opioid epidemic, Dr. Kolodny guides us through the FDA’s missteps that helped fuel our nation’s worst health crisis in history. Join us on today’s podcast as we uncover the mistakes that helped perpetuate a growing opioid crisis and the missed opportunities to keep it in check.

Ohio has one of the highest opioid overdose death rates in the entire nation. Despite research from the Ohio Opioid Education Alliance revealing that most Ohio parents are aware of this, they still underestimate the risk opioids pose to their children and family. To counteract this “not my kid” mindset from leading parents to overlook the importance of preventative measures, the Alliance brought it to life through a 2018 public awareness campaign set in the imaginary town of Denial, Ohio. Last year Greg sat down with the President of the Nationwide Insurance Foundation, Chad Jester, who introduced the program in episode 214 of the Cover2 PPT podcast series. In today’s podcast, Chad returns to share the success of the program and the plans to spread it throughout Ohio in the coming year. Join us for today’s podcast where returning guest Chad Jester shares the results of the “Living in denial, Ohio” public awareness campaign. If you’d like to learn more about the Ohio Opioid Education Alliance or become a member, go to their website: dontliveindenial.org.

For years now, schools across the U.S. have been striving to implement more effective drug abuse prevention and education programs to protect adolescents from alcohol & drug abuse. However, despite investing millions of dollars into prevention programs such as D.A.R.E and Nancy Reagan’s “just say no” campaign, recent studies have revealed they’ve been largely ineffective. In fact, some of the programs intended to prevent drug use, have been known to trigger use in teens with certain personality types. PreVenture, an innovative evidence-based program that identifies at-risk teens through personality-based screening, has been gaining worldwide momentum. Bay Middle School, in Northeast Ohio, began rolling out the PreVenture program during the 2018-2019 school year. Last month, we sat down with the team of educators who introduced the program in Bay Village. Joining us today to share their experience with PreVenture, is Bay Village Middle School Principal Aaron Ereditario, Bay Middle School Teacher Chris Mullarkey, and former Bay Village High School Principal Jim Cahoon. Together, we take a deep-dive into how the PreVenture program was selected, rolled out, and what’s in store for the next phase of this ground-breaking prevention program at the Bay Middle School.

Earlier this year, Greg interviewed bestselling author Beth Macy in a series on her book, Dopesick: Dealers, Doctors, and the Drug Company that Addicted America. It’s a compelling account of the opioid epidemic in our country and profiles the over twenty-year history of the opioid crisis as it emerged in the state of Virginia. Recently, he caught up with Beth to talk about her latest project, Finding Tess, the story of Tess Henry, a young mother in her 20’s who does her best to recover from heroin addiction for her son. In November, Beth and her producer, Emily Martinez, released an Audible Original podcast series portraying Tess' graphic struggle against heroin addiction in obscure parts of Las Vegas. Join us for the return of bestselling author of Dopesick, Beth Macy, and Audible Originals producer Emily Martinez, as they introduce us to Finding Tess, their five-part podcast series sharing the last days of a young mother’s life as she battles heroin addiction on the Las Vegas streets.

It’s difficult for a non-addicted person to rationalize the addicted mind, and the societal stigmatism around addiction doesn’t make that any easier. How can they keep making these decisions if they know they’re wrong, and why won’t they make choices that lead to recovery? The truth is, an addict isn’t in complete control. Like cancer or diabetes, addiction is a disease. In spite of a sound moral compass, a lot is going on in an addict’s brain that drives them to behave badly or make poor choices. Returning to the Cover2 Resources podcast to help explain the science behind the addicted mind, is Dr. Nicole Labor. Dr. Labor is not only a successful addiction specialist but a former addict herself. She uses this experience to bring a unique perspective to her work and the conversation surrounding addiction. Dr. Labor has spoken at many events, breaking down the biology of addiction in ways a layperson can easily understand. To empower more families, Dr. Labor's new book, The Addictoholic Deconstructed: An Irreverent Quick and Dirty Education by a Doctor who Says F*ck, a Lot, further explores the science of addiction through her personal experience. Breaking down the ideas she shares in her book, Nichole takes us through her journey with addiction, providing a personal, and technical perspective, into the science of the addicted mind. Join us for today’s podcast, with returning guest Dr. Nichole Labor, where we deconstruct the science of addiction. If you want to grab yourself a copy of "The Addictoholic Deconstructed: An Irreverent Quick and Dirty Education by a Doctor who Says F*ck, a Lot",  By Dr. Nichole Labor, click the link here. https://bit.ly/2qEh7is

