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Mainstream mental health is flawed and I’m pulling back the curtain.
I’m Andrea Clark, a former family therapist, who walked away from the system to expose the truth. After my own journey from medication maze to holistic healing, I’m here to challenge the status quo and reveal the mental health truths most people don’t know.
”The Truth About Mental Health” is your radical roadmap to wellness. Raw stories, expert insights, breakthrough solutions – this is where traditional modalities end and real healing begins.
Andrea Clark (00:00)
Hello, my friend.
Lindsey (00:01)
it going? I'm so excited to talk to you today and to get to see your beautiful face on film on camera. Here we are.
Andrea Clark (00:09)
I know I'm so
pumped. I've been waiting for this. So you guys listening in and watching, I just want you to know a huge reason why I took the leap of faith to even start this podcast is because of my dear friend, Dr. Lindsay Elmore here. And I've been waiting for you all to have an opportunity to hear from her. You already heard her intro, but I'd love for you to share just a little bit about what led you from conventional
traditional pharmacy to being a holistic pharmacist and all the things that you you're really into and that you share about.
Lindsey (00:43)
Yeah, I mean it was it was a really natural progression in my career. I absolutely loved pharmacy school. I loved residency and then I kind of got out into the real world and had some disagreements about curriculum at a university where I was employed because you know I was advocating for women's health and saying like we need pharmacists to know
every single product that is on pharmacy shelves. And, you know, that includes prophylactics, that includes now emergency contraception, that includes, you know, menstrual care products, all of those things. And I kind of got pushback to which surprised me because
I was in charge of the over-the-counter medicine course and I was like, wait, so we're going to graduate pharmacists who like can't explain all of the products that are actually over the counter? That didn't make sense to me. And really got some pushback along the lines of like, you know, those are things your mother teaches you and no one else does. And I was like, well, God forbid, like a scared 14 year old with her single dad walk into your pharmacy.
Andrea Clark (01:44)
Mm-hmm.
Yeah,
Lindsey (01:59)
Yes, it was
Andrea Clark (01:59)
that's a very interesting answer that you received.
Lindsey (02:03)
very interesting. And I also worked in a variety of pharmacies where sometimes people with addiction issues were treated like second or third class citizens. I have always believed that clean needle exchanges save lives. And I worked in some pharmacies that were like, no, we don't do that. And I'm like,
Andrea Clark (02:16)
you
Lindsey (02:26)
I don't know if you've ever seen.
the movie with Julia Roberts where her son is an opiate addict and she, Julia Roberts, the mom goes to try to fill a prescription for Narcan, which is absolutely bar none, a life saving drug in someone who has an opiate addiction or even someone who just has an opiate dependence and gets overdosed on a valid prescription. And the pharmacist is like, no, we don't fill that. And then turns around and gives her son clean needles. So there was already this
disconnect for me in like, I truly believe that pharmacists have a right to have their own ethics and integrity and to refuse to fulfill prescriptions. I also think if you're going to refuse to fill a prescription, you need to send somebody somewhere else that will if it is a safe prescription. Then then
Andrea Clark (02:58)
Mm-hmm. Mm-hmm.
Lindsey (03:15)
I had this moment, I was working as a transitions of care pharmacist, which if you don't know, Medicare and Medicaid services has this program where if a patient has certain disease states, like they have a stroke or they have a heart attack or they come in with a decompensated COPD and they come back to the hospital within 90 days, CMS won't pay for that index hospitalization.
Andrea Clark (03:21)
Mm-hmm.
Lindsey (03:43)
they're like okay you didn't do enough follow-up with the patient you didn't make sure that they filled their medications correctly they didn't have enough medication education whatever and so I was working in that field and you know really liked it but I remember one day I was talking to a patient and I was going in there and I was bringing him you know his little white sack and it had five different medications in it
Andrea Clark (03:52)
Mm-hmm.
Lindsey (04:08)
And I said, when you're a transitions of care pharmacist, you have to do something called medication reconciliation, where you reconcile what meds did you come in on, what meds were you given in the hospital, and what are you going home on, and are all those the right med, the right dose, the right route, the right patient, all of the everything. And I was doing his med rec, and I was like,
Andrea Clark (04:15)
Mm-hmm.
Lindsey (04:34)
this guy came in on no medications and I was taking him this bag of five brand new medications and I just had this moment of just agony in my heart of like, okay, so this guy's been on these meds for two, three days after a heart attack. A lot could go wrong when he gets home.
Andrea Clark (04:58)
Yeah.
Lindsey (04:58)
And
going in there, I mean, I think I spent an hour with this guy just trying to explain over and over and over again how to take these medications correctly. And it just wasn't sinking in probably because he'd been hospitalized for several days. You know, it is confusing being in the hospital. And I was like, is there anybody in your family we can call? And he was basically like, I have no one.
outside of these walls. And so I reached a point where I kind of realized I was potentially doing more harm than good.
Andrea Clark (05:31)
Yeah, I was going to say that
probably felt scary to send him home when that was the conversation and you could tell he didn't really understand.
Lindsey (05:40)
Well, there was that piece of it, and you really want to talk about something scary. I had a patient one time with severe diabetes, and he was a young guy, and he had developmental delays as a child and a lower IQ as an adult. And we were transitioning him from standard insulin, which has
100 units of insulin per 10 mls. It's called U100. Well, we were transitioning him to U500, which has 500 units of insulin per 10 mls. So five times the dose. And I remember sitting down and using all of my health literacy education, know, taping off his syringes to be like, okay, here's your first like three days.
Andrea Clark (06:07)
Mm-hmm.
Mm-hmm.
Lindsey (06:28)
but I couldn't sleep that night. And this is also one of the most common med errors that nurses make because it is so uncommon to have this strength of insulin because it's only for people that are injecting just milliliter after milliliter after milliliter, which is unsafe when you're doing it sub-Q. It leads to all kinds of nodules and it's just not safe. And so I think recognizing how
Andrea Clark (06:47)
Mm-hmm.
