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Archive for May, 2008

April 5, 2008 - Sunday Alcohol Sales In Georgia

Breakthrough Addiction Recovery Hour
4-05-2008

Brian: Welcome to the Breakthrough Addition Recovery Hour.  My name is Brian Fujii and with me is Jill Mattingly, and also we have a special guest with us, Dr. Lois Dutton.  Dr. Neil Johnston, our Psychiatric Director, is off on vacation today, but he’ll be back at another time.  We’re glad to have Dr. Dutton with us.  She is one of our new staff that has come on board with us, and we’re very excited having her with us.  She works a lot in our medical area, but also supplements many times when I’m busy and doing other things, and she comes in and does the day treatment with us and does an excellent job there.  Welcome Lois, I’m glad to have you with us.

Lois: Thank you, Brian.

Jill: She wears many, many hats.

Brian: She does.  We might want to still continue just a little bit Jill, from last week on our talk on how we’re looking at these Sunday sales and I know that there was some new pieces in the newspaper this week, already contesting some of the statements that were made.

Jill: Every time I open up the AJC it seems like something or someone is talking about this, so the alcohol sales debate goes on in Georgia.  And we did look at a few of these articles last week and the week before and we got a lot of passionate callers on that day.  Just finding out that Dr. Neil Johnston, as he joined us last week when he was going over the New Mexico study, actually dispelled some of that study and then we find out this week there are some professionals that have definitely brought up the same point.

Brian: Indeed. In fact, in the AJC, there was a gentleman named Jason Rudbeck, he’s a lecturer at the University of Georgia, Terry College of Business, and he’s an economist.  And it’s interesting in that article he mentioned that the study did not really account for an increase in the speed limit during the same period Sunday sales were allowed.  That’s the statement that was made by Sonny Purdue, that it increased the amount of accidents and deaths.

Jill: Yeah, traffic fatalities is what this study was looking at, but they didn’t do a very tight-knit study.  So people are finding holes in it, and even letter writers are writing in to the AJC saying the same thing we’ve been saying about alcohol dependency and there’s a lot of people that feel very passionately about this on every side, and we’re going to have a really interesting show today talking about addiction treatment, not just this alcohol Sunday sales, and I just want to start giving out the number right now so you can write it down and get near your phone if you want to join in on the conversation, if you have a question or a comment, 770-226-0920.  And if you want a friend to tune in and they’re just outside the listening area, they can actually tune in on www.920WGKA.com.  And so it’s basically if you Google 920 AM you’ll probably find how to get to the website and you can listen live to the radio show.  Anyway, we’d really love to hear from you today so if you feel the need, go ahead and give us a call, ask a question, get in on our conversation.

So it looks like we have the guest that I’ve been wanting to get on the show for a long time, Dr. Lois Dutton.  As Brian said, we just added her to our staff at Breakthrough Addiction Recovery . . .

Brian: And a welcome addition.

Jill: Yes, what a great addition she is.

Lois: Thank you.

Jill: And Dr. Dutton, from now on I’m going to call you Lois.  Is that okay.

Lois: I wish you would.  That’s my preference.

Jill: Well, I want to just say a few things about Lois and her journey to this seat in the radio studio.  It started back in the late 60’s when she actually got her Bachelor of Science in Nursing and went into the field of addiction treatment and also she did get her Bachelor’s of Nursing from UNC at Chapel Hill, and I’m sure she’ll be watching basketball this weekend, and also went on to get her Masters of Public Health at Chapel Hill also, so you really like that area.

Lois: Oh yeah.

Jill: Then she went on in 1984 to receive her PhD from the University of Alabama, Tuscaloosa, in education.  Her resume reads like an historical novel of addiction treatment.  So Lois, I’m going to give you the mike and just go for it. I want you to tell a little bit about your journey through addiction treatment, but also just through the medical side and also administrative side of addiction treatment.

Lois: Thank you Jill.  I’m glad to be here with you guys.  I actually got into drug and alcohol treatment quite by accident.  When I graduated I had a brand new degree, a Masters degree, and I didn’t really have a good clear idea of what I was going to do with it.  And I ended up back here in Atlanta from Chapel Hill, and I was chairperson of Maternal and Child Health at the Piedmont School of Nursing, and I did that for a couple of years and then decided that I wanted to go back home, which is Florida.  I went back to central Florida and a friend of mine called me to tell me about a National Institute of Mental Health grant that the state addiction program in Florida had gotten, and they were looking for two nurses that were accustomed to doing home presentations, home visiting, that kind of thing.  And our charge was we were going to take a look at family therapy as a modality for the treatment of alcoholism.  Being the renegade and being young and not knowing what I was getting myself into, I responded and there begins the story.

I ended up in Avon Park which is in the middle of nowhere in central Florida, it’s down around Highlands, down in that area – beautiful orange groves – and it was the state facility for chemical dependency.  And the mental health grant that we had, we actually brought people into the center, we brought their families after they had been in treatment for two weeks alongside of their addicted or identified patient, is what we used to call them, then they went back home and we nurses went out and did home visits, and we did family therapy sessions in the home.

It was an incredible experience for me because I got to meet people like Virginia Satir, who was the quote – deaconess of family therapy in those days.  I met the young man that had started the alcohol program in Haight-Ashbury back in the 60’s.  I had an incredible experience with a Dr. Ivan Nagy, who had also written a book on family therapy, so this is how I got started.  But back then, we thought we were really doing a wonderful thing by bringing the family in.  It was like we had discovered all of a sudden that alcoholism doesn’t occur just in one person, that it’s a family disease.  There we were, we go the whole 9 yards, but back then what we had to offer was extremely limited.  We had Alcoholics Anonymous, which then was the premier modality.

Brian: That was the gold standard during that time.

Lois: It was the standard.

Jill: What year was this around?

Lois: This was in the late 60’s.

Jill: Late 60’s.

Lois: Late 60’s.  We did that for just about anybody who came in.  It was the 90 meetings in 90 days concept, where everybody who came through, came through with the idea that they were to hook up with someone back in the community, and this was going to be your best friend, was going to replace the John Barleycorn, the Jim Baynes, and all of the things that had been your best friend for so long, and it was to get yourself aligned with someone who had been sober for a while and hang with them.  That was our treatment modality.  In those days, we actually watched, in a very brief period of time, we watched addiction go from a sin, to a crime, to an illness.

Jill: Wow!

Lois: In a very brief period of time.

Jill: And that was from the late 60’s going into the 70’s.

Lois: Going into the 70’s, correct.

Jill: So you would say the most significant change that you saw during that time was . . .

Lois: Was our knowledge base.  As we got more and more into it, as more and more people came into the field, people who were non-addicted, and that was really unusual back in the early days . . .

Brian: Back then, they believed that if you were not recovering yourself, you didn’t have anything to contribute to the field.

Lois: Absolutely.  You could not possibly understand what it was like to have this kind of a difficulty to deal with.  We moved very rapidly though, as we started to look at addiction and what that meant and how it happened and how it occurred indifferent people, we began to ask ourselves a very basic question – why is it some people can drink everybody at the party under the table and get up the next day and go to work and not have a problem?  The next guy who sits there, and once he starts to drink he can’t stop, and he ends up in serious, serious trouble down the road.  What is the difference between these two people?  We didn’t have a clue.

Brian: Right.  And I think from that question, that was a launching pad for even more medical research.  We tried to find out what was the real reason, rather than just saying, ‘I’ve got weak will power.”

Lois: Absolutely, it wasn’t a matter of will power at all.

Jill: Right.  Well Lois, hold on to that thought just for a moment because we’re coming up to a break.  770-226-0920.  And when we get back we’re going to talk to Dr. Lois Dutton a little bit more about those early years in addiction treatment and how the change in thinking how to do this, changed so rapidly in those decades.  We’ll be right back.  Stay with us.
Brian: Welcome back to the Breakthrough Addiction Recovery Hour.  My name is Brian Fujii and Jill Mattingly is with me along with our guest, Dr. Lois Dutton, and today we’re talking on the subject about the development of how drug treatment began and how it’s changed over the last few years.

Jill: Let’s go ahead with Lois and talk a little bit more about the change of addiction through the years, addiction treatment that is, and we talked about in the last segment that we were talking about the knowledge base changed while you were actually in the field.

Lois: More and more attention began to be directed toward answering some of the questions that were baffling us.  Why do some people get addicted and other people do not?  We began to see patterns in families, and it was not just an environmental influence, we finally realized.  And there probably was some genetic connection, some genetic component in this whole process of addiction, but we had no idea what it was.  We just thought, particularly if you had fathers with addictive problems and young sons following in their footsteps, that they were just being what their dad had always been.  And so it was environmental and we got into years of back and forth, nature versus nurture, how much of it is genetic and how much is environmental.  Then we got into how much of it can we actually attribute to some basic flaw within this individual that’s also in the family.  If your dad was no good, you’re going to be no good kind of thing is what we struggled with for years because it seemed as if that’s the direction we were going in.  Then lo and behold, as more and more attention started being directed toward the field of addiction, and I think probably part of what happened to us is that we had so many named individual celebrities who began to come out of the woodwork and out of the closet and it meant that they indeed had an addictive problem.  And then all of a sudden . . .