Four years ago, actor, writer, and Akron Ohio native, Jeremie Campbell, was unaware that the opioid crisis was continuing to ravage his hometown. Following his high school graduation, the former all-state football player left Akron for Hollywood. In part to pursue his acting career, landing roles in Spartan, Bicycle Dreams, and Dangerous Words from the Fearless, and to escape the tightening grip of opioids on his community. For a long time, it seemed Jeremie had escaped the epidemic. However, the situation got personal when he began losing his boyhood friends to opioid overdoes. Today, Jeremie’s back to develop and film his latest screenplay. A fictional story, inspired by his life experiences, about the very real impact of the opioid crisis on four friends from Akron, Ohio. Join us for today’s podcast, with special guest Jeremie Campbell, as he shares his dream to put Akron on the cinematic map, and use his voice to bring hope to the voiceless. If you want to get involved with this project, stay tuned to Mdifilm.com and email Video & Photography Company, Back To One Productions, at backtooneprods@gmail.com.

In August, a closely watched Oklahoma opioid trial concluded. Johnson & Johnson was found guilty of deceptive marketing practices and public nuisance, the judge awarded the state $572 Million to cover the first year of abatement. However, the judge later announced he had made a $107 million miscalculation. Instead of $572 million, the amount awarded to Oklahoma was actually $465 Million. The miscalculation brought an outcry among Oklahoma state attorneys, mental health specialists, and addiction experts. All claim that the true cost of the opioid crisis is much higher than $572 million, and will take at least 20 years to resolve. After this surprising announcement, we decided to try to answer the question: What are the latest cost estimates of the opioid crisis, and how do they correlate to the judgment awarded in Oklahoma? Our guests on today’s episode, Dale Hall and Dr. Christopher Ruhm, share the results of their research. Together, they detail the massive financial burden Big Pharma has placed on our country and break down the Judge’s award against Johnson & Johnson. Join us for today’s podcast with Dale Hall and Dr. Christopher Ruhm, to hear the true cost of the opioid crisis.

You wouldn’t pay for something without knowing what you were getting, but all too often, our tax dollars are spent on programs without accountability for results. With the new ResultsOhio initiative, led by state Treasurer Robert Sprague, Ohio is looking for data-backed solutions to guide its funding decisions for social and public health programs. As Ohio’s Treasurer of State, Robert Sprague manages the state’s $20 billion investment and $10 billion debt portfolios, collects and deposits all state revenues, and oversees custodial assets. Taking a collaborative approach to government-funded recovery, ResultsOhio focuses on collecting the best treatment ideas and supporting what gets results. Organizations are invited to pitch their best recovery projects for a chance to earn government funding. However, they must prove their project will get results. With the ResultsOhio initiative, organizations of every size, background, and sector, will have the chance to make meaningful change for those on the road to recovery. Join us for today’s podcast, where Treasurer Robert Sprague returns to share his innovative, “pay for success” recovery program, guided by data-driven results. While still in the process of creating a more detailed application, anybody that interested in more information can follow the link here, or contact Results Ohio at (614) 466-8557 or ResultsOHIO@tos.ohio.gov .

On October 21st, just as a landmark opioid trial was about to begin, a $260 million settlement was reached. The deal negotiated between three major opioid distributors, one opioid manufacturer, and Cuyahoga and Summit Country Ohio, resulted in a combination of cash payouts, and donations of addiction treatments. The first of its kind, this case could become a settlement model for thousands of similar cases against the pharmaceutical industry. The details of the settlement are extremely dense. To help break them down, Andrew Pollis, Case Western Reserve professor of Law and friend of the podcast, is joining us to share his reaction to this week’s settlement news. Finally, we conclude today’s podcast by revisiting our op-ed collaboration about honoring the lives lost in the opioid epidemic with a settlement providing the best chance at long-term recovery for those in need. Join us on today’s podcast, as Andrew Pollis returns to share his insight into one of the opioid epidemics' most influential cases.

