All language subtitles for VICE - S04E14 Heroin Crisis - New Age of Nukes

This week on "VICE":

The effects of America's
growing heroin epidemic.

Woman: Unfortunately, with this
epidemic you have to throw out

what you thought addiction was,
what you thought an addict was.

And then the next nuclear arms race.

Man:
Dive! Dive! Dive!

It's a pretty surreal feeling to come
up on a ballistic missile submarine.

It looks like a giant steel whale.

Man: We are restarting
a nuclear arms race,

and our public is
blissfully unaware of that.

Sync & corrections by honeybunny
www.addic7ed.com

Crowd: Hands up!
Don't shoot! Hands up!

Today the United States is
in the middle

of the worst drug crisis
in our history.

Overdoses and deaths
are at an all-time high.

Now, this epidemic involves scores of
new and powerful pharmaceutical drugs,

but at the center of it is
one of the oldest: Heroin.

Morning. We're
in Guerrero, Mexico...

at the source
of America's heroin problem.

Ah...

There they are.

So, all these little flowers in
here will be harvested for opium,

which will then be turned into heroin

and shipped up north.

But right now,
they're just pretty flowers.

These are the scorers.

So you cut the pod?

Sí.

Sí.

Well, what do you do now?

Who buys it?
Who's the buyer?

Forty-three is responding.

Upstairs to the right.

Sweetheart, let me get in there
and check a pulse. Okay?

When did you find him?

Okay, he took a breath.

Go ahead and get the Ambu bag out.

Okay, drag
him out in the hallway.

Okay.

Is he a known addict?

Okay. Can you get some Narcan?

I can get him nasally real quick.

Mickey? Hey, Buddy!

He's coming back.

Mickey?

We've had this gentleman multiple
times in the last couple weeks.

He'll probably wake up en route
to the hospital completely.

But it's very common
that we have repeat overdoses.

Heroin is definitively
back in America.

Over the last decade,
the number of addicts

nationwide has more than doubled,

and the overdose rate
is four to five times

what it was in the 1970s,

which was basically
the heroin decade.

The epicenter
of this new wave of junkie-dom

is not the urban centers
of New York or Baltimore.

It's in the hills of West Virginia,

smack in the middle of Appalachia.

We are a microcosm of everything that
has happened across the country,

but it's just so focused right here.

We knew that we had
to step up our efforts

from a law enforcement standpoint.

What we're trying to do
is clean things up

to get back to the glory
that we once knew.

Morton:
Right now, at least

according to what
statistics are available,

Huntington is the worst hit
city in the state.

In order to fight the problem,
the mayor here

has assembled an office
of drug control policy.

Essentially modeling it after
the country's drug czar,

which is, you know, kind of a crazy thing
for a town of 50,000 people to need,

but in light of the fact they're
averaging three overdoses a day,

I guess you sort of have to find a way
to fight crazy with some form of crazy.

One of this town drug czar's
best resources

is Scott Lemley, a young "Moneyball"
sort of kid from the police department,

trying to use statistics
to get a grasp on the problem.

How do the numbers
here work? Like, what's...

Basically, all the overdose
deaths we've had in the county,

they've all been opiate related.

If you look at
the city of Huntington,

we have a death rate,

119 per 100,000.

National average is 13.

So we're about 11 times
the national average.

Do you have figures about the socioeconomic
background of the people who are dying?

We've had overdoses in the best
neighborhoods in Huntington.

We've had overdoses in the worst.

It's across the board, it really is.

Morton:
Jan Rader, a trained nurse

and deputy chief of the
Huntington fire department,

as well as the woman
who we just watched

save an overdose victim,

is also part of the drug task force.

It's sad when you can
drive around the city

and you remember places
by who overdosed and died.

Unfortunately, with this epidemic,
you have to throw out, you know,

what you thought addiction was,

what you thought an addict was.

You know, I don't think the medical
field realized what they were creating

when this wonderful pain medicine,

synthetic opiates, was invented.

Morton: What's crazy is, all this
new smack and pill addiction

can essentially be traced to one specific
opiate and its maker: OxyContin,

released to the public by
Purdue Pharmaceuticals in 1996.

OxyContin is extended
release oxycodone.

That's a very good drug
to prescribe to someone

with cancer pain, at the end of life.