Brian: All those other adages and all the social issues, parental raising, it all didn’t fit.  And now we’re looking at, how are we going to answer this question?

Jill: Right now I think it’s a badge of honor to be a celebrity with an addiction problem.  The pendulum has swung too far over.  But the nature versus nurture, I really like that.  When you go from thinking it’s just an environmental problem - dad’s no good, you’re going to be no good – and having a mother saying that to the child is not going to help, but I like when they start to look at there’s actually something genetically, like a predisposition for the person, and obviously there’s some hope in that.

Lois: I think that for those of us that have been into it for so long, it gave us something that we could actually hold on to.  Because for years we struggled, and we saw people die, they would come out of the treatment facility sober because we had tucked them away for that proverbial 28 days, we put them in an environment that was safe, we put them in an environment where they couldn’t get the drugs or alcohol, and then we discharged them back into unsuspecting families . . .

Brian: With very little support.  And you’re exactly correct – we ended up discharging them back into the highly dysfunctional environments from which they came with no additional support to help them deal with all of those challenges they were facing prior to entering into treatment.

Jill: But they were sober.

Lois: They were sober – that was the only thing they were.  But they were sober, and many of them were clean.  But wewere so elitist with our view in those days that we separated.  We did not want hardcore drugs to be mixed with the alcohol.  So we put alcoholics in one treatment program and people in another that had other drug addictions, we put them in another program.  And then we went so far as to separate the mental health issues from the addictive issues, like the two never could occur in the same person.

Brian: And that’s the topic we had several weeks ago and even last week, about how co-occurring disorders, we used to call it a dual diagnosis, meaning having a mental illness along with a alcohol or drug addiction.  And now through studies and research we come to realize that it is the alcohol many times that people are using in order to self-medicate their uncomfortable psychiatric condition, so depression and anxiety, all of these seem to be self-medicating with drugs or alcohol.

Jill: Right.  And if you are really getting something out of this conversation, please call us 770-226-0920.  This is a call-in show, you can get in on the conversation, comments and questions are welcome.

We are talking to Dr. Lois Dutton if you just tuned in, and Lois is talking about what she’s see in the changes in addiction treatment through the years.  Here’s something Lois, I wanted to ask you about.  You floored me when you were telling me about the proverbial drunk tank.  Obviously if they thought it was a sin to be an alcoholic, they were not going to treat them, or a crime, they were not going to treat them very well.  And that visual you gave me was very striking.

Lois: It’s a visual that I will never forget either. I was very, very young, and just a young pup in this business.  People would get arrested for public intoxication and be put in jail and if they were obviously very intoxicated then the people in the jail knew what inevitably was going to happen.  They would be sick, they were going to go into DT’s, they were going to do all kinds of things.  So in local jails, they had one cell and they called it the drunk tank, and it was stark.  It had a metal floor that was slanted and had a drain in the center of it, and people would be put in there and for however long they were there – 24 hours, 72 hours, depending on their offensive behavior that got them in there.  And they would just leave them there.  We had many people die in those proverbial drunk tanks.  But I as a young, renegade kind of nurse, I could remember the one and only time that I ever went in that I really got so incensed that I said I’m never going in there again and I’m going to do something to change this.  There was a young client that we had, we had discharged him from treatment, he was sober but he went right back into the hostile environment he came from, and he ended up within a week, in jail.  And he had my business card in his pocket, and somebody from the jail called me.  And when I went to see him, the jailer says to me, “You don’t want to go back there, little lady.”  And I said, “Ho, ho, yes I do.”  And back I went.  And it cured me.  I never wanted to go again.

Jill: That’s awful.  And he called you “little lady”.   Okay, so we were in the south.

Lois: We were in the south, yeah.

Jill: And you’re probably wondering, why would people die in a cell like that?  Well, when you are going cold turkey off of alcohol, daily alcohol drinking or a huge binge, you run the risk of alcohol withdrawal which actually is the most deadly type of withdrawal.  Heroine looks terrible, but it usually doesn’t kill you.  But alcohol, go cold turkey, you can end up with a seizure and stop breathing.  So I am sure that they found a lot of bodies back there, someone wasn’t paying attention.  That’s just phenomenal.

Brian: That goes back to this whole idea that now instead of looking at it only as a social environmental issue, now we’re beginning to realize the medical component of addiction.  And I think that’s what we’ve done in trying to raise the consciousness and through the fact that we now are doing more and more research, not only from this medical side, but from a neuro-physiological side.  I think that has been so phenomenal, as people have done PET scan and other kinds of brain scans to help us to understand how the brain is impacted.

Jill: And that’s what we do at Breakthrough Addiction Recovery.

Brian: Exactly, to help individuals understand that this is a brain disease.

Jill: If you’d like to read a little bit about Breakthrough Addiction Recovery, you can go to www.BreakthroughAddictionRecovery.com.  A lot of the things that we’re starting to talk about with the biological issues are in that website, it’s chock full of information.

We’re going to slide out into a break.  770-226-0920, if you’d like to call and get in on this conversation.  If you’re an addiction professional and want to call in with your comments, we welcome that.  So stay with us and we will be right back.
Jill: 770-226-2690, that’s the number to call if you want to get in on this conversation about the history of addiction treatment and someone who watched the change through the years. And we are talking with Dr. Lois Dutton right now, she’s actually the newest member of our Breakthrough Addiction Recovery team and she’s just joined us today and hopefully next week if you can Lois, to talk a little bit about the history of addiction treatment and what’s been happening over the years.  You’ve seen it firsthand, as a nurse, as a director, as been many, many hats that you’ve worn.  And over the break I was just thinking about the young man that had your card in his pocket as he sat in the drunk tank, and you were called in to start to talk to him.  When these people are struggling in these drunk tanks, or when they were made sober and put out on the streets, what would happen next?  Did anybody start to realize that this was a dangerous situation and try to treat these people medically?

Lois: I think we began to really realize that we were probably doing a disservice by bringing people in to a stable, 28-day environment that was cocooned and protected in an in-patient setting and then we sent them back to basically a toxic environment for many of them, and we saw people who were sober going out our front doors who would end up committing suicide because we failed to recognize underlying depression, underlying other kinds of mental health problems that we just did not see.  We didn’t recognize and we didn’t treat at that time.  So we sent people back home with very little, very, very few tools that would help them on a day-to-day basis, get through one 24-hour period of time.

Now, what we did have was the proverbial 90 meetings in 90 days that we could offer people, and that was basically our support system for once people get through their 28-day treatment programs and got back into the community, we would hook them up with AA, which is what we had.  And it worked for a good number of people.  We had some doctors back in those days, physicians, some of whom themselves had been down this slippery slope of addiction and were now recovered and were now knowing, down deep inside, that something more was going on and something more needed to be done.  And we had those docs then begin to start looking at how can we reach out to the recovering population and do something.

Jill: And there weren’t any addiction-ologists back then.

Lois: I did not know of one.  Everybody who was in the field was a family practice, well not a family practice in those days, a GP, a general practitioner, surgeons, anesthesiologists, most of the physicians that were involved were physicians who had gotten into trouble themselves and were now clean and sober and were back trying to reach out to their fellow addicts.  And they’re the ones who sort of spearheaded, starting a whole medical piece of this recovery process.  Before then, the physician community was pretty new and pretty out of it.

Jill: They probably didn’t want to dirty their hands.

Lois: They didn’t know what to do.  I really am convinced that they did not know what to do.  Addiction was a baffling kind of thing to them.  If someone came into the emergency room with bleeding esophageal varices, that could be treated.  But you know what would happen to us a lot of time is that we would couch the varices with a bleeding ulcer so that we could get them admitted to a hospital, because the diagnosis of bleeding esophageal varices associated with alcoholism, you very seldom could get someone admitted, particularly with an insurance coverage.  You just couldn’t do it.  So they would go in with a gastro-intestinal bleed, and that way we could get them into the hospital to get some treatment and I think that the physicians back then who started the whole process of people looking at this as a medical disease.

Brian: That’s great.  And again, that’s when we started moving more from seeing it as a physiological issue, where now people saw it medically – they’re not seeing it as a character defect.  They weren’t seeing it as a sociological, environment-only situation.  It didn’t mean it didn’t contribute to it, but the fact is that was not the only reason.  I think that’s a very powerful move.  Now we’re looking for some scientific reasons, and the fact that what you brought up, physicians and maybe the nurses that were having problems with alcohol and drugs, began to realize some of these descriptors didn’t fit me – why am I using alcohol or sneaking drugs out of the medicine cabinets and using them?  So as they began to see their owns lives taking shape, they said, ‘There’s something else to this.’  Even today, many times many of my clients will come in and say, ‘You know, my doctors tell me go to AA,’ rather than trying to find some ways to really understand the issues about addiction.  So even though it’s been many years, I still think there is a sense of a stigma that’s still involved with addiction, which with that stigma comes a lot of shame and guilt, and people just don’t want to seek the help.  And I think that is going to be one of the challenges we have.  I think a radio show like this will help break the stigma and really begin to help people know this is an illness, no different than hypertension or diabetes, and come get some help.