Last week, in part 1 of our series on harm reduction, Dr. Jeffrey Singer talked with us about the current state of Naloxone in America, and how to get it to those in need. Today, in the 2nd part of this series, we explore Dr. Singer’s argument against the opioid prescribing limits that have been implemented by many states as a means to slow the opioid epidemic. With more prescribing leniency, a nonprofit group's bid to open a medically supervised drug injection site in Philadelphia could be the first of many alternative treatment methods. . . . On April 6th, 2020, Dr. Springer will debate author Sam Quinones on the premise of his bestselling book “Dreamland: The True Tale of America’s Opioid Epidemic”. Join us next time as we continue our conversation with Dr. Singer and Preview his faceoff with Mr. Quinones.

As a regular listener of our podcast, you know that Naloxone can revive an unconscious overdose victim, and stabilize them until proper medical help arrives. 130 people die in our country every day from an opioid overdose, and many deaths could be prevented if Naloxone were more readily available. While first responders carry the life-saving drug, it’s not always possible for them to make it to overdose victims in time to save them. So, how can we get Naloxone to those who need it most? Many leaders, including the US Surgeon General, believe the answer lies in making Naloxone more readily available in our communities. In today’s podcast, we’ll examine the hurdles that stand in the way of making Naloxone ubiquitous in our communities and what’s being done to remove those hurdles. We’re excited to welcome Dr. Jeffrey Singer to lead our discussion. Dr. Singer is a Senior Fellow at the Cato Institute, the founder of Valley Surgical Clinics, and an expert on US Naloxone policy.

This past August, we started our two-part series covering the public release of the ARCOS data, the DEA’s virtual roadmap to the opioid epidemic. Today, we finish that coverage with Washington Post Investigative Reporter Scott Higham. Scott is a Pulitzer Prize-winning member of The Post's investigations unit. Since joining The Post in 2000, he’s examined conflicts of interest on Capitol Hill, the origins of the opioid epidemic, and much more. With his expertise, Scott guides us through an in-depth look at the ARCOS data. We discuss what communities were hit the hardest, how this data was hidden from the public, and the people you never knew were involved. With so much information it can be difficult to pinpoint who’s responsible. Scott provides some much-needed clarity, but ultimately, only you can decide. Join us on today’s Podcast we breakdown the ARCOS data, the fight to get it released, and what it means for America.

Last time on the Cover2 Podcast, David Siegel, the CEO of Westgate Resorts, shared how the opioid epidemic changed his family forever when it took the life of his daughter Victoria. With a new purpose, David decided to tackle the pandemic head-on, meeting with several of our nation’s leaders responsible for solving the crisis. He quickly learned they weren’t close enough to the issue to make any real change. Shifting tactics, David took to traveling the country. He met with people struggling with addiction, and others in recovery, learning as much as he could about the epidemic from the front lines. He quickly became an expert in the field and took his fight to Congress, aiming to make rapid, meaningful change. In part two of this two-part series, David shares the story of what happened after he testified before congress. As you’ll hear, it didn’t take long for things to begin happening. Guided by an unparalleled sense of urgency, David’s mission to stop kids from using drugs before they start, took shape in less than a week. Join us for the conclusion of David Siegel’s story, as he shares his vision for a new, national prevention program he and his team will officially launch in Las Vegas Next Month. To learn how you can become a part of that change, visit the Victoria Siegel Foundation’s website. There you can find information on David Siegel’s new National prevention program, Victory Clubs, and it’s launch at his Gala at the Westgate Resort in Las Vegas on October 25th.

Since we began this podcast series three and a half years ago, we’ve met some amazing people doing incredible work, each making a difference in the opioid epidemic in their own way. Today’s guest is no exception. What sets him apart is the scope of his latest initiative and his sense of urgency in getting it done. David Siegel is the founder and CEO of West Gate Resorts, the largest timeshare business in the world. He and his family were featured in a reality show as they began building a 90,000 square foot home in Orlando Florida, just as the real estate market crashed. But nothing could prepare him for the impact it would have on his family, and oldest daughter Victoria. After losing Victoria to a drug overdose, David gave up running the day-to-day operations of his company, to dedicate his life to fighting the opioid crisis. He quickly learned that some of our leaders responsible for addressing this epidemic weren’t close enough to the issue to make any real change. David took to traveling the country, meeting with those struggling with addiction and people in recovery, to learn about the opioid epidemic from the front lines. He quickly became an expert in the field, ready to take the fight to Congress and make rapid, meaningful change. Join us for part one of our two-part series for David Siegel’s story and how his impact on the opioid epidemic can be felt throughout our country.

