The Status Quo is Killing People. Dr. Drew Talks to Armstrong & Getty

a long form interview. Uh so. Dr Drew Pinski is indeed a well known fellow from the media, but he is an internist addiction medicine specialist UM and has been dealing with folks with substance abuse problems for decades and is absolutely, uh not only dead serious about the bums and junkies problem, the homeless problem, if you want to call it that, but it's really crusading and trying to get people to see it for what it really really is. Dr Drew, this is a pleasure. We really appreciate you

joining us. How are you? And we definitely have three people here that are in the category of don't get us started on the homeless situation. Yeah, yeah, I'm afraid of how when you When when I get going, I'm afraid of where I go. I'm the same way too, be part partially because I had a personal situation with my family where an aggressive bum got in our faces threatened to murder and rape my family. Uh, in front of me. I had to intervene physically with the dude.

Cops are called the guys now in prison. I I hated the homeless situation before that, but since then I really do. Yeah. So listen, why don't we start with what it's not, the the giant homeless explosion in particularly the West. Let me jump in right there. I'll tell you the guy that threatened to kill my family, he was not a guy who couldn't afford his apartment, right, That is not what he was. It's not a guy for whom four walls is going to help. It's not going to help him to push him in a room

of his own. He needs serious mental health treatment long term. And the conflation, the conflating of the real problem of a act of affordable housing, I would a couple weeks ago at the Schwarzenegger Foundation meeting he held, and at that meeting there was absolute consensus that the lack of affordable housing was a self created problem by the extraordinary regulations in the state of California. Therefore, we could undo

that if we had the will. That's one problem. Now, the lack of affordable housing, I would argue, is not that acute. If we in Los Angeles could absorb one point five million undocumented workers in the last two years and none of them are on the street, they're not on the street, how bad could the housing? Probably I wanted to have million people found housing, all right, But okay, we all agree there's a shortage of affordable housing. That

is a separate and distinct issue from homelessness. Homelessness is the result of the dismantling of the mental health system of the state that resulted in the patients pouring out onto the streets, the prisons and the nursing homes. We have now wish them out of the prisons, they're on the streets. And then we've made the problem more acute by legalizing drugs and drug trafficking, So all the other

addicts in the country are homeless. Headed it all way, that's homelessness, and it is killing justin l A county three people a day. Would you would you body count need to be everybody before we do something about this? Right? Would you agree that it's useless to discuss homelessness unless we start breaking down percentages of the drug addicted, the mentally ill, the mentally ill, and drug drug addicted guys who are just bums, they're just dropouts, they'd rather not work,

et cetera. There are probably that latter category is about ten percent, and even those a majority of probably taking math. So it is. You know. Look, I was up in Sacramento about a month ago. I went on the streets, I went around with the cops. I talked to all the homeless, and they all told me the exact same thing. The cops and the homeless using mess on a regular basis. And these were unprompted ad hockey interviews with homeless and cops, and they, you know, on the streets of Sacramento, they

all said the same thing. When I go out in the Los Angeles, I asked what percentage you're doing drugs, they'll say somewhere between six. You go downtown in downtown on skit Row, and it's higher and the mental health issues are much more acute. This is unconscionable. No other country on Earth doesn't take care of people with brain diseases. It's too much, it's too much. I can't even believe what I'm seeing. This is a population I served for

thirty years. I know exactly what's going on. I know exactly what can be done for them, and I know exactly how well they can do. And I know those that need chronic custodial care. We have to get realistic about this well, and I just did. I became aware of this for the first time just a couple of

months ago. The trends, the almost crazes in mental health care that happened during the twentieth century, including zyra calls late fifties, early sixties, that there was this this craze that the community mental health centers could take care of the mentally If you want to read it, that's exactly

where we went off the rail. It was in It was a guy named Robert Felix, an unelected official, who got the ear of President Kennedy and got him to sign the Community Mental Health Hack, which was designed to eliminate institutions for the care of the mentally ill, because in the mind of these social engineer whack jobs, there were three psychiatrists that ran the National Student Mental Health

for forty years, non elected officials. None of them had ever been in One of them only had been in a state mental hospital, none of none of them had ever been in it. The rest of them watched One Flew Over the Cuckoo's Nest and thought they were watching a freaking documentary. They were not. And they decided to dismantle the system, and that their goal was to create these community mental health centers who were going to quote,

prevent mental illness. So no provisions for what to do with those pouring out of the state hospital, some ill conceived plan which we still don't know how to do to this day prevent mental illness. They were going to be social engineers. The excesses of psychiatry in the fifties and sixties on that side and what they did to the patients that were in institutions unconscionable. So laws were put in place in the sixties and seventies that were

