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CHRISTIANE AMANPOUR: Hello, everyone, welcome to “Amanpour and Company.” Here is what is coming up.
My exclusive interview with Tim Cook, CEO of Apple, the world’s first trillion-dollar company, in a candid and wide-ranging conversation. We
talk about his surprising support of privacy laws around the world. The responsibility he feels as an openly gay leader and the danger posed by
what he calls the data industrial complex.
Also, tonight, a deep dive into the devastating opioid crisis. Our Michelle Martin talks to Beth Macy, author of “Dopesick: Dealers, Doctors,
and the Drug Company that Addicted America.”
Welcome to the program, I’m Christiane Amanpour in London.
A titan of the America’s tech world stands before a room full of European government regulators and calls for comprehensive privacy laws in the
United States and around the world. Why? Apple’s CEO, Tim Cook, says that we have a crisis on our hands and if we don’t rein it in technology’s dark
side now, problems will soon be too big to fix.
Since the 2016 U.S. election, we have been aware of the danger posed by the abuse of our private data. And Cook also paints a dark portrait of society
ridden under unbridled tech influence.
So, this week, just before a spate of mailbombs unsettled America, Tim Cook delivered a landmark speech to the European parliament and asked what he
calls a fundamental question, which is, what kind of a world do we want to live in.
(BEGIN VIDEO CLIP)
TIM COOK, APPLE CEO: Our own information from the everyday to the deeply personal is being weaponized against us with military efficiency, taking to
its extreme. This process creates an enduring digital profile and lets companies know you better than you may know yourself.
(END VIDEO CLIP)
AMANPOUR: Apple’s extraordinary size and its global influence means that Tim Cook has the unique power to influence solutions, not just to privacy
and surveillance challenges, but also in the wider control realm of gay rights, migrant rights, climate change. These were all on his radar as we
sat down for an exclusive interview at, where else, but the Apple store in Brussels right after the speech.
Tim Cook, welcome to the program.
COOK: Thank you for having me.
AMANPOUR: So, we are here at the Apple store in Brussels —
AMANPOUR: — and you have given a speech on privacy. This probably is the era where we are so concentrated on privacy, trust, surveillance. In
brief, what was your message to the audience today?
COOK: My message is that we need to deeply look inside ourselves and ask us what kind of world we want to live in. The fact is, now, you have more
information on your devices, than you do in your own homes, and this is a major change over the last several years. And so, we are trying to raise
the level of awareness and to ask countries all around the world to begin considering legislation over what companies can do and what they can’t do.
AMANPOUR: Well look, that’s really interesting because it’s an issue of great controversy, especially in the United States, not so much here in
Europe where they have a whole new data protection regulations, there’s a lot more regulation here, presumably of all your content than in the United
Do you — where do you see the parameters of regulation?
AMANPOUR: Because you have called for a Federal regulation, right?
COOK: Yes. You know, usually I’m not a bit pro-regulation kind of person. I believe in free markets. But I think we have to admit when a free market
doesn’t work and taking action. And in this case, it’s clear that the amount of things that can be collected about you, without your knowledge,
maybe with your consent, although it’s a 70-page legal piece of paper, just isn’t reasonable.
And these things can be used for such nefarious things. We have seen examples of this over the last several years and we think it’s time now to
take this thing and put it under control. Because if we don’t, the problem gets so large that it may be impossible to fix.
AMANPOUR: Well, you actually were quite blunt in your speech today just on this issue, you are talking about profiles, people’s profiles.
AMANPOUR: Your profile is run through algorithms and can serve up increasingly extreme content, pounding our harmless preferences into
hardened convictions and then you say, we shouldn’t sugarcoat the consequences. This is surveillance.
AMANPOUR: That’s pretty controversial.
COOK: Well, it’s the truth. And I always get back to that, it’s what is the truth and I do see it as a crisis. I see privacy as one of the top
issues, the top few issues of this century and it’s to that level and because of the number of nefarious things that can happen. And I advocate
to put the user in control, completely in control of their data in a very transparent manner and, you know, there’s a lot more behind that than that,
but that’s the spirit of it.
AMANPOUR: And you said —
COOK: Your data is yours, it’s not mine.
AMANPOUR: — if we don’t get a grip and you’re saying —
AMANPOUR: — take industry doesn’t get a grip, if the market doesn’t get a grip then either it can get out of control or others can impose regulations
at some point. I mean —
COOK: Well, but just to be clear though — I’m sorry to interrupt.
AMANPOUR: No please.
COOK: I’m not saying this to the tech industry. This is a broader than the tech industry because many, many firms out there are collecting data.
And so — and there’s a whole data industry called the data broker kind of industry, right, that sole objective is to gather data on people.
And so, I made a broad speech about a very key policy element that I think is critical to every country in the world.
AMANPOUR: But —
COOK: And our future to society.
AMANPOUR: And I’m going to get into that in a second.
AMANPOUR: But I mean, obviously, the big content providers have been under the microscope, whether it’s Facebook, particularly the Cambridge
Analytica, I mean, tens of millions of people’s information shared and monetized with their knowledge or their permission.