Jill: Amen to that.

Brian: If we’re touching your lights, call us at 770-226-0920 and we’ll be back here with further discussions.  Join us.
Jill: Welcome back to the Breakthrough Addiction Recovery Hour.  My name is Jill Mattingly and my co-host Brian Fujii, and we have a guest today, Dr. Lois Dutton, another team member at Breakthrough Addiction Recovery.  Thanks for listening to us on this dreary day.

Back to our discussion, we’ve been talking about the history of addiction treatment, and the thing is is there has been change.  There has been positive change.  In some places there’s been a lot of change, in some places they’re just waking up to the new medical research about addiction, and one of the things that I’m very proud to work at a facility that recognizes the cutting edge of addiction treatment.  And Brian, I know you feel very strongly about that also.

Brian: Absolutely.  We are hearing so much about what Lois is saying, about where there’s been so much really ignorance, and we are all ignorant about something, it doesn’t mean that it’s bad, it’s we don’t know about it.  Many, many people come into our treatment program and we tell them about the disease process of alcoholism and other addiction, and when they come to understand how their dopamine levels, which is a neurotransmitter in the brain, is lowered because their constant use of alcohol, when they begin realizing that it’s not something because they have lack of will power, or because it’s a character defect, that it truly is a brain disease with the hopefulness that their brains can heal if they allow themselves the time, 8-12 months of being able to be alcohol-free, that the brain miraculously can begin healing itself and causing those dopamine levels to get back up to normalcy.  And so many times they don’t understand the reasons they keep on using is because the fact trying to make up the deficit between what is normal dopamine levels and what is considered abnormal because they use the alcohol.  And when they understand that, it’s like light bulbs going off in their brain.  They go, ‘Oh my goodness, I never knew that.’  It removes so much of the guilt, the shame, the remorse, they get really, really hopeful.

Jill: And you see that every day, don’t you Brian?

Brian: Every day.

Jill: In that day treatment.

Brian: I want to segue over what Lois said, and so many times people in the past used to get into the 28-day program and they do a great job, but they send them out drug-free, alcohol-free, but for 28 days they had no other choice.  Whereas in an out-patient setting like at Breakthrough Addiction Recovery, we’re teaching them skills, we’re teaching them coping mechanisms, we’re teaching them the understanding of the disease concept of addiction.  They do get to go home, they go past that bar sometimes, they go past that liquor store on the way home.  They have to make a decision – am I going to pull my car into that place, or am I going to use the tools that I have in resisting that and being able to make a choice, and it truly is always a choice.

Jill: And we’re not afraid to medically treat them, and psychiatrically treat them.. It’s all a part of addiction treatment and in your view Lois, I’m sure you saw this change occur some places more than others, and you were going to comment on that just a little bit for us.

Lois: Yeah, I think that the thing that impresses me actually the most about Breakthrough, is the fact that this is aggressive, this is progressive, and this is individualized treatment where individuals are coming in.  Whether the drug of choice is alcohol or whether it’s opiates, or the benzos, whatever the drug of choice is, there is a designed program to address that addiction in the person.  And we treat aggressively because this is an aggressive illness.  It is consuming the person’s life, it is literally taking the person’s life.  It has to be addressed as a medical entity, a process if you will, a medical process that has to be treated and viewed aggressively, and we’ve got tools now that are new to us, that have only been around probably for less than 10 years.  We know that we’re got medications that we can give individuals so that we can taper them off of these drugs, get then medically free, stop them from being so compromised with their drug use that they can now sit and hear what Brian has to say.  Brian is arming them with a toolbox for every night they’re with us, they go back to their own environment, and they go back with yet another tool in that toolbox that they’ve learned in the process of being with us during that day.  We bring the families in, we give them the toolbox also.

Brian: I’m so glad you brought that up, because that family education is such a vital part.  I know every week, when these family members come in, they share their brokenness, they share their hearts, because they’re dealing with that same issue too, where the person who’s addicted, they have their own issues, but we call it “families in recovery” because they’re carrying their own pain and their own burdens too.

Jill: Right.  I’m just exasperated by just the fact that there are treatment facilities that aren’t using all the things in the arsenal, and I wanted you to comment on that.  Why are there still places that say, ‘Okay, you can come here.  We’re going to help you not drink.  But don’t you dare be on the FDA approved alcohol craving medication, Naltrexone, because we don’t know enough about it – it might be addictive.’  That floors me, Lois.

Lois: But Jill, you have to know historically that we’ve got the traditionalists, we’ve got those individuals who are moderate, and then we’ve got the progressives.  This is still a relatively new field of treatment.  Addiction has been around since Jesus was an alter boy and longer, but nevertheless, the treatment part of it is relatively new, right Brian?

Brian: Very new, in relation to the addiction field.

Lois: We have not known, it’s like the story you and I were sharing Jill, about the old spirituals, Sweet Little Jesus Boy.  We didn’t know who he was.  We didn’t recognize you.  We didn’t know that you were the savior.  We didn’t know any of that.  The same is true in addiction, that we did not know that there was something going on in people’s brains that separated them from everybody else who used.

Brian: That’s so true.  And again, when you take a look at the new studies, the brain scans that are being done, and the ability for us to really see what is transacting in the brain.  One of the studies that really still blows my mind Lois, Dhama Progressive Studies.  They did a study with rhesus monkey’s brains, they gave them 10 days of normal adult, proportionate use.  It took over 2 years for those brains to return to normal.  Only after 10 days – phenomenal.

Jill: We’re coming down to the end of the segment, and now that you have rhesus monkey brains on your brain, we’re going to be right back for our last segment.  Don’t leave – stay with us.  We’ll be right back.
Jill: Welcome back to the Breakthrough Addiction Recovery Hour.  My name is Jill Mattingly, my co-host Brian Fujii, and our special guest today, Dr. Lois Dutton.  I’m going to read a few things, registered nurse, certified addiction professional, but this is what gave me the most respect for you Lois, is the fact that you were Director of Women’s Recovery Center in the Grady Health System in Atlanta.  Let me tell you, I did a lot of time at Grady too, and to know that you cut your teeth and sharpened them in addiction in Grady Memorial Hospital, that says a lot about your tenacity in addiction treatment.  And I really do appreciate that you joined us today.

770-226-0920, that’s the number.  We’re on our last segment.  You can call, questions, comments.  We were just talking at the break about the holistic approach, and Brian, I thought I was going to have to tie you down to your seat.  You get real passionate when we talk about this.

Brian: I am very passionate about what I do, I love what I do.  I keep telling folks, they actually pay me to do this.

Jill: We can take care of that.

Brian: I was just thinking as Lois was talking about how people get out of the 28-day programs, when the finally get through, they get back in the toxic environments, and you were talking about the idea that it’s more than just not drinking.  That is really true.  People that I work with, every day, it gets me so excited, I’ve see people’s live improving.  They come in, they’re initially in detox or they’re being detoxified, they’re very tired, very fatigued, very irritable, which is normal for being in withdrawal, but as the days go on, I really begin to see a brightness in their eyes, a smile on their lips, and they being telling me, ‘I have never felt this good in over 10 years.’

It’s really amazing.  So what I’m thinking as we’re talking about it, it’s not just stopping the drinking or stopping the drugging, the program that we’re trying to do is help people enhance the quality of their lives.  If we don’t do that, then all we’re doing is giving them their shots and they go home.  We’re trying to enhance their quality of their life.  And the studies have shown that many times what clients are telling the treatment providers is, ‘I want to have a sense of well-being.’  And when asked the question, what do you mean by well-being, they’re saying, ‘I want to have a sense of enriched life.  That my creativity comes back.  That I have a satisfying spiritual and sexual life.  That I really have a sense of happiness that I’ve never had before.’

The thing that really drives home to me is just this week I had one person, and she just graduated from our program, she said, “Brian, you know, this is the best I’ve ever felt.  And you know what really got me excited, the fact that I can remember when I went to bed.”

Lois: Absolutely, absolutely.  And to me, the idea if I’m going to need to spend the rest of my life just avoiding taking that first drink, which is what I’ve been told in my treatment program, if I’m just going to spend every waking moment trying not to drink, then my question for me would be, is it going to be worth it?  If I’m not going to have a better quality of life, if I’m not going to be able to make it day-by-day-by-day doing the things that are important to me in my life as a sober individual, then why am I going through all of this?  Why am I shaking out all of the heebie-jeebies from my detox, why am I sobering myself up to the full reality of where I’ve gotten myself in my life if that’s all there is.

Brian: That’s such a powerful piece and that’s the beauty of our program.  We not only tell people how they move into addiction from a very scientific approach, but the beauty about it is we also show them how they will move into recovery, and there are some very specific timetables that they can experience as they move through recovery as long as they stay drug and alcohol free and that’s so encouraging because now they know they have a way out of the woods.

Jill: And if you’re listening to this and you or your loved one need help with an addiction with alcohol dependency or another drug dependency, that’s what we do at Breakthrough Addiction Recovery.  We do a free consultation.  We take you through and look at it, each individual situation and build the program appropriate for you or your loved one.