a backlash to that. Those laws are approaching one hundred years of age, they are at least sixty or seventy years old, they're anachronistic, and they're the barrier to the ability to treat the patients today. It was a reaction. I get it. I'm not apologizing or excusing the excesses, but those laws are the barrier right now, and they're they're they're approaching a century old. We've learned a little bit about how brains work and how to treat them,

and that's sixty seventy years. It's time we changed the laws that's going to be necessary to address this problem. Why does it seem I mean, we're talking about the seventies when a lot of these laws were passed, and they were reaction to the cruelty of some of the first half of the twentieth century mental health care. But why is it seems so much worse on the streets in the last ten years. That is that is right. First of all, there's Newton people in mental illness every day.

They gradually strangulated the definition of gravely disabled. So so you can't bring people into a facility for treatment unless they say they're going to kill themselves or kill somebody else. And if on the way in they go I was just kidding, they can. They're only allowed to ask two questions. You know where to get food? Yeah, there's an Arby's over there. You know where you're gonna live? Yeah, I've got a tent at the underpass on Highland. That's it.

You have to let them go at that point. So the notion of assembly being gravely disabled, having losing their legs from infection, lying in the street, you can't touch them. They they not only do you not touch them, you can't touch their belonging. So one of the one of the phenomenon of the chronically psychotic patients is they will hold their duels and urine. Can't touch that, can't touch anything. They're intended to do whatever they want, man, and that

is killing people. It is ridiculous that we don't have gravely disabled anymore. There's a bill in Sacramento, s B sixty. State Senator Um Morlock has brought families up there by the dozen saying, please help us. We are loved ones on the street. We have resources, we have doctors, we have a bed to put them and will nourish them. Help us get these people home. They're told to take a hike. It's it's morally reprehensible what our legislator is

doing in Sacramenty. It's truly reprehensible. We got a heartbreaking letter from a listener with a son in exactly that position today. Yeah, hey, listen, you mentioned California's Prop forty seven, And I know from reading some of this have you written you're as staunchly critical of it as us. Why don't she explain for folks what it was and why

you think it relates to our problem. I'm actually probably not as critical of you, because I'm very sympathetic to the idea that these people do not belong in prison. Drug addicts don't belong in prison. They belong in mandated treatment that is not prison, that is life saving intervention. Drop for seven was an attempt to deal with the excessive uh imprisonment of the drug addicts. Instead, they made

drug use and drug trafficking essentially a misdemeanor. And you give drug addict a misdemeanor citation, are you ever going to see them again? No? So it's a zero. It's a zero. You're also allowed in Prop. Fifty seven to steal nifty dollars a day misdemeanor, so they can traffic their drugs, use their drugs, steal the support the habit, unencumbered by law enforcement who have just given up. They don't even You just watch it at a target that

someday and watch people walk right past the cashier. It happens all day long because law enforcement can do nothing. Citing them does nothing, So we have to create some kind of mandated treatment system. Otherwise you are murdering these people. These are make no mistake about it. People that defend Prop for seven are murderer. I've been dealing with drug addicts for thirty years. This is active killing of drug addicts. You can't allow an addict to use unencumbered and not

expect them to die. It's a fatal illness. We know that. So anyone that defends the status quo is a murderer period. Just because we're acting as enablers as a society, it's worth an enabling it's it's actually an active encouragement of the progression of a fatal illness rather than intervening in a way that and by the way, if they wanted to say, hey, you know what we're gonna do. We're gonna create nursing homes where nurses administer the heroine and

the amphetamine all day long, we keep them safe. If they want to do that, fine, go do that. I wouldn't even object to that. But if you're just letting addicts run unencumbered, they die. So if you have to do one or the other. You have to all the way and start administering the substance to them in a controlled environment, or you have to intervene. And trust me, having dealt with thousands homeless drug addicts, they're way happier when you get them so their way, they and they

can be great. In fact, I have people in the Department of Justice that I'm working with right now who are recovering homeless drug addicts. It's not that unusual. It happened. It's tough, it's time consuming, it takes a lot of resource, and a lot of structure, and a lot of a lot of sort of damocles over their head all the time. But they do fine. So for God's sakes, everybody, let's let's let's get realistic here and where. Why aren't they

listening to clinicians. This is the mystery of me that you have a mental health and open air asylum and then refuse to consult with people that work with them too much. So I don't I've never understood this completely. There's there's mental illness like my son's got um, you know, just it's it's something that happens that you didn't make any life choices that brought this on your or whatever.