And so, it’s a big deal and I wonder how you think, at least, those platforms, those parts of the industry will take what you have said.
Because the other thing you said, again, was very blunt. You have talked about the fantastic opportunities provided by this technology.
But you said at the same time, we see vividly, painfully how technology can harm, rather than help. Platforms and algorithms have promised to improve
our lives can actually magnify our worst human tendencies. Rogue actors, even governments have taken advantage of user trust to deepen division,
incite violence and undermine our shared sense of what is true and what is false. I mean, this is the opposite of a brave new world. This is really
a dark —
COOK: It’s a crisis. It’s the realization that a lot of things that have been created have some downside to them. And now, they have — and as a
part of the technology, there’s an amplification affect.
And so, I talked about gossip in the speech. You know, gossip has been — it has existed since man was created. But it’s a little different if it’s
you and I gossiping versus if I can go on something and all of a sudden, the world is in on this.
And you have things like cyber bullying and a lot of other things that really affect deeply people. And so, this is my concern, and I’m not
speaking to one or two companies, I’m speaking to all of us, the broader worldwide community, because it’s not just one or two companies that are
collecting data, it’s everyone. We have to realize that data is precious and should be treated as such and we’ve got to ask ourselves, do we really
need all of this.
AMANPOUR: I agree with you.
AMANPOUR: We ask ourselves that a lot. We, the people, who are implicated now and who are being sort of invaded, I think, in many of these invasive
But I guess what I wanted to ask you is this, many of the companies who you might be including in your speech use content as their profitability, that
is what it is, you click, you sell, you get money. That is what data is often used for. It’s not the case really with Apply. So, perhaps you
could stand up there and say that and it wouldn’t affect your bottom line as much as it might affect some of the others. Is that a valid point?
COOK: No. Because it’s a valid point that our business model is different, yes. But you have to — but — and cause and effect is
important here. So, why is it different, it’s because we’ve elected our values, tell us to go in a certain direction. And those value have always
been — this is not in the last year or so. We’ve also been very deeply committed to people’s privacy. We’ve always viewed it as — in the United
States, we viewed as a fundamental civil liberty. I mean, these things our guaranteed to us — and because our forefathers had the vision to know how
important this was. So, that it’s — to us, it’s a basic human right.
AMANPOUR: So, you just decided not to share, sell or otherwise, disseminate data?
COOK: Yes. And so — that’s right. And so, we made that decision, it was against our values and therefore, that drives a difference business model.
Now, I’m not saying the — I want to be clear on this. I have no personal issue and Apple has no issue with digital advertising. Digital advertising
can be good. We may find something that we want. That is good. It’s the formation of a deep detailed profile that knows more about you than you may
know about yourself because it has information about all of your browsing, perhaps all of your purchases, maybe some of your health information and
maybe who your friends are, maybe who their friends are, maybe the messages that you have sent, maybe what you talked about.
I mean, these things — I mean, think about all of this information that is out there, it is too much. This is too much. This should not exist.
AMANPOUR: Before I get into some of the trade and other issues —
AMANPOUR: — particular with the China, particularly in the Trump era with tariffs and all the rest. So, I just want to ask you, you have also — you
say it’s too much but you have —
AMANPOUR: — also said that you thought you were quite disciplined in your screen use, in your device usage, but then, you’ve developed a new app,
right, screen time.
COOK: Screen time. This is very important. You know, for us, we have never wanted people to spend all their time on a device. We want people to
live. And you really live if you’re always in a digital world. I mean, I get more out of our dialogue here than I’ll ever get out of reading
something online, it’s that human interface that I think is so valuable.
And so, we developed something called screen time because we knew that people were getting uptight about both themselves and maybe more
importantly their kids and how much time they were spending.
So, now, this started shipping in the fall and this bills on all the parental controls we’ve had in for years. Now, you can monitor what your
kids are going, you can get a report, every week, you can check it more often if you want, to see where they’re spending their time, how much time
they’re spending, you can control certain apps from them not having access too, they can — you can give them a budget for how much time they can
spend today. And if they hit that amount, in order to spend more, they have to come back to you and ask you for permission.
Now, I think — that was job one, to do focus on kids. But frankly, what I have learned and I think many of your viewers will learn too, is that they
spend too much time too.
COOK: Because it’s — adults. Because as I looked at my information, we’re — we tell you how many times you pick up your iPhone every day, we
tell you how many notifications you get, we well you how much time you are spending on your phone.
And for me, the number of times I picked up my phone and the number of notifications I got were unacceptable. I mean, it just didn’t make any
sense at the end of the day when I backed up and said, “Do I — is this how I should be living my life?”
AMANPOUR: Did you change your habits?
COOK: I whacked it. Yes. And I hope everybody takes a hard look at their habits. And it’s something — there’s something about having this moment
of truth. You can’t kid yourself. Oh, I’m only getting a few minutes today. Because the facts are right there. It’s powerful.
AMANPOUR: So, let’s get to the Trump era.
COOK: Yes, yes.
