Listen to the Silence: Women Trapped in the Opioid Epidemic

[Jaunty Guitar Music]

Mike: Welcome everybody. This is Avoiding the Addiction Affliction, brought to you by Westwords Consulting and the Kenosha County Substance Use Coalition. I'm Mike McGowan.

Mike: We've had a number of conversations about underserved and misunderstood populations regarding substance abuse. The conversation today is so important to have as we continue to struggle with the opioid epidemic.

Mike: Our guest today is Debra Gonsher Vinik, a film producer, writer, and director who lives just outside New York City. She founded Diva Communications in 1985. She's produced and written 21 documentaries, including six Emmy winners and her newest film, "Attention Must Be Paid, Women Lost In the Opioid Crisis" is a call to action for more women specific addiction, treatment and recovery services nationwide.

Mike: Also, we were just talking before we started, the new film was edited into a two hour series airing on A.B.C. Affiliated stations. I think you said Debra, August 5th?

Debra: Right. So it has been airing for the last 60 days and in the New York metropolitan area that would be like W.A.B.C., New York, New Jersey, Connecticut.

Debra: It will be airing on August 5th, which is a Saturday at two in the afternoon on W.A.B.C., which is the A.B.C. Affiliate in that area.

Mike: And I looked it up. There are affiliates nationwide, so you have to look it up on your own D.V.R., but that they change the title a little bit. So look for, "Listen to the Silenced Women Trapped in the Opioid Epidemic".

Mike: Well, thanks so much for joining us, Deborah.

Debra: Thank you for having me. It's my pleasure.

Mike: Well, okay, so I wanna start a little bit backwards here. Our culture, much of your work has been about women in our culture. And I read, I don't remember where I read it, that you realized early in high school that rules were different for men than women.

Debra: Absolutely. And I might do a documentary that really focuses on the moment where young girls, young women realize just that, that the whole playing field was completely slanted. And I'm gonna tell you the incident that happened. So I was a sophomore which is 10th grade in high school.

Debra: And I met a very interesting boy who was a senior and who was editor-in-chief of the yearbook. So people don't usually work on the yearbook when you're a sophomore. You usually work on it when you're a senior. But because he was so interesting, I worked with him. At the end of and I continued to work as a junior.

Debra: So at the end of junior year, I thought that I would be named editor-in-chief of the yearbook because after all nobody else had even worked on it. And the editor-in-chief, who was a senior, chose a boy who had never been involved with the yearbook whatsoever. And I said, are you kidding? How do you even do that?

Debra: And he said, "Well, you know, women can't possibly negotiate the way they would have to with publishers and the printers." So I had to go with this guy who was, you know, very, very smart. I said he knows nothing. He had not even one moment of interest. [he said] "Yeah, I know, but I, you know, I think it'll work out fine."

Mike: I, I think women hear that a lot, that phrase "women can't".

Debra: Correct.

Debra: Can't. And it's not like there was any evidence back to, you know, we talk a lot about evidence-based. There was, there's no evidence that would've allowed someone to come to this conclusion. It's not like, oh, well, during my junior year I had negotiated poorly, no. So, It was just women can't, it's not something that women do.

Debra: And it's an eon later and I've never, I've never forgotten it. And you know, at a high school reunion, You know I, I talked about it because it was really pivotal. And so in later years over the 21 documentaries we've done, about six of them are really focused about women. So we did a documentary that looks at the ordination of women into the rabbinate.

Debra: One of my favorites, although I'm not supposed to say that, but a documentary called "Beauty of Their Dreams", and that looks at the importance of girls' education. And so around the world. You know, there are a lot of countries, as you know, that girls' education is not only a priority, it's actively denied.

Debra: And so we, we filmed in Uganda, we filmed in Rwanda. We had footage from Haiti. We had women who have Muslim backgrounds in the United States, and we really looked at, you know, just the importance of girls education and how it can so meaningfully change a country's economics as well as, of course the, the girls and young women's lives.