Morton: Dr. Andrew Kolodny
has been studying

the skyrocketing rates of heroin
addiction across the country

from its beginning
in prescription pills.

The way you get a blockbuster drug

is by getting doctors to prescribe
it for things like low back pain.

And if it's a drug that is
very difficult to stop taking,

then you've got the magic formula.

Morton: Purdue campaigned
heavily throughout the '90s

to convince doctors
that not only was OxyContin

safe to prescribe for chronic pain,

but that opiates in general,

the drug class
that includes OxyContin,

as well as morphine, Dilaudid,
and heroin,

were far less addictive

than all previous medical
science had shown.

Now, in fact, the rate of addiction

amongst pain patients
who are treated by doctors

is much less than one percent.

The statistic that was
used over and over again

was much less than one percent
of patients would get addicted.

But what you would find is
that what everybody was citing

wasn't actually a journal article.

It was a one-paragraph
letter to the editor.

And yet, that's what
was used as evidence

and cited hundreds of times
by experts in the field

as proof that we shouldn't be worried

about getting our patients addicted.

Something you have to understand

is that when when we talk
about opioid pain medicine,

we're essentially
talking about heroin pills.

From the beginning of
the opioid addiction epidemic,

the young people
who were opioid-addicted

who were having trouble getting
enough pills from doctors,

would go to the black market,

and if they were in
a region of the country

where heroin was available,
they switched.

Morton: Can I ask you
how you started using?

Had you ever touched
heroin before that or...?

Why'd you switch?

Ah.

Morton: What's particularly
insidious about opiate addiction

is how quickly the body
develops a tolerance,

requiring increasing amounts of the
drug just to generate the same effect,

which, obviously, also increases
the chance of accidental overdose.

Morton: You're making
these big lines.

If you had just started,
like, how big a...

how big of a bump
are you doing? Okay.

Morton: While pill makers like
Purdue teed up all this madness,

at the very least,
their product was regulated.

If you took an 80mg OxyContin,

you knew exactly how much oxy
you were taking.

This is not the case with heroin,

whose strength can vary
from batch to batch,

and even bag to bag.

On top of that, heroin has to be cut,

because pure heroin alone would
kill even a veteran junkie.

But what it's cut with
is anybody's guess.

Yeah.

And how much could you
sell it for if you cut it?

Are those... What are those?
Are those movie tickets?

Oh, lottery tickets.

So, what do you cut it with?
Is that...

No. Okay.

Mm-hmm.

When you say pills,
do you use painkiller pills?

Well, it's basically the same
thing as heroin, isn't it? Right.

Morton: The strongest cutting
agent of all is fentanyl,

which is the strongest opioid
painkiller in existence,

up to 50 times
the strength of pure heroin.

Do you know anybody
who cuts with fentanyl?

Yeah?

Really?

They were intentionally trying
to get someone to overdose.

Yes.
Okay.

Morton: Accidental
overdoses have long served

as a perverse form of
advertising for heroin dealers.

But the fact that they're using
pharmaceutical drugs to induce them

shows just how extreme
the demand has grown.

So now the heroin epidemic that
the OxyContin epidemic started,

has itself turned into
a fentanyl epidemic.

They didn't understand why they're
cutting heroin with fentanyl,

because fentanyl is really expensive.

And I kind of have this idea

that they're not cutting
heroin with fentanyl.

They're cutting
the fentanyl with heroin.

Morton: With an increasingly
toxic, and seemingly inexhaustible

supply of heroin
entering the country,

the government has finally
started making overtures

towards addressing the problem
on the demand side.

More Americans now die
every year from drug overdoses

than they do from
motor vehicle crashes.

Morton: President Obama has
come to Charleston today

to address the heroin problem.

But there's
an ironic note in the fact

that this is a crisis
that started in 2007,

before the Obama presidency,

and it's taken till the second-to-last
year of his administration

to address a problem
that's been in plain sight

down here for over eight years.

Obama: I've made this a
priority for my administration.

With no other disease
do we expect people to wait

until they're a danger to themselves

to self-diagnose
and seek treatment.

You understand that
here in West Virginia.

We want to make sure the whole country
understands how urgent this problem is.

One big part of the problem with
the opiate crisis in West Virginia

is they've... this is basically
their first time dealing with it.

