151: Revisionist History: The Triplicate Program and Opioid Epidemic

We’re sharing a bonus episode from our friends at Revisionist History, Malcolm Gladwell’s podcast about things misunderstood and overlooked. This season, Malcolm’s obsessed with experiments – natural experiments, scientific experiments, thought experiments. In this preview, we learn about Paul Madden, who ran the California Bureau of Narcotic Enforcement in the 1930s. He enacted an expensive, burdensome, annoying bit of bureaucratic anti-drug hysteria known as the “triplicate program” that made every doctor in the state miserable because it involved a lot of paperwork. But Madden insisted this kind of paperwork would save lives. Fast forward to the 90s and early 2000s, when opioids were being prescribed as painkillers at a rapid rate – and killing tens of thousands of Americans due to overdoses. The government looked to Madden’s triplicate program as a way of preventing the epidemic. A handful of states started their own triplicate prescription programs, but most ignored the warning signs. The result was a devastating natural experiment. You can hear more from Revisionist History at https://podcasts.pushkin.fm/rhs7?sid=warroom.