Debra: And so when we got to this issue of opioids, I, I said, little did I know how really abused. That's, that's the word I would use. Women are, in terms of the resources, we also did a documentary in 2010 about intimate partner violence, also known as domestic violence, but it's called, "I Believe You". And so here we are four years ago starting this, and what I realized very early on is that the lack of resources for women, it's a form of abuse.

Debra: There are no resources. And when I say that, it sounds like I'm being hyperbolic, but if you are a pregnant woman and you need to find someplace to go, if you are a single woman who has children and you wanna go into recovery, there's less than 1% of facilities in this country that will take you.

Mike: Especially if your income and socioeconomics are also not reflective of getting insurance.

Debra: Correct, correct. But even if they are, the fact is that so many facilities don't want the liability. They, they're not, they don't wanna have, let's say a seven year old little boy running around there. No. Because they're concerned about the liability issues.

Debra: So you can't, you can't even go. It, it's beyond shameful. And I'll tell you something. If you had told me when I started this four years ago, that four years later the situation would actually be in some ways worse. I don't know what I would've said at that time.

Mike: Well, you know, addiction has always been treated.

Mike: It's a disease, right? But it's been treated different. And it carries much more of a stigma for women than it does men.

Debra: Oh, absolutely. If you are a woman, you know it. If you have an Uncle Joey who has an addiction, it's, "Oh, you know, Uncle Joey, we all know". But if you are a woman, whoa! Suddenly you know your motherhood, your ability to mother is called into question.

Debra: You're a bad mother. "How could they do that?" Do that? What does disease do? You know, where people say, "How could they, how could you go out and get cancer? If you're a mother, what kind of mother are you for going out and getting cancer? Hmm."

Mike: That is great. That is exactly (laugh), that is exactly right. Well, tell us then about attention must be paid.

Mike: What drew you to the topic of substance abuse, especially opioids?

Debra: Well, I. You know what drew me is that there was clearly a problem in this country. And as, as I said, I started it and quickly decided to focus on women. And one of the reasons why is because nobody, what a surprise Debra, nobody was talking about women.

Debra: You read. You pick up almost any article and there'll be enough about opioids, about opioid use disorder. There'll be a number of examples given of unfortunately young men who passed. Maybe there was fentanyl mixed in. Maybe they didn't know whatever. And then there might be a, the, the sub story is about the mothers, God bless them, who've started foundations in their son's names.

Debra: There's no discussion about women who suffer from the same disease, and we've lost 200,000 women. Since the year 2000. Now, somebody asked me if we have lost a lot more men, and we have, I'm not denying that. I'm not saying we haven't lost more men, but what's happened is we've lost more men. So everyone decided, okay, let's not even focus on women and let's treat the way the government has.

Debra: Up to 1993, there wasn't even a mandate to include women in clinical trials. That means all of the things that were being tested, all of the drugs, everything, women were not included in the clinical trial.

Mike: Well, historically the trial's studies have all been done on male, well, for that matter, white, Caucasian insured, middle class, and above males.

Debra: Correct. And, and we know now that certainly both the doses are radically different between men and women. And I say in the documentary that as one person said, women were just considered small men, so.

Mike: (laugh)

Debra: Oh, everything's exactly the same, just a little smaller. And you know, it's ridiculous for me to say that's not the truth. It's, it's obviously not the truth.

Mike: Well, I have to ask you, where did you find the women for your documentary?

Debra: Well that's the interesting, fun and challenging part. So in some cases, you know, I reach out, I've been doing this for a long time documentaries on social justice issues.

Debra: So I reach out to people I know or organizations that are involved in this arena. So I knew about Baychuva (??) in Los Angeles because I had done a documentary with the person who had the organization a number of years ago. So I reached out to them. I was really interested in including Native American women.

Debra: Because, man, if you know as a point of reference, if women generally aren't looked at in this epidemic, certainly women of color are really giving short shrift. So I wanted to include Native American women who come in number two in terms of usage. And then we were able through people we knew to meet Kay, who's a woman of color and you know, it's, this person knows this person.