This is actually a big part
of a larger problem

with America's response
to drug problems.

It's just general inexperience
with addiction,

like what it means to be an addict,
why people behave the way they do

when they're hooked on heroin
or OxyContin or other opioids.

Mickey, the addict who overdosed at
the very beginning of our piece,

he survived, thankfully,

and was lucky to find a bed

at a treatment facility
here in Huntington.

What's up?
What's going on, bro?

Morton: Now, you've been here before,
though, right? You were telling me.

Mickey: Yeah, the first
time I was in here,

I just wanted that
damn judge off my back.

The second time I came in, I just...

needed to learn how to manage,

to get back to where I was
able to use and still work,

and pay bills and all that shit.

Yeah. And, yeah, it
don't work that way.

That's like trying to be, like, a
social drinker for alcoholics.

Yeah. I was trying...
Yeah, I failed miserably.

That's when I met you guys.

Morton: How many times had
you overdosed before that?

Mickey:
About seven.

I mean, I've overdosed
a bunch more than that,

but seven of them, I had
to go to the hospital for.

Right. Okay.

I woke up with everything
from hoses down my throat,

to adrenaline shots, to Narcan.

All:
God, grant us the serenity

to accept the things
we cannot change...

Hell, I've lived on the
streets, riverbanks, and tents,

spent winters out there.

I mean, it's... You would
think it'd be enough

just to make a person
want to stop and change,

but, fuck, it didn't stop me.

Most people come in here to get a
life that they've had prior to here.

I never had one. It's like
learning to walk again.

I mean, if this was easy,
everybody would do it and quit.

Right. Right. Drug dealers
would be out of business.

It ain't that easy.

There are some alarming
new numbers out from the CDC

showing a dramatic rise in the
heroin epidemic in this country.

Anchorman: Today the state of
Washington set a new record.

For the fifth year in a row

the number of heroin
overdoses went up.

Overdose deaths
skyrocketed in Ohio last year.

Kolodny: This is a problem
we're going to be dealing with

for the rest of our lives.

What you're hearing is,
we cracked down on painkillers

and everybody
switched over to heroin.

There hasn't been
a crackdown on painkillers.

There's still massive
over-prescribing of opioids.

Every state in the country
has within it counties

that are feeling
the effects of this epidemic.

This is the worst drug addiction
epidemic in United States history.

Decades after the end
of the Cold War,

America's now rebuilding
our aging nuclear arsenal.

Now, the Pentagon wants to spend
hundreds of billions of dollars

on new warheads and new
vehicles to carry them.

But this effort isn't just expensive,

it could actually be a threat
to our global security.

Man: As you can see, it's kind of
tradition for a lot of people,

once they spend their time
working in the missile field,

they'll kind of write their name,

and put in a time frame of how
many years they spent out here.

We're at about
60 to 80 feet below ground.

So this is the first blast door,

to protect measures of, you know,
before you get the capsule,

who also has another blast door, too.

And the purpose of this is...

Pretty much to sustain the
equipment down here so nothing...

In the case of a nuclear attack?

Exactly. Exactly.

Larsen: This command capsule can
launch a nuclear missile strike

against any target on the planet.

The officers here pull 24-hour
shifts called "alerts."

During that period,
they're responsible for ten

of the 450 intercontinental
ballistic missiles, or ICBMs,

buried at three bases
around the American West.

So we're having a little party
down here in the capsule today?

Uh, it seems like.

It's my 100 alert,

so Lieutenant Busbee surprised
me with a cookie cake.

Larsen: One hundred
alerts means 2,400 hours

locked in a bunker
no bigger than a family van,

which may seem like a long time,

but there have been officers
on continuous alert in here

since 1963.

It might be super old,

but it's still reliable

and it still gets the mission done.

Do you guys ever have
the feeling like,

"Hey, we practice these things
all the time,

"but we never actually use them"?

We use these every day.

The mission is deterrence.

And part of deterrence
is being capable of doing it.

So if the president
wants to actually launch,

we are ready to go.

Push door open.

Three, two, one, mark.

Larsen: Many people thought
that when the Cold War ended,

these weapons would go away too,

but they never did.

And the Air Force tests them regularly
at a secure base in California

to show the world
that they still work.