Lindsey (06:57)
dangerous drugs can be and recognizing how flagrantly the drug industries have been with their research and just like how, know, there's a lot more that I've learned even now studying pharmacy law so much, but drug companies aren't truly required or mandated to prove that their drugs are safe or effective before they go to what
Andrea Clark (07:00)
Yeah.
Lindsey (07:25)
we jokingly call the phase five clinical trial where you just release it to the masses and go, we'll hope for the best. And then eventually there's a class action suit. And so I just started, honestly, I started praying and was like, just God, me away, give me away, give me away, make me away. And ended up getting higher.
Andrea Clark (07:43)
Yeah.
Lindsey (07:48)
as a director of education for a multi-billion dollar supplement company and spent the next years teaching people about supplements. And then I got some of the best advice I ever got from a boss, which was, seem to really understand social media. That's what I want you to focus on. And really gave me permission to show up day after day after day on social media and just teach.
And so then I end up leaving that employment and becoming the contractor for a few years. And when that contractorship ended, that's when I started exploring podcasting and started exploring like, okay, what does it mean to be affiliate marketing? And what does it mean to really be an entrepreneur that's creating multiple income streams? like, know, what does it mean to make money in your sleep?
Andrea Clark (08:38)
Mm-hmm.
Lindsey (08:44)
And that was around the time that I got introduced to another supplement company. And it was one of those things, like I had spent 10 years building confidence and trust in an audience that all of a sudden I was an overnight success. it just, it really was nothing short of miraculous the way that it all happened. But.
It really was just this desire for people to have options. trust me, I love pharmaceutical options. There is no doubt that in certain situations, they are absolutely life-saving. But I think that there are a lot of superfluous meds that just kind of get tossed around as like, let's throw spaghetti at the wall and see what sticks. And I just couldn't be a part of that anymore.
Andrea Clark (09:15)
Yeah.
Yeah.
Yeah, you're I mean, you're totally right. That's how psychiatry works. It is very much trial and error. And there are a lot of people hurt in the process of that trial and error. And I would love I would love to go back to something you said about stage five, right, where they launch it to the public for people listening, some people listening, they already understand this. And then some people
Lindsey (09:39)
yes, absolutely.
Andrea Clark (09:58)
are hungry to understand and they really don't have a lot of knowledge in this area, would you be willing to share how a drug gets on the market, like the process?
Lindsey (10:09)
Yeah, so you know market research starts in in vitro. So you're starting kind of in a Petri dish trying to figure out there's also modeling that you can do where you know, let's say you want to make another another antidepressant that works at the serotonin reuptake receptor. Well, you know what that receptor looks like and so then you have to do a new drug application with the FDA.
that you're saying, all right, we want to take this into either animal testing or we want to take it into really small clinical trials with humans and then you scale up from there and then drugs get released into market. Sometimes quickly, sometimes not so quickly. You know, we have these emergency use authorizations which most of our listeners will remember.
when HIV and AIDS first came onto the scene and how scary it was. And that's a whole nother rabbit hole we could go down of, you know, conspiracy theories that may or may not be true. But, you know, we did see emergency use authorizations for those medications, which have now proved to be life-saving. We saw them for...
Andrea Clark (11:17)
Yeah.
Lindsey (11:23)
The COVID vaccines that came out much more recently with emergency use My concern is when you speed a drug to market and then all of a sudden you release it to the masses You haven't done true due diligence to decide if The drug is safe and effective. I know that when I was in residency there was a drug dirt recogen alpha that we thought was like
Andrea Clark (11:38)
Yeah.
Lindsey (11:50)
this miraculous life-saving cure for people who had septic shock and so people who were really really getting close to death because of infection when their cardiovascular system their kidneys their liver everything starts shutting down because the infection the infected the infectious load is so high
Andrea Clark (11:57)
Mm-hmm.
Lindsey (12:10)
Yeah, three years later, the drug gets pulled for market because the data was falsified, you know, and it's like, and so you get into those situations where you're just like.
Andrea Clark (12:16)
crap.
Lindsey (12:20)
You know, you're talking a very, very expensive drug for people already on the brink of death. And then you come to find out like it never worked in the first place. Because here's the thing too, during all this phase one, phase two, phase three clinical trials, nobody goes back and demands the raw data.
Andrea Clark (12:31)
Mm-hmm.
Lindsey (12:42)
like the Microsoft Access database or whatever they're storing all of this raw data in can just be deleted, you know? And it's very well known. And John Abramson, who I interviewed on my podcast, he's a Harvard MD, and he wrote really a very easy to read and fascinating book about just how skewed
drug research has become because of the lack of transparency. Another tangent book on this topic is David Michael's The Triumph of Doubt, where he talks about how the tobacco industry really wrote the textbook on how do we create doubt in, is this product really dangerous? We don't know. mean, here's a study that says it is. Here's a study that says it's not.
And that model has not only been adapted by big pharma where it's not necessarily about, let me show you hardcore point blank that this drug is safe and effective in this patient population for this disease state at this like stage of development. And we also haven't seen, we've seen women strategically sidebar.
Andrea Clark (13:33)
Mm-hmm.
Lindsey (13:54)
from medical research, mean, women were only allowed to be participants in clinical trials in like the 60s and 70s. And so we're, and that was just because they wanted to bring birth control to the market. And, you know, and so that model that tobacco created of like, let's not try to prove it safe and effective. Let's try to sow seeds of doubt that it is dangerous.
Andrea Clark (14:05)
Yeah.
Lindsey (14:19)
has been duplicated by the sugar industry, by the NFL. Like, yeah, guys, banging your heads into 300 pound linebackers doesn't sound unsafe at all. But what does study after study show? Nah, it doesn't increase the risk of concussions. Excuse me, madam. But there's also...
Andrea Clark (14:32)
Right.