Debra: I knew somebody down in Illinois that introduced me to, you know, and it's just. It's a long evolving process where I interview the women over the phone and then you know, if I feel that they'll be a good fit then we'll we'll go out. But I do wanna mention one story, which is just about how it really is.

Debra: A little bit of hand of God, and I'm not necessarily a person who speaks with terms like Hand of God, but there is an element involved here, and this is what I mean. So we were out filming in outside of Seattle where the Muckleshoot tribe was, and we have two stories of women from that tribe. And so now we're returning home on a red eye.

Debra: People were still wearing masks on planes and it was still a little dicey. And I'm sitting in a seat. My back was killing me. My husband, who's a camera person is sleeping and it's like three in the morning. I can't, I'm like, I'm thinking all these bad jokes like, oh, I could use opioids now.

Debra: I mean, really bad jokes. And I got up and I walked to the front of the plane and I start speaking to the flight attendant and she asked me what I was doing out in Seattle and I said I was finishing the filming and we had just finished the last two stories. And that's, and, and she, I told her what it was about.

Debra: She said, oh my goodness. My friend just lost her daughter last year just lost her daughter a day after she got out of the rehab facility a month after giving birth. She said to me, would you be interested in including that story? I said, listen, we're really done. This was our eighth story.

Debra: We're really done, but thank you so much. She asked me for my card. I gave her my card. I didn't think about it again. A month later, I get an email from the mother of this young woman who passed and I met with her over Zoom. She told me a story. I start off and said, "You know, Juanita, we're really done with the filming. We've gotta edit, we've gotta put together". And she said, "I understand". And I said, "No, really? There's no more money. We have no more funding". And then she told me her story, and at the end of the story I went, "I have to include this story". And that's what we did. And you know, a story is a cautionary tale, really is a cautionary tale.

Mike: What struck you as you talked to the women?

Debra: Well, there's a number of things. What struck me for many of the women, so I had about nine women, six of the women you know, began using opioids through a prescription from their doctor for some medical, physical injury. And what struck me is that almost all of them thought, "Hey, this is okay. This is something a doctor gives you this, you know, there's no problem here. You know, it's not anything to worry about". And then, you know, after relatively short period of time, I mean, I'm talking days, I'm not talking, you know, weeks, relatively short period of time. What happened to many is when they didn't take that pill, they started feeling in many cases, you know, I have two women who are in their seventies.

Debra: They were on, one of them's been on fentanyl patches for. 12 years. So when she stopped taking some earlier pills, she just didn't feel well. She didn't realize that she was going through beginning withdrawal. So she just knew if she just took another pill, she'd feel better. So what struck me is that for six out of the nine women, you know, you wanna talk about no fault. These are people who were given a medication that their bodies became addicted to. And then they just didn't wanna feel that physical uncomfortableness and they kept on taking it and taking it. And then in some cases, in some cases, they never took any more than they were prescribed. That's the case of two of the older women.

Debra: But in other cases, they kept taking more and more and, and getting more. Kay says at at points she had hundreds of pills cuz she was taking six at a time.

Mike: How'd she get 'em?

Debra: Oh, she said she would shop for doctors like she shops for clothing.

Mike: (laugh)

Debra: And she had, yeah, and she had a doctor for, you know, podiatrist, a doctor for this, a doctor for that. And she would go in with an, with, you know, a prescription for, you know, from one doctor and say, doctor X is away now and I just need to get she, she talks about busting a script. I didn't know what that is.

Debra: That's when you take, like, you know, you have, they write x-rays for Debra or something on a, you erase that and then you can write in a prescription and you do that with an ink eraser. And she, because of that, she went deaf in both ears. It's very unusual. But extended opioid use can lead to deafness.

Debra: It rarely does it in both ears. Kay was the lottery winner, so to speak.

Mike: Well, and then what we discovered is, okay, this is a problem. So they kind of shut the spigot off, right?

Debra: Yes, yes.

Mike: And, and then they're like, okay, now we're hooked. What? What do we do now?

Debra: Right. And so that makes an even worse monster because people move to heroin.

