Last Week Tonight with John Oliver (2014–…): Season 3, Episode 27 - Drugs - full transcript

John talks about opioids, the final presidential debate and Donald Trump's charity roast.

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LAST WEEK TONIGHT
WITH JOHN OLIVER

SEASON III
EPISODE 27

Welcome to Last Week Tonight.
I'm John Oliver. Thanks for joining us.

And unfortunately, we must begin
yet again with the 2016 election.

Or: "I don't even know if I can
make it another two-and-a-half weeks."

"I've been drinking a lot and
frankly my family is worried, 2016."

The most-anticipated event of
this week was on Wednesday,

with the final debate of this
election season and possibly ever.

It was the candidates' last chance

to show that they can elevate
the tone of this campaign.

How did that go ?



Look, Putin from everything I see,
has no respect for this person.

He'd rather have a puppet
as president of the United States.

No puppet.
You're the puppet !

- You won't admit...
- No, you're the puppet.

That is a pretty childish tone.
"No, you're the puppet"

sounds like something teenage
Pinocchio would yell at Geppetto

before slamming his bedroom door:
"You're the puppet !"

"I wish I'd never been carved !"

I would love to say that that was
Trump's low point of the evening,

but there were so many more.

We have bad hombres here,
we're going to get them out.

Nobody has more respect
for women than I do. Nobody.

In the ninth month,
you can take the baby

and rip the baby out
of the womb of the mother.



- Let me translate that, Chris...
- You can't.

My social security payroll
contribution will go up,

as will Donald's, assuming he can't
figure out how to get out of it.

- We want replenish...
- Such a nasty woman.

Now, to be fair, the questions that
the moderator asked were:

"What is an offensive way
to describe Mexicans ?",

state an objective falsehood,
a nonexistent medical process,

mansplain in two words, incorrectly
name your favorite Janet Jackson song.

He kind of went five for five.

But the most notable moment
of all came when Trump was asked

whether given his constant claims
that this election is rigged,

he would accept
the results of the vote.

To which the easy and
only answer is "yes".

But he took a different path.

I'm not looking at anything now.
I'll look at it at the time.

You're not prepared now
to commit to that principle ?

I will tell you then.
I'll keep you in suspense.

What do you mean,
you'll keep us in suspense ?

This is a presidential election, not
an "American Idol" results show.

I'll tell you whether my followers
will plunge the country into anarchy

after the break.

After criticism, Trump appeared to walk
back his statement the next day,

before throwing in
a twist at the last moment.

I would like
to promise and pledge

to all of my voters and supporters

and to all of the people
of the United States,

that I will totally accept
the results

of this great and historic
presidential election...

... if I win.

You got us !

That's so funny 'cause we thought you
were going to say the rational thing

that would have put the
country at ease but instead,

you continued to destabilize
the foundations of our democracy.

That is a solid bit !

As we have discussed,
the odds of voter fraud are very slim.

A study found that out of the billion
plus votes between 2000 and 2014,

there were 31 credible instances
of voter impersonation.

By comparison, in 2009 alone,

there were 32 newborns
in the U.S. named Abcde.

We should be less worried
about voter fraud

than we should be about those
32 sets of parents voting.

Trump and Clinton didn't only share
the stage during the debate this week.

The following night, they were at
the Al Smith dinner in New York,

an annual fundraiser for
Catholic charities where

presidential candidates gently roast
themselves and one another.

This should've been an easy win
for Trump, because Clinton is,

to put it kindly,
less than side-splittingly hilarious.

And Trump is basically an insult
comic writ large.

It is hard to imagine a philanthropic
event he'd be better suited for

other than
a charity groping booth.

And yet, somehow,
he completely lost the room.

Hillary is so corrupt,

she got kicked off
the Watergate commission.

Here she is tonight in public,
pretending not to hate Catholics.

Everyone knows Hillary's
belief that it takes a village,

which only makes sense,
after all, in places like Haiti,

where she's taken
a number of them.

How are you blowing this ?
It's a charity roast !

Watch the face of the man
sitting next to him,

after that first joke.

It says something about how
horrifying Trump's speech was

that his expression is that of
someone who just realized:

"My God, I've been shot.
I've been shot."

Of all the negative things
you could, should

and are morally obligated
to say about Trump,

being unentertaining
is not one of them.