Lindsey (14:39)
Duplicated by by the alcohol industry, know back in the 90s and 2000s We all saw that J-shaped curve where no alcohol is is is dangerous and then you drink two to three drinks a day and that's gonna be protected for your Cardiovascular system and then only after like four to five drinks a day. Are you getting into like the danger zone? Well, we now know that to be patently false so
Andrea Clark (15:01)
Yeah.
Lindsey (15:05)
You know, we also saw a proliferation in the 2000s of what are called Me Too drugs. And these Me Too drugs, this is another form of drug development, is you take a current drug and the drug company goes, wait a minute, we're about to go off of patent for this drug and we need a new drug that can be on patent because we can charge more for it. And so they will create like a cousin.
of that drug. A great example of this is satalipram and S-satalipram. So Lexapro and Selexa. And so in chemistry, there are two ways that a molecule can kind of sit. And so it can sit with like, if you put your hands up beside each other, if you're just listening on audio, with all your fingers pointed up, or you can point half of, you one hand down and then the other half up. Well, that's
Andrea Clark (15:33)
Mm-hmm.
Mm-hmm.
Mm-hmm.
Lindsey (15:59)
what are called enantiomers, which is the R configuration or the S configuration. So a lot of the times what these drug companies will do is they will take a blend of the R and S, like the way the molecule is flipped, and they'll just isolate for one of those, call it a new drug, now it's on patent and now they get to charge more for it, and they employ
huge amounts of what used to be called detail men are now called drug reps to go out there and convince you that this new drug that is more expensive with arguably no additional benefit because this is another thing that happens in drug research is we all talk about the randomized placebo controlled trial.
Andrea Clark (16:49)
Mm-hmm.
Lindsey (16:49)
Well, if
all I'm doing is splitting this R and S configuration of drug, I don't care how it compares to placebo. Like if I've got S, Citalopram and not just Citalopram, you need to be comparing that to Citalopram because if you've got an ultra cheap, relatively safe, although arguably ineffective drug,
Andrea Clark (17:02)
Right.
Right.
Lindsey (17:16)
You know, this, it doesn't matter how it compares to placebo. You need to compare it to the active constituent. you know, another thing, you you and I love to talk gut health and how important it is for our overall mental health. And the serotonin hypothesis about depression has been like widely debunked at this point. But the thing that really gets me is the way that these drugs work is your
Andrea Clark (17:36)
Mm-hmm.
Lindsey (17:41)
Gut has to be healthy enough to actually be making serotonin because if you can't make serotonin, there is no serotonin to sit in between your nerve endings and what's called the synapse where the nerves come together. And so if there's no serotonin in your gut getting made, the drug doesn't even have a fighting chance to work. And so I am a pragmatist. I'm just like, if we're gonna use medications,
Same with supplements. If you're going to use supplements or medications, let's at least use them correctly and let's at least use them in a way that gives them a fighting chance to work.
Andrea Clark (18:16)
Yeah.
Absolutely. What's really interesting, you bringing that up, a client of mine is having her son see a pediatric psychiatrist who will not prescribe whatsoever until they address gut health.
And they see the psychiatrist, I'm really hoping to get the psychiatrist on the podcast, but they see a transformation just with addressing the gut health oftentimes and don't even need to go to prescribing anything.
Lindsey (18:48)
Well, the thing about pediatrics and psychiatric medications, number one, all of the antidepressants carry a black box warning, which is the strongest warning that the FDA can offer for safety risks.
And so all of the antidepressants in adolescents and teenagers carry a black box warning for suicidality and suicidal thoughts and suicidal tendencies. And so you've got a child who's already depressed and really a lot of the time just doesn't know how to handle big people feelings for the first time. And instead of walking them through it and in training good lifestyle behaviors that have been
like you know I mean come on there's a reason that every health care advocate out there is basically telling you the same thing you need to get up in the morning and go outside and get some sunshine you need to go to bed when the sun goes down you need to eat right you need to exercise you need to cut out toxic friendships and relationships like
Andrea Clark (19:50)
It's not a trend. It's the foundation of your mental health. Like that will make a tremendous difference. Just that itself. Yes.
Lindsey (19:57)
Yeah.
Absolutely. And so the other thing that really concerns me about the use of psychiatric medications in pediatrics is if you look at the typical antipsychotics, which are generally not used even in adults because they have such a severe side effect profile. But if you look at the atypical antipsychotics, which are commonly prescribed for solely pediatric conditions like oppositional defiant disorder, you stay
out of that at age 18 according to the DSM-5. And so like you look at these atypical antipsychotics, I mean the average weight gain on some of these medications can be upwards of 10 pounds. If you get to like some of the bigger boy medications, you're talking 30 pounds of weight gain. Well, now we're talking about bringing in issues of being bullied, having
like a lesser self image. We're also talking about a lifetime risk of diabetes and cardiovascular disease. When I agree with you, if you look at functional medicine, the starting point for everyone is an elimination diet.
Let's figure out what's causing you to be inflamed. Let's figure out what's causing you to have high cortisol and to have high stress levels. And, you know, I mean, you and I are both such huge advocates for therapy and like how much it can help. like, it's, we've got to get to a point where starting with medications, because especially when it comes to the antidepressants and atypical antipsychotics, it is 100 % a guessing game.
Like which one's gonna work better? You know, is it gonna be fluoxetine or peroxetine? Like I can make a differentiation based on the fact that peroxetine is gonna cause more weight gain but fluoxetine, you know, has got more data. And so it's like, it is just a guessing game. And the worst thing, you know, if you are listening to this podcast and you're like, crap.
Andrea Clark (21:39)
It was.
Lindsey (22:01)
Now I don't know what to do because here's this pharmacist telling me like all of these meds have these side effects. I mean, again, give them a fighting chance to work. The cyclical nature of like every month when you go in, you're getting a new prescription for a new drug is simply ineffective at best and dangerous at worst.
