Dr. Robert DuPont: America's Drug Crisis, Marijuana & the Miracle of Recovery

Voiceover 00:00:01 The addiction podcast Point of no return. Joanie Sigal 00:00:06 Dr. Dupont, thank you for being on the podcast today. Dr.

Robert DuPont 00:00:10 I am really proud to be here. This is a great achievement for me and a milestone in my long career. Joanie Sigal 00:00:17 Oh, that's very kind of you. You know, when we spoke to you before, we were kind of in the midst of, or maybe coming to the tail end of the whole OxyContin and opioid epidemic.

And one of the things I found interesting about what you talked about, because you have a long history of working in this area. I mean, you were like the second drug czar in the country talking about. Dr. Robert DuPont 00:00:42 Drugs and the first director of nida, National Institute on Drug Abuse.

Joanie Sigal 00:00:46 Exactly. And I remember you saying that way before there was OxyContin in that whole mess. There was heroin, and that was a huge mess when you were first, you know, taking over. And then we segued up to what was happening with OxyContin.

Because, as you remember, we were talking to you at the Anti Drug Summit held by Drug Free America in Tampa. And, you know, we're kind of, you know, as you just said to me before I hit record, the drug addiction scene changes, and yet it sort of stays the same. What are you seeing today? What are you addressing and how.

Dr. Robert DuPont 00:01:30 Well, the key to the drugs is chemical stimulation of brain reward with various chemicals and the number of chemicals. We tend to think about it in each era as if it was one problem, but it's always been poly drug problem. It never has been a single drug problem.

And so the way we look at it is, is one at a time, and there's very few people who just use one drug. They're using lots of drugs and usually at the same time. So even when you look at overdoses, it misinforms you because it isn't a single drug that's going on. And there's a very creative, powerful, big global network of drug providers.

And what drives all of that is the money from the users. And people talk about they want to get China out of the thing or Mexico or something like that. You could take China and Mexico out and it wouldn't change anything because it's the money from the users that is the problem. And that money will attract people with the chemicals ready to pick up the money.

And until we stop that money, we're not going to have any success with efforts that are focused just on one thing or one drug. And that's. That, I think, is really important to understand. We think of.

Joanie Sigal 00:03:15 You make a good point. It's supply and demand. If there's demand for drugs or money as you're saying, there will be drugs wherever they come from, but it doesn't. Dr.

Robert DuPont 00:03:25 Come from the suppliers, it comes from the users. Joanie Sigal 00:03:28 But that's what I mean, the demand. Dr. Robert DuPont 00:03:29 Yeah, yeah, that's what the problem is.

And, and that's American money that is going out. And you know, people talk about if it was legal you wouldn't have the problem. But that, that does, that just makes it more available to, to, to the users. And, and the users are making a decision day by day with what they do with their money.

And that's where the core of the problem is. And to reduce, the problem is to reduce the drug use. That's, that's what has to happen. And there's a trajectory of drug users.

How do they do it? How do they start? Well, it's interesting, they start when they're young. Most of this starts in a teenage and the younger it is, the more malignant the course is to it.

But then problems come with the use and the problems mount over time and there comes a point in the person's career when he or she says, you know, that's enough. And then the process goes on. Some kind of treatment oftentimes, but not necessarily. And then the issue of recovery and then what that is all about, the miracle of recovery is a very happy story in our field.

But the number of people who thing that's really interesting to me is what's the risk of an IV opiate user of dying in the course of a year? What kind of risk is that? And the answer is it's half a percent that 1 out of 200 active users will die in the course of a year. And that, that's not enough to get people's attention.

They see so many people who are doing a new don't die. So their immediate experience doesn't confirm that that fearful thing. I think most people think that probably 20% of them die a year, you know, but no, it's not 20%, it's half. Joanie Sigal 00:05:41 Who knew?

Dr. Robert DuPont 00:05:42 Yeah, I didn't know. But that's very important. Yes, trying to understand the problem because the headlines are all about the overdoses.

But, but actually that doesn't change the behavior of the user because they see so many other users who aren't dying that they don't their experiences. And even people who have overdose overdoses that are non fatal go right back to using it again. Joanie Sigal 00:06:09 Yes, they do. Dr.

Robert DuPont 00:06:11 That's so interesting to think about that. But what, what we need is a recognition of the vulnerability to this and like we've done with drunk driving, the risk of a drunk driver having an accident is actually very low. Almost all the drunk drivers arrive home safe. But what the percentage.

There is a small percentage again and, but there's so many people. It's a lot of people who are dying. And we've done a pretty good job with the idea of, you know, don't drink and drive. Well, that's kind of like if in our area that's, you know, don't use drugs because that's a very negative experience.

Even though it's unusual, it's not common in, it's common for the whole country, but for an individual user it isn't. And I think that's, that's really important. The other thing that I think is so important to me in my 45, 50 year career is the miracle of recovery and what that's like. Drug use is contagious and so is recovery.