And then there's ruining your brain from drug use. Can you fix somebody's brain who's ruined it from drug use? Are they just an award of the taxpayer at that point or what do we do with them? It's a great question. So that it's let me answer your question, and then I'm going to give you a corollary issue. One is about three quarters of the time the even

the psychotic drug user will reconstitute. There was some crazy data that just came out, however, that shows if your psycho psychosis was induced by either cannabis or methamphetamine, you're actually more likely to stay and remain psychotic from cannabis then amphetamine. This was shocking data to me. So both drugs are inducing psychosis, but one actually is more likely to be a long term problem. Now, the issue of a spontaneous mental illness, which are about one percent of

the general population, We're always going to have this. It is a phenomenon. It just a brain gets sick, just like hearts. And when that happens and we don't treat it, you can lose people forever. If you treat it early and aggressively, they can do very well and actually return

to a product of life. Weirdly, in this in the state of California, if somebody has a dementia and as confusion and hears voices and is delusional and you don't intervene, you're guilty of abhuse with schizophrenia with the same exact symptom complex or you can't touch them, You're not allowed to touch or go near them. And the schizophrenia is the circumstance in which you can change the course of the illness by intervening. Dementia intervening does nothing, and yet

that's the one that we have to intervene on. It's insane. It's insane from a clinical perspective. And and look, listen, you you hear what the case I'm building here. People that defend the status quo are defending ruining lives and killing people. It's a genocide and these people are defending it. It's too much. I wake up every day beside myself thinking about this because I know during the day three

more will die, justin l A County. Well, the case you just built, the comparison between schizophrenia and UH and dementia is incredibly powerful. Who are you? Who are you pushing against who is saying no, Drew, You're wrong on that, or is anybody just The only person that really is listening is Ben Carson, and he's he's coming, He's coming. Uh. Some of the immediate advisers to the President who listened very carefully, and they're looking for ways to pull levers

to try to make things better. Catherine Barger, Eli County Boarder Supervisor chair here in southern California, listening carefully and taking a deliberate action. Everybody else, well, even when they start to talk about mental health with I'm I'm happy that meyr Steinberg and Sacramento has begun to talk about it well, then mention it and back into a conversation about affordable housing, and that to me, I just I

jumped out of my skin. I can't stand even to listen to it when I hear that, because yes, go go deal with affordable housing. Do not contaminate that topic with the topic of homelessness. It's a contamination and it's reprehensible for them to do it. It's clearly a moral failing on their part, and they need to change or this problem is not getting better. So let me tell you what we gotta do. Are you ready all right?

We gotta pass s six forty and re established the idea of gravely disabled, so we can bring gravely disabled people to care like every other country on Earth. Number one. Number two, we need to expand conservative ship are three. We need a directive to physicians when there's a psychiatric diagnosis, just like we have a directive to physicians when there's a medical diagnosis. There are circumstances in which the brain stops working due to metal or medical or psychiatric conditions.

In medicine, we do it as a matter of professional mandate called the pulse form. We need the same thing for psychiatric care. So when somebody does decompensate, which is inevitable and most psychiatric illnesses, we are directed to go in and take care of them. We need to build resources, right, We need these in particular intermediate residential care, not housing treatment centers. Call it what you will. We used to

call them psychiatric hospitals. Let's call them something different, let's call them life centers, whatever you want to call them. But the the Social Security Administration and Department of Health are in the way, so it takes years of paperwork to get past them. Plus sequel the environmental protection laws that I don't know how you get around them, maybe declaring emergency. They need to be swept aside, and in a year you can have thousands of events with them

in place. It's going to take may never happen. So these are some of the things that are simple, simple. Our legislator legislature in Recramento could do it. Now they're not doing it. They're not doing it, and it's it's reprehensible. Dr Drew Pinsky and listen, Drew will have links to the some of the stuff you've written at Armstrong and getty dot com. So folks can go over it again and get a little more acquainted with it. But keep fighting, a good fighting. Let us know how we can help. Huh,

we're just talking about it. Help and again, don't don't don't fall for the rhetoric. The rhetoric is so ill placed and so loose base. It's it's about modifying forty seven, it's about repealing fifty seven. It's about expanding conservatorships, it's about six disabled, it's about resources for people that need mental illness that we've been ignoring for close to seventy years.