AMANPOUR: You know, there’s a lot of upheaval, disruptions, some say chaos, a lot of business leaders have approved of his tax reforms, like
yourself, I believe you like the fact that the corporate tax and being able to bring money back to the continent of the United States.
How have you dealt with President Trump and this administration to your advantage? For instance, you were able to get him to exempt sort of
tariffs on technology that Apple uses like Bluetooth when it comes to China and all the rest of it.
COOK: Well, I do believe the corporate portion of the tax cut that came out in January is great for the U.S. economy. Because I think you are
already seeing people invest more in the U.S., I think it is creating jobs and I think it does have a long tail to it, it’s not a short kind of sugar
high. And so, I applaud them for doing that. And I think that people will see and more returns from that.
I terms of how do I deal with it, I believe in engagement. I believe in in engagement. I believe in engaging with everyone, whether I agree or
disagree. I think you should engage even more when you don’t. I think that’s one of the issues with our society today, is people tend to go in
their silo and they only talk to people that agree with them, and I never see that.
So, I engage on everything. I engage because there are some policy things that are being discussed that are incredibly important to Apple like DACA
is an example of this and immigration more broadly. I think, you know, fundamentally, in human rights issues. We talked about tax, environmental
issues, this privacy regulation that I’m talking about. And so, there’s these enormously large important things and I do feel both an obligation,
both personally as an American and as the head of Apple to represent us in these policy discussions.
What I don’t do is, I don’t participate in politics. I disdain politics. And so, I steer clear of that. What I focus on is the policy. And in
terms of trade, to just add a little bit on this, is I think these — you know, when I back up and look at this, the trade that’s goes on between two
countries, particularly U.S. and China, you have two very large countries, very complex arrangement between the two, the agreement had not been
touched in a long period of time. It does need to be updated. There’s no doubt about that. There’s some big topics that need to be addressed. I am
not a fan of tariffs because I did — I don’t see the issues as tariff related. And so, this is an area of divergence in —
AMANPOUR: Are you concerned because the president talks about another round of tariffs, even higher than the previous ones? Are you concerned
that that — that maybe some Apple products and things that you depend on might get caught up in the next round?
COOK: I would encourage the administration not to do that because I don’t think it would be good for the United States and I don’t think it would be
good for China either, by the way. And I think the reality is, as I see it, my experience says, that in order for the world to do well, the two
largest economies have to do well, and that’s the United States and China.
And so, I think there’s this mutuality about the destination of these two countries and I think it’s inescapable that that is the case. And so, what
I am hoping for is more dialogue, significant dialogue, the issues being discussed and addressed and moving forward.
AMANPOUR: You had mentioned, I think, something about in regard to this and President Trump sort of tweeted back, you know, “Build more plants here
now. Bring — you know, stop doing business with — as much business with China and building so much there and manufacturing so much there, bring it
back to the United States.” That was a little skewer.
COOK: Yes. Here is the — here is what we do today, is the iPhone is really not really made anywhere, it’s made everywhere. That’s the truth.
It’s developed in the United States, there’s many components that come from the United States, like the — a lot of the different silicon, the glass of
the iphone comes from Kentucky, the face ID module is coming from Texas, there’s technology from France and Germany and the U.K., and there’s
technology from Korea, there’s technology from China.
And so, we are using things from all the different countries. So, everyone is gaining from iPhone. And in particular, it’s been a job engine in
mobile app development. And so, if you look at the total number of jobs Apple has created in the U.S. its 2 million. I mean, this is huge. We’re
a job engine. And we have also created a lot in many of the countries, including the European countries that are represented here today.
And so, I’m a believer in, you know, finding the best around the world and utilizing those skills and know-how and technology, because we make global
AMANPOUR: You talk about a lot of European countries that are based here – –
AMANPOUR: — and you talk about quality of life and economy and jobs, not just in the United States but globally as well. And, you know, Tim Berners
Lee created the World Wide Web, he’s very concerned about with the growing inequality that —
AMANPOUR: — technology seems to be exacerbating. So, I guess I wanted to ask you, because you are right here in Brussels now, you are one of the
biggest taxpayers in the United States. But the Europeans want you to stop paying taxes to Ireland, for instance, where you brought a lot of people
and business. Both you and the Irish government are challenging that. Why?
COOK: Because the law in the past was very clear, that that tax revenue, which is on essentially the intellectual property that Apple has created in
the United States, that tax should be paid to the United States. That was the law and is the law. And until that law changes, I — we will follow
Now, I understand there’s a lot of emotion around it and a lot of point of view that are valid points of views that perhaps the allocation should be
different for multinational companies, and we embrace that conversation by the way, and are actively constructively participating in those.
But I think it’s important that companies today follow the law and pay taxes where it’s due. And also, you know, fundamentally participate in the
discussions about how the tax system may change going forward.
AMANPOUR: Are you concerned, given all the privacy issues and the security issues around your technology, are you concerned about this rather
controversial report that was in Bloomberg that suggested based on a number of anonymous sources that the Chinese military, especially unit of the
Chinese military, had infiltrated little chips into servers that were used, among others, by Apple and Amazon? Is there any evidence to that? I know
that you have pushed back on that very strongly.