Debra: And so that's the case of what happened with the, one of the young women whose past is, she was taking medication for a knee injury and she became dependent and then the spigot is closed down and you know, you move to heroin and the heroin of 10 years ago. I hate to sound like grandmother time here, but the heroin of 10 years ago is not the heroin of today.

Debra: All the drugs that anyone can get, even amazingly to me, pot, which to me seems like, come on, even pot is now being cut with Fentanyl. So if you are putting Fentanyl in pot, like man, all bets are off. I say if you wanna smoke pot, you gotta come to a state that has it legalized because you can't buy it.

Debra: You know, when I was growing up, I know once again, grandmother time. People did drugs, people smoked pot, people did cocaine. No one ever thought that if they smoked pot or if they did a party drug, that they were taking the possibility of their own life in their hands. And now that has to be on everyone's mind.

Debra: And that leads me into, there needs to be Naloxone in every single place, every single building on a university campus, not just one building. Every single building, every single church, every Walmart, every IHOP, every Bloomingdale's, every store has to have Naloxone there, has to.

Mike: Well, they've all got defibrillator paddles, right?

Debra: Right. And they all have that ax with the, you know, handle for the fire. They all have that. How is Naloxone not there? I don't, I, I don't even know. I don't even know how that can be a possibility, quite frankly.

Mike: You know, it's easier on these podcasts to get people on them in recovery who have a story of, you know, their recovery.

Mike: It's a lot harder to get people who are currently struggling, and you made it a point to have stories of optimism, hope, and despair. And I, I think I read that you didn't wanna leave a Polyanic view at the end of your film.

Debra: Right. So I was asked, I think that I think that Hazelden Betty Ford asked me point blank, you know, they, I don't think that they were let's put it this way.

Debra: I think that they would've preferred and more upbeat ending but a more upbeat ending wouldn't have been true. And so that ultimately is what happened. You know, when we go through many, many thousands of edits and when I edited a certain way, I went, wow, this, this is so, it's so not true.

Debra: And so we re-edited and we have a lot of stories of women in recovery and, and with years of recovery. But, but for us to say, listen, all you have to do is go into recovery and it all ends up happily ever after that would be just completely a lie. We wouldn't have these hundreds of thousands of women who have passed.

Debra: And quite frankly, almost every one of the women who you know had, I'm not talking about the women who developed a physical tolerance and were doing this in a different way, but I'm talking about women who really were using it more than they should have and were getting it illegally and this and that.

Debra: Most of them haven't, have had, I think the number is seven. There are seven attempts at rehab. So what does that tell you? It tells you that it's really, really horrifically difficult, and it's not just because you can physically, your body can get off of the drugs. It's that, A: your brain has been rewired, and B: you need continuity of care after you get outta rehab and you need a community of support.

Debra: You can't do it alone. There's just no way. There's just no way. It's one of those things in life.

Mike: Well, going back to one of your first statements, you know, we don't take cancer and say you get one shot at chemotherapy.

Debra: Right.

Mike: Right. So if it's, if it's seven, it's seven. If it's nine, it's nine.

Mike: It's hard to get one, let alone seven.

Debra: It's very difficult. I think in a way, one of the takeaways is that these women who are in recovery have a strength of will and character. That is really to say impressive is really an understatement. And you know, for all the stigma of like, "Why can't they just say no?", which is just like ridiculous.

Debra: But you are really talking about women with strength. Women who, when they physically were not feeling well when they physically were, but then were had all these opportunities of loneliness and of depression and of wondering whatever, had the strength to pick up the phone or go to a group or connect with people so they wouldn't use, man you know, rather than say, wow, it's taken seven times. I go, "Man, only seven times". It just seems like you're the, they're amazing to me. They're amazing.

Mike: You know, you mentioned Betty Ford and I think you were in Dallas recently, right? At the Community Anti-Drug Coalitions of America Conference.

Debra: Yes.

Mike: And you, screened the film, how's the film been received?

Debra: The film's been received terrifically.