At a launch in late February,

Pentagon leadership was
on hand to make sure.

Even though these
systems are getting old,

anyone who is a nuclear power is
sure to be watching these tests

and has to be at least aware

that the United States nuclear deterrent
is as strong as it has ever been.

Larsen: The next morning, we sat
down with Deputy Secretary Work

to ask him why he thinks
it's still important

to have nuclear weapons at all.

The president, your boss, has said

he'd like to see a world
without nuclear weapons.

How does that play into the
current modernization program?

Well, what the president says, in addition
to wanting to get rid of nuclear weapons,

he says as long as we have them,

they are going to be
safe, secure, and effective.

So he recognizes very clearly,

that as long as adversaries or
potential rivals or countries

have nuclear weapons,
we're going to have them too.

So as long as that is
our national policy,

we will recapitalize them.

Larsen: The United States still
controls a massive nuclear arsenal

powerful enough to end
the world as we know it.

It's made up of what's called
the nuclear triad:

Land-based ICBMS,

gravity bombs and cruise missiles

dropped from
long-range bombers,

and missiles launched from submarines

that hide in the ocean.

Now, the military wants to spend

as much as a trillion dollars

to modernize all of it.

And that's ignited an intense debate

about whether we should
be spending so much

on weapons we'll likely never use.

We spend more money
on nuclear weapons

than all other countries combined.

This is the epitome of overkill.

Let's start the year
by putting to rest the notion

that our nuclear deterrent
is unaffordable.

That's just ridiculous.

Larsen: At the top of the
Pentagon's wish list

is a new fleet of
nuclear-armed submarines.

We traveled to an undisclosed location
off the southern coast to see why.

Larsen:
It's a pretty surreal feeling

to be in the middle of the ocean

and to come up on
a ballistic missile submarine.

It looks like a giant steel whale.

This is the USS Wyoming.

Beneath these hatches are
underwater launch missiles

that together carry seven
times the total firepower

unleashed during World War II.

Cue the launch of the 1C dive, dive.
Two blasts to dive alarm. Dive, dive.

Dive! Dive!

Establish launch conditions.
This is the captain.

This is an exercise.

Boat is XO, target package ID.

Whiskey, Yankee, Oscar
has been directed.

Larsen: The crew simulates launching a
nuclear strike several times a day.

Obtain the launch key. Obtain
the launch key. Aye, sir.

Why do you drill this component
of the mission so often?

The nation as a whole is depending
on us to be able to deliver

whenever the president tasks us.

Any time of day, any time of night.
We cannot fail.

Fourteen, aweigh.

Fourteen, aweigh.

Larsen: That urgency is one of
the Navy's major justifications

for replacing these submarines
with new ones.

The core function here is to keep these 24
missile tubes up and running at all times.

But the equipment that runs them,

and much of the rest of the ship

is getting too old to be reliable.

This is like 1970s technology.

The size of it, which you see in an
old movie, you know, in a warehouse.

So the upgrade for the Ohio
replacement will take this room

and could probably put it into
basically a laptop-size computer.

And then the hardware
that's made to run this

is so out of date that it costs
the government more money

to have someone actually
go back in and build that,

and to be able to repair
some of that stuff, so...

Space is very vital on a submarine,

so every single big cabinet that we have
is taking away space from the crew.

This is a nine-man bunk room. Okay.

Right here next to the missiles?

Next to the missiles.
We sleep with them.

What's it like to sleep
between missile tubes?

It feels kind of odd sleeping,

you know, on a weapon
of mass destruction,

but, you know,
you get used to it, I guess.

It comes with the job.

Larsen: If the Navy gets its way
and we do buy new submarines,

the first one is projected to cost
at least 8.8 billion dollars.

And the eleven subsequent ships would cost
more than five billion dollars apiece.

And that's just one part of the
nuclear modernization shopping spree.

The Air Force released more
details about its plans

for a new long-range
strike bomber.

Larsen: A brand-new
fleet of B-21 bombers,

to replace the B-2
and other models,

could cost more
than 100 billion dollars.

Stephen Schwartz is
a nuclear weapons analyst

who says all this spending
is getting out of control.

