"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." "(siren blaring)" "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." "Crowd (chanting):" "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." "(speaking Spanish)" "These are the scorers." "So you cut the pod?" "Sí." "Sí." "Well, what do you do now?" "Who buys it?" "Who's the buyer?" "(siren blares) (police radio chatter)" "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." "(woman crying) 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." "(siren blaring)" "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." "(sighs)" "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." "(alarm sounding) 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?" "(speaking Russian)" "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."