And so we need to, if you're gonna do a trial of antidepressants, give it six to 12 weeks to see how you truly feel while simultaneously giving the drug a fighting chance to work by working on your gut health, working on your relaxation patterns. Because if we also think about functional medicine, the way that you heal the gut is something called the 5R protocol. And I'm sure most of your listeners are familiar with
with probiotics and replacing, you know, enzymes and vitamins and minerals. But the fifth R is really, really important. And that is to rebalance your attitude because as long as you are living in a state of chronic flight or fight or flight, you're never going to calm down your body enough to really be able to sit with your emotions and sitting with your emotions sucks.
and it takes work. It takes a lot of work. Nobody likes sitting with your bad feelings, but, you know, I, I'm a huge fan of the feelings wheel, so that you can actually articulate not just like, I'm angry, but like I'm exasperated by this thing. And if you really dial in on that language and give yourself permission to feel your feelings, all
All emotions are just data. They're just data. And you gotta sit back and go like, why am I getting triggered by this other person? Or like, why am I angry out of nowhere? Because that's where true healing and true mental health can come from.
Andrea Clark (23:58)
Absolutely, and I think speaking with the on the site on the pediatric psychiatry piece You know, have a story with like a personal story with that and it's interesting because I was prescribed Paxil before the black box warning and I was prescribed during the time when that study was suppressed and I talk about this a lot in when I share my story online that
Lindsey (24:13)
Mm-hmm.
Mm-hmm.
Andrea Clark (24:24)
I definitely had dysregulated emotions. I definitely was struggling with my home environment, but I do not remember having feelings that I wanted to die or I wanted to try to take my life or anything like that. And then...
Lindsey (24:35)
Mm.
Andrea Clark (24:40)
that I was prescribed Paxil and then I stopped being able to sleep. So then I was prescribed Ambien. And really that's when these feelings of entertaining this idea of death and not wanting to be here anymore. And this idea of, well, what would it feel like if I ended my life came into my brain and...
Lindsey (25:05)
Thank
Andrea Clark (25:05)
Nobody ever questioned that, which I thought was really interesting. And looking back now, right, as an adult and really being able to see a lot of it for what it was, but nobody ever questioned any of that.
Lindsey (25:10)
Mm-hmm. Well, there's also such-
Well, I think there's such a stigma around admitting that you are having these thoughts that it just, it's something as a kid, you you're, you don't even quite know how to articulate how you're feeling. But I too had had my own mental health struggles. I mean, I struggled with bulimia for a really, really long time, was placed on Prozac as like a 14 year old.
Andrea Clark (25:48)
Mm-hmm.
Lindsey (25:49)
and same
thing. And it wasn't just the thoughts. was like, you know, there were some scary moments in there that I won't, you know, describe in detail just because I don't want to trigger anyone. But like, I don't remember bringing that up to my prescriber and being like, hey, I'm having these thoughts and these actions. And now looking back on it, it's like,
I was the same as you. Like that black box warning didn't exist and you don't know what you don't know until you know it.
Andrea Clark (26:20)
Yeah, well, I was hospitalized actually for two suicide attempts. my, mean, it was very out in the open, right? Like, but I think what wasn't questioned is I gained so much weight. I probably gained 20 pounds, maybe more. I have pictures of this progression of.
Lindsey (26:24)
I'm sorry.
Yeah.
Mm.
Mm-hmm.
Andrea Clark (26:43)
just how my, like the glossiness of my eyes. I went from being this very studious young lady to I still earn the grades, but I was sleeping through like my first three classes every day. I mean, it was just crazy how it changed me. And I also didn't, none of the original feelings that I was experiencing went away.
Lindsey (26:56)
Mm-hmm.
Andrea Clark (27:06)
And so it just made things worse, at least in my experience, right? I know that's not everybody's experience, but I just find this phenomenon fascinating around how things are prescribed, just trying to play around and figure it out. And most kids can't express what it's doing to them. Most kids can't, right? And most teens can't. And it's really the parents who are in charge and it's
Lindsey (27:31)
Right.
Andrea Clark (27:32)
It's Russian roulette of what type of practitioner you get put in front of and how this
Lindsey (27:36)
Well,
and you know, I think for a lot of people, opiate medications are meant to dull pain, but they don't just make you not feel pain. They make you feel nothing. Anti-anxiety medicines don't make you not feel anxiety. They make you feel nothing. And antidepressants, it's not that they make you feel less depressed.
Andrea Clark (27:51)
Yeah.
Yes, yes
Lindsey (28:03)
They just make you feel nothing. And that's not who we were meant to be as human beings. Like we're supposed to have these fluctuating emotions. I can't remember who said it, but you know, if you didn't know what sadness felt like, how will you ever know what joy feels like? And you know, I think of like the mood stabilizing medications for people with bipolar disorder, you know,
Yeah, it'll stabilize your mood so that you're not up on an Amazon shopping spree at 3 a.m. But you just don't feel anything. And that puts people at risk for more drug-seeking behaviors where you're still trying to chase that like dopamine rush or the oxytocin rush or whatever because we're not meant to feel nothing. As much as it sucks to sit with your negative emotions,
It's better than feeling nothing, in my opinion.
Andrea Clark (29:02)
Yeah, and it's so complicated, right? Especially for pediatrics because there's so much that goes into it. It's family dynamics and school dynamics and so many things, peer pressure and social dynamics. And I feel very strongly that we're just not resourced enough and that the first line of defense
Lindsey (29:23)
Mm-hmm.
Andrea Clark (29:27)
is not medication, it's getting all these other ducks in a row. I think back to, I mean, at this point, this is how I have this passion and so it is what it is. But if we just had some family therapy, if my mom really understood how I was feeling about my stepdad, right, and things he was doing, or things could have looked a lot different for
the journey that I've been on and how those medications affected my health. Also how it made me feel to be put on a medication when I felt like nothing was wrong with me, to be really honest with you. Like, why am I being medicated? Like, what is happening? I'm pretty sure my stepdad's a dick. Like, that's how, I'm just like, what? I'm the problem? I'm pretty sure you two need to be sitting here, right?