He's a born showman !

And that room couldn't have given
him more of a home field advantage.

This wasn't a town hall
or a debate:

it was a $3,000-a-plate
fundraising gala

at a moth-eaten Manhattan hotel
organized by the Catholic church,

a real-estate owning, male-dominated,
sex-scandal-plagued organization

with whom Trump shares a uniquely
unqualified interior decorator.

Look at the audience there.
White bow ties ?

They are dressed to play a game of
steerage-darts onboard the Titanic.

Terribly high-stakes,
steerage darts.

If you're not careful,
you could lose a dart.

But there is no better index of
just how badly he did than this.

People were really cringing
a lot of times with Trump.

I was sitting next to Henry Kissinger
and he said "this is not good".

It's true. Henry Kissinger
thought Trump bombed horrifically,

and Kissinger is the world's leading
authority on horrific bombings.

Despite the audible boos
during his speech,

Trump did not seem to be aware
of how badly he was doing.

Hillary believes
that it's vital to deceive the people

by having one public policy

and a totally different policy
in private.

I don't know who
they're angry at, Hillary, you or I.

It's you. They're angry at you !
And I'll tell you why.

You are treating a benefit for needy
children like open mic night

at Rascal McBigot's, Long Island's
fourth-best alt-right comedy club.

But Trump did so poorly

because the dinner is supposed
to involve selfdeprecation.

He is almost pathologically unable
to acknowledge any flaw or fault.

There was one revealing moment
in Wednesday's debate,

when Clinton
hit something of a nerve.

He didn't get an Emmy for his
TV program three years in a row.

- He tweeted the Emmys were rigged.
- Should have gotten it.

Of course
he wants an Emmy !

It's a woman, it's gold, and it's
proportionate to his tiny hands !

It's basically Trump's ideal mate !
And here's the problem:

it increasingly seems like,
if Donald Trump loses,

we are not going to get the concession
speech the country badly needs.

Because he is medically incapable
of accepting that he is a loser.

So we need to find a way for him
to give a concession speech

while he's still able to claim
that he won something.

I might have the answer here,
because I have a proposition:

let's bet
on the outcome of this election.

I will take the side that you win,
you take the side that you lose.

That way, if you lose,
you still win.

As for the stakes of the bet,

I have something
I know that you want.

She's so small, she's so shiny.

You don't even have
to take her furniture shopping !

Take the bet, Donald.
Take the fucking bet.

And now, this.

You'll never guess what
Chris Matthews' favorite movie is.

We'll be joined by NBC News
correspondent Chuck Todd,

who's in London
with the president.

Here's a clip from the great
movie Love Actually.

It's been brought to the fore
so many times in movies,

my favorite being Love Actually.

We still remember this scene and we'll
play it again, from Love Actually.

Like in that great, memorable
scene from Love Actually.

- Did you see Love Actually ?
- I did.

Every time I rewatch
Love Actually.

Everybody fell in love with
Colin Firth, in Love Actually.

One of my favorite movies,
Love Actually.

My favorite movie, Love Actually.
Love Actually.

That reminded me of Love Actually,
I've seen it about a million times.

Moving on. For our main story,
I would like to talk about drugs.

I already sound like
a middle-school health teacher

about to show a video like this.

The pattern
is generally the same:

take a lack of responsibility,
the inability to make right choices,

add to it ignorance, and top it off
with a desire for escapism and kicks.

The sum total is then found in the
bennies, the reefer, the pot needle.

Yes, the pot needle.

Now you may laugh, but that
film worked. Think about it.

When was the last time you saw
a pot needle ? Exactly.

America is now in the midst
of a new drug crisis

and it seems
no one is safe from it.

Laura, Charlie's owner, who asked
us not to use her last name,

says Charlie had to be
rushed to the vet.

You can't see the suspect throw
the drugs over the fence in the video,

but that's Charlie, and what she's
eating is a full bag of heroin.

You can't process the fact
that your dog ate heroin.

If she can't process it,

imagine how it must have felt
for her dog when it kicked in.

Who's a good boy ?
I'm a really good boy.

I'm the best boy.

Even that lighthearted local news
story had some chilling context.

Bishop runs the bark
and play where it happened.

He says it highlights
a bigger problem.

This heroin problem
here is ridiculous.