And it took me a long time to understand about how important recovery was. And that recovery is more than just not using, is a different person than the person who's in recovery. And that's to me, the most exciting thing in our field. Joanie Sigal 00:07:53 Dr.

Dupont, sorry to interrupt, but explain what you mean when you say the miracle of recovery. We talk to a lot of people in recovery. How would you define that or describe that? Dr.

Robert DuPont 00:08:02 Well, it includes not using and it's not just using one drug. It's not just using fentanyl, it's not using any drug. That's very important to make that distinction. And the experience of the person is not just that he or she is not using now and was using.

It's a different person, the person that thinks differently, they have a different way of thinking about themselves. They have a different way of relating to people. The person in recovery is a different and a better person than the person. And why is that?

Because the addiction makes you extremely self centered and narrow in who you are, how you relate to people and what goes on. And recovery is shared and related to that. To me is AA and na, how important they are. I think even most of the people who are expert in the field don't understand how important that uniquely American institution is where there's no experts, no money and nobody making money on it, people helping each other.

You know, I think it's purely American. It's America's gift to the world and is AA and na and it's not like anything else. What's strange to me is that it took me 20 years in the field to figure out how important AA was NA. And how did I learn?

I learned from my patients, right. I watched what they'd happened to them. I watched that miracle before my eyes. Joanie Sigal 00:09:51 And you made a very good point.

Because I've said it in a different way for I don't know how many years we've been doing this and that is that a lot of people think that addiction is purely physical. And therefore if someone just goes, I'm going to stop that all is well. But what a lot of people don't understand, and I think this is what you're saying, only I'm saying it differently, is addiction is physical, mental and spiritual. And if you don't address all three, you don't get full on recovery.

You just don't, you know that's right. Dr. Robert DuPont 00:10:24 And not everybody, every recovery is the same. No, but, but, but there's, there is a core experience here that is quite inspiring and it inspires not just other users, but other people around that person to see that transformation is, is, is, is very, is very exciting.

I think, I think all of that. Oh, that's true. And the other thing people don't understand is we're actually making progress on drugs. It's pretty impressive.

And the bedrock of that is what percentage are not using. And that's going up especially it's dramatically in kids. And it's been going up for four decades. And people don't understand that.

And why is that? Because the culture is learning, the kids are learning about it and learning from their own behavior. And that's all of that is very good news to me. One of the things that's so interesting is the evolution of what the drugs are we have and the ingenuity of the suppliers and in coming up with ever new drugs and how they market that and make their living from doing it.

What I say is that if you got entirely got Mexico and China out of would be the next day it would come from other places. It used to be when I got in the drugs we used were plant products, you know, like opium for example or cannabis. And now they're mostly synthetic. And what that means is they don't have to be planted somewhere, anybody can make them.

They got chemicals, they make it out in the garage. You don't have to have a field, you don't have to have a factory to make the drugs. And the number of drugs is, you know, astronomical. I'm limited what it really is.

And just using chemicals to produce brain reward, produce positive feelings, that's what make, that's a drug. What makes a drug Whether it's a planned or purely synthetic. And it's part of the human experience to have that. And people are very inventive and there's money in those chemicals and that's what attracts people to their careers in, in drug sales, both legal and illegal things.

And, and that's a struggle, a history that is made about that. And, and it started with the baby boom in the, in the 60s and it's, it's been. Become global and it's part of our culture. And you know, your wonderful podcast are collecting the stories of dealing with that, that epidemic, that, that uniquely human epidemic.

And it's a, it's a heck of a story. Joanie Sigal 00:14:04 Well, thank you. And it's good to hear you say that you believe the problem is improving because we like to hope so, because that's why, that's why we do this. Can I ask you kind of a specific question?

Dr. Robert DuPont 00:14:18 Sure. Joanie Sigal 00:14:19 So, you know, we've covered recently, as we mentioned before we went on air, we've covered recently this whole idea of like, let's take marijuana and basically make it a Schedule 3 consult controlled substance, which basically makes it less restricted than it is now. Would you think that would lead to more widespread use of it?

Dr. Robert DuPont 00:14:40 Yeah, I think it's your. I think the idea that it's a medicine, I think it does that and it opens up. But, but remember this, that, that, that when you make a drug legal, it doesn't stop the illegal supply.

There's the presumption that if people could get it legally, they wouldn't buy it illegal. But we've got experience now with marijuana where you have legal marijuana. The issue here has to do with thinking of it as medicine. Joanie Sigal 00:15:19 Right.

Dr. Robert DuPont 00:15:20 That's what's different. Joanie Sigal 00:15:21 Yep. Dr.

Robert DuPont 00:15:23 It isn't that it's a different substance or anything. It's just that it's medical. And what happens when you do that is you legitimize it, you encourage the behavior. And making it legal for medicine will not close, slow down the illegal marijuana at all.