If you’d like to call our office, we’re right up in Norcross, we’re at 770-734-8091, and you can check out our website, it’s www.BreakthroughAddictionRecovery.com.  We’re available 24 hours by phone.  You can call at any time, you might even get Brian if you call – the radio personality.

So I really do appreciate that you all joined us today and think about what we said.  Think about it.  We’ll be back next week.

February 9, 2008 - White House Office of National Drug Control Policy

Breakthrough Addiction Recovery Hour show transcript

February 9, 2008

Welcome to the Breakthrough Addiction recovery hour. During this hour we will be discussing topics on addiction as it relates to alcoholism and other drugs. Our phone lines are now open, so call us at 770-226-0920 with your questions and comments.

Brian: Good afternoon, Atlanta. Welcome to the Breakthrough Addiction Recovery hour. My name is Brian Fujii, clinical director at Breakthrough Addiction Recovery, and with me is my cohost, Jill Mattingly, our physician assistant, and Jill, take a look outside, isn’t it a gorgeous day, Atlanta? Beautiful!

Jill: I know, what are we doing in here?

Brian: Well, you know, last week…

Jill: This is when we should be in the parking lot of, like, Lenox Mall doing this, so we could enjoy the weather, you know what I mean?

Brian: We’ll need to talk to our boss about that… that’d be great. You know, we had a wonderful experience last week, being able to talk about the issue relating to opiates, and also the key is that we had that antidrug campaign and we really had a wonderful time talking with Laura Ashley Overdike, who’s with the White House Office of National Drug Control Policy… that is a mouthful…

Jill: I know, can you imagine?

Brian: I hope everybody did see the Super Bowl, and did see that ad…

Jill: Oh my gosh, I did see the Super Bowl, I was a big Giants, I was for the Giants, so I just gotta say that, yay!

Brian: You did. (laughs)

Jill: But anyways, I was real excited about watching for the commercials, and it was probably right before halftime, if you were watching the Super Bowl, you might have seen a commercial where a guy, kind of a seedy character, was next to a payphone waiting on a call. He was obviously a drug dealer, and he was saying, hey, you know what, I’m out of business because where the kids are going now are right upstairs to their parents’ bathroom in their medicine cabinet…

Brian: That’s right…

Jill: …and that’s where they’re getting the drugs these days. And I thought, that was really a great ad. And I hope it wasn’t lost on people what was actually going on. I’ve actually seen one other ad in U.S. News & Report. It was on the back fly of the magazine, and it shows a regular medicine cabinet sitting on the side of a brick wall in an alley, trying to get home to people that…

Brian: Well, that makes it home, you can get your drug dealer right out of the daggone medicine cabinet hooked on to the back wall of an alley…

Jill: Exactly. Yeah, I’m just, you know, I was excited, you know, over a month ago we were talking about this on the radio show, and then found out that this huge national campaign is taking place, and I think it is so timely and the message has to get out because, you know, learning some of those things that we found out from Laura Ashley about how teens are getting into this type of drug abuse…

Brian: Let me just recap… We have come to understand just basically having overheard with Laura Ashley that the past 12 years there was 12.6 million nonmedical users of pain relievers. Can you imagine that? Nonmedical. That means they were using this medication in nonprescription ways.

Jill: Absolutely.

Brian: 70 percent obtained them from a friend or relative. Now whether or not they were given them or they actually took them, the issue is 70 percent were able to obtain them. So when you are talking about medicine cabinets, not just that only family members can go in there, but who knows, we have friends of family members who are over there, and they may be kind of looking around and perusing each others medicine cabinets trying to find this, such as oxycontin and percocet and lortab. There are approximately 2500 teens who try prescription painkillers to get high for the first time each day.

Jill: Oh, that’s the one…

Brian: That is absolutely phenomenal.

Jill: and that’s their first time for doing anything to get high…

Brian: That’s right.

Jill: …which, it used to be, you know, most of us remember…

Brian: a cigarette…

Jill: Yeah… No. No, now Brian, you’re really aging yourself. No, back in the day, it was, you know, marijuana was that first drug that you’d use with the friends in the basement and things like. But now it’s becoming, let’s just go to parties with a handful of mom and dad’s pills. And sometimes they even do what they call pharming, or pharm parties, where they actually take drugs from the medicine cabinet of their parents, go to parties, put them in a bowl… and I know that was back in the 60s that was pretty popular, but they are doing it again because they’re so easy, easy to get from their own homes.

Brian: That’s right.

Jill: And, you know, when we were talking about this last week with parents, we didn’t want to say, ok parents, all of the teenagers out there, including yours, are trying to do this. Well, that’s not the message we’re trying to say. We’re trying to say, anyone that comes into your home, anyone can be susceptible to the lure of easy medication, easy drugs.

Brian: You know, Jill, I’m really glad you said that because so many times parents think, oh, not my little child, that person would not be doing this. But you know the interesting thing, the average age, prescription drugs are the drug of choice among 12 to 13 year olds. Now that’s got to be a shocker for individuals who have young teens or even preteens to realize they’re already experimenting at that young age. The question then is, why do they feel they need to feel high at that young age?

Jill: Well I think that just goes back to being a teen. Most teens start to experiment with something and, you know, like I said, it used to be something that was kind of hard to get, you know, the marijuana, the alcohol, you know, sneaking the alcohol from your mom and dad’s liquor cabinet, things like that. This is much more difficult to detect, first of all, and as we know about the brain disease of opiate addiction and benzodiazepine dependency, it changes the brain…

Brian: Yes it does.

Jill: …much more efficiently than marijuana and alcohol do at that young age. Yes, alcohol does have a bearing on the brain. However, these medications create a very intensive dependency very early…

Brian: …and very quickly. And when you begin realizing how easy they are to get, in fact, I still remember about your niece saying, when she was there at her locker, and someone actually came up to her locker and offered her these kinds of pills crushed up in such a way they could actually put it in a ballpoint pen and saying, buy some of this. This is just, blows my mind. How easy it is to pass this on, even at the lower school levels.

Jill: Yeah, and it seems like it’s a safer high, too, because…

Brian: That’s the false thinking…

Jill: Yes, exactly. But, you know, we at Breakthrough Addiction Recovery, we treat opiate addiction, benzodiazepine dependency, alcohol. But here’s the thing, we got into this antidrug campaign because what we see at Breakthrough is the average age of an opiate-dependent person is usually from 20 to 35.

Brian: Mmm hmm.

Jill: And so I always do a very intensive medical history and exam, and in talking to these yioung people, I find out they started this whole situation back in high school, 17, 16, they started taking oxycontins, because they were in the house, or because a friend of them said, hey, this will make you feel better, or you know what, the girl may say, you know, I had really bad menstrual cramps so I started taking them from my friend because they took care of it. But then they find out very early on that they have to have that or they start to get sick, the withdrawal.

Brian: Right. And you know it’s interesting you say that, too, because from your side of the house, as you’re doing your medical assessment and finding that age, as I’m doing treatment on a daily basis, I said, well how early did you start drinking alcohol? And usually it’s around 13, 14 years old. So here we go, we’ve got youth testing and trying out alcohol at 13, 14, 15 years old, and then you’re saying they’re experimenting now with these opiates, these pain medications… what a deadly combination that is.

Jill: Absolutely. I hope in our listening audience if you hear this, what you, we have been saying this every week, go to your medicine cabinets, find the medications such as the benzodiazapines, which were going to talk a lot about today, and all the pain killers, or pain medications, put them in a safe place. Maybe a locked area that your children or you know people that visit you are not going to be able to get to when they use your restroom. And, you know, we have also come upon people saying they even go into, what is that, open houses that real estate agents have…

Brian: Oh yeah, when, like on Sunday open house people end up going to these various real estate open houses, they visit all the homes, they take a look…

Jill: …and the owners are gone…

Brian: Yeah, that’s right, they’re gone, and unknowlingly they leave their medications ion the cabinet, people go there, and they kind of have a heyday. They say, oh, here’s a bottle. In fact, we know based upon what Paul was saying…

Jill: Yes. If you are selling…

Brian: …I’m just grabbing this opportunity out of the shelf and stick it in my pocket.

Jill: If you are selling your home, please be aware you need to lock up your medications, because people will be coming through and looking at your home…

Brian: Yes. And keep it safe.

Jill: …and making excuses to go to the restroom.

Brian: Exactly.

Jill: So we’re going to talk a lot about some very devastating news that came out a couple weeks ago, the death of Heath Ledger, and were going to talk a little about that dangerous mixing of medications. So I really hope if you are listening today, you’re going to stay tuned. We’re going to really help you know one important thing, and that is, if you have these medications in your medicine cabinet, there could be a time when you take more than you intended to take. And we’re going to talk about the mixing of medications when we come back. And if you want to join us, 770-226-0920. You can call us, ask a question, and comment, get in on the conversation. Also, outside of Atlanta, 1-888-920-2665. Stay with us, Atlanta. Be right back.