We find needles, we find everything
around here

and I can't let
my employees go outside.

That is terrifying. Although, rampant
heroin abuse near a doggie care center

is the first case that McGruff
is actually qualified to solve.

That is symptomatic of the fact that
America is facing an epidemic

of addiction to opioids, like
heroin and prescription painkillers.

As of 2015, an estimated
2.6 million Americans were addicted,

and they're involved in almost 30 000
overdose deaths a year in the U.S.

The prevalence of this problem
astonishes some people.

Listen to Donald Trump
up in New Hampshire.

They said the biggest single problem
here is heroin.

How does heroin work with these
beautiful lakes and trees

and all of the beautiful... it doesn't !

Yeah, it does though.
Heroin works basically everywhere.

Because it's heroin. It's not a cell
phone. Heroin has full coverage.

So tonight, we're going to look at one
of the major causes of this crisis:

prescription painkillers,
chemical cousins of heroin.

Around 75% of heroin users
started with a prescription opioid,

drugs like Oxycontin,
Vicodin and Percocet,

which some take recreationally
and others take as prescribed.

But however it starts,
it can get out of hand fast.

So, how many have moved
from prescription drugs to heroin ?

- Everybody.
- Heroin is so much more cheaper.

Once people became dependent
on painkillers,

they'd do almost anything
to get them.

One time, I was hurting so bad that
I ended up punching a 4x4

and breaking three fingers
to get pain meds from my doctor...

- You'd hurt yourself ?
- Absolutely.

I had nine teeth pulled out
of my head for prescriptions.

To get a prescription ?

I've been in groups where they've
taken bats to their wrists.

How many people do know someone
that's died of overdose from...

Everybody.

This is happening everywhere.
Odds are you probably know someone

who is struggling, or died
from an opioid addiction.

Some towns have been devastated.
Two months ago,

in and around Huntington,

28 overdoses occurred
in one five-hour span.

Given their risks, it's amazing how
freely doctors prescribed them.

There are a lot in circulation.

We have currently
nearly 250 million prescriptions

for opioids written every year.

That's enough for every adult to
have a bottle of pills and then some.

Holy shit.

Those bottles aren't
sitting on a shelf, unused,

like that bottle of wine
you are saving for a special occasion

that serves as a reminder that you
haven't had an event in four years

that was deserving
of getting fancy-drunk.

These pills are getting used, or
falling into the hands of others,

from those who are already
addicted to just bored teenagers.

How has this happened ?
As recently as the early nineties,

doctors were excessively wary
of prescribing opioids.

Back then, there was
a thing called opia-phobia.

A lot of healthcare professionals
did not want to prescribe opiates,

they thought the slightest amount,
you turn your patients into addicts.

Even people with stage four cancer
they were left to suffer.

Yes, opia-phobia. Which is not
to be confused with "Oprah-phobia"

the irrational fear
of screaming talk show hosts

giving you
a brand new Pontiac Sedan.

Oprah, I can't afford the taxes !
You haven't thought it through.

That level of under-treating pain
was a huge problem in itself.

Pain care advocates worked to
dispel some dangerous myths.

But in doing so,
they made a key mistake,

as you will see
right at the end of this clip.

The federal government said
that half of all surgery patients

suffer needlessly because doctors don't
pay enough attention to pain killer.

Health Secretary
Louis Sullivan talked about myths,

that pain builds character,
myth, he said.

That infants don't feel pain,
another myth.

That elderly patients have a higher
tolerance for pain

or that painkillers are
addictive, myths !

Okay...

First: of course babies feel pain,
how did we ever think otherwise ?

The fact that painkillers are
addictive was not a myth !

It's like a book of Greek mythology
with stories of Zeus,

Sisyphus, Oedipus and Yanni.

That last one is very real
and it cannot be dismissed.

A discussion
between the medical community

about the complexities of pain
treatment is important.

That discussion became dominated
by the pharmaceutical industry,

who started amplifying the message
that opioids should not just be used

for acute pain,
like that from cancer or surgery,

but for all sorts of pain
like arthritis and backaches.

Which makes sense as a motive
coming from the pharma industry.

End-of-life pain care
is a narrow business.

It's hard to make a lot of money
off of a product exclusively marketed

to people
who are close to death.

I don't know how Fox News even
does it. It's a mystery.