It'll just validate it and give it a covering. Right. The people who wouldn't want to do something that is illegal, you know, are attracted to that. It also gives it a sense of being a good thing.

Medicine is a good thing. And so you get the introduction to marijuana through, through a medical channel or a quasi medical. And that's not gonna. The difference of present and absent, but it'll add to the number of people who get into it and have, have problems with it.

Yeah. So it's, it's a, it's an endless battle that's going on for the, you know, the health and the money. Joanie Sigal 00:16:41 Well, it's not dissimilar to the opioid epidemic. I mean, most of the people that got addicted, they originally did it for pain management, and then when they couldn't get it anymore, they had to move to heroin because it was too expensive or they couldn't get prescriptions.

Dr. Robert DuPont 00:16:55 That was one avenue. Joanie Sigal 00:16:56 And that's. Dr.

Robert DuPont 00:16:57 Right. Joanie Sigal 00:16:58 So OxyContin was legal. You could get that from a doctor. But it didn't stop the illegal use of it.

Dr. Robert DuPont 00:17:05 No, because the money is there, and the buyers are going after that money. They'll go one way and another way and another way about it to do that. And I think it's also fun that there's no animal model for addiction because there's no drug in nature that an animal can get into and have a problem with The.

It's a purely human experience. Joanie Sigal 00:17:36 Interesting. I never thought of that, but you're right. Dr.

Robert DuPont 00:17:39 Yeah, it's. It's. It's. It's.

It's. It's. People are amazing and very diverse, do all kinds of different things. And you and I are beneficiaries of their mistakes by creating this problem that, uh, you know, keeps us in business.

Joanie Sigal 00:18:01 Well, I hope ours isn't really a business, but it keeps me busy, I'll say that. Dr. Robert DuPont 00:18:05 Well, I don't know. It's a.

It's. It's. It's a career. Joanie Sigal 00:18:09 Yeah, exactly.

Are you seeing. Dr. Dupont? Are you seeing people today?

Are you seeing a difference in the drugs that people are using? Because I remember, as I said, when we talked about the opioid epidemic, you pointed out heroin and opium. But are you seeing any difference today? Because we hear a lot of people talking about fentanyl and marijuana.

Are you seeing that in your practice? Dr. Robert DuPont 00:18:33 Yes. Yes.

Well, now I'm retired from my practice. Joanie Sigal 00:18:36 Okay. Dr. Robert DuPont 00:18:37 Any patients now?

Joanie Sigal 00:18:38 Okay. Dr. Robert DuPont 00:18:40 But, you know, and. And also alcohol is in the picture.

Joanie Sigal 00:18:45 Yep. Dr. Robert DuPont 00:18:47 Picture. You've got a lot of.

And. And the. The different ways the drugs are distributed, the way they're packaged, the way they're sold. It's what, one way to think positively about it and is there's a.

There's a growth goes on in terms of overcoming the addiction, and it's. It's inspiring to. To everybody. That.

That is pretty neat. When, When Bill Wilson started aa, he only wanted to do alcohol, and nothing else mattered. And. And obviously those alcoholics were using other drugs, too, and he.

He. He didn't want to have them in. But then he changed their mind, and he had to. To stop alcohol.

You had to stop other drugs, too, to be in recovery. And that's why we got N A because we had to expand beyond alcohol. And I think that that's right to see the. The generalization of the.

Of the problem and of the. Of the solution. But the class of drugs that are. That are producing chemicals, that produce brain reward, that make people happy and feel, you know, excited and happy and in the way that mushrooms out into all kinds of different chemicals, different sources of them, different patterns, has been.

You know, the story of my life is, is, is that. That happening, that becoming global and that becoming a. A major part of decision making about living with or without the drugs. And it, the.

The. What makes it all. Well, it's. The whole thing is absolutely fascinating, but most rewarding is that miracle of recovery that is just like the drug use, it's contagious.

Joanie Sigal 00:21:03 Dr. Dupont, I appreciate you talking to us today. I appreciate your insight and I appreciate your positive outlook, and I love the whole idea of the miracle of recovery. And that's what we hope for, for everyone.

And that's what we enjoy talking about when we talk to somebody, somebody who has had a substance abuse problem and they are now in recovery. It definitely is a miracle. And I think it's happening more. More than we even know.

And I do. I do appreciate you very much. Dr. Robert DuPont 00:21:35 Well, I appreciate what you're doing.

You're making a great contribution, and it's an honor to me to be on your program to do this. I salute you and I thank you for, for your contributions to our society, and I'm very proud that you wanted to take the time to talk to me. Joanie Sigal 00:21:54 Absolutely. We are honored.

Thank you so much. Dr. Robert DuPont 00:21:57 Thanks very much, Tony. Bye Bye.

Voiceover 00:22:03 You have been listening to the Addiction podcast, Point of no Return. For more information, reach out to us on Facebook or go to www.the addictionpodcast.Com. Our email is theaddictionpodcast@yahoo.com.