We're actually spending more today

to maintain and sustain

and modernize our nuclear arsenal

than we spent on average
during the Cold War

when we were building
new nuclear weapons

and testing them on a regular basis.

That's just incredible.

Do you ever step outside
your job and be like,

"This is crazy. We've built the
world's most expensive, elite,

practice football team that
we hope never plays a game"?

Right. Well, the people
on the other side will say,

"We use nuclear weapons every
day." I'm sure you've heard that.

You know, the other
argument they'll say is,

"Well, obviously,
all this stuff worked.

"Okay, we spent trillions of dollars.

We built all these weapons.
We're still here."

That's a myth. That's probably the
number one myth of the Cold War.

We could've done it with a lot less.

How much? I don't know.
But we didn't need it all.

We definitely didn't need it all.

Larsen: But even though
our arsenal was huge,

it followed a certain logic.

The weapons were
so big and so destructive

that both sides knew
they would never be used.

But now that we're modernizing,
we're building a new weapon

that's moving us
in the opposite direction.

At the National Security
Campus in Kansas City,

technicians are working on
a polarizing new project.

Behind me is a trainer model

of the B61-12 gravity bomb.

This weapon itself has
become very controversial

because of its ability to target
more accurately and to be smaller.

The explosive yield
of the B61-12

can be throttled down
to .3 kilotons,

a thousand times less powerful

than the warhead
on our current ICBMs.

And a new tailfin allows it

to be guided directly to its target,

giving it accuracy that our
nuclear bombs have never had.

Taken together, those traits could

make these weapons more usable

in the minds of American commanders.

Dr. William Perry was in
charge of America's nukes

as our 19th Secretary of Defense.

It's hard to argue
there's anything wrong

with having lower yields
or more accuracies.

But in fact, there is.

We can devise tactical situations

in which we might want to use it.

The problem is,
those tactical situations

are a snare and a delusion

because they lead us into believing

we can use nuclear weapons
at lower levels of danger

that would not lead to a full-scale
attack on the United States,

that would not lead
to a full-scale nuclear war.

That's a very,
very dangerous assumption.

Larsen: At the age of 88,
Perry's now the leading voice

warning that we're in increasing
danger of a nuclear disaster.

The threat is real.

In a sense, we are living
on borrowed time.

Larsen: Which is all the more
striking because during the Cold War,

he helped build up our nuclear
force to what it is today.

I've devoted a lot of my career
helping to build this deterrence

because I believed it was important.

Even as I did that,

I understood that it was
a dangerous situation,

that we should be looking
for some way out of the trap.

I did not see any way out of it

when there was a Soviet Union
that was hostile.

But when the Cold War ended,
that opened up the possibility

of moving away from deterrence.

And we did start moving away
for the first few years,

but now we're falling back
into the deterrence trap.

Are we in danger of a new
nuclear escalation though?

Yes, we are, already, in a sense,

restarting the nuclear arms race.

Even more dangerously,

we're on the threshold
of starting a new Cold War.

Larsen: That's because
the more we modernize,

the harder it is to convince countries
like China, North Korea, or Russia

not to ratchet up
their own nuclear programs.

Anchorman:
A key question tonight:

How will Russia respond to
America's enhanced nuclear bombs?

Larsen: When President Obama hosted a nuclear
security summit in March of this year,

Russia refused to attend.

At the same time, Russia is building
new submarines and missiles,

and they're warning that they
may be forced to use them.

The Russians have used terms
about nuclear weapons

that we view
as extremely destabilizing.

This is stuff we haven't heard
since the Cold War, literally.

And the Russians have said,

"Look, we'll go
to nuclear weapons early.

We will escalate
to deescalate."

Once you start up the escalatory
ladder with a nuclear weapon,

you don't know where
you're going to end up.

Are we living in
dangerous nuclear times?

I believe...

that the likelihood
of a nuclear catastrophe today

is greater than it was
during the Cold War.

And our public is
blissfully unaware of that.

Is there any way out of this?

Maybe not, but I hope so.

The first thing we have to do
is don't make it worse.

If we go ahead with the complete
remodernization of the force today,

we're just digging the hole deeper.

Sooner or later,
we've got to get out of it.

It's not going to be soon,

but we ought to be moving
in that direction,

not in the wrong direction.

Sync & corrections by honeybunny
www.addic7ed.com