This Summer there’s been a great deal of news on the opioid lawsuit in Oklahoma and the MDL here in Cleveland. We’ve heard how communities and native tribes thought the country have suffered at the hands of the pharmaceutical industry, and now with the ruling against J&J in the Oklahoma trial for $572M and Purdue Pharma offering to settle for $12 Billion giving up their company, it appears it’s time to pay the piper. How that money will be spent is still unclear. We’ve been extremely fortunate to have met with many different voices in the opioid epidemic community. Thanks to their insight we thought we’d weigh-in on the debate for the best use of the settlement money. We didn’t just stake out claim on opinion, however. We made sure to do the research and calculations necessary for the best result. Of course, we couldn’t accomplish this on our own so we reached out to some of our featured guests for help. Together, with addiction treatment specialist Dr. Stephen Loyd, of Mountain Home Veterans Administration Medical Center, recovery expert Tom Stuber, President and CEO of Lorain County Alcohol and Drug Abuse Services, along with feedback from Center on Addiction Director of Health Law and Policy, Lindsey Vuolo, we collaborated on an op-ed published in USA Today, this September. Join us, as we cover our op-ed, the inspiration behind it, the creative process behind it, and our take on the best use for the 12 billion won in the Oklahoma settlement.

First Responders have 6 minutes to make it to an overdose victim and begin administering life-saving Narcan. Sadly, that’s not always possible. The Community of First Responders Initiative is about making Narcan available in public spaces and linking Narcan Carriers with overdose victims while they wait for emergency responders to arrive. Each year on August 31st International Overdose Awareness Day is held to remember those lost to overdose deaths. Today, on the eve of the 2019 Overdose Awareness day, we’re delighted to release our CFR introduction video. A special thanks to our International visitors from Morocco, Mustafa and Samia and their entire team at Artcoustic Creative Studios. They generously donated their time and expertise to produce an exceptional explainer video to help promote CFR in communities across the country, saving lives with this innovative non-profit program. The following 3-minute track is the CFR video in its entirety. To watch it, go to www.CRF.HELP/INTRO. This summer, City of Green Mayor Gerard Neugebauer partnered with the Summit County Department of Health and Cover2 Resources to implement the country’s first CFR program. Implementation is a three-step process. Step 1. Installing stationary NaloxBox units in hotels along the Interstate High way and the Akron Canton Airport. Step 2. Training volunteers to administer Narcan to overdose victims, registering trained volunteers as Narcan Carriers, and distributing the life-saving drug to CFR members for free. Step 3. Registering Narcan Carriers and NaloxBoxes in the NaloxoFind app to create a network of Narcan and first responders equipped to administer aid within a two-mile radius of an overdose. To celebrate our progress, I invite you to share this podcast and video on social media, introduce as many people as you can to this program, and join us for the Barberton Ohio Labor Day Parade Monday, September 2nd. We’ll be there driving an enormous army truck with the Teamsters Local 21 and Travis Bornstein. Come out and Join Us at 16th Street Southwest, Barberton, OH. at 9:30 AM. Everyone has a role to play, so please, join the fight today and together we can save lives.

On July 15th, DEA data covering 2006 to 2012 American opioid sales, was released to the public. The ARCOS data revealed the distribution path of every oxycodone and hydrocodone pill sold in America. A trail of opioids from manufacturers to distributors, to pharmacies, to patients. Undeniable evidence for their responsibility for the opioid crisis. Big Pharma didn’t hand this “smoking gun” for the opioid epidemic over easily. It wasn’t until the Charleston Gazette-Mail, and Washington Post prevailed in a fierce legal battle that ARCOS data was released. However, this was just one fight in a struggle that began long before knowledge of this crucial evidence existed. In part one of this two-part series covering the history of the ARCOS data, you’ll learn how an underdog journalist’s relentless pursuit of the truth succeeded, despite insurmountable odds. Our story begins with Patrick McGinley, and Suzanne Weise, lawyers and Professors of Law at West Virginia College of Law. Hired to help investigative journalist Eric Eyre gain access to DEA and Big Pharma court records, they’ve joined us to share their role in the fight against the opioid epidemic. Listen to today’s podcast for part one of our journey into the history of the ARCOS data. You'll learn how it was finally released, and why the DEA, Justice Department, and Big Pharma tried to hide this information from the public. Remember to tune in next week for part two, where we interview Washington Post Investigative Journalist Scott Higham. He shares his account of the battle over the ARCOS data and what we have learned from their analysis of a 380 million record database.

