On this weeks show while the political right is scoffing at the new green deal they seem unconcerned about how Climate Change is threatening our National Security how real is that threat grab the armrest but 1st the scourge of opioids how we got here and how when an orthodox legal maneuver which you might have heard about 1st here. He is rocking big pharma holland cook in washington this is the big picture on our t. V. America. The National Institute of drug abuse reports that every day more than 130 americans die after overdosing on opioids how did we get into this situation and how do we get out lets ask dr John Dombrowski a Board Certified anesthesiologist and Board Certified addiction Medicine Specialist washingtonian magazine named him one of the serious top docs and the website for his Washington Pain Center is d. C. Pain doc dot com john welcome back and you know i had a root canal about a week ago how many of those hydrocodone pills should the doc have given me well its not what they should give you its what is really being limited by both c. V. S. And rite aid now do it is about a year ago in response the opiate crisis so they probably gave you a weeks worth of prescriptions if you needed beyond that youve got to go back to your doctor because they make we want to make sure theres not over exposure to these medications theres only appropriate when used appropriately but sometimes physicians and patients could want more and we need to be cautious of that i was glad i had a day to exactly that you know we hear in these legal actions a lot about how big pharma has marketed to docs how did doctors in your view get hooked on overprescribing opioids and is it marketing well i think its a little beyond that i mean thats a very simple answer but when you have a complex situation like this simply its really cant be correct answers for that we always are always responsible for marketing we get this all the time from medical from pharmaceutical industry but we as physicians always make the right judgment is this the right medication for a patient not just listening to a rap we go to a lecture. And things like that but also we have to remember what we were looking in the early ninetys was the pain price that we had we had Jack Kevorkian people were going to die we had the right to die movement so the government the federal government the were wanted us to write more pain medication to produce pharmacists we have this medication we can educate physicians that were kind of off to the races and actually physicians were actually graded on how many pain medicines they gave a Patient Satisfaction scores so we want to make sure such a fight your bike incident with your tooth ache we want to make sure happy heres all you need you know the pharma reps you mentioned some of them look like a former n. F. L. Cheerleader. And the doc only has so much time is he the or she the victim of the elevator speech length version and thats all they need to know when they start prescribing the stuff well they cant be the right way and you know that i mean no one is going to make a medical decision based on acute man or woman giving me an elevator speech we always get medical information from outside sources you know whether its lectures or programs and then we do our Due Diligence through our scientific Background Research is this the right medication it should never be limited to an elevator speech how common is it for a pharmacist to check back with the doc before filling an opioid prescription its very common it is a great idea these are checks and balances that we have in the system i am not almighty i dont write a prescription a pharmacy you follow my orders we do this with nursing to doctor are you sure this is the right patient are you sure this is right medication we need to give so its a great check and balance i get few phone calls from pharmacists and they say what i didnt catch that great point maybe you should change that medications are not to positive you appreciate getting that call of course they do with doc in the box under so much pressure to see more and more and more patients how much is managed care to blame again going back to blame im not really so sure but your point is exception well taken theres a vine we have to have a lot. Throughput and perceptions are very easy to write heres of 22 minute prescription you gave me money i give you a prescription is a fair deal thats not the way medicine should be run maybe we need to talk to patients look at other options that do take time and im sorry that may not be very efficient but thats the right way to move forward here Nurse Practitioners advertising on radio saying we will give you more eye contact and more quality time than the doc i only have to see 20 people a day to see 60 i got to think that theres a squeaky wheel thing going on where if the patients cry and bloody murder in the waiting rooms full the doc could take the shortcut right of course they should take you know of course they could take the shortcut but also we need to be careful with which we have you know physicians assistants and Nurse Practitioners doing medical care we have to make sure its done by a physician thats the main thing this is still the practice of medicine they have a very Important Role but certainly complex medical problems like chronic pain should never be said well my Nurse Practitioner care for you that cant be true for the people watching us how can we be smarter Health Care Consumers in this regard advocate for yourself if it doesnt someone right its not right it cant be one simple pill one simple procedure and you have to have a relationship with a physician come back over and over again its like getting a suit tailored heres the 1st fitting we get the next fitting and next fitting and we Work Together it cant be one and done thats impossible and if they tell you that run from that doctor because thats cant be thats cant be true and when youre through with the pain right get rid of the extra pills get rid of the pills and thats the biggest part of diversion not your choosing to do it but people can go into your medicine cabinet d oh i had my my grandchild over i had a babysitter come over they take a few you never knew so the 1st thing go is get rid of their always take back