I've really been enjoying this podcast. It covers a variety of public figures and events from modern history, it's interesting, entertaining, and the host generally sounds like he knows what he's talking about and seems quite well read. Can anyone here vouch for this podcast's accuracy?
With regards to their Episodes on the Sackler Family and the Opioid Epidemic in the US, the podcast is superficial, misleading, ignorant of the basic facts, and flatly wrong on several points. I also found the glib and self-satisfied tone pretty gross considering the subject matter.
It is clear the podcast took the simplistic narrative they wanted and ran with that, using equally superficial journalistic sources to bolster their chosen narrative, while not talking to anyone who had actual expertise about the topic.
It’s a two-part episode, the meaningful discussion of the opioid epidemic is mostly in episode 2.
-They begin part 2 describing pharmaceutical sales conferences and tactics, which they describe as resembling a “multi-level marketing scheme.” The podcast misleadingly presents these tactics as an aberration, rather than the industry norm for prescription drugs. They read some deposition transcripts but clearly haven’t spoken to a single doctor about it.
-The podcast observes “you used to only get something like Oxycontin if something was really wrong” and earlier mention the movement to treat pain as the ‘fifth vital sign.’ A major progressive medical movement in the 1990s to improve patient agency and take patient suffering more seriously. A big part of the reason opioid prescription remained low in places such as Germany and Japan were more paternalistic medical establishments which were resistant to this movement to take patient pain more seriously. The hosts dismiss this movement conspiratorially, implying it was sponsored or ginned up by Purdue Pharma, and conclude that patients are meant to suffer. A stupid conclusion that easily could be avoided by talking to literally anyone with any expertise on this.
-Discussing frequent prescription, they fail to note that opioids have a clinical profile that offers significant but different advantages and disadvantages than NSAIDs. For example, about 15,000 Americans die every year from NSAID-induced GI bleeding. NSAID effects on circulation, liver function, clotting can be severe. Depending on the patient profile opioids can be a much better option for many patients, and there is some debate over whether NSAIDs of opioids actually cause more mortality.
-the narrative of normal people becoming addicted is highly misleading, they cite a statistic of 50% of patients becoming addicted. Which not only obscures the causality, but is wrong. About 1/3 of American adults (80 million people) have been prescribed opioids in the last two years. There are about 1.7 million Americans with opioid misuse disorders, and the best data I’ve seen indicates 80% of opioid addicts had a preexisting addiction (usually alcohol) and either sought a prescription (drug-seeking behavior) or switched their narcotic of choice after being legitimately prescribed opioids. So the actual rate is a population of about 340,000 addicts as a result of prescribing opioids to 40 million people every year. Which is less than 1% year on year. A huge figure, but not close to the single statistic the hosts used.
-An incredibly superficial discussion of chronic pain, the host says the better option is “usually a combination of physical therapy, there are some lighter painkillers that can help [they cite marijuana]” but conclude usually it is a matter of “just dealing with more pain”, which honestly is so blindingly ignorant and insulting for them to say without having spoken to a single patient or doctor.
I’m not going to go through the rest of it in detail, as I found the tone and lack of substance too grating.
Purdue Pharmaceutical and various individuals were found guilty of misbranding and mismarketing of Oxycontin. But journalists continue to fixate on that narrow finding of culpability, ignoring the reality that regulators, elected lawmakers, doctors, patients, and the pharmaceutical companies all linked arms and walked off this cliff together.
The opioid crisis does implicate one greedy corporation, but it also implicates:
The opioid crisis is far more complicated than I even have got into in this post, and the treatment by this podcast was a disservice to their listeners.
I would second u/bjuandy observations, linked by /u/Holy_Shit_HeckHounds, and can provide a bit more context. First, I am a newer listener to the show - I think I started with the History of American policing series which was mentioned on a different history podcast. It's become one of my "listen the day it appears in the queue" podcasts, mostly because I'm struck by his and his guests' ability to laugh about topics without it ever sounding like they're laughing at those harmed by the subject of their episode. He always seems exceptionally aware of power dynamics among groups and seems to be very thoughtful about how he talks about those who wield and are subject to different levels of power, especially within movements. (The most recent example that comes to mind, was in the middle of an episode about Pick Up Artists and incels, he realized that the author of a guide he was reading cold was a young man, clearly dealing with some difficult stuff, and immediately apologized and moved the conversation away from the young man's writing.)
As someone who listens to an obnoxious amount of history podcasts, I feel comfortable saying I've never gotten the sense that, unlike other high-profile amateur history podcast hosts, he takes himself seriously as a researcher nor that he expects his readers to view him as an expert on the topics. Rather, he chooses a path for a particular argument about a person he wants to make and follows research he finds online to support it. And, I suspect, for most of his episodes, he does a fairly good job of constructing an argument that, generally speaking, matches what historians who study the topic would endorse or support. The challenge, however, is in the details.