Debra: And here's my story from this, and this was just this week at C.A.D.C.A. So I say at the, you know, before the film and then there was a great question and answer period. And I tell the story and then I'm gonna tell you what happened after that. So at, at the screening and at the Q and A I tell the story that before the film came out, when we were finishing the film, I had two focus groups. I conducted two focus groups, one in Austin, you know, on Zoom, and one in the New York metropolitan area. There were eight people in each group. And before I started my questions, two people from each group said to me before you begin, it's almost like they had a cheat sheet or something, but they said, before you begin, I've gotta tell you, Debra.

Debra: For the first 10 minutes of the film, I just sat there with my mouth open because I didn't even know that this was an issue. So I said to them, I understand that. Because when this was happening, and this was being told to me, there were two articles in the New York Times during that three weeks.

Debra: And neither article in the New York Times mentioned women, neither article. So how would anyone be expected to know about women if there was no mention of women? Okay, so now to C.A.D.C.A. I kind of tell the story and you know, people are talking. The next day, we're walking through the small area. They have like an exhibit area.

Debra: And a woman comes running up to me and she said, "I really wanna tell you how much I love the film". She wanted to know some specific questions about one of the women, and then she said, "I have to tell you what you said is true, because I didn't know that this was something that was impacting women to, to this extent at all".

Debra: Here she is, somebody's involved in advocacy, in the community level. And I think that many groups are just really not realizing that this is affecting women that they don't see and they, nobody talks about women are taking these opioids and nobody knows. Like I once did a, with domestic violence, I did a thing where how many people, how many people are, you know experiencing or have experienced domestic violence, stand up. And then how many people know somebody who's experienced domestic violence? So now you had another third stand up. And then I said, and will everyone else stand up? Because even though you think you don't know somebody experiencing it, you do.

Mike: You betcha.

Debra: And that's the exact same thing for opioids.

Debra: You think It doesn't. I don't know anyone. You do, you know, somebody who went to a doctor who had a back operation, who had a whatever, took pills for the pain, and then has continued to be taking pills. And sometimes in the case of two of the women in Peoria with Fentanyl patches and with other kind of for years and years and years, never take more than prescribed.

Debra: But they're, you know, it's impacting their life.

Mike: Well, clearly your film is shining a light on the issue, but, you know, you took a long time to produce this.

Debra: Yeah.

Mike: What's your takeaway? What else should be done if you were gonna advocate?

Debra: I know exactly what needs to be, what first thing needs to be done is that $54 billion of settlement money.

Debra: So I know that that 54 billion is such a large number that it, it, it's hard for me to understand it. So I say to everyone who's listening to this, To better understand that there's a little video online that this guy did showing you what a billion dollars did. He counted out rice. He spent all these hours to count out rice.

Debra: Yes. And he shows you like what, you know, if a billion dollars is this mound of rice then 10 billion and what, like maybe $50 million house for Jeff Bezos. Is this little dweeby thing. It's just nothing. So it gives you an, it just gives you an idea of what this money is and somebody is bound to annoy me.

Debra: So I would say there's $54 billion of settlement money given to every state. Now, what the states do is generally decide how are they going to give out the money. States usually go one of three ways.

Debra: The state gives it out, the counties give it out, or a third entity. All of this is actually made transparent up to this point because some people have been tracking this money. Here's where it starts getting dicey. So let's say I live in a state, I wanna know where is that money going for? Because what I want is I want people to advocate for money going for resources, for women.

Debra: So then you try, maybe I live in Kentucky, I go and see how Kentucky, is it giving it out by the state, by the county, or a third organization? If it's a third entity, then you try to track down that third entity. Then you get into problems because the transparency for half of the states starts to completely disappear, and suddenly you can't find out who's on that committee making those decisions, where that money is going.