Lindsey (30:07)
Yeah.
away.
was
just about to say, and can we just talk about the emotional regulation of parents and like how that can completely throw off?
Andrea Clark (30:27)
Right.
Lindsey (30:31)
childhood dynamics and their experience with their mental health, you know, it's like if your parents are constantly fighting in front of you or if you're having like people calling you names or if you're not getting adequate nutrition or you've got an absentee parent like all of those things are really hard and and it is I'm not a parent. So, of course, I know exactly how to raise children and so it's like it sucks because as much as you try
All parents mess up their kids in some way, or form. We all were messed up. But you do such a great job on your social media of talking about, here is where I really messed up and the conversations that I've had to have with my child about, hey, that was me in a state and you should not have seen that. But how do we deal with that now that you have?
and so, and I think, yeah.
Andrea Clark (31:23)
The repair
is honestly, you have rupture and then you have repair, children do really okay. It's when you have rupture after rupture and they're, you know, or dist, kind of what would be considered neglect, right? And there's no repair. That's when damage really is done, right?
Lindsey (31:34)
Hmm.
Mm-hmm.
Yeah.
Andrea Clark (31:43)
So it's not
an excuse for anybody to just keep rupturing and, and, well, I can repair, so it's fine, but it's more the repair really re really keeps that trust there. And, and I think, and if this isn't a, like, let's poop all over parents, it's just more, sometimes there's such a lack of awareness and there's so much pressure to have compliant children and teens in this world.
Lindsey (32:03)
Mm-hmm.
Mm-hmm.
Andrea Clark (32:12)
And I do think that that's where a lot of these Medicaid, like I try to put myself in my mom's shoes a lot, because she and I have not had this conversation. We can't be honest with you. that's, she doesn't even know I have this podcast. That's how much like she struggles with talking about, you know, the past. And so,
Lindsey (32:21)
interesting. Is she listening right now? I don't know. Okay.
Andrea Clark (32:36)
I'm always like, okay, what was going through her mind? And I know she had a lot of pressure. I know she had a lot of pressure. She had no idea what was going on. She had my stepdad, you know, pushing a certain agenda about needing me to be compliant. And I wasn't compliant. I stood up for me and my siblings a lot. And she was overwhelmed and there were a lot, right? So I can have a lot of empathy.
Lindsey (32:54)
Mm-hmm.
Andrea Clark (33:00)
And I think a lot of parents experience this. And then what happens is they get in front of sometimes the wrong practitioner who's just kind of like, let's just try all this different stuff and let's add. And then there's this snowball effect of poor health and other things that are happening. And it's just hard.
because people don't know where to look for this information. That's the biggest thing for me is my mom didn't know to go look at the FDA website. It's a public website anyway. And I'll be honest, I just started diving into it the last week and I'm thinking there's so much information here. This is beautiful. Why aren't we all looking at it more? know?
Lindsey (33:22)
Mm-hmm.
Well, number
one, number one is because, you know, if you don't know, you don't know what you don't know. So if you don't know where to look, you don't know where to look. And if you're not really highly schooled in health education, reading clinical trials is like a foreign language. mean, there's a reason that I have a...
doctorate of pharmacy is because I've been indoctrinated into a new language. All, all, you know, doctors, I guess I don't have a doctorate. I have a doctor of pharmacy. That's a distinction that lots of people will get onto me for. But anyone who has a doctor of something has learned a new language, a new way to think, a new way.
to assess a situation. It's like trying to talk to an attorney. Like you have no effing clue what they're trying to say, you know, because they have been indoctrinated into legal Latin, just like I was indoctrinated into pharmaceutical Latin. And so if you don't know how to read it, it all seems so foreign. But that's why,
Andrea Clark (34:45)
Yeah.
Lindsey (34:48)
pharmacists are the most accessible healthcare practitioner. you know, if you go to a pharmacy and your pharmacist doesn't have time to talk to you, it's time to change pharmacies. And you guys, we are facing a crisis in pharmacy that is very, very scary if you're kind of in the know, where there's a total vertical integration that is being proposed.
Andrea Clark (34:59)
Yeah.
Lindsey (35:13)
where all of a sudden your prescribers and your drug developers and your drug manufacturers and your drug distributors and then the middlemen that negotiate drug pricing, they're called pharmacy benefits managers and they are, one of the reasons your medication costs are so high. And then you've got the patient distribution side, the pharmacist, when you totally vertically integrate all of that to where they're all employed by the same people,
scary, very scary. And we're also, because the US subsidizes drug development for the entire world, we pay up to seven times on average what foreign countries pay. When I did my Diplomat and Pharmacy Law, it was all about drug pricing. And I was absolutely fascinated by
how much we subsidize the whole world. Well, the problem with that is small local community independent pharmacies can't sustain. If you're being asked to dispense a drug and the patient is paying a $9 copay, but the drug costs you $109 to keep on the shelf, what do you do?
You can't continually run a business in the red in that way. And it is creating massive pharmacy deserts, especially in places that have less population. mean, I think in the entire Western side of Montana, I think there's like less than five pharmacies. Can you imagine? mean, like absolutely can you imagine if you're having to drive
Andrea Clark (36:22)
Yeah.
Interesting
Lindsey (36:48)
100 miles, 200 miles, 300 miles to get to a pharmacy.
Andrea Clark (36:50)
Yeah, you are really dependent
on your medication. Yeah, that's very scary and very hard.
Lindsey (36:55)
Yeah.
Yeah. And then we've got also there's another whole class of medications that are called orphan drugs. And the idea behind the orphan drugs is one that is so philanthropic and one that is so good. It's basically saying we are going to incentivize drug companies to come up with life-saving medications for diseases that like six people have.