Volume, I guess.
But I don't know.

Within the pharma industry,
the loudest voice was Purdue.

In 1996, they released
the blockbuster drug OxyContin

and they marketed it
to doctors aggressively,

giving out swag like fishing hats,
swing-music CDs

bearing the slogan "swing in the
right direction with OxyContin",

and oxy-branded
stuffed plush toys,

and if you think we didn't get
hold of one of those,

you have never watched
this show before.

Because yes, here he is.
And yes, he is my new best friend,

and yes, his name is Harold.

Purdue, this is the perfect
choice of mascot.

Much like a gorilla, OxyContin
might seem appealing,

but if you're not careful,
it will tear your fucking life apart.

Won't you, Harold ?
Yes, he will.

Purdue distributed inspirational videos
like "I Got My Life Back",

seven patients whose lives were
turned around by OxyContin.

Since I've been on this new medication,
I have not missed one day of work

and my boss appreciates that.

Lauren is there every day.
I'm able to be very productive.

One of the things dear to my heart
and which I'm excited about

is the fact that I'm able to spend
time with my grandchildren.

It's amazing just to be able
to keep up with them

and not have to tell 'em
grandma can't play now,

grandma's hurting,
grandma's back hurts.

That's genuinely sweet,
and it's a powerful message.

"It makes time with your grandkids
more fun" could apply to any drug.

Grandpa's gonna take you to the
park, I'm gonna take you on the swings.

I'll push you real high,
we'll stay up all night,

I'll come up with inventions,
you're gonna write them down fast.

We're having quality time !

It wasn't just uplifting stories. Other
videos sought to reassure patients

who might've been nervous
about taking such a strong drug.

Less than one percent of patients
taking opioids become addicted.

Less than one percent !

I know it may seem like they are
pulling that number out of their ass,

but they actually pulled it out
of the "Letters to the Editor" section

of the New England
Journal of Medicine.

That paragraph is the whole thing.
It wasn't peer-reviewed,

and it was only about short-term
use of opioids in hospitals,

but it became the main source
for that one percent claim.

And letters pages are not
a solid source for information.

This month, a Pennsylvania
newspaper published a letter

featuring a man's question about
Hillary Clinton's fitness for office,

because "what if
that time of the month comes ?"

To which the obvious answer is,
one, she's 68,

and two, fuck you, maybe,
a little bit.

Even if doctors started noticing

that more than one percent of their
patients were getting addicted,

Purdue had a ready answer:
what if they're not ?

They had doctors on their payroll
like Alan Spanos,

who were happy to explain the helpful
new concept of "pseudo addiction".

I'll let him tell you about it.

Pseudo-addiction is when a patient
is looking like a drug addict

because they're pursuing pain relief.

So pseudo-addiction is relief-seeking
behavior mistaken as drug addiction.

That is so convenient.
That is like Chipotle going:

Have you heard of this fascinating
new thing called "pseudo-diarrhea" ?

It looks a lot like diarrhea,
but it's not diarrhea,

and the cure
may actually be more tacos.

Purdue's overall message of
a easy cure for pain was appealing,

especially for primary care doctors who
might have 15 minutes for a patient.

So it is no wonder that,
by the year 2000,

doctors were writing nearly six million
OxyContin prescriptions per year

and its sales were more
than even Viagra.

That was a drug that had the distinct
advantage of being sold by Bob Dole,

the red-hot late-'90s it boy.

Evidence started piling up that
it was riskier than promised,

with headlines like
"OxyContin abuse is increasing"

and
"OxyContin abuse called 'a plague'."

Or, as Purdue would call it,
a "pseudo-plague".

And even the stars of Purdue's
"I Got My Life Back" video

were not immune from this trend,
because a investigation discovered,

two out of the seven of them
died as active opioid abusers,

and that grandmother became
addicted and nearly lost everything.

I lost my house.
Yeah, I've lost cars.

I lost a lot. A lot.

I lost a lot to keep

the high and taking
that drug when I did lose my job.

Had I not lost my medical insurance,
or if I was to go to the mailbox

and I would find OxyContin,
I'd still be on it and I'd be dead.

Losing her health insurance
might have saved her life.

That is an irony so deep it would
vaporize Alanis Morissette

into a cloud of fucking steam.