<commercial break>

Brian: Welcome back to the Breakthrough Addiction Recovery hour. My name is Brian Fujii, and my cohost is Jill Mattingly. And today we’re continuing our discussion about the issues related around opiate addiction and also opiate treatment. And Jill, you know, we’ve been looking today at all the different issues related to the promotion of understanding how people are actually going to individual’s medicine cabinets and pulling out these drugs and using them at a very, very early age. I know there’s a deep concern, especially as a physician assistant and me as a person who does clinical treatment on a daily basis, how these are impacting our young people. I love the way you said the other day, I mean, just a few minutes ago…

Jill: The other day…

Brian: Yeah, the other day…about how individuals, 21, 22, are now getting to the point of addiction, but they’d actually began at 14, 15 years old. So we know this does take some time, as people begin to continue to use and their brains begin to change. Here they are now using it instead of just socially, they’re now becoming addicted to them.

Jill: Yeah, and that doesn’t show up right away in some of the teenagers. You know they may do it here or there at a party, you know, it’s something, you know, a claim to fame, like, oh yeah, I had that at a party. But then they get into college or post-high school and they start to remember, you know, I remember how that made me feel, and I’m a little stressed out now, so I’m going to try to use this for sleep, or they have something where they actually get a, you know, medical reason to get these pain relievers…

Brian: And that’s where so much of it begins. Maybe they had oral surgery, or perhaps they had lower back pain…

Jill: Uh huh…

Brian: And now they’re using this, initially using it as a way to deal with their pain…

Jill: Right.

Brian: …a healthy pain that we know is there. But now, they probably had that memory.

Jill: Plus, you know, remember that opiates, when you’re talking about them, don’t treat everyone the same. There are people out there who are listening know the first time they had surgery and tried to take an oxycontin or vicodin they felt very sick to their stomach, dizzy, and it was not a pleasant experience whatsoever, so they determined, I’m just going to go with naproxen from here on out. Then of course you have those that say the first time I took this med, I was on, I felt good…

Brian: …fantastic…

Jill: …calm, I could do anything I set my mind to. That means, biologically, they have a very high tolerance or propensity to go into dependency…

Brian: Propensity. Indeed.

Jill: Here’s the thing, they go into high school, college, they have the stressors of life, and they start to take it on a regular basis. And then they have to get it, because then once they’re dependent they’re going to get sick if they try to stop. Well, what I see at Breakthrough when people come in, they’ve been on this medication for 3 to 5 years. They are actually looking at a very difficult life, and they are looking at it and their families are looking at this, and that’s usually why they come in, because all of a sudden they realize, I am completely a prisoner to this, and they’re only 22 years old.

Brian: And they’re wanting to stop because their lives are just getting miserable. They’re beginning to have these withdrawals, they know when they stop taking it they get these severe flu-like symptoms, they’re just really trying to find some way to get their lives back. Especially at 23, 24, 25 years old.

Jill: And that’s where suboxone can actually be a lifesaver. Suboxone treatment, for those of you that don’t know, it’s an FDA-approved medication, and we use this medication to help people get off opiates when they are dependent on them. And it’s basically just a day and a half to two days, um, induction, they get medical and clinical wraparound services to do so at our location. And, it’s becoming very easily managed…

Brian: …And I’m glad you said that. Right.

Jill: It’s not something like methadone that you have to do every day.

Brian: And that is, we need to make sure that our listening audience understands, it’s not just only the detoxing. It’s so critical to get that psychosocial support that therapy, because they really need to work on something. Looks like we got a call coming in here, Carrie from Norcross. Hello, Carrie.

Carrie: Hi.

Jill: Hi, Carrie. Did you have something, we were going to be talking about Heath Ledger. You probably heard us talking about that. Did you have a story or something about Heath Ledger’s death you wanted to talk about?

Carrie: Well, it was just a, in our family, a couple of years ago, my 22-year-old nephew took an accidental overdose.

Jill: Oh, wow.

Carrie: And the interesting part to begin with was that we didn’t even know he had a drug problem. His family, his parents didn’t let us know, and, um, he had become addicted to xanax. And they sent him off to rehab, he came home, he was clean for about a week. He went out with his friends on a typical, you know, like a Saturday night type of thing, and the next day he did not show up for work and the police found him in his apartment. He had one pant leg on, they said he was trying to get dressed, he was putting his uniform on, he was trying to get dressed for work and his heart failed.

Jill: Oh, wow.

Carrie: The autopsy showed that he had taken at that, evidently at the party or wherever he was, he had marijuana, cocaine, xanax, oxycontin. Um, there were also other drugs found, one was an a sleeping drug. So it just really brought back a lot of memories, and…

Jill: I’m sure it did.

Carrie: I think that a lot of people don’t understand how important it is to know these things. I mean families try to keep everything a secret, and had we known, you know, maybe we could have done something. Maybe something could have been said, we could have been more proactive, but, um, needless to say we lost a wonderful young man. It was a horrible waste of life.

Brian: It is. And you know you’re so right, and that’s the reason I think programs like this, Carrie, are so important to help the general public understand the dangers involved. I think so many times we have a feeling, well, it’s medicine, it’s been prescribed by a physician and filled by a pharmacist, and so we think it’s all fine. And as a result we don’t really understand how the dangers occur. And again, I think what Jill is saying here, that really when they start using opiates at a very young age these days, and then they just begin to move more and more into using those, and now the brain chemistry has changed, and in that…

Carrie: But what I found interesting was that the xanax had been prescribed to him because of depression he was experiencing due to his parents’ divorce and remarriages. Both parents remarried, both parents started new families, and he was the ping pong ball going back and forth…

Jill: And Carrie, how old was he when he passed?

Carrie: When he died, he was 22.

Brian: 22.

Jill: Ok. Wow.

Carrie: So, what really shocked us was that it was, the original intent was to of course to bring him out of his depression but unless he got any counseling, that wasn’t, there is no magic pill. But he was mixing that with his drug use.

Jill: And probably alcohol also.

Brian: Yeah, I’m sure alcohol was part of it.

Carrie: Oh absolutely, because he was a bartender.

Jill: Yeah, well…

Brian: Oh that’s, ok…

Carrie: So there were so many… and so what upset me too was by the time we got to Florida, and we got to the church, and we began to see his group of friends begin to file in, my husband looked at me and said, most of these kids are high.

Brian: Mmm hmm. And you know that’s so true, Carrie, because so many times we hear this, if their friends are there, the way they’re going to cope with the death of a deep friend is to use, so they can cope with the fact of their own grief.

Carrie: Literally it looked as if it didn’t even phase them.

Brian: Yeah, I mean, if you’re under the influence, it probably looked like it didn’t phase them. But believe it or not, there’s a lot of struggle. We hear this so often…

Jill: Yes, we do.

Brian: People are saying, you know, I had a friend who passed away as a result of an overdose. I know I was taking this, I know how close I could have come to doing this, and I had to just have a pill or two, just so I could make it through the funeral.

Carrie: I don’t know if any of you know this, but the interviews with Heath Ledger prior to his drug abuse, I think he was, I think he became dependent on drugs. Because the interviews right before his death, the pictures of him, he looked unkempt…

Jill: Yes, he did…

Carrie: …he looked like there was something definitely wrong with his appearance. Which is what I noticed, the pictures they put on top of the casket, they showed his senior picture, this nice healthy-looking young man, you know, with meat on his bones. And then the most recent picture he had a shaved head, he had piercings all over his face, he looked like his cheeks were drawn, he wasn’t that boy anymore.

Brian: Right.

Carrie: And if that doesn’t tell you something that maybe there is something else going on…

Jill: Absolutely. You know, that’s one of the things were trying to get out to parents, too. And Carrie, thank you so much for this call…

Carrie: You’re welcome.

Jill: And we’re going to continue talking about this Heath Ledger overdose and really try to educate people on that.

Carrie: That’s a good idea.

Jill: Yeah. Thank you so much for your call….

Brian: Appreciate your call.

Jill: …and we are going to go to a break now, Atlanta. Please stay with us and we’ll be right back.

<commercial break>

Jill: Welcome back to the Breakthrough Addiction Recovery hour. My name is Jill Mattingly, and my cohost, Brian Fujii. And we are talking about some difficult things. We just had a caller talking about a nephew of hers that had been found, dying from an accidental overdose similar to Heath Ledger’s. We’re going to talk a little bit about what was found in the toxicology report from Heath Ledger. And I want to clearly get across to the listening audience how the medications that Heath was taking were actually prescribed to him and were legal medications. We are going to go through each medication and how it can be very dangerous to mix these. But it looks like we have a call. Brian?

Brian: Todd, Atlanta. Welcome to the show, Todd.

Todd: Ah, yes, thank you. I just had a quick question regarding teenage opiate addiction. And I was curious how it affects teenagers neurologically because I know that they’re still in a developmental phase in a lot ways, and how it affects them compared to adults. And how opiates differ from, like, Ecstasy addiction in the brain.