Today’s guest, Dr. Andrew Kolodny, is an authority on the opioid epidemic. As a Senior Scientist and, Co-Director of Opioid Policy Research at the Heller School for Social Policy and Management, Dr. Kolodny has a deep-rooted interest in public health. He began his career working for the New York City Department of Health and Mental Hygiene, helping develop and implement multiple programs to improve health and save the lives of New York City citizens. These initiatives included: city-wide buprenorphine programs, life-saving naloxone overdose prevention programs and emergency room-based screenings, and brief interventions and referrals to treatment (SBIRT) programs for alcohol and drug misuse. Using his expert knowledge and vast experience fighting the opioid epidemic, Dr. Kolodny guides us through the FDA’s missteps that helped fuel our nation’s worst health crisis in history. Join us on today’s podcast as we uncover the mistakes that helped perpetuate a growing opioid crisis and the missed opportunities to keep it in check.

While many people in power ignored the mounting evidence of the Opioid Crisis, one leader refused to turn a blind eye. In 2009, fresh from seven years as NYC’s health commissioner, Dr. Tom Frieden was appointed a director of the Center for Disease Control (CDC) by president Obama. Dr. Frieden immediately got to work and started by wading through eight-hundred-pages of Health Statistics Us. To say he was stunned by what he found is an understatement. The number of lives lost at the hands of opioids was comparable to that of AIDS in Africa, the 1918 influenza pandemic, or a war. Fifteen thousand people died from prescription painkiller overdoses in 2010 alone, and enough narcotics were prescribed to give every adult in America over a month’s worth of pills. One thing was clear. There weren’t just a few careless people dying of overdoses. America was facing an epidemic, and big pharma was pulling the strings. Today, Dr. Frieden joins us to share his insights from his watch as Director of the CDC and his perspective on the state of the opioid epidemic today. For the full story of America’s first real stand against the opioid epidemic, from the first leader to get it right, listen to today’s podcast.

About 21 million Americans struggle with addiction every day, yet only 10 percent receive treatment. While that percentage is unbelievably low, the reality is that traditional methods of aid are inaccessible for many people, even if addicts are ready for treatment. Fortunately, many organizations recognize this issue and are creating paths to make treatment more accessible. Two innovative programs that are literally taking treatment to the streets are Boston Massachusetts’ Care ZONE, an on-wheels overdose treatment facility, and New Jersey’s Mobile Intensive Care Unit (MICU), paramedics equipped with lifesaving Suboxone. To guide us through these innovative programs is returning guest Dr. Jessie Gaeta, the Chief Medical Officer for the Boston Healthcare for the Homeless Program, and Dr. Shereef Elnahal, Commissioner of the New Jersey Department of Health. We first met Dr. Gaeta 3 years ago, when we discussed her Supportive Place for Observation and Treatment (SPOT) program. Today, she shares her insight into her latest project, Care ZONE, a mobile treatment facility helping to bring addiction treatment to those unable to visit treatment centers. Furthermore, Dr. Shereef Elnahal discusses the progress the MICU has made by adding of the gold-standard of opioid addiction treatment drugs, Suboxone (buprenorphine and naloxone), to their overdose recovery arsenal. Given these success stories, many people have argued that it’s time to relax our tight regulations on Suboxone prescriptions, and remove obstacles for recovery. In the meantime, programs like Boston’s Care ZONE and the New Jersey MICU paramedics, prove that outside-the-box solutions are crucial to progressing against the . For the full details of these revolutionary addiction treatment programs, listen to today’s podcast, and be sure to let us know what programs are making a difference in your home town, down in the comments.