COOK: Yes. I want to be unequivocal on this, that article, the part about Apple is 100 percent a lie. It is completely inaccurate. There is no
truth behind it. We never found a malicious chip in any servers, we never reported something to the FBI like that, the FBI never contracted us about
anything like that.
And so, I think that cast down on the broader story, but that’s for someone else to look at. Amazon has also made comments, as you can see.
And my view is, they need to retract that article. Because this is not doing anybody any good to have fake information out there. It doesn’t do
them any good, it doesn’t do the cause any good. Cybersecurity is an important topic, a really important topic, and we should put all of our
energies into protecting, you know, the companies, the country, but not chasing a ghost.
AMANPOUR: Is it something that you were ever concerned about? Is it something that Apple ever looked into or would continue to look into? Has
it ever been a concern?
COOK: You see I sleep with an eye open. I sleep with an eye open. And so. in that world, in the cybersecurity world, you want to employ people
there that are so skeptical of everything in life, that they are always thinking, because in this world, you have to stay a step ahead of all of
the hackers. Hackers used to be the guy in the basement, you know, doing some stuff. Now, hackers are sophisticated enterprises.
And so, it’s like running on the treadmill and you keep running or you fell off the back, and we need to keep running toward real topics not fake ones.
AMANPOUR: Let’s get to — you mentioned DACA. Obviously, one of the —
AMANPOUR: — areas of disagreement you have with the Trump administration and the president is on immigration. And last month, we saw a really quite
alarming article, a report, about how the immigration crackdown is harming hi-tech community, hi-tech job and even low skilled jobs. People on both
ends of the spectrum, employers, cannot recruit enough people, workers, to fill their jobs. How dire a situation is it?
COOK: Well, I’m a deep believer in the power of the United States. One of the great things — many great things about our country, but one of those
is that we are accepting people from everywhere and they are all come together and they have the opportunity to, you know, build their business
or do whatever they want, and we give them the freedom to do that. And that’s always been a power.
And so, that’s the world I would love to continue for the country. I think on DACA, I’m very emotional on this, we have 300 folks in Apple that are
here on DACA and these guys are living one court order away from a problem. And I’m deeply worried about it. I continually push on this and talk about
I believe, based on my conversations, that the vast majority of people in both parties want to address this. It hasn’t been addressed yet. I’m
optimistic that it will be. But I’m going to be pushing until it’s done.
You mentioned inequality earlier, and I just want to comment a bit on that. I am deeply worried about inequality as well. And I do believe
globalization has created more inequality. And so, I’m not one of these guys that say, “I’m not involved in this.” I think it has created more.
And I think it’s up to us — us, that had benefitted. You and I had benefitted from globalization in a big way. I mean, your whole show is, in
a way, would not exist without globalization.
AMANPOUR: But so too of hundreds of millions of people around being lifted out of poverty by globalization.
COOK: Yes. That’s absolutely right. And I am happy to have participated in that. But when I look in the mirror, what I see back is that some
people haven’t. And it’s not just that they haven’t, it’s actually been hurt by it. And so, I think it’s incumbent on all of us to help address
that issue. And to me, that is about education.
So, I look at my own life. In my own life, I came from a very lower middle-class family. And the way you moved through society, it was
education, and you counted on having a great public school down the road with teachers that really cared deeply for you, with access to enough stuff
that you could really learn and take the next move and the next move.
And I’m deeply worried that we’re not providing that for lots of people today. And that should not be the case in a country as wealthy as the
United States and many other countries around the world as well.
AMANPOUR: And do the specific issue that the administration tends to say, the more foreigners we have, the less jobs Americans have, the less good it
is for Americans, et cetera.
But this report seem to suggest that not being able to recruit workers is harming the GDP of this country, is harming the economy of this country.
COOK: What I think is that many people coming in, that have immigrated in, are creating jobs, because they have ideas to create a new company or
they’re entering a company like Apply and participating on the next big thing that creates more jobs.
And so, what I see is there’s a lot people with significant skills coming into this country that add to GDP. And so, I think not only from a
humanity point of view, which I feel deeply but from a shared business point of view, immigration is an add to GDP.
Yes, it’s very true that the border has to be controlled, right. And so, I’m not at all saying come one, come all. There has to be a control in a
way of doing it. But the truth is, the United States needs large immigration to continue to grow.
I mean, people like me, at some point, are the baby boomers are retiring and we need more people working.
AMANPOUR: You talked just a moment ago about growing up and you described it as a lower middle-class environment. You are gay and you came out very
proudly. It’s quite rare, it’s quite brave for CEOs, especially in Silicon Valley, it doesn’t happen much.
What do you make of — do you believe the environment has become better, more tolerant for gay people, let’s say just in your industry? And
secondly, what do you think of the current debate by the administration over how to redefine transgender? They’re saying, “Forget what we thought
a year ago, now we’re going to say only identified by the sexual organs with which you are born.”