Brian: Ok, well, typically, Todd, when they’re really young, from what I understand, the brain actually develops from the back to the front, if you want to put it that way. And around age 21, 22 is when really gets to its full development. And one of the things we’re finding out for teenagers and really, pre-adolescents as they’re using we’re finding out many times their brains don’t seem to develop as quickly or as maturingly. As a result, they’re not really thinking very clearly, and this is why they end up start taking all kinds of high-risk behaviors. They definitely have seen that frontal part called the prefrontal cortex, where we get the majority of our logical thinking, and so if that part of the brain is not being developed because the use of painkillers or alcohol or other types of drugs, they really are impairing their future thought patterns.

Jill: Right. And you’ve got to understand, having a drug that attaches to an opiate receptor, which most painkillers do, is going to send out neurotransmitters, and that’s going to strengthen a neuroconnection with the psychological part of the brain. It strengthens, I feel stress, and so the brain will send out messages to your frontal cortex, then this is what you need to do. So it starts what I call a neural connection or a neural circuit that strengthens with each use that is telling the brain, this is how we handle stress, this is how we handle sadness, this is how we handle depression…

Brian: Exactly.

Jill: And the other thing you asked about is Ecstasy. Ecstasy is kind of related a little bit to the amphetamines, which has a different function. It doesn’t join to a receptor per se, but it causes dopamine to be released by the neurons, which gives you that excitatory kind of feeling, and actually that can have the same effect. You have a release…

Brian: …a dopamine dump…

Jill: …yes, a hyperrelease of neurotransmitter, and that produces a great, great feeling, and so the brain remembers it. The biggest problem for the teens and anyone that’s using a medication to alter their mood is your memory. Because your memory will work against you when you start to have things like sad ness, depression, stress…

Brian: That’s a great point, Jill. You know, Todd, that’s one of the things that we talk about in our treatment is, the brain has tremendous drug memory. It usually as it goes through what we call the pleasure pathway of the brain, in that lower brain, that’s basically the part of the brain that’s basically responsible for fight or flight, or pleasure pain. When they start feeling that kind of pleasure, it moves right back to a part of the brain that has great emotional memory, and so as a result, with that emotional memory, if they use any other type of drugs or alcohol, it triggers that brain to remember how good it felt and they’re right back into relapse or really feeling intense. And I like what Jill said, too, you know so many times when you’re taking those drugs at such an early age, and so if you’re taking those drugs because you’re sad or you’re frustrated, or you’re worried, or you’re anxious…

Jill: Or you’re having a good time.

Brian: …or you’re having a good time too, yes, either the good or the bad. What happens there is that the only thing that is being truncated here is that, they’re saying, if I feel this way, the drug will help. Rather than learning how to cope with these particular emotions in a mature way so they really are impacting both their emotional growth as well as their psychological growth.

Jill: Are you still with us, Todd? We’ve given you a big earful, huh?

Todd: Oh, no, that’s great. I’ve, that’s a tremendous show. I just have one more question: Does the opiate receptors in the brain, do they grow with the continued use of the narcotic?

Jill: That’s an interesting point. There are different studies out there about what the opiate receptors do. There’s actually I think 4 different ones, and what we’re interested in usually in treatment is the mu receptor, opiate receptor, which is what suboxone works with, but actually there are some amazing books and studies out there that talk about opiate receptors being all over our body, not just in the brain, and they are actually found in one-celled animals like hydras and things like that so opiate receptors must be important for our survival or they wouldn’t be all over our body. I don’t think they are destroyed and I don’t think that you get more of them, I think it’s just a situation where we have them and they can be used to make us feel better naturally or we can take something in to tickle them and make us feel better.

Todd: Wow.

Jill: Very interesting stuff. There’s an interesting book out called Bliss, by Doctor Candace Perd if you ever want to look more into the science of opiate receptors. She actually discovered that in 1972 as a biochemistry graduate student, and she was the one that discovered, not discovered but proved that there was an opiate receptor. Interesting stuff. Todd, thank you so much for your call.

Brian: Great questions you asked today.

Jill: I could talk for hours, can you see that?

Brian: Thanks for your call.

Jill: Looks like we’re coming down to a break, and we are going to get to the Heath Ledger accidental overdose. Stay with us.

<commercial break>

Brian: Welcome back to the Breakthrough Addiction Recovery hour. My name is Brian Fujii, and my cohost is Jill Mattingly.

Jill: Me.

Brian: And today we are talking about painkillers and how they impact the brain but also how they impact devastating lives. And if you are listening out there today and want to be a part of this conversation, give us a call 770-226-0920. Or out of the area is 1-888-920-2665. You know, Jill, we really need to let people know about our wonderful website. We have a tremendous amount of information on our Breakthrough Addiction Recovery website, and if you’re wondering about how all these different kinds of medications or drugs or alcohol can impact you or your loved one please go to that website. It’s www.breakthroughaddictionrecovery.com. And we offer a free consultation. It’s a wonderful opportunity for people who just say, you know, I’ve got a loved one that needs some help, or I need help, I don’t know what to do. We get this call a lot, and so if you’re just wanting to know, what can I do for my loved one or for myself, you know, we’d like for you to give us a call for a free consultation at our office at 770-734-8091. That number again is 770-734-8091.

Jill: That’s our office number.

Brian: That’s the office number, that is correct. So, you mentioned talking about Heath Ledger and his tragic death as a result of overdosing on several different kinds of medications. And they did determine that it wasn’t a suicide, that it truly was an accidental death.

Jill: Right, and it did say, the medical report did say acute intoxication, and unfortunately, when they did the toxicology report, it does show he had 6 different medications that when taken by themselves actually do someone good, you know, can help take away pain, can help a person get to sleep, can help with anxiety. But once you mix these together and you don’t understand pharmacologically how they work, you can easily and mistakenly end your own life. You just don’t wake up.

Brian: Well, we know that he had at least oxycontin and vicodin, and both of those definitely are painkillers…

Jill: Exactly.

Brian: What people need to understand is they also can depress the respiratory system.

Jill: Yes, when they reach a level that is, actually we call it, like, a tissue dependence, when they reach a level that it can actually work on the brain stem and start to decrease respiration. Now that may not end up in death. You could actually find someone passed out from the pain medication, take them to the ER, give them a medication called Narcian, reverse the whole process and they’re breathing again and they survive. However, when you mix in other things—alcohol, benzodiazepines, barbiturates—when you mix those medications in, unfortunately they do the same thing, they depress respiration at different places in the brain and actually can cause it to be very difficult to reverse if you find someone that actually has taken too many of these medications. And it looks like we do have another call coming in. This is Phyllis in Norcross.

Brian: Welcome, Phyllis, to the Breakthrough Addiction Recovery hour.

Phyllis: Well, good evening, good afternoon I should say. I am appreciating and I’m learning so much

Jill: Great.

Brian: Wonderful.

Phyllis: …I’m just glad I happened to tune in to your show for the first time last Saturday. I’m also listening today. But my question is, what does opiates, or opiads, what does that term mean?

Brian: Well, it means an opiate is any particular medication that is generated or manufactured from the opium plant.

Phyllis: Ah, so its o-p-i-a…

Brian: O-p-i-u-m. Opium.

Phyllis: Oh, that’s what you were saying…

Brian: Uh huh. And opiates are actually medications that are derived from the plant called the poppy plant, basically, and the drug that comes from that is opium. So they are both actual medications that are either straight from using the opiate…

Jill: …like morphine, mmm hmm…

Brian: Morphine, directly from the opium, or they can be synthetics, which is a combination of opium and other medications. So sometimes they pout it together with acetaminophen, and combine some of these medications synthetically, and the result…

Jill: They are synthetically made.

Brian: Right. And those are called the opiates. So that’s the reason why, and they’re used as pain medications, and this is what Jill was talking about how they occupy the opiate receptor sites and help you to be able to usually withstand extreme pain. Our bodies normally have natural painkillers. They’re called endorphins, and we get that naturally from our bodies. But many times when you’re going through, say like you had back surgery, or maybe oral surgery, or something in which you have excruciating pain, then typically the physician will order some of these painkillers to help you manage the pain.

Phyllis: Thank you, and one more question: What’s the difference between an opium based drugs and cocaine-based drug?

Jill: A cocaine?

Phyllis: Yes.

Jill: Ah, ok. Different plant.

Brian: Yeah. They’re different.

Phyllis: I know it’s from the coca plant.

Jill: Uh huh.

Brian: Right.

Phyllis: But an opium, I understand they’re different plants, but what’s the difference between and what are some of those drugs that are coca based?

Brian: One of the things I was talking about was opium, of course, is dealing with painkillers, and typically things like cocaine is what we call a stimulant. And so that stimulant is one that will actually cause people to get an extreme high. IN fact, that’s one of the real dangers sometimes about using things like cocaine in a form called crack cocaine where they can actually smoke it. They get such a tremendous high, more than just your normal feeling of well-being.

Jill: And also, Phyllis, we were just talking about our website, breakthroughaddictionrecovery.com. We have sections that explain what these different drugs are and how they act right in our website. And if it’s not in the website it will link you. It’s full of information and very interesting.

Phyllis: Thank you so much.

Jill: You’re welcome.

Brian: Let me tell you that website again, www.breakthroughaddictionrecovery.com. Please go to that site. There’s a wealth of information there.