Okay, sounds great, right? And the problem is, if you're a parent and you've got a child with this disease, or if you're an adult child and your ailing parents have this disease, you're willing to go to the ends of the earth to save a loved one's life. Well, what happens when you get slapped with, okay, yeah, you can have this medication, but it's going to cost you
$150,000 for three doses. It's, know, look at look at PaxLavid. That was the the medication created to help prevent death in COVID. You're talking $37,000 a dose.
Andrea Clark (37:51)
Yeah.
It's capitalism and pharmacy.
Lindsey (38:06)
Yeah. yeah. Pharmacy
is 100 % capitalism. Well, mean, listeners can have their own views, but socialized medicine globally is built on the back. The US subsidizes drug development so much. And it's one of the reasons that the Inflation Reduction Act, we need to be paying more attention to it.
Andrea Clark (38:11)
It's horrible.
Lindsey (38:31)
because that is the only negotiating tool that we've ever had in American history that allows us to wrangle drug pricing.
Andrea Clark (38:40)
Okay, so can you explain to me why we're subsidizing?
the entire world essentially and did I say that correctly?
Lindsey (38:50)
because
we have no cap on what drug companies can charge for their medications. So if you live in England or in Norway or in Finland, the government is going to say like, yeah, right, you're not charging that. like, you know, at what happened with the COVID vaccines when they went off of governmental subsidies.
which we can have a debate all day long about like whether or not the COVID vaccines are safe and effective. But before we had them, we did have a lot of people dying in very rapid order. But when we stopped subsidizing the medications, you would think that because taxpayer dollars paid for the vaccine development and then subsidized
the price of it so that we could distribute it, not just within the US, but globally, you would think that drug companies would sit back and like have a heart and go like, hmm, maybe we should continue. If you believe that the COVID vaccine is life-saving, give it away, give it away. mean, Jonas Salk, the creator of the first ever vaccine has a very famous quote because he did not want to patent it.
Andrea Clark (39:50)
Mm-hmm.
Lindsey (40:01)
And he said, this is, I mean, number one, was close-ish to a natural product, but he said, you can't patent the sun. Meaning, and in his mind, he was trying to say like, if I know that this is so life-changing, why would I charge people for it? But instead, what drug companies did was jacked up the price of the COVID vaccine, and now we're paying out the wazoo for it, and it just...
We have to wrangle how much we are willing to pay for medications as other countries have been very, very successful with. But it is in part the reason that we're subsidizing drug development is because we, number one, Americans love capitalism and we want to be the best of the best at everything. But it's also because we don't hold drug companies accountable.
in tons and tons of ways. mean, you know, look at the opiate crisis and how misleading the initial data was on that. And what was done was nothing short of criminal and yet no jail time has ever been served. It's just, it's a messed up system, which was why I kind of had to take a step back from it. Even though I love the knowledge base that I have as a pharmacist, because I know that what has become so ingrained into my DNA,
Andrea Clark (41:07)
Mm-hmm.
Lindsey (41:20)
has the ability to save someone's life from having an adverse drug reaction.
Andrea Clark (41:25)
Yeah, okay, I wanna make sure I'm following you. Just bear with me. What I'm hearing are kind of the puzzle pieces I'm putting together from listening to you is that we don't put a cap on what we charge, we're subsidizing, but also does that have to do with the payout that different people are receiving? Like, why aren't we putting a cap?
Maybe I didn't follow you fully. I mean, I just...
Lindsey (41:47)
Because we've
never had legislation to ensure that we have to. Like I said.
Andrea Clark (41:52)
Okay. Right. And I know that a
lot of politicians do get paid personal payouts.
Lindsey (41:59)
Yeah, lobbyists are real. Yes.
Andrea Clark (42:02)
So I'm
assuming that this plays a big part in it, right? This in us not having...
Lindsey (42:07)
Well, and it's not just politicians, it's like the revolving door between the FDA and big pharma. And it is the revolving door between the NAAID where all the infectious disease medications go through. It's like, you know, if you've got somebody who
Andrea Clark (42:16)
Thank you.
Lindsey (42:31)
has a few years as an insider, like at the FDA, and has this really niche drug class, well, a drug company is gonna come in, swoop them up, and all of a sudden they've got a million dollar sign-on bonus as like a big old thank you gesture. And so it's not just that we don't, I mean, let's be completely honest, drug companies make up drug pricing. They just make it up.
You know, yes, they're trying to cover their R &D costs, but until we had the Inflation Reduction Act, we did not, which is now a law, we did not have any kind of cap on what drug companies could charge, irrespective of how much taxpayer money had been put into the drug development process. And so we're starting to wrangle.
those drug prices, which you got, again, not to make this a political discussion, but it, the inflation reduction act goes back to the affordable care act. And unfortunately the drug legislation is buried within hundreds and hundreds of pages of manufacturing, electrical retrofitting, and all of this stuff that's considered.
like green technologies. And so that's one of the problems with the way that we write legislation is number one, it's like they said in Hamilton, like it's too many dang pages for anybody to understand. Nobody reads it, nobody reads it. And so buried within this, what Trump has referred to as like this new green deal, where we see a lot of people still dependent on
oil and gas mining and coal mining in this country, you know, it's like you're trying to throw the baby out with the bathwater when it comes to drug pricing. And so my hope and prayer is that we're able to maintain this portion of the legislation because if we throw it all out as just like,
who cares about solar panels? You may or may not care about solar panels. I don't care what your personal opinion is. But the fact of the matter is why is drug pricing including in what is a manufacturing bill? It's, yeah, it just got kind of snuck in there. But that's like, that's the way, that's the way you got to be in the right rooms. I mean, not to quote Hamilton again, but you got to be in the room where it happens. And somebody was back there saying like, okay,
Andrea Clark (44:43)
I'm why is that lumped in there? That's weird.
Lindsey (45:02)
We'll give you this, but you give us that. And, you know, that is the way our democracy functions in a way.