COOK: Yes. The — my strong view is everyone should be treated with dignity and respect. And that’s the way I look at everyone regardless of
their sexual orientation, regardless of their religion, their gender, their ethnic, history, regardless of their gender identity, anything, right. And
so, that’s the way I look at things.
I was public because I begin to receive stories from kids you read something online that I was gay and they were going through being bullied,
feeling like family didn’t love them, being pushed out of their home, very close to suicide. I mean, just things that really just pulled my heart.
And I started saying, you know, I am a private person and so I have kept me to – to my small circle and I started thinking that is a selfish thing to
do at this point. I need to be bigger than that. I need to do something for them and show them that you can be gay and still go and do some big
jobs in life, that there’s a path there. And so that is the reason I did it. I did not do it for other CEOs to come out. It wasn’t even in my
mind. I was the first which is kind of shocking that I was the first. Now I think…
AMANPOUR: So you’re proud of it?
COOK: I’m very proud of it. I’m very proud of it. Yes, absolutely. To me it is God’s greatest gift to me because in doing so I learned what it
was like to be in a minority and all minorities are not the same, everybody has their own experience. But the feeling of being in a minority gives you
a level of empathy for other people who are not in the majority and you begin to look at life a little differently. It also, for me and this is
very good for being the CEO of Apple because I take a fair amount of shots from different people along the way, is having thick skin which comes out
of being gay as well, was actually pretty beneficial for this role.
AMANPOUR: Did you face the same kinds of bullying and hardship that you describe hearing from other people actually when you were growing up?
COOK: I was fortunate to be in a loving family.
AMANPOUR: And they knew?
COOK: At – at different points in time. I wouldn’t want to go into exactly when and that sort of thing but – and so I never had the situation
of kids that I’ve now met and talked to personally that are being pushed out of their homes. I’ve never had that and so personally I can’t say I
have an experience there. The bullying part, of course. Of course this happens to almost 100 percent of people out there and not just gay people.
It’s basically anyone in the minority in some way.
AMANPOUR: Anyone who’s a little different?
COOK: Yes, and we had to get beyond this as a society. These are relevant differences in people that really don’t matter.
AMANPOUR: It is extraordinary to look in and see how huge a cultural debate the transgender issue is. I mean just bathrooms. It’s almost like
it swayed an election. I mean I’m exaggerating but it’s huge. It’s a huge, huge topic and wonder whether that caught you by surprise or/and what
you make of, as I said, the potential for this administration to declare and define transgender as the sexual organs you were born with.
COOK: It doesn’t surprise me, unfortunately, because I grew up and I saw discrimination my whole life. Right? I saw it with African-Americans and
their fight for their rights. I’ve seen it with women and you know it was only 100 years ago that women were given the right to vote and so – when
you think about this and you go, “What? Women weren’t allowed to vote? Who came up with that?”
And so I think each generation has a responsibility to increase and expand the definition of human rights and I feel that. And I think what I can do
is not only for the gay community and the transgender community but I want to help women. I want to help African-Americans. I want to help
Hispanics. I want to help immigrants. I want to help religious minorities. Because at the end of the day the problem comes down to one
thing, treating people with dignity and respect.
At the basic that is what it is. I look at that and go, “Oh my God. If in one day somebody could declare everyone treat everybody else with dignity
and respect,” the world would be totally different. We could be great.
AMANPOUR: You mentioned Steve Jobs in your speech and he’s obviously the lode star and that will never end. His legacy is all over the place. I
wonder what you think your legacy is even though you’re not – you’re not about to retire but what would you say that you have done that’s legacy?
COOK: The truth is that I don’t think about it. That is the honest to goodness truth is I think – I think if you focus on that you begin to
fixate internally and be focused on yourself and I just – first of all I’m not good at it and I don’t believe I should be doing that. I think I
should be focusing on other people and so I don’t really think about it. I just do stuff.
AMANPOUR: You do stuff?
COOK: I hope — I hope that some of the stuff I do winds up helping other people and if I do that and somebody says at my funeral that he was a good
man, a good and decent man, then I feel like that’s a good life.
AMANPOUR: You know his widow, Laurene Powell Jobs is addressing a very key issue of our time which is the press and how to support the press and
she’s used a lot of her money to buy “The Atlantic” and to try to revive that. And we see Jeff Bezos has done that with “The Washington Post.” How
do you assess that?
COOK: Well I – I love Laurene and I love Steve and applaud all the work she’s doing with Emerson Collective which is the sort of her organization.
She’s working on everything from climate change to education, focusing on the news as you just said and so many other things that are immigration
that are so important to our times. And I applaud her for doing that.
AMANPOUR: Now I could end there Tim, but I want to ask you one more question.
AMANPOUR: Apple park, huge wonderful new glassy building. I’ve read that it’s being very heavily integrated with designers at every level of the
operation there. If Jony Ive, the designer and chief just gave an interview and described it. And he was asked whether this might be used as
a precursor or the incubator for a future Apple product for the autonomous driving system. What can you tell us about that?