I'm guessing you are
pretty angry at Purdue.

In 2007, they admitted
some responsibility

in a lawsuit so big,
it led the evening news.

Good evening. The maker
of a hugely popular painkiller

has some pain of its own.

The company and its top officers
will pay $634 million in fines

for lying to the public.

They fucked up if they had to pay
$600 million for misleading marketing.

You get a lot of leeway on that.

That's why Dunkin Donuts has
not yet been sued for:

"America runs on Dunkin",
when their real slogan should be:

"Sometimes
you can't find a Starbucks".

It wasn't just Purdue
pushing the envelope.

Cephalon paid a $444 million settlement
for over-marketing drugs,

and Insys has been investigated for
a drug they made containing fentanyl,

an opioid which can be 100 times
more powerful than morphine.

Their drug is only approved
for cancer patients.

Insys is accused of not just pushing
it for non-cancer patients,

but helping convince insurance
companies to pay for it.

And to do that they used
a particularly shady technique.

If you don't have cancer
and breakthrough cancer pain,

no insurance company
is gonna pay for this medication.

If you call up and you tell them
the patient doesn't have cancer,

it's denied.

Instead what were you doing ?

They would always ask does
the patient have cancer ?

- That's what we would say.
- You would say yes.

But I'm not saying yes, right ?
I would just say...

- Isn't that a yes ?
- That's what they did think.

I wasn't blatantly saying yes.

My God. Except everybody knows
"uh-huh" means yes.

literally the first word that
comes up is "yes",

followed by "absolutely", "definitely",
"unquestionably" and "yep".

I should say that Purdue
and Cephalon's owner told us

that those practices were in the past
and Insys has denied wrongdoing

and didn't respond to our questions,
not even with a "nuh-uh".

But at a certain point,
the question has to become less

"what did we do wrong ?",
and more: "what do we do now ?"

These drugs are the most effective
solution for certain types of pain.

Many patients need them.
So we can't get rid of them.

We have to be more careful
about how they're prescribed.

And to their credit, the CDC issued
voluntary guidelines this year

suggesting doctors use non-opioid
therapies when possible,

and to start patients with a lower
dose and a shorter supply,

a technique that they call
"start low and go slow".

Which does sound good,
but also sounds like

how your creepiest high school
friend described cunnilingus.

Dude. Start low, go slow and
afterwards take her to Friendly's.

Chicks love root beer floats, dude.
They love them, dude.

Low and slow, dude.
Low and slow.

While that sounds great,

not all areas of the country have
access to alternative pain treatments.

It's easy to say, use some non-opioid
alternative, but in rural areas,

patients don't have access to physical
therapy and mindfulness meditation.

Insurance companies
won't pay.

And that is a big problem.
Because even in a rural area,

alternative pain treatments should be
as easy to find as Waffle Houses.

Which, like heroin, are hazardous to
your health and dangerously addictive.

It does not seem that
the pharmaceutical industry

is expecting major reversals
in opioid sales soon.

They're now marketing extra drugs
to fight one of opioids' side effects,

constipation.

If you need an opioid
to manage your chronic pain,

you may be so constipated it feels
like everyone can go except you.

You know painkillers are powerful
if people use them

despite the side effect:
"being jealous of a dog's butthole."

And that commercial
aired during the Super Bowl,

which means,
it is a big business,

and I can assume there was a reverse
commercial during the Puppy Bowl,

featuring a jealous dog
and a shitting man.

We cannot just work
to prevent future addicts,

we have to do more to help
the millions that already exist.

Means investment
in treatment programs,

as well as increasing the availability
of drugs like Naloxone,

used in a nasal spray to rescue
people from overdoses.

As this firehouse makes clear,
it is a tool they use with frequency.

Every single firefighter
has been trained on this.

- Yes.
- And has used it.

From the chief down. We tend to have
more overdoses than we do fires.

So it's a piece of equipment
we can't go without now.

Just like we have the hose.

Firefighters might be more likely
to use a nasal spray than a hose.

Which is really going to fuck up
those hot firefighter calendars,

because an overdose-reversing nasal
spray isn't quite as sexy.

It's still sexy,
but just not quite as sexy.

It is still sexy, though.
Just not quite. But still.

And that's not the point. The point
is, there is no one simple answer.