Andrea Clark (45:11)
Yeah, okay, so even I, not that I'm some guru, but I've come from the mental health field. So even I, at moments, were like, okay, let me follow this because I'm on a learning curve right now with a lot of this stuff. And so I know that some of my listeners are probably, ooh, what? Like my brain just blew up. And so can you give that...
Lindsey (45:30)
Yeah.
Andrea Clark (45:36)
that person, right, who's just starting their journey of really trying to understand things on a deeper level, educate themselves, inform themselves. What are a couple of basic things they can do to just start that journey to informing themselves and making more informed decisions when they go in to speak with their doctors and things of that nature?
Lindsey (45:59)
Number one is go in with a list of questions prepared because in that heat of the moment, know, one of the downsides of American medicine is doctors are paid on volume, not on results. And so if you go in and the physician's coming in, you got like 12 minutes before they're scurrying out the door, every question that you had in your head just goes blblblbl.
Andrea Clark (46:22)
Yep.
Lindsey (46:22)
You just
forget, even I do, and I am in this field. And so go in with questions prepared. I've already mentioned, pharmacists are a very accessible healthcare professional. If you've never sat down with a pharmacist with your entire group of medications, that is something called medication reconciliation or medication therapy management, where I would sit down with patients and say,
Tell me what this medicine is, what it is for, how you take it, what do you know to look out for, and really just think about, you need to know your dose route and frequency, right? If you're gonna take a medication, you need to know what's the dose, how do I take it, and how often do I take it? Beyond that,
You need to know what to look out for to know if the medication is working or if it is not working. And so this is like, I think of blood thinning medications when I think of this. Well, okay, if I'm on a blood thinning medication, let's say for atrial fibrillation where your, know, top of your heart's just kind of quivering instead of having coordinated beats. You need to know signs and symptoms of a stroke.
You also need to know signs and symptoms of bleeding and ask those questions. What do I need to look out for while I'm on this medicine? You know, we talk about side effects, but I laugh because there aren't really side effects of medication. There are just effects that you like and effects that you don't. And so you can ask like, what effects am I gonna be looking for?
Andrea Clark (47:46)
Right?
Lindsey (47:52)
And so, and if you're not seeing those effects, especially if you're experiencing the side effects, maybe it's not the medication for you. But really go in with that attitude of like, why am I taking this medication? What is it prescribed for? How long will I need to be on this medication?
Andrea Clark (48:02)
you
Lindsey (48:16)
Is this a lifelong thing? Are there lifestyle interventions that I can take that would help me to get off of this medication? These are all really basic questions. APHA always says know your medicines and know your pharmacist. And I completely agree with that. And if you are in the hospital and you're being discharged, before discharge, ask, are there any outpatient education programs?
If you've recently been diagnosed with diabetes or COPD or heart failure or just had a heart attack, chances are your local hospital or a local pharmacy has some sort of education program where you can go in and if you don't understand how to use your glucometer or how to check your blood sugar, they can explain that and make sure that you know how to do those types of activities that are gonna keep you safer long-term. so ask for the education.
and you may have to ask multiple people and it, you know, the answers may surprise you where they come from. It may not come from the doctor, but a nurse that you mentioned something in passing or a pharmacist who's coming in to check on you. I think a lot of people when they're in the hospital, they don't even know they have a pharmacist, but you always have a pharmacist. Yeah.
Andrea Clark (49:28)
Yeah, I mean, honestly,
I didn't even think of that until you said it, right? It's like I knew it, but I didn't remember it.
Lindsey (49:36)
Mm-hmm and ask to talk to your social worker ask to talk to your case manager Ask to talk to the chaplain ask to talk to loads of different people You have access to resources, especially if you're Not self-employed and have really good insurance from a corporation Which is a huge blessing that I don't have and I'm a little salty about it But ask ask for the support
and ask for it in all the places because guess what? You do have a case manager, you do have a social worker, you do have a nurse, you do have a pharmacist, you do have a chaplain, you do have a physician. You have all of these people that honestly wanna be called. I was just talking with a group last night and one of the girls was bemoaning that she just took a new job and she's like, I'm the only counselor, everybody else has their clicks and I'm all on my own.
How good does it feel if a patient is all of a sudden like, I wanna speak to a counselor, I think. She's like, off I go to save the day, just like getting the best of it. So ask the questions and if you're being rushed and you feel like you're not getting the information that you really want.
really have the authority within you. mean, like, look, let's call a spade a spade. You're paying that physician's bills. You're paying the pharmacist bills. Say, before you go, I have a few more questions. And just sit there and wait. you know, most people don't get into healthcare because they don't want to help people. You know, they, people genuinely want to help.
Andrea Clark (51:01)
Mm-hmm.
Lindsey (51:12)
It's just, you get so jaded by the system. But a patient who is genuinely empowered and really wants to learn is an inspiration for a healthcare professional because we just want you to be healthy. We want you to be better. We want you to wake up tomorrow feeling better than you felt this morning when you woke up. That's the whole goal.
Andrea Clark (51:16)
I'm here.
love what you just shared and I want to just tack on to that because I think some people don't feel they can take that authority as the patient, right? That ownership. Maybe they don't have the knowledge, they don't have a degree, they don't, and it doesn't matter. It's your body, right?
Lindsey (51:47)
yes.
Andrea Clark (51:53)
and this is your treatment, this is your life, and even if you feel a question sounds stupid, it doesn't matter, don't worry about that. And if you don't get...
the education you're looking for with grace and patience, because that has happened. I've experienced with plenty of doctors who were irritated by my questions and were rushing me, then try somewhere else. Just like Lindsay said, try a pharmacist, right? There's many, don't stop trying because you're too important. Your health is too important. Your life is too important. And it really starts with you knowing that even if you don't have the knowledge.
Right?
Lindsey (52:30)
absolutely. Yeah, absolutely.
And I mean, I also just I've been listening to some podcasts recently, just about, you know, everybody gets into health care because they want to help people. But sometimes people get a little derailed and you have to, especially in moments of crisis, be it
childbirth, an emergency surgery, be it hospice, be it end of life care in any way, or form, sometimes you need somebody to advocate for you. And don't be afraid to ask for that. Cause you know, I, I was, you know, I, I've listened to some podcasts that are just absolutely horrifying about things that happen.