Debra: What happened to the open meeting laws, man? I would say half of the states, that's the case. Half the states are much more transparent and you can track and you can see who's on the committee and where it's going. But at least half of the states in this country. So my goal with this film is to have everybody who sees this and sees the complete marginalization of women's health in this, to just call up their elected official and say, "Hey, Mr. Elected official, where is the opioid money coming into this state going to?" Now, of course, everyone's not getting 54 billion. 54 billion is divided over the states, and it's over 17 years. It's still a lot of money coming into each state, each year. Where is it going? It has to be dedicated. Some of the money has to be dedicated for women's specific resources because we're talking about impacting generations to come.

Debra: If I'm in a state where you're taking away someone's baby because you decided that they tested positive for drugs, so now I've take, that's not a good plan. Taking away babies, not a good plan. How about creating some transitional facilities where mother and baby can be together and we can work on getting mother the help she needs as well as baby.

Debra: How about that? There are only maybe five of those in the entire United States. Five.

Mike: Horrific.

Mike: You know, you remind me a lot of what happened with the tobacco settlement money. Same deal, correct?

Debra: Right, absolutely. That's exact. And you know, now that it's 2 cents per dollar that actually goes to tobacco related initiatives.

Debra: 98 cents goes to balancing, you know, state budgets, all sorts of things. I've heard, I don't know if it's true, so I wanna make it sure that I'm clear about this. I've heard that in one case with the opioid money, a recreation, a rec house, a playhouse is being built in Florida. Yeah. And quite frankly, If there's no oversight, are you really surprised if nobody's being allowed to go to the meetings where these decisions are being made?

Debra: And if no one knows who's even on the committee, what do we expect? We're just gonna repeat the bad tobacco settlement money story again.

Mike: Well, and Debra, when you're surrounded and you spend all this time immersed in the stories, it can somehow, I'll give you an out here to the podcast. It can sometimes get a little heavy.

Debra: Yep.

Mike: But I, I read something also really fascinating. Where are you gonna be at 2:30 today?

Debra: Wherever I am at 2:30, my phone will give me an alert that tells me to stop everything I'm doing. Just look around and say pretty unbelievably wonderful. It's called Mincha Moment, taking time to be grateful.

Debra: And I always stop and everyone who knows me and my husband, my husband can be, will be on the golf course and all his golf buddies will stop at 2:30 cuz his phone will go off. It used to be years ago on my running watch, now it's on the phone and everyone just stops and it says it's not a long thing.

Debra: I just stop and think. I am so grateful for malted milk balls.

Mike: (laugh)

Debra: I am grateful for my cats. I am grateful for your help in, in getting the word out about this film and about women. I am grateful for every single thing in my life. Now, I am also very clear that I am not walking around all the time going, "I'm the happiest person, you know!" No. I think that there are days which all of us have where you, you know, I, I mentioned my cat. I, I lost a cat. A cat tragically. One of my cats died six weeks ago, and it was absolutely devastating. It was very hard at 2:30. I was just engulfed in tears and pain, but I had to look around and look at my other cats and my husband and my work that I do and the support of my friends and my family, and, and I had to be grateful for that.

Debra: And I am grateful. I'm not trying to imply because. I hate the, I'm not a Pollyanna. I think that if you are living with addiction, if you can't seem to get out, if you don't have the money, if there are all these things, the idea of being grateful is really incredibly challenging. But I also think.

Debra: There's at least one thing. That's all you start with, just one thing. You're grateful for the fact that today is not 107 degrees or you are grateful that you actually had a good pizza for lunch.

Mike: Well, you know what, I'm, I'm always grateful for malted milk balls, so.

Debra: There you go!

Mike: I'm grateful that you for your work and for you taking the time to be with us today. Really appreciate it.

Debra: Absolutely. It, it's really my pleasure. And I thank you so much for having me on today.

Mike: You know, those of you who are listening know how this goes. We put links to Deborah's work on the podcast.

Mike: And as a reminder, "Listen to the silence. Women trapped in the opioid epidemic" is on an A.B.C. affiliate. You may have to search for it. But then you can hit record on your D.V.R.. Watch it at your convenience. And for now, just a huge thank you for everything that you've brought to this Debra. And for those of you listening, listen in next time.

Mike: And until next time, stay safe. Take time. Just take time, even if it's not 2:30.