programs at pharmacies and you can if that can work just flush it down the toilet get rid of it dont have it in your house thank you dr John Dombrowski d. C. Pain. Dach dot com thank you home producer pharma has filed for bankruptcy they make the profitable addictive painkiller oxycontin the owners the billionaire Sackler Family say they would rather give their money to victims than lawyers but how much of it several states have rejected the proposal meant as reports surface that the sac lawyers have moved money billions of dollars out of the company over the past decade 2 accusers say protected from judgments so were watching that story but this house of cards began collapsing in a in a courtroom in Norman Oklahoma after 2 other opioid makers settled to avoid the trial the state attorney general took an unorthodox approach against johnson and johnson charging them with creating a public nuisance and it worked the judge in oklahoma ruled that j. And j. Had participated in a deceptive Multifaceted Campaign the change the culture of opioid prescribing and lead to a Public Health crisis and he ordered the company to cough up 572000000 to help his state fight the epidemic and repair the damage and other states are now charging big pharma similarly could this nontraditional legal tactic be a game changer assessed legal journalist molly barrows of trial lawyer magazine molly translate legal ease to english what is a public nuisance. Well im going to give you a oklahomas definition since were talking about the oklahoma trial but its pretty similar in general to the standard definition of public nuisance in the legal world and thats defined as an act or failure holland act that annoys injures or endangers the health and safety of an entire community in other words a large group of people its usually there is there for cases that are connected to someones objectionable use of land like in the at the airport polluting factory a drug how the house of ill repute but lawyers for johnson. Once and they jumped on that they called it a radical theory they said it didnt fit with oklahomas case on fact thats what theyre appealing on but the judge in that case has disagreed from the get go that bachmann he said there was nothing in the states definition of the public nuisance law that limits a nuisance to only property related matters and he found like you said that the drug companys marketing practices were harmful enough to qualify the state argued that the Company Created a public nuisance by showering the state with opioids while downplaying the risks persuading doctors to prescribe them for minor problems and that led to the addiction epidemic by finding the states favor under that ruling that finding it did show that j. And j. Did in fact create a public nuisance with the Opioid Epidemic and it gave him Broad Authority to order the company to fix the problem so in his abatement he has funding set aside for addiction in Mental Health treatment programs along with other Services Like housing and employment assistance so in general youve got public nuisance that can be applied to a variety of things but like you said this was a definite a different approach but it was successful and its certainly a good sign for other states attorneys generals other plaintiffs attorneys that are going after a similar argument you know the way you described public nuisance was the 1st thing i thought of Airport Noise public works stuff there. Public nuisance lawsuits against gun manufacturers lead paint manufacturers how they fared. Pretty successful now. I dont get to the gun manufacturers in a 2nd they were actually pretty successful decades ago and then the gun industry put a stop to that but in the meantime paint manufacturers that complaint has been successfully used with them in california just last year that the success of a public nuisance complaint led to other similar cases who say pain companies promoted this lead paint a safe even when they knew it caused harm to people especially kids now going back to the gun industry and their case after several lawsuits sought to hold their members liable for wrongful death public nuisance the industry lobbied congress for protection claiming that they could be bankrupt by these lawsuits which could threaten their ability to manufacture weapons for the military so those efforts were Successful Congress passed and george w. Bush signed the protection of lawful commerce in arms act that was in 2005 but you know there have been renewed efforts to apply public nuisance claims last may an Appeals Court indiana says the city of gary and others can go after gun makers under public nuisance laws under an exception there are a handful half a dozen exceptions that are allowed but most challenges on these arguments even using those exceptions have been defeated because of that 2005 law holland columbia universitys Michael Berger calls this approach authority that other courts might find persuasive or useful analogy and that the judges in the climbing cases may look to this flow home opioids case to help them figure out what to do about the fossil fuel industries dissin from ation campaign molly talk about president how much do you think this oklahoma decision will play out in other states. Its darn sure encouraging for him ill tell you that holland they are going to be likely pursuing this very same argument and of course we saw a similar tactic taken in 1000 nineties against the Tobacco Industry 5 of those huge cigarette manufacturers essentially with the same argument that they are producing a product that was common that was widely distributed but they downplayed the negative consequences even though they knew about them an essentially that was that public nuisance a part of the case that they were successful states attorneys generals were successful in applying that and to this day the settlement they received is one of the largest civil settlements in u. S. History so i think youre seeing a continuation of that and its certainly encouraging to the numerous nearly 2000 of the lawsuits that remain pending against big pharma over opioids out of time so ill need the short answer but how do you think this is going to work against big oil with the Climate Change actions. Theyre working on it theyre