As negative press continued to increase for Purdue Pharma and the opioid epidemic, their market in the US began to dwindle. Prescriptions for OxyContin fell more than 40% since 2010, equating to billions lost revenue. The company’s owners, the Sackler Family, started pursuing a new strategy. Go global through their international company Mundipharma, and put the pain killer that set off the US opioid crisis into medicine cabinets around the world.” On May 22 of this year, Congresswoman Katherine Clark and Congressman Hal Rodgers released a report titled, Corrupting Influence – Purdue and the World Health Organization. This report exposed the dangerous opioid manufacturer’s influence on the WHO, and the potential jeopardy they present to foreign nations and developing countries. Today, we’re joined by Guardian reporter and bestselling author of American Overdose, Chris McGreal, and Daily Caller Journalist, Evie Fordham. Together we discuss this report, its impact on the World Health Organization, and Purdue Pharma’s strategy to breach international markets at the cost of making opioid crisis a global epidemic. We’ll frame today’s episode by revisiting an interview from 2 years ago with LA Times Journalist, Harriett Ryan on an article she wrote titled “OxyContin goes global – We’re only just getting started”. Join us on today’s podcast for an in depth look at Purdue Pharma’s influence over the WHO and its attempts to spread OxyContin worldwide

In June of 2016, we sat down with Dr. Tom Gilson, the nationally known medical examiner from Cuyahoga County, Ohio. Hoping it might inform and help others, Dr. Gilson reviewed Sam McNeil’s report from the medical examiner of Palm Beach County. Today, we revisit that discussion and uncover how some communities, such as the Baltimore Department of Health, are studying overdose victims to discover new prevention strategies to impede the opioid epidemic. Also joining us today is Brittney Spencer, the Overdose Fatality Review (OFR) Coordinator for the Maryland Department of Health. Ms. Spencer and her team have been fighting the opioid epidemic since 2014, researching the autopsy reports, treatment admission reports, police reports, and medical records of overdose victims to identify missed opportunities for prevention. This research helps the OFR collaborate with stakeholders to develop new programs for overdose prevention. These programs save lives and prevent substance use disorder in the future. The OFR team has learned much from studying the opioid epidemic’s effect on their community. Through their efforts, this one team from Baltimore provides the framework for strategies and programs such as Levels of Care, EMS Leave Behind, and LEAD. Together, these resources provide the necessary response tools to influence and impact the worst health crisis in our country’s history. Listen to today’s podcast for a detailed breakdown of Maryland’s impact against the opioid crisis, with Brittney Spencer.

In our three-part series with American Overdose author, Chris McGreal, we took an in-depth look at some of the policies and practices of the FDA that helped lead to our nation’s worst health crisis in history. During the series, I spoke with the former chair of the FDA advisory committee, who’s role is to review and advise on drugs under consideration for approval by the FDA. I was surprised by his responses to my questions, rejecting the notion that mistakes were made, despite the number of deaths the opioids approved during his tenure caused. My take away from this interview was that the FDA is stuck in an inflexible mindset, and has made no attempt to rectify the impact the opioid crisis has had on our country over the last twenty years. Unsettled, I decided to dig a little deeper to find out if my impressions were representative of the today’s FDA. To help me answer that question is Dr. Raeford Brown, who for the last five years has been the chair of the FDA’s anesthetic and analgesic drug products advisory committee. Listen to today’s podcast for insight into the FDA’s policies and practices from the inside, with Dr. Raeford Brown.

When award-winning author Chris McGreal sat down to write American Overdose: The Opioid Tragedy in Three Acts, he wanted to answer two questions. The first: How could the opioid crisis go on for nearly 20 years before it reached public awareness? The second: Why did the opioid crisis happen in America, and nowhere else in the world? We uncover the answers to these questions and more, as we conclude our series on American Overdose. Joining us today alongside author Chris McGreal are Congressman Hal Rodgers, and former director of the Centers for Disease Control and Prevention (CDC), Dr. Tom Frieden. Congressmen Rogers introduces us to Operation UNITE, Kentucky’s response to the opioid epidemic and Dr. Frieden reveals how the CDC sounded the alarm over the opioid crisis, while the rest of our government neglected to act. What does this mean for the future of America, it’s policies and politics? How can we reform the medical industry? Is the end of the opioid crisis in sight? Listen to today’s podcast for the comprehensive conclusion of our American Overdose discussion, with bestselling author Chris McGreal.