COOK: Well I can tell you that we love Apple Park. I moved in there in January and I have such high expectations for it but it’s exceeded all of
those. The thing I didn’t appreciate before I moved, I knew it was going to be fantastic but I didn’t know it was going to make the company seem
smaller but when you’re all in one building or a significant number of people are in one building, you see so many more people during the course
of the day and all of the sudden, you feel really small again. And I think there’s a privilege in doing that.
AMANPOUR: And the autonomous driving system?
COOK: We’re working on autonomy. We are working on autonomous systems on the software side of it to be very clear and because we think autonomy is a
core technology but it can be used in many different ways, right? It’s people automatically think about it in the car sense but the autonomy
itself can be used in so many different ways. I wouldn’t want to give you the list but it can be used in a lot of different ways and it turns out
that autonomy is the – probably the mother of all machine learning projects. And so you also build a lot of skills in working on autonomy that
can be used across the company.
AMANPOUR: Tim Cook, thank you very much indeed.
COOK: Thank you for inviting me.
AMANPOUR: And remember in the alienation that so many people feel, technology has been the main disruptor, not immigration and yet,
immigration is what’s used when it comes to elections by many on the political spectrum. So as the clock ticks towards the U.S. midterms, we
now turn from the dangers of unregulated technology to the horrors of opioid addiction.
Seventy-two thousand Americans died from overdosing last year alone. It is a crisis that strikes right at the American heartland – Trump country.
This week the president signed a new legislation which aims to add more resources for those suffering from addiction. Journalist Beth Macy has
reported extensively on the epidemic. Her new book, “Dope Sick” captures America in a state of emergency from users and dealers to grieving families
and exhausted nurses. And she told our Michel Martin what drew her into this tangled web.
MICHEL MARTIN: Beth Macy, welcome. Thank you so much for speaking with us.
BETH MACY, AUTHOR AND JOURNALIST: Thanks for having me.
MARTIN: But it hard now since you’ve been living with the subject for so long. But do you remember when you first heard the word “oxycontin?”
MACY: Yes, I was a reporter in Roanoke, Virginia, and my colleagues were going off and covering rural, western Virginia where they were have spate
of overdoses, kids overdosing in the library, coal miners overdosing, farmers losing their farms, murders happening in communities that had never
happened and this was in the late 1990s. So that really is how long we’ve been dealing with this crisis. People tend to only think it’s since heroin
picked up but it goes back 22 years.
MARTIN: So how did you hear the word? What happened? Did people come back to the office and say that was the craziest thing, you’re not going to
believe it. Like how did it — how did it become real to you?
MACY: Yes, yes, one of my colleagues, Lawrence Hammock(ph) covered the crime that was happening in localities in central Appalachia where people
had never locked their doors, now they were broken into because people were stealing their Oxycontin. There was a grocery store manager got shot as he
was doing the night deposit so people could steal money to get their black market Oxycontin. We had never seen that kind of crime on that scale in
these rural communities.
MARTIN: So how did you realize that was the story because it’s almost like it was hiding in plain sight. I mean these terrible things were happening,
when did you realize that this was the threat that tied it all together?
MACY: Not until I started working on the book in 2015 actually. I had written a three-part series on heroin landing in the upper middle class
suburbs of Hidden Valley, aptly named, outside of my home in Roanoke, Virginia. And even then people didn’t put the connection between the over
prescribing of opioids and the introduction of Oxycontin in the late ’90s – mid to late ’90s with the fact that when the pills got hard to get, people
were still having to go to heroin now and later to fentanyl because once you’re hooked on the morphine molecule whether it’s Oxycontin, Oxycodone,
hydrocodone, or heroin, you have to keep having it in order not to feel dope sick which is what they call this excruciating withdrawal.
MARTIN: Yes, tell me a little bit more about that. What is dope sick?
MACY: Dope sick is what users call the feeling of withdrawal. It is sweating, diarrhea, cramps, vomiting, nausea, restless leg. They all say
it’s like the worst flu times 100 and as somebody early in the book says, at the end of your journey, you’re not doing heroin or pills in order to do
high, you’re just doing it not to be dope sick.
MARTIN: You know for people who have no experience with this and that’s a dwindling number of people in this country as you make abundantly clear. A
lot of people might think what’s the appeal? How did this all start?
MACY: Well three out of four people start with prescribed opiods, whether it’s prescribed to them. Some kids who are experimenting will start out
stealing left over pain killers from their parents, grandparents medicine cabinets.
MARTIN: Why? Just for the fun of it? Just for the thrill?
MACY: Yes, I mean when you and I were growing up it was maybe alcohol, maybe marijuana. But now kids are doing pills at parties and if you look at
the data, the number of prescribed, diverted pills is just off the hook. Two thirds of college seniors have been offered ADHD medication.
MARTIN: You the fact the thing about your work is you don’t point the number at any one cause or any one thing but you definitely point the
finger or lay a lot of responsibility on aggressive marketing tactics by pharmaceutical companies and one in particular which is Purdue
Pharmaceuticals which was owned by three brothers, the famously private Sackler family. What exactly did they do to lay the groundwork for this
MACY: So when Oxycontin came out in 1996 the FDA allowed them to make this sort of nebulous squishy claim that because it had this brand new 12 hour
time release mechanism that was supposed to allow Oxycontin to bleed out over 12 hours, it was less likely to be abused or to set people up for
addiction and if you go to those communities where it tended to be prescribed a lot – central Appalachia, Machias, Maine, it was really clear
that users very quickly figured out an end run around the time release mechanism.