And it's costing lives on a daily basis. Listen, if Corona were killing three people in Los Angeles on a daily by basis, you don't think we would take action immediately. Come on, everybody's get with it. Wow, good stuff, Dr Drew Pinsky, Thanks Drew. Good to talk to you. There's an interesting point in the coronavirus. Yeah, and he's right, which, Yeah, if three people got it at all, it would be

in the news, let alone dying from it. You know, I appreciate what he said about the affordable housing thing. That is an issue, but it's not this issue. I'll never understand that. How do you how do you not move if you can't afford to live somewhere? I just don't understand how you just don't go somewhere else cheaper. And again it's a different question completely to in question then the You know, it's obviously a mental health problem.

Spend Spend ten minutes among the homeless, and you'll understand it's a drugs and mental health problem. I just but government gets power by passing money through itself. So how mare's a hell of a lot more money in housing than there is in fixing a schizophrenic Well, that's what I was gonna ask is how much of it is just cynical. It can't be as much as I hate Steinberg, the mayor of Sacramento. Um, he can't be so cynical that it's just I just want the money to go

to my friends. No, I think it's misguided. How could you be so misguided? Howegical? Bubbles? How could you possibly And it seems like it plays into these people's a wheelhouse, the compassion for drug addicts and everything like that in the mentally ill. Why are they making it a housing thing? I just I don't get it because that's the conventional wisdom. I guess I'm We've been hearing that for years from uh and this is awfully California centric. But you know

that's both Drew and us. That's what we're most acquainted with. So wherever you are, you can apply this to where you are. But um, Jerry Brown was previously the governor, was always calling it a housing thing. Gavin Knewsom calls at a housing crisis. He admits that it's also mental health. But um, and and you just hear it all the time.

I don't know why in particular, but it's just time to stop, just stop bringing up housing when you're talking about homelessness, because his Drew put it these people and oh he makes it. I I read something he wrote that was really interesting. One of the primary symptoms of some of the psychosis that keeps you from living a normal life is that you can't recognize that you have a problem. And then if your standard is this person has to self report and turn themselves in and or

kill somebody. I mean, that's just idiotic. Is dementia comparison? That's what it was about these people. It's he compared it to stroke. A lot of times, when you're having a stroke, if it knocks out, I think it's the right side of your brain. You can't comprehend that you're having a stroke, and there's not a doctor in the world even as your hand flops in your face, right, And so doctors know if a patient has those symptoms and says no, I don't think I'm having a stroke,

you don't send them home. You say, oh, yeah you are, and we're taking care of you. Any problems on the street. But literally, in schizophrenia, you don't know that you have a problem. And so anyway, well, yeah, the people I see yelling at the cement wall. They just need an apartment. They're not any position to self diagnose anything. They need a tiny home. They're having a very loud conversation in which they are in direct opposition, vehemently with the position

being held. But that cement wall. Yeah, well, I could go on and on about um and I wish I had in front of me. I gotta grab it. But that history of mental health and mental illness care in the twentieth century, it reminds me a little bit of of the crazes that catch hold and education or it's it's practically like music or fashion, like clothing. Fashion, In that a particular ideology caught hold in the like fifties,

and it swept the nation. All the pros got super excited about this idea of shut down the hospitals, go into the communities and say, look, you're feeling a little stressed, here's what you do, and that will prevent people from becoming psychotic. It was idiotic. It was based on no data,

on no sound research. It was just a craze. And they convinced Kennedy and his people of it, and and they all turn them loose, and Reagan off and gets blamed for closing the mental hospitals, but he was pressured like crazy from the left to do it, and so yeah, and and we ended up with this idiotic system that doesn't work, and now people are afraid to deal with it. And listen, libertarian types like ourselves were a little cautious about the idea of the government stepping in and locking

you up for your own good. And oh yeah, I think there's gotta be a break as well as gas pedal on that move back to sanity. But when we currently live in a society where the aforementioned Because I saw this woman the other day yelling at the cement wall under the overpass, like just really angry, pointing and

yelling at this mount wall. What did it do? Don't you have to have a society where somebody can pick her up and take her and and and incarceraate her for that, You're doing her an enormous act of kindness if you do. How how is that not a possibility? Even as a libertarian, You've got to be able to look at her and think that person, it's got to

be put away. They're not capable of making their own decisions. Yeah, I don't think it's not safe for that her or me, right right, Well, you could absolutely make the argument, and again you have to be careful with this argument, but you can make the argument as Drew did. Dr Drew, that it's an incredibly cruel thing to leave her out to freeze, starve, get raped, self, medicate with math or whatever.

I mean, that's other than, like, you know, putting her in some torture chamber and torturing her her to death. What could you do worse than than insisting that she have that fate. So I don't know. I'm hoping change is gonna come. Just stop conflating the homeless thing with a housing thing. That'd be a big step in the right direction. It's two separate issues, for God's sake.