To many, how and why the opioid epidemic came about remains a mystery. How did these dangerous and addictive substances earn approval for distribution? Why were these drugs approved if they were clearly so addictive and dangerous? Why has our legal system taken so long to react to a crisis that began in the early 2000s? We continue uncovering the answers to those questions in the second episode in our three-part series on American Overdose: The Opioid Tragedy in Three Acts, with award-winning author Chris McGreal. Together, we uncover the extent of the pharmaceutical industry’s influence over the FDA, the drug approval process, and Congress. With special commentary from the former chair of the FDA advisory committee, Dr. Nathaniel Katz, former California Congresswoman Mary Bono, the former attorney general of West Virginia Judge Darrell McGraw, and Kentucky Congressman Hal Rogers, we walkthrough congress’ early actions against deceptive pharmaceutical practices, as our nation’s worst health crisis emerged. Listen to today’s podcast for Part 2 of our American Overdose discussion, with bestselling author Chris McGreal.

The Opioid epidemic is the deadliest drug crisis in American history, claiming over 350,000 lives since 1999. While many people have an idea of what caused the opioid crisis, few understand the why and how. For example, how did a tragedy that started 20 years ago, only start gaining attention in 2017? How was the greatest drug crisis in American history allowed to go virtually unchecked for nearly two decades? Why is there still no end in sight? To help answer these questions and more, today we’re joined by the award-winning author of American Overdose: The Opioid Tragedy in Three Acts, Chris McGreal. Together, in our first episode of a three-part series, we discuss the origin of the opioid epidemic, the negligent policies that allowed Big Pharma to profit from the suffering of patients, and new evidence on the FDA’s complicity in driving the mass over-prescription of opioids. Listen to today’s podcast for Part 1 of our American Overdose discussion, with bestselling author Chris McGreal. To follow along with our discussion, you can pick up Chris’ book American Overdose: The Opioid Tragedy in Three Acts here.

Many people that view addiction from the outside don’t understand the struggle addicts go through and can’t appreciate how addiction impacts their families. To educate people from that perspective, the new documentary, Heroin’s Grip, features the families of Frederick County Maryland, whose lives were transformed by addiction and the opioid epidemic. Joining us today for a prerelease, behind the scenes, look at his film, is Heroin’s Grip director Conrad Weaver. A filmmaker by trade, Conrad was touched by the stories he experienced surrounding the opioid crisis in his community and was inspired to act. His documentary exposes the real, emotional stories, of several families whose lives have been forever altered by opioid addiction. Due to cultural stigma, we often push away people who are struggling with addiction when we should be offering support. Conrad hopes to use Heroin’s Grip as an educational tool and a rallying cry for communities across the country, that addiction isn’t someone else’s problem, it’s our problem. On May7th, a screening of Heroin’s Grip will be held in Akron Ohio at The Chapel. To get in touch with Conrad and find out how you can bring a screening Heroin’s Grip to your community, click here. Listen to today’s podcast for a behind the scenes look at Heroin’s Grip, with Director Conrad Weaver. Listen to today’s podcast for a behind the scenes look at Heroin’s Grip, with Director Conrad Weaver.

In March of 2019 the Center on Addiction, a nonprofit organization committed to supporting families struggling with substance use and addiction, published Uncovering Coverage Gaps II: A Review of Addiction Benefits in ACA Plans. A follow up to their 2016 report of the same name, this new report reviews and compares the addiction benefits in the Affordable Care Act (ACA) plans for all 50 states. This most recent report was an eye-opener, both for what coverage was available through the state plans, but even more so, what was omitted. Here to further our understanding of the 2019 report, is the Center on Addiction health law and policy director, Lindsey Vuolo. Lindsey is the research lead on the adequacy of SUD benefits offered in the ACA health plans, an expert on federal and state responses to the opioid crisis, and author of (Ending the Opioid Crisis: A Practical Guide for State Policymakers). Drawing on her extensive experience in legal, regulatory, and policy work related to addiction prevention and treatment, Lindsey shares her discoveries of the essential coverage gaps in the ACA plans nationwide, and provides her insights regarding the current state of addiction health care coverage and policy in America. Listen to today’s podcast for an extra-informative episode on your state’s addiction coverage, featuring Lindsey Vuolo.