They would put the pill in their mouth, let the coating, the time release coating melt off and then they would wash it on their sleeves. So they
would go around with like orange from the 40 milligram, green from the 80 milligram stains on their shirts from this and they would get the full
euphoric crush of that pill in one fell swoop and that sets people up for addiction and the company said they didn’t know until 2000 that it was
being abused. But I mean it took me about a half hour to find the first sop who saw people walking around almost immediately with these orange and
green stains on their shirt.
MARTIN: So many people tried to sound the alarm. People tried to call the company and say, “Hey, this is actually more dangerous than you’re saying.”
MACY: Right Dr. Art. Van Zee who practices in a sliding scale clinic in central Appalachia was one of the first to call them on the phone and he
said, “I know you said the drug isn’t addictive or addiction is exquisitely rare, but we’ve got high schoolers O.D.-ing(ph) in the Lee High library,
kids I immunized as babies. We’ve got farmers losing everything to this drug; it is addictive. And he wrote them a letter in 2000 and was very
pression. He said my fear is that these distressed communities that are now seeing crime like they have never seen before, overdose deaths like
we’ve never seen before are the sentinel areas much like San Francisco and New York were in the early days of HIV.
MARTIN: Why were the areas that you write about – places that you live central Appalachia, why were they so vulnerable I guess would be the word?
MACY: So many things, it was kind of the perfect storm. The coal mines were shutting down. The factories, textile mills and furniture factories
were going to China or Mexico so people had this desperate need to pay their bills and so when Oxycontin came out people figured that they could
also sell them on the black market for thousands of dollars especially if they had Medicaid card they could buy them for a dollar or two and make a
lot of money.
But the other thing that was happening was the (inaudible) of this vital sign movement. The hospitals were now being judged on how they treated a
person’s pain. You’ve seen the smiley face charts when you visit somebody at the hospital. There was this movement being much of fueled by lobbying
and pharma dollars to say we’ve been under treating pain.
MARTIN: But then people tried to sound the alarm, what happened?
MACY: Sometimes the company would send people to make sort of peace offerings, grants were offered. Art Van Zee and this coalition he started,
they turned down a $100 thousand grant that Purdue wanted to do to the community because they thought it was just accepting blood money as they
called it. A lot of teenagers were overdosing on Oxycontin and as it became known, they sort of got organized, the parents. They called
themselves relatives against Purdue Phara and they started feeding information to this nascent federal investigation that was happening out of
Virginia, out of the area I’m based from and in 2007 the company had pled guilty to criminal misbranding and the three top executives pled guilty to
a misdemeanor version of that charge but nobody went to jail.
MARTIN: The numbers are just so staggering that it’s hard to kind of wrap your head around them. I mean drug overdoses have now surpassed heart
disease as the number one killer of Americans under the age of 50; 72,000 Americans overdosed last year alone, and this after some of the
interventions that you spoke about. This after the drug company was taken to court multiple times. Most people assume that the purpose of the
government is to keep people safe, to keep its citizens safe. What was the government’s role in all of this?
MACY: Right. So what the government did was basically nothing. It – it seemed to look the other way and if you go back to political campaigns and
lobbying from pharmaceutical companies, they spent eight times what the gun lobbyist spent on political campaigns and lobbying between ’06 and 2015,
almost $1 billion and that’s what we need to be looking at. These people in Congress now are allegedly grilling the opioid makers and distributors
but you look up – some of them are taking money from the opioid makers and distributors. I don’t know if you saw Eric Eyre’s reporting out of
Charleston, West Virginia, but he found a little tiny town in Kermit, West Virginia, with 400 and some people that a pharmaceutical distributor was
sending 9 million pills. I mean where’s the oversight there?
MARTIN; Was there a point at which this could have been stopped?
MACY: Oh, Dr. Van Zee talks about that all the time and so do some of the early parents who I’m still in touch with; those early Relatives Against
Purdue Pharma. If somebody would have went to jail, if they would have taken it off the market when Van Zee said look I’ve got kids O.D.-ing(ph)
in the high school library. He wanted them to take it off the market, to reformulate it to be abuse-resistant like the makers of Talwin had done a
number of years earlier and that worked. And they didn’t do that.
MARTIN: I guess one point which they were meeting with some of the parents – were meeting with representatives of the pharmaceutical company and one
of the dads had a picture of his son and he said to one of the executives, I’m paraphrasing here, aren’t you enough of a patriot to care about…
MACY: To care about…
MARTIN: … this. Aren’t you enough of a patriot to want to change something so this doesn’t keep happening? Why wouldn’t the company change
MACY: Well they were making a lot of money on that drug. It made over $30 billion now. The Sacklers are on the Fortune 500 list. It’s all about the
money in my opinion.