trying to make it fly its going to be interesting though because youve got competing federal laws that are going to take into consideration that you have california that filed these laws as well and its and its moving forward these fossil fuel companies dont even argue anymore whether or not Climate Change exists or if they are actually contributing to the problem but under public nuisance what theyre going to argue that is that that theyre not responsible for those emissions that are contributing to the problem thats where youre going to see the rub is. Where it will be will they be responsible and where will it be heard or federal court stay tuned thank you molly barrows from trial lawyer magazine. Coming up republican president Richard Nixon gave us the Environmental Protection agency republican president george bush 41 beefed up the Clean Air Act why are Congressional Republicans concerned the president from stand on Climate Change makes them and dangerous. Is the big picture on archie america. Negative Interest Rates are telegraphing a drop in population if you look at forced himself from the present to feed the ponzi scheme that means youve got this generation will have to be sacrificed and so you know humans have not really psychologically evolved much from the days of just used to outright cliques or children for the gods of their books during that generation see the policy gods. Israels parliamentary elections to begin ended in deadlock feel that 3 is divided divided on the political right sitting Prime MinisterBenjamin Netanyahu says its either my right wing blogs or again just back government how does this kind of rhetoric bode for the palestinians middle east ability. This president from continues to roll back and fire middle regulations Rush Limbaugh and a parade of talk radio parrots continue to scoff that there isnt any science in this this is all politics theres no science to Climate Change its all made up begging to differ the worldwide threat assessment from the director of National Intelligence earlier this year warned the Global Environmental and ecological degradation as well as Climate Change are likely to fuel competition for resources economic distress and social discontent through 21000 and beyond climate. Such as extreme weather higher temperatures droughts floods wildfires storms Sea Level Rise soil degradations and acidifying oceans are intensifying threatening Infrastructure Health and water and food who to believe lets ask Sherry Goodman former u. S. Deputy undersecretary of defense now a senior fellow in the environmental change and Security Program at the Wilson Center here in washington sherry welcome pleasure to be here the conversation about Climate Change tends to focus on Environmental Impact but recently you told congress it is what you call the threat multiplier against National Security talk about that well 12 years ago now with a military Advisory Board comprised of some of the most distinguished generals and admirals of our era we characterized Climate Change as a threat multiplier for instability in fragile regions of the world and now we see that even a new ocean in the arctic has opened up with geopolitical competition potentially on the rise as access to resources and shipping lanes and new trade to have. Become more and more accessible in a new region of the world and then with extreme weather hitting all around the world including our military bases right here at home that have suffered devastating consequences just in the last few years costing billions of dollars now the american taxpayers money to repair it read my mind because you talk about this the 1st thing people picture is the polar bear on the chunk of ice but to the military preparedness here at home earlier this year Tyndall Air Force base on floridas panhandle took a direct hit from hurricane michel 155 mile an hour winds clobbered nearly every building there and you werent low balling the estimate the rebuild theyre figuring is going to be some 3000000000. 00 what are some of the other dollars and cents examples of the hard cost. Climate change is imposing on our military readiness well another base in North Carolina also suffered devastating consequences from hurricanes last year with also a price tag of about 3000000000. 00 and in the pacific where we have a radar a space radar site and quadrille an atoll in the pacific at the cost of a 1000000000. 00 and that is now threatened to be overrun. In the next decade or so so putting that investment at risk in alaska will now permafrost is sinking infrastructure there collapsing infrastructure including some of the new infrastructure were building in order to be able to defend against missile threats from russia china or north korea thats one aspect weve covered on the show how the melting north pole is a military game changer and during the Senate Confirmation hearing senator sullivan from alaska ticked off a list of actions in just the last several years in the arctic give a listen. A new arctic command for new arctic brigades 14 operational airfields 16 deep water ports 40 icebreakers with 13 more on the way 3 Nuclear Powered huge new land claims in the arctic for massive oil and gas reserves the most Long Range Air patrols would bear bombers since the cold war a snap military exercise in 2015 that included 45000. 00 troops 303400 military vehicles 41. 00 ships 15 submarines and one 110. 