Not all opioid addicts will respond
to the same treatment.

Not all people will find
relief from alternative therapies.

This is going to take effort
and a significant investment.

It won't be cheap, it won't be quick,
and it won't be easy.

And it is hard not to be angry
at the drug companies like Purdue,

whose promise of cheap, quick,
easy pain solutions

helped put us in this mess.

While they may not be
solely responsible,

if you were to ask me if they bear
significant blame for greedy behavior,

which contributed to this massive
public health crisis,

I might not say yes, exactly, but I
would definitely say... Uh-huh.

Elected officials, whether at
the local, state, or federal level,

these are the people who make us
look like idiots for electing them.

Let's meet another in our series:
People Who Somehow Got Elected.

This week's person who somehow got
elected, Glenn Grothman.

U.S. representative
from Wisconsin's sixth district,

the picturesque home
to cheeseheads,

and that creepy prosecutor
from Making a Murderer.

Grothman was elected
to congress in 2014,

but before that, he spent 22 years
in the Wisconsin state legislature,

making his name as a fiscal
and social conservative.

Taking bold stances such as speaking
out against unequal pay law.

Senator Grothman said: "You could
argue money is more important to men."

"A guy in his first job, maybe because
they expect to be a breadwinner,"

"may be more money-conscious."

Yes, Glenn Grothman talks
like a character out of Mad Men

and dresses like a contestant
on 1987 episode of Jeopardy.

Which is not to say Glenn Grothman
does not support women,

he loves all of them,
even the single moms.

I know lot of gals who are having kids
out of wedlock and I love them.

I've been outside abortion clinics
and encouraged them.

See ? Would a man who hates women
talk to them outside abortion clinics

or end that same speech this way ?

Our country is not going to survive
if we continue this war on men !

But if there's one issue dear
to Glenn Grothman's heart, it's racism.

Or as he calls it...

This is one more example of screaming
rashism where obviously none exists.

The idea that somehow opponents
say it's rashist is ridiculous.

For some reason Grothman pronounces
this word, "rashism"

which is weird because he has no
problem making an "s" sound.

Governor Walker is going to be
given tech schools, the schools,

the prisons, the counties,
the cities, all less money.

And Grothman's obsession
with rashe is especially strange

given that his district
is so overwhelmingly white.

It wasn't just a location of the state
2015 Polka Hall of Fame awards,

it was also the birthplace
of OshKosh B'gosh,

the closest wardrobe equivalent to
dressing your child in an banjo.

That doesn't mean Grothman
can't link rashism to any story.

Take Planned Parenthood.

Given the rashist background
of Planned Parenthood

and not liking people who
are not white,

I wonder why Planned Parent likes to
do these sex-selective abortions

is disproportionally are done on
people of an Asian background.

Incidentally,
that's 100% falsh.

But that's just scratching the surface
of Grothman's rashe-bashed opinions.

He's also opposed to making
Martin Luther King Day a holiday.

The vast majority of African Americans,
as the vast majority of everybody,

isn't doing anything for Martin Luther
King on Martin Luther King Day.

Most employees who are off
are shopping at the mall,

maybe taking an extended vacation
over the weekend, let's be honest.

And that's not the only African
American holiday he opposes.

Senator Glenn Grothman isn't backing
down on his stance

that the holiday Kwanzaa, should
"die a quick death."

The underlying problem
is not enough TV types,

when they talk about Kwanzaa,

about the horrible, rashist,
violent past of its founder.

Grothman says Kwanzaa's
a holiday that:

"almost no black people
today care about."

And if you're wondering how he can
be so sure, he checked.

I spent some time interviewing
briefly, 20 black Americans

from either California or Arizona,
or people getting on airplanes,

and none of them
celebrated Kwanzaa,

so I don't think Kwanzaa's important
to the average African American.

That's a flawed study, published
in the New England Journal

of Harassing Strangers Who
Are Just Trying to Board a Plane.

Glenn Grothman knows, whether
it's African Americans at airports,

or women at abortion clinics,
everyone's entitled his insane opions.

And that's why it's so remarkable
that Glenn Grothman is a politician

who somehow got elected.

That's our show. Thanks for watching.
See you next week. Good night !

LAST WEEK TONIGHT
WITH JOHN OLIVER

END OF EPISODE 27,
SEASON III