MARTIN: Did you ever have a chance to talk to any of them – any of the principles? I know Arthur Sackler is diseased, but did you ever have a
chance to talk to any of the officials and say what about that?
MACY: So I got hold of Howard Udell’s son, Mr. Udell is diseased…
MARTIN: Mr. Udell being?
MACY: He was the head leading counsel for Purdue Pharma and he appeared – he took the 160 milligram off the market. He was behind that and he was
trying – or he said he was trying to – they cared about addiction and abuse and I just wanted to see if there was any responsibility because even when
they pled guilty to criminal misbranding, they never – they figured out a way never to take responsibility — those three executives. So I asked his
son did he think – did he think about that?
And there was – it was a lot like the drug dealers. It was like there was no – from what we did to the point where the needle hits the vein and
people die, there was no – there were too many connections that people couldn’t make in between and they were – they think they’ve created this
wonderful drug and they say they’re very concerned about addiction now and you see their full page ads in the “New York Times” and “Washington Post.”
MARTIN: I mean there are so many people you profile in your book and it’s heartbreakingly hard to keep track so I just want to you to tell me a
couple people’s stories. In fact, why don’t you tell me the story of the locket that you’re wearing now?
MACY: Sure – sure this is a locket. It was given to me by a mother that I became very close to. I followed her story and her daughter’s story for
two and half years. Her daughter is Tess Henry(ph), she had been a published poet at a young age, had studied French in college and she was
over prescribed two 30-day opioid painkillers for a simple case of bronchitis.
MARTIN: For bronchitis? Opioid for bronchitis?
MACY: Cough syrup with codeine and hydrocodone for sore throat pain, 30 days and by the end she had been doing some experimenting with drugs and I
watched her over the course of this two and half years just try to access treatment, try to access rehab and this is somebody who is the daughter of
a surgeon, a hospital nurse, you know people in the medical system. And what I watched was just the system of medical abandonment I will call it.
She would get – she would get in with Buprenorphine-prescribing doctor, that’s medication-assisted treatment that has the best advocacy for staving
off overdoses and relapse and then she would lose here Medicaid because she lost custody of her child. She would have a relapse and then eventually
she’s living homeless, on the streets until she fell through the cracks and she was murdered last Christmas Eve after failing out of a rehab in Los
Vegas that was abstinence only and that’s something I saw over and over again.
Hurclean efforts made to send people to treatment but it was really not necessarily the right treatment for them.
MARTIN: There are half a million people who are dead who shouldn’t be dead according to a study from 2015 and we’re talking here about since 1999,
half a million people who’ve died because of drug overdoses or conditions related to them who shouldn’t be dead.
MACY: We’ve lost 300,000 people in the last 15 years to drug overdose deaths and we’re going to lose that many in the next five, so it’s a curve
going up with no sign of plateauing.
MARTIN: Is anything OK?
MACY: Well we are…
MARTIN: Is there anything that’s going to continue hope?
MACY: Yes, we are starting to see some slight decreases in overdose deaths in some New England states that were early Medicaid expansion states under
The Affordable Care Act. So Rhode Island, Vermont, and Massachusetts and what they have in common is they’ve made access to this medication-assisted
treatment available to people like Tess(ph) who are living on the streets. We’ve got to just educate people about this because in places where syringe
exchanges are places where people can come in and for no money they can get access to treatment and they can get access to HIV and hepatitis C testing
and treatment and treatment works.
It’s not a cure all, sometimes it take people four, five, six, seven, eight times on trying this drug buprenorphine or methadone to get that or to get
their lives together and then they can start seeing success and – but it’s still only 1 in 10 opioid – people with opioid use disorder have access to
this. Seventeen states haven’t passed the Medicaid expansion yet.
MARTIN: Beth Macy, thank you so much for talking with us.
MACY: Thank you Michel.
AMANPOUR: So in this program, two very important conversations about critical problems that can sometimes seem all but intractable.
Now tune in next week for my interview with two of the world’s most influential comedians who also have an impact on the political and cultural
space. They are Dave Chappelle and Jon Stewart on a rare transatlantic tour, they have teamed up to satirize everything from comedy in the Trump
Era to America’s racial divide.
Here’s a sneak peak of our conversation at London’s world famous Royal Albert Hall.
JON STEWART, COMEDIAN: You know in terms of a resurgence of the country being divided along racial and class lines and gender lines and all that.
I feel like that’s always with us, it’s just at times it’s maybe bubbles up more explicitly. But even when you don’t say it out loud, it still exists
and it’s always foundational and so I don’t know that it ever goes away.
AMANPOUR: Do you think it’s more acute right now?
CHAPPELLE: The division?
CHAPPELLE: No, man no. It is in fact, some of the things they say, even when they say Russians influenced the election, it’s kind of like is Russia
making us racist? Is that who’s doing it? OK, I thought it was, oh my God. Thank you, I thought it was us.
AMANPOUR: And that is it for our program. You won’t want to miss that next week, but that’s it for our program tonight.
Thanks for watching ‘Amanpour and Company’ on PBS and join us again next time.