Andrea Clark (53:02)
Yes.
Lindsey (53:12)
around these critical, critical moments. And unfortunately, birth and death bring out the best and the worst in families. And if there's dissension in the ranks about what to do, sometimes you just need somebody to come in and put a different pair of glasses on and look at the situation more objectively and say, okay, here are your actual options and
You know, I've been listening to a lot of childbirth podcasts recently and, and I think having somebody in the room to say like, do you understand what they're saying? How can I clarify this for you? that's another thing just on advocacy to advocate for yourself. If you're, if your healthcare professional is always asking closed ended questions and all you're saying is yes and no.
expound on that because I don't want to should people, but they could be asking open-ended questions. Tell me what you understand about this medication. Tell me what you understand about your new diagnoses. Tell me about this. Tell me about your life and what you're going home to. I mean, the number of patients I saw with
Andrea Clark (54:12)
Yeah.
Lindsey (54:26)
you know, acute COPD exacerbations that I didn't know to ask them like, hey, is there mold in your home? You know, but really you want people to be asking you questions that require a full sentence as an answer and not just yes and no.
Andrea Clark (54:32)
Right.
Yeah, absolutely. I think that's a great point. mean, all of my experience.
Yeah, pretty much almost all of my experience with medical providers specifically have been very close ended, right? Get right to the business. There's not a lot of asking about peripheral things that could be affecting.
And any time that conversation was had was because I brought it up. And the only reason why I felt like I could is because of how I'm built and because I have somewhat of a background in academia. It might not be direct, but, and I understand why other people don't always feel they can.
steer the ship of their, you know, of asking questions and what their appointment looks like, like co-labor with the medical provider. And it's intimidating. I mean, I have felt intimidated and I know I'm smart and I know that I am working, asking these questions and it can be intimidating. And so,
Lindsey (55:32)
Yeah.
yeah.
Andrea Clark (55:42)
It's really important to, in fact, your story or what you said reminded me when I was in labor, I was very, it was a very vulnerable time. went from having a home birth to having a hospital birth and definitely very frowned upon, right? As I come into the room and I was being questioned nonstop about all sorts of things while I'm in labor.
Lindsey (55:49)
Mm-hmm.
Yeah, scary.
Andrea Clark (56:09)
and things I'm advocating for is just like being shut down, shut down without really an explanation. And one of the nurses finally said, why don't you just let her try it? And was so thankful because I was in so much distress that I couldn't articulate in any kind of.
Lindsey (56:19)
Yeah, I mean...
Andrea Clark (56:28)
intelligent, constructive way why I wanted to try to put myself into labor with nipples, all this stuff, right? And she's like, just let her try it. How much harm is that going to do? Then she's gonna feel like she did what she needed to do for her child. And if it doesn't work, great, then you'll give her the pitocin. And they let me try it.
Lindsey (56:40)
Yeah.
Mm-hmm.
Andrea Clark (56:51)
And I was so thankful, she's an angel, right? And I did put myself into labor. And so, but it was just, even if I hadn't been able to put myself into labor, I just wanted to feel like I had somewhat of a participation in what was going on. But in that moment, I was so deeply vulnerable, right? That I just, was too chaotic, it was too crazy. And so I love what you're saying about,
Lindsey (57:09)
Well, absolutely.
Andrea Clark (57:13)
Find somebody to advocate for you, whether it's another professional, wherever you are, or a friend, a trusted friend, a trusted family member, right, who is not as emotionally involved or whatever it is. This is so important. I think it was really great that you said that.
Lindsey (57:28)
Yeah. And you know, I mean, there are professionals that you can hire for this exact thing and just special shout out, like as much as nobody wants to think about end of life, get your advanced directive done, get your will done, like get it in writing what you want. And I was really grateful for my medical power of attorney. I chose one of my best friends because she is,
one of the most highly skilled intensive care pharmacists that I've ever known. And I was like, well, at least she's going to know what they're saying when they're talking. And she had me answer a series of like 20 or 30 questions about like, okay, you know, it's not just about, do you want to be placed on mechanical ventilation? Well, I had like to really sit back and think like, okay, if I'm in a wreck tomorrow,
Do I wanna be placed on mechanical ventilation? Absolutely, if I'm 99 and like have lived a great life, I just want like people with like pennants around and us having like a party. You know what I mean? Like, you know, and so really get descriptive with your family because it can save so much heartache. so, know, write it down, write it down. There's nothing morbid about it and...
If you wanna know more about that, listen to my podcast interview with Alua Arthur. She, just like there are doulas for birth, she's a death doula. And so she helps families to navigate death and how it can impact family structures, family dynamics. And she'd be great on your show to talk about how it impacts mental health. Absolutely.
Andrea Clark (58:58)
wow.
have been chatting forever I don't want to and I just want to say I'm so thankful for you have given such an incredible education and just some insight
Lindsey (59:11)
I know.
Andrea Clark (59:19)
that I think will be so powerful for people listening. And I'm so grateful for you. I love you so much.
Lindsey (59:26)
Aw, I love you sis. I mean, it's been such a
blessing to get to know you and to work with you and thank you for having me on the podcast.
Andrea Clark (59:34)
Absolutely.
you guys go tell everybody your Instagram handle. I'm going to link everything you provided in the show notes as well, but tell them where to find you.
Lindsey (59:42)
Yeah, so I'm at Lindsay Elmore on Instagram and at Dr. Lindsay Elmore on Pinterest. And I also, you can find me at the Lindsay Elmore show, lindseyelmore.com. If you know my name, you know how to find me. There you go.
Andrea Clark (59:55)
Okay guys, I can't wait to hear what you think about this episode. Thank you my friend, appreciate you.
Lindsey (1:00:00)
Thank you.