00 aircraft so the north pole is getting crowded how is Climate Change changing the game elsewhere in the world well in certain parts of the world were seeing much drier temperatures which is lead and drought much drier and hotter temperatures in north africa and across the middle east that is looming to food and water insecurity that. Neighboring terrorist groups like boko haram and others to take advantage of vulnerable populations thats why in part why our forces and others are coming either to the rescue of vulnerable populations or to defend those terrorist threats at the same time were having to deploy our troops in hotter and hotter temperatures putting their lives and readiness at risk then we have in the pacific small island states that may be completely overrun within our lifetime where their populations will have to migrate elsewhere so were seeing global migration patterns also deeply affected by Climate Change when people cant eat they will listen to somebody who says i have food even if theyre the bad guys thank you Sherry Goodman from the Wilson Center thank you your time now lets go to our Team New York for rory varada he is Media Liaison for Extinction Rebellion in n. Y. C. A ph d. Student at columbia and adjunct professor at fordham rory welcome and to understand your group we should take Extinction Rebellion literally tell us how you advocate civil disobedience. Great thanks for having me ali and yes we advocate nonviolent civil disobedience as a proportionate response to the Global Climate emergency and so we emphasize taking again nonviolent actions that this group disrupt business as usual for the purpose of raising awareness and also hoping to sort of coalesce a Broader Movement around making the drastic changes necessary to address the catastrophes that are ongoing and on the horizon where you got a crowd in washington here today on friday as we taped this they got 100000 in london 100000 mel born 100000 in berlin at the Brandenburg Gate this does attract Media Attention but do you feel as though the media generally is shorting this story. Absolutely and its for multiple reasons the probably the largest one in the United States is that the media is thoroughly captured and controlled by corporate interests including especially fossil fuel Companies Like exxon mobil as well as the Defense Department and other defense contractors i find it a little ironic that someone from the Defense Department is expressing concern about Climate Change when the us military is the largest emitter of carbon on the planet more so than about 140 other countries so there are incentives in the media and elsewhere throughout American Society and global capitalism largely that inhibit against speaking truth about the Climate Emergency that were in in his 1991 National Security strategy president bush sr a republican warned that Global Environmental concerns include such diverse put into related issues is stratospheric ozone depletion Climate ChangeFood Security water supply deforestation biodiversity and treatment of waste a common ingredient in each is that they respect no International Boundaries the stress from these environmental challenges is already contributing to a political conflict rory how much has Corporate Cash or lobbying against addressing what president bush warned has stalled our response to Climate Change you talked about advertising influencing the media talk about that money on capitol hill. Sure its influenced our a policy to the core as George Carlin once said the United States is an oil company with the military and i think that remains largely true the amount of money that the fossil fuel sector spends lobbying politicians is unparalleled except perhaps by the pharmaceutical industry and we see this across the aisle both parties republicans and democrats are thoroughly captured and controlled and beholden to these interests we see it reflected for example in the way the democratic leadership has resisted the implementation of the Green New Deal which is rather modest actually in the face of what needs to be done regarding the Climate Emergency and so Extinction Rebellions position is that the change that we need is simply not going to come from the top it must rise from below through direct action and civil disobedience by regular ordinary people who share a common vision of the problem and the solutions to that problem well about that Green New Deal which the political right is having a field day mocking the various warnings about 12 years from now and you will form that the historical record of environmental change isnt accurate to predict the future land in your view is the point of no return. In my view the point of no return and was before i was born and likely before you were born as well i mean the problem is the Industrial Revolution from a geological perspective the 250 years since the Industrial Revolution is the blink of an eye on par with the impacts from the asteroid that killed the dinosaurs which was the catalyst for the 5th great extinction event were now currently in the midst of the 6th which is the direct result of the Industrial Revolution and the societe of emission of carbon from fossil fuels owing to human activity so the point of no return as i said happens long ago now we are at the point of mitigation only prevention is over its a myth we must mitigate and be realistic about what we can do because already 400000 people die annually from causes directly attributable to climate breakdown i think thats a low estimate that will only increase exponentially in the coming few years thank you rory wiranto Media Liaison for Extinction Rebellion n. Y. C. Appreciate your context and perspective on this vital issue. And i thank you for watching the big picture if you see us somewhere else you can now also watch r t america live at youtube dot com slash r t america got directv were channel 321 on that super cool pluto t. V. App we are now moved to channel 279 and dish were live at channel 218 and all of our shows are available any time anywhere on any device at youtube dot com slash the big picture r t m holland cook in washington at holland cook on twitter where if you follow me ill follow you question more. Live live. Live. Live live. Live. Live. Live. Live live. Live. Live. Live. Oh. Please. Liz. Liz liz claim. And a very warm welcome to you watching on since last. They all see themselves as dying swans in their dreams. But only one of the cells will ever make it to the top. Theyre ready to give their lives for the chance to die on stage if only once. Not even broken wings could deter them. For generations with the merits. But they sweat and tears. Through the. Honey badger dont care yeah i mean better dont care here we are at the honey badger baltic conference in radio a lot. Oh yeah its really cool lets check in with. Max today is a good day to talk about mad cow and mad men because these are good lessons for why weve been calling and why we need big coin and why honey badger dont care about these mad men and and mad cow hes running our world 1st of all you know a lot of people disagree about Climate Change whats causing it why why