By delightful coincidence, his recent episode on Nestle happened to drop right as I was in the middle of working on a project related to the history of breastfeeding in America. I read multiple books, articles, listened to podcast interviews with historians, etc. on the topic and was deeply immersed in the intricacies of feeding small humans for days at a time. I will offer that none of those authors are listed in his reference list. Which is fine, because it's not an episode about the history of feeding infants (he even says it's not meant to be a history of wet nursing), it's about a particular event. Funny enough, though, he clearly consulted sources that aren't listed. I recognized a quote from this Medium article (which is very much not written by a historian - if someone had posted that article as an answer on AskHistorians, it would have been removed) that doesn't appear on his list.
At the beginning of the episode, he offers some context about enslaved women and nursing that is ... not wrong. It's also woefully incomplete. The relationship between enslaved women and white woman and their infants varied dramatically between plantations and communities. For every enslaver who forced enslaved women to feed infants that weren't their own, including the enslaver's own children, there were enslavers who felt white babies would be harmed by being fed by an enslaved woman. Meanwhile, there were white women enslavers who routinely fed enslaved babies who needed more milk than their mother could provide and others who handed their babies off to an enslaved woman, indentured servant, or paid wetnurse for feedings as soon as the baby was born. So... it's a lot more complicated than a single section of a single podcast episode can cover.
Shortly after that history, he references "dry-nursing." I suspect he got the word from this article on his reference list, A concise history of infant formula (twists and turns included) - bolding is mine
Eventually, wet nursing fell out of favor, and attention turned to finding an adequate substitute for mother's milk.^2 The practice of feeding human babies milk from animals, called dry nursing, began to flourish in the 19th century. Milk from a variety animals - goats, cows, mares, and donkeys - was used. Cow's milk became the most widely used because of its ready availability (although donkey's milk was thought to be healthier because its appearance most closely resembled that of human milk).
Unfortunately, the author of that piece - and then the host of the podcast - get it a bit sideways. Generally speaking "dry-nursing" referred to the act of a woman caring for a baby or infant who was not her own and doing everything except feeding the baby her own milk. The woman performing that role was known as a "dry-nurse" but more commonly, especially in America, as a "nurse" or a "nursemaid" (unless she was an enslaved woman, then she might be referred to as a "mammy") and the use of the word "dry" was used to distinguish her from a caregiver who could feed the baby herself, AKA a "wet nurse." It didn't always mean the baby would be fed animal milk, but it might, depending on the specific conditions. As far as I can tell, there was no specific word that referred to feeding babies only animal milk. I won't get into the entire history of big humans using animal milk to keep small humans alive but it's safe to say humans have always done it.
All of which is to say, when the host said "dry-nursing" refers to feeding babies animal milk, he was mistaken. Instead, in most contexts when "dry nursing" was used, it was because the person caring for the baby did not directly feed the baby their own milk. In other words, there's a linguistic and historical line from dry-nurse --> mother's helper --> babysitter as seen in these newspaper ads from Dublin in 1853:
As Dry Nurse, a steady, respectable young Woman, of regular habits, who has a perfect knowledge of-her business, would undertake the care of a baby from its birth, or a couple of growing up children; has long and satisfactory discharges and lived with some of the first families; .can be highly recommended by her last mistress; understands hair, dressing perfectly well; has no encumbrance whatever, would have no objection to a country family.
AS Dry Nurse, a steady, active Woman, who has had much experience during the past eight years, both in the capacity of wet and dry nurse can take charge of a baby from its birth, or of growing up children; understands the management of a nursery, plain work, and making up of fine things; can be well recommended by her last mistress and other ladies at present in town with whom she lived.
We can see uses of "dry-nursing" discussed by physicians in the 1800s, but implied in that usage was that someone other than the mother would be feeding the baby. I don't begrudge the host of BtB for not understanding or recognizing the nuance around the topic. I wouldn't recommend, though, treating his historical analysis as the final word on a given topic or subject. But what happened to him - and the author of the piece he cited - is not uncommon. In fact, it made a collection of anecdotes about times a judge or lawyer was stymied by a word that appeared in a New York State newspaper in 1901:
'Another dilemma was produced a little while ago on the western circuit by the introduction of the words "dry nurse" in an address to the court. This bewildered the Judge, who asked if a dry nurse was a nurse who dried babies after they had been washed. That solution did not occur to the learned counsel, who, after some hesitation, said he thought it meant a nurse who was not addicted to drinking and therefore most suitable to look after infants. Nobody seemed to know what the term really meant, though several more guesses were made, the last of them that a dry nurse was one who could not amuse children.
There is always more to be said on a topic like this, but Here is ONE response by u/bjuandy. Obviously, on a topic like this, opinions may wildly differ. Likewise, the podcast itself can change (for "better" or "worse") over time, effecting the usefulness of the response I linked.