The opioid epidemic has taken a deep toll on families throughout Appalachia. In Tennessee alone, over 1,631 people, (more than five per day), died from a drug overdose in 2016. To respond to such a massive loss of life, Tennessee state leaders developed a special program to unite faith-based communities and take coordinated action against substance abuse. Faith communities have a long history in the struggle against substance abuse. By working together and building a Faith-Based Recovery Network, not only can the state of Tennessee provide educated, welcoming, and supportive places for individuals struggling with Substance Use Disorder (SUD), but also, they can increase outreach, and build more pathways to recovery. Dr. Monty Burks, is the leader of Tennessee’s Faith-Based Recovery Network, and State Director of Special Projects and Faith-Based Initiatives. Fresh off his speech from the National Drug Abuse & Heroin Summit, Dr. Burks shares his insight into this program’s collaboration with Faith-based communities in Tennessee and beyond. Listen to today’s podcast for a preview of Dr. Monty Burks, Fair-Based Recovery Network- empowering faith communities for substance abuse recovery.

While there are many high-quality treatment centers, organizations, and programs for people struggling with opioid addiction, their families often lack the same resources. Opioid use changes the lives of the addict’s family as well as the addict, and many families don’t know what to do when a loved one is faced with opioid addiction. Opioid addiction is a battle for everyone involved, and without proper guidance, adjusting to this change can be its own challenge. To help families become a positive force in their loved one’s struggle with opioid addiction, joining us today is Roy Poillon. Founder of R~House Alzheimer’s Family Learning Center and Families Impacted by Opioids, his mission is to empower families in their journey to support a loved one struggling with substance use disorder. This May 4th, through his Addiction Family Empowerment Conference, Roy is channeling his veteran experience in aiding families with Alzheimer’s, to empower the families of Opioid addicts by providing them with the therapy, training, and educational resources they need to be a positive force in their loved one’s recovery. Listen to today’s podcast for a preview of Roy Poillon’s, Addiction Family Empowerment Conference – for families that have been impacted by the opioid epidemic.

On March 26, 2019, the pharmaceutical company Purdue Pharma, a high-profile figure in the Opioid Epidemic, agreed to a $270 Million Opioid Settlement with the State of Oklahoma. The money from this settlement will fund a national addiction research and treatment center in Oklahoma. This is a unique case for several reasons. First, Oklahoma Attorney general Mike Hunter had originally sought $20 Billion in damages. Second, this is the first of more than 1,600 cases against Purdue to settle. Third, the settlement occurred one day after the Oklahoma Supreme Court denied Purdue’s request to delay the trial from its May 28th start date, and the judge had ruled that the trial could be televised. There’s a lot of subtext in a case like this, and it can be difficult to understand the intent behind each parties’ actions. With the help of legal authority Andrew Pollis, Professor at the Case Western Reserve University School of Law, we unravel the deeper meaning behind this key settlement in our struggle against the opioid crisis. Listen to today’s podcast for an expert’s perspective on Purdue Pharma’s Settlement with Oklahoma, joined by Case Western Reserve University School of Law Professor, Andrew Pollis.

Pharmaceutical companies spend billions annually on influencing physicians and other pharmaceutical providers, to write more prescriptions for their products. For most companies, the majority of their marketing budget is dedicated to direct contact with doctors, offering token gifts and free lunches, in tandem with information on their products. Many aspiring medical practitioners and physicians are unaware of the impact this can have on their practice and their patients, with recent studies revealing the full extent of this influence. Fortunately, there are those dedicated to preparing today’s students on where to draw the line when pharmaceutical reps come calling. Today, we talk with Dr. Elizabeth Gundersen, the Director of Ethics at Florida Atlantic University in Boca Raton, Florida. An expert on physicians’ vulnerability to the pharmaceutical industry, Dr. Gundersen’s ethics class helps prepare students for ethical challenges they face as future as practicing physicians. Listen to today’s podcast for the eye-opening truth about the pharmaceutical industry with Florida Atlantic University, Director of Ethics, Dr. Elizabeth Gundersen.