Phyllis: I appreciate you so much and I’m quite sure I’m not the only one that’s listening… I know that I’m asking questions that perhaps people who aren’t even calling in, but the information would be very helpful to them.

Jill: Thank you, Phyllis. You have a wonderful, beautiful day.

Phyllis: Thank you.

Jill: And it looks like we’re going to talk more about the Heath Ledger overdose when we do come back from this break. But I want you to listen to the drugs that were in his system when they were found: oxycontin, valium, or vicodin, valium, xanax, restoril, and unisom. If you have that in your medicine cabinet I want you to listen when we come back from this break.

<commercial break>

Brian: Welcome back to the Breakthrough Addiction Recovery hour. My name is Brian Fujii, and I have with me Jill Mattingly, my cohost.

Jill: Hello.

Brian: And today we’re talking about painkillers. And you know we just got through talking…

Jill: And benzos.

Brian: …and benzos. And also we just got through talking about 2 of the drugs found in Heath Ledger’s death report. And now we’re looking at valium. Tell us, Jill, what does Valium do for the body when it begins combining with all these other drugs.

Jill: Actually, you know, I want to talk about that. I’m going to talk about the other 3, because a lot of people don’t realize that these next 3 medications that were found are actually the same type of medicine. There’s valium, which is usually prescribed for anxiety. There’s xanax, which is very commonly prescribed for anxiety and panic attacks. And Restoril. Restoril is actually a metabolite of a longer-acting benzodiazepine, but it works for sleep. So what I see in that report there, other than that an antihistamine, an over-the-counter drug was also found called Unisom. Ands so what I see there in those last 4 drugs is that he had a lot of anxiety and sleep issues. And that is the number one reason people do take benzodiazepines. And don’t get me wrong, those medications work wonderfully for those people that really suffer with these problems.

Brian: Right.

Jill: You might see anxiety being treated with xanax, Librium, or valium and those are a little bit different from each other too, because their onset of action is different. Xanax is short-acting. You take it, you get an effect from it, and two to four hours later, it’s gone. It’s not gone completely out of your system but its efficacy has decreased. Now you’ll have, like, an intermediate-acting medications like Librium, klonopin, valium, those are all benzodiazepines also doing the same thing.

Brian: But they last a little bit longer.

Jill: They last a little bit longer and their onset of action is a little longer. Now this is where I see the possibility of Heath getting into problems, because he might have taken the xanax, the xanax wears off, he has taken valium but the valium is taking too long to work so he takes another xanax, or, you know, and I can’t presume to know what happened. However, the reason that someone sometimes gets caught up in this problem is that they are looking for an effect, and they’re not getting it right away, they’re not falling asleep, they’re not getting over their anxiety, so they take more. And unfortunately some of these start to kick in, 30 minutes to an hour later, and all of a sudden you have a synergistic effect or an additive effect of these medications. And like we said before, that can cause respiratory depression, they fall asleep, and they don’t wake up.

Brian: That’s what we’re seeing so many times, in fact when I get people asking me in treatment saying well I have a high tolerance for this medication, and so because I have a high tolerance, I should be able to take a lot more. And what they don’t understand is, what you were talking about, the synergistic effect. They may not be getting that feeling, but the medication is still having its impact. And there’s a difference between those two. And that’s how people can move into overdose.

Jill: Looking at half-lives, a half-life is half the time it takes for the medicine you took to be halfway out of your body, how’s that?

Brian: Great. I love it.

Jill: But, you know, all these medications have different half-lives. This has highlighted what Carrie said earlier, in the death of Heath Ledger shows us that this is devastating to people. And if you have this in your medicine cabinet, and you’re using this to control your stress, or to control pain, or sadness, or anything, you can end up in this same scenario, where you mix too much of the same thing. And you have to be very careful if these are actually prescribed to you. Usually doctors will not do that and prescribe a medication like this, but just looking at that today, watching the funeral for Heath Ledger and seeing his fiancée and his little girl and everything else. This is a devastating thing, and this is not the way to handle life’s situations. Hopefully this has taught some people, but I think we need to continue this information…

Brian: We do. And again, if this is a concern, give us a call at our local offices, 770-734-8091, for a free consultation. And we’d be willing and happy to help you or your loved one. Hope you’ll join us next week and I hope that you’ll be a part of this exciting and meaningful and informative program. And thank you for listening.

March 29, 2008 - ADD & ADHD

Breakthrough Addiction Recovery Hour

3-29-2008

Brian: Good afternoon Atlanta and welcome to the Breakthrough Addition Recovery Hour. My name is Brian Fujii and my cohost is Jill Mattingly, and again we have with us our Director of Psychiatric Services, Dr. Neil Johnston. Good afternoon, ladies and gentlemen.

Jill: Hey Brian, nice rainy day. I hope you all are listening to the radio today – well obviously you are because you’re hearing us.

Brian: Absolutely, and what a great team to listen to.

Jill: Yeah, we’re going to talk a little bit about co-occurring disorders today. We promised last week that we would continue with that subject, and go into ADD, ADHD and how it affects substance abuse, addiction. But I’m going to tell you the Friday newspaper gave me a whole lot of information that I don’t think we can ignore today. And we’re going to talk a little bit more about the Sunday package sales in this first segment. Obviously a lot of you are very passionate about it and I have a feeling you might want to call and get in on this conversation, So I’m going to give you this number very clearly, it’s 770-226-0920. If you are listening outside the Atlanta area and want to call toll free, 888-920-2665 and of course you can be listening to us online if you can’t get good reception, and that is at www.920WGKA.com. And we would love to hear your questions, comments, get in on the conversation. Just remember we are a family show.Anyway, we’ve been looking at these AJC articles for the last hour, all three of us. We all have a little bit of a different take on it, but the one that probably got the most dander up was the one that was written by our ‘gub-ner’, Mr. Sonny Purdue, and it was in the AJC on Friday. It was “Sunday Package Sales Will Drive Up Deaths”. So I think I understand now where Mr. Sonny Purdue is coming from, and I know Neil, that you have read this and you have underlined a whole lot on your newspaper. So tell me what your thoughts are on what Mr. Purdue is writing.

Neil: First of all, you called him Dr. Purdue and I think it’s funny that he started off the article with “Do no harm” which is the physician’s credo – first, do no harm. And he started off with that. And as I have said previously, some of these blue laws are morality laws – period. And in this article he makes his stab or attempt do something other than religiosity – the producer is just telling me that Governor Purdue is also a veterinarian, so he is a doctor as well.

Jill: A chicken doctor . . . I’m sorry . . . you know, Purdue Chicken. Got it? Okay, sorry about that – he’s not on the commercials.

Neil: But anyway, as I was saying, it’s mainly a morality play, not a health issue for whether or not to sell it on Sundays or not, if you’re really going to look at from a health perspective it would be going back to prohibition. And you know we’ve been down that road and had a constitutional amendment and a constitutional repeal of that. But he went though, and I think it’s important to notice that he extrapolated himself from the study from Robert Wood Johnson Foundation that there would be 371 alcohol-related crashes and 6 alcohol-related fatalities per year in Georgia should the blue laws be passed. That’s based on the study in New Mexico which is the first study of the time. The Robert Wood Johnson Foundation is a fantastic organization. Their only purpose is to improve the health and welfare of American citizens and that’s what they study. But if Governor Purdue had bothered to look at some of their other articles and some of the other things that they had to say, that they’ve studied, there are many other ways that are probably more effective at controlling alcohol-related accidents and deaths than stopping Sunday sales. I’ll run through a few of those in a minute when we talk about other ways of doing it, but he also stated that “the republican principle of individual freedom is just as important to me as my colleagues in the legislature, but so is the principle of protecting innocent Georgians.” Well, he’s not even letting us Georgians decide if we want that protection or not, he doesn’t want us to vote on that and he compared this to letting Georgians vote on prostitution or not, which I consider a straw man type of argument that creating something that is offensive to most people, that’s really unrelated, and then comparing it to alcohol use – so I think that’s a little bit of a bad argument.

Jill: Okay Dr. Johnston. You know how I like to look at all sides, and he really does talk very strongly in this article about safety issues, and I appreciate the fact that you’re looking at wide range of ways we can decrease drinking and driving, not just stopping a Sunday alcohol sales. And I kind of understand a little bit of the point he’s coming from . . . why even mess with this? If a study out there showed that the alcohol-related deaths went up, however the study was done, isn’t it just a good idea to leave this alone? I kind of hear his heart coming out while he’s writing this. So I don’t know, I kind of see his point but I also see the clinical point about alcohol dependency and how dangerous it is for someone who is alcohol dependent to go without their medication, meaning alcohol, for a full day if that happened, They would go somewhere and get it. Isn’t that right, Brian?

Brian: They’ll not only get it from that place, or they will be creative enough and probably get it from somebody who already has a stash. We find this happening a lot too. If they can’t purchase it, usually they will find somebody that either has it and they can get it, or they take it.

Neil: Or they can still go to their local bar, pub, and drink as much as they want to.

Brian: And then drive home. If this topic is stimulating your thought processes, give us a call here at 770-226-0920, or 1-888-920-2665. It’s a tremendous stimulating discussion because I’m sure there are different viewpoints, and like Jill you were saying, we’re looking here at individual who may have loved ones who have suffered from the results of drunken drivers and not the fact that because we have it on Sundays is it going to prevent people from buying alcohol during the week and still have accidents, but I do know that that is a real concern for many people about how drinking and driving at the same time is a very difficult, and obviously has caused a lot of damage to many families. So I think this is the reason why this is such a sensitive and volatile issue.

Jill: I was just going to say, we’re so ready to talk about this. I was also going to say this . . . that’s something I don’t understand though, when he talks about it so passionately and about keeping Georgians safe, I don’t understand why then Georgians can find alcohol at other locations, such as bars, restaurants, and to me this might smell a little bit like ‘who’s the stronger lobbyist – the grocery lobby or the restaurant lobby?’

Neil: Jill, I think when you said that you heard his heart coming out in the article, I’m sorry, I heard his wallet coming out. The taxes on many things help support the state and I’m sure that the taxes and the lobby for restaurants and whatnot are present here. And even going back to the Olympics, when Sunday morning at 1 AM or 2 AM etc., alcohol sales were prolonged, that was obviously an economic decision. If we’re going to save any lives, that wasn’t going to help anybody. And Brian doesn’t like it, but also compare it to cigarette smoking, that if you were really worried about protecting individuals in Georgia, why not stop selling cigarettes on Sunday as well? Why not do that? Probably because of all the tax money that’s brought in from cigarette sales.

Jill: But you know, you’re not impaired when you smoke cigarettes.

Brian: And I’ll come back with that one. And you’re right, Dr. Johnston, in that respect, cigarettes certainly kill more people than alcohol does annually. I believe you had some figure like 750,000 people annually that die because of nicotine. And for those that heard that number – yes, 750,000. So put those packs away, across the United States. But at the same time, I’ll contend with this, and that is when we look at alcohol sales, it does not relate to because someone smokes cigarettes, other than what you might call the indirect inhalation of smoke, that they really would cause the death of someone else. Whereas in alcohol-related deaths, it usually is the result of someone else driving under the influence, and because they’re impaired, end up killing one or more people.

Jill: Well, 770-226-0920. We’ve got a lot of opinions right at three different mikes today, so if you’d like to give your opinion or if you’d like to call, I would really like to hear what your ideas are about this legislation. And another thing that Dr. Johnston you were talking about is, what are some other ways that besides just saying nobody can buy a bottle of wine at their grocery store on Sunday, what are more better studies being done to look at how alcohol-related deaths from MVA’s could be decreased?

Neil: Well first of all, going back to the study, it was done by the Robert Wood Johnson Foundation, and they specifically have a substance abuse policy research program, and they have several different studies within that that I will talk to after the break.

Jill: Yeah, we’re going to take a break real quick. 770-226-0920. Dr. Johnston, we’ll be right back with your comment.

Jill: Welcome back to the Breakthrough Addiction Recovery Hour. My name is Jill Mattingly, and this is my co-host, Brian Fujii, and we are sitting here with Dr. Neil Johnston. From now on we’re going to call him Neil because it’s easier than calling him Dr. Johnston, is that alright Neil?

Neil: I get no respect.

Jill: Oh right, right. Anyways, we’re talking about the Sunday alcohol sales and if you have a question, comment, please call us 770-226-0920, once again that’s 770-226-0920. And we’re noticing that people fall on all different points of this argument, especially legislature is falling on many different sides of this argument, and we know now where our governor, Sonny Purdue, falls because of the article he wrote in the AJC. What we came to at the end of the last segment is talking about DUI’s, and talking about driving under the influence of alcohol and are there other ways that we can try to reduce this other than just saying you can’t buy it at your grocery store on Sunday. Dr. Johnston, or Neil, what were you saying about that?

Neil: Well, the same foundation that Governor Purdue quoted have done some other studies that are more recent and one of them showed that immediate license suspension for a first offender DUI would save 800 lives per year. Now that’s not something that I think occurs in Georgia and I’m not a lawyer but I don’t believe that driving is a constitutional right, it’s a privilege and it’s one that the state can take away. So that’s one way that’s been proven to save a lot more lives than reducing or restricting Sunday package sales would be. Another one is for first time offenders, immediately requiring them to have a breathalyzer on their ignition switch so that they cannot get in their car unless they blow a negative alcohol level. That saves lives as well and was proven more recently than the article that he quoted.

Jill: Okay, but can’t you have a friend blow into it so you can start the car? Well that’s not a friend. What am I even saying? I don’t think that would be a friend that will allow a friend to drive drunk.

Neil: You could probably get a turkey baster and blow into it, but again, you got a much more devious mind than I realized, Jill.

Jill: Sorry.

Neil: And then another one that I find interesting was a study that they showed that local bars, not liquor stores, associated more with heavy drinking, and the study linked neighborhood alcohol abuses to minor-restricted establishments, meaning where minors could not get in – they’re going to be carded, etc. But that would seem to support more allowing package sales on Sunday but not allowing bars to be open. So the logic just doesn’t seem to be here to me. I can’t be convinced.

Brian: I think where we’re looking at here is all these controversies are there and that is very true and these are things that probably won’t be answered by the end of this show, but one thing we can answer is how we have probably a lot of people out there listening, Jill, that are having loved ones who are really suffering from alcoholism and we begin to realize that individuals who have problems with either just using alcohol, abusing alcohol, and actually becoming dependent on alcohol. And I think the area that we work with the most is those that are dependent on alcohol. And that dependence is really something that is fairly basic. If a person begins having tolerance that means they means they need more and more alcohol to get the same effect, or they start having withdrawal, when they stop using they really begin having some physiological reaction for not having the alcohol in their body and I think for me as a therapist is to realize that when they continue to drink in spite of no negative consequences, so if they keep on driving after multiple DUI’s, or they keep on drinking in spite of the fact that their boss says you’re going to lose you job if you keep coming to the job site drunk. I think this is probably the more critical. And I know that here at Breakthrough Addiction Recovery, we have a program for people who are suffering from alcohol dependence and they don’t necessarily have to go into a hospital or a closed unit for that, we actually have a ambulatory detox program that can really help individuals detoxify off of the alcohol and get them engaged in our treatment program. And I’d like for people to give us a call at 770-226-0920 and I’d like to talk with them about some of the things we offer. Because not only do we offer the fact that we can help them detoxify from alcohol, we can also let them do it safely and either in one of our private suites or maybe even in their own homes, comfortably.

Jill: There’s not many places out there that provide that type of service and I think that’s the obstacle to a lot of people going out and trying to look for treatment for alcohol dependency, but if you’re someone that is in the back of their mind thinking all day Saturday, ‘Okay it’s Saturday, I need to get to the liquor store before midnight,’ and you’re rushing out in your house slippers at 10:30 Saturday night to make sure that you have your alcohol so you can get through the day on Sunday. And it is devastating, I mean those of you who are suffering with alcohol dependency, you know what we’re talking about in terms of those withdrawal symptoms. The withdrawal symptoms being the increased anxiety, the nausea, the sweating, the wondering about your family worried about because you just don’t look like you feel so well. It’s Sunday afternoon, Sunday evening, and you don’t have enough alcohol to sustain you because it has become a self-medication at this point.

Neil: And a chemical addiction that with more severe symptoms with increased or decreased heart rate, changes in blood pressure, arrhythmias that can occur, it can be fatal coming off alcohol without medical support and treatment.

Brian: And a lot of people try to do that, where they feel they can just detox themselves, but if they’ve ever had some issues with seizures, delirium tremens, I mean those are the individuals that are really at risk physically, and it can be a life-threatening situation, and they do need that medical support.

Neil: And by the way, for those of you who don’t know what delirium tremens is, or DT’s, it’s a state where people are confused, they become delirious, they don’t know where they are, they often times will hallucinate things . . . a pink elephant, seeing snakes, things of that nature often occur. There are lot more people out there who have that symptom and don’t realize that is a hallmark of someone who, if they’re going to come off of alcohol, they need medical supervision to do it.

Jill: And I think that’s where we’re coming from at this program, Breakthrough Addiction Recovery Hour, we’re coming from the understanding of the alcohol dependent person, and knowing that stopping sales at a grocery store, or a liquor store, is not going to stop that alcohol dependent person from finding their medication. And they will get in a car and they will travel to the nearest bar or restaurant and complete their medication regime and by the time they leave they will, if they don’t have the breathalyzer ignition, they will get in their car and drive home . . .

Brian: Intoxicated.

Jill: And that is what are concerned about, about limiting sales if you’re going to limit the sales, it just needs to be a little more logical. So I think the legislature is going to battle this out and people are going to take their sides in terms of morality and logic and studies, but what it comes down to, if you have a problem or have a loved one with a problem with alcohol dependency, it is necessary and it is very important for you to seek help.

Brian: And not only the fact that physically, but also from a psychological side too, we come to realize that as individuals become addicted to alcohol, the approach that we have at Breakthrough, we don’t see it as a character disorder, we don’t see it as they don’t have enough will-power as the reason they can’t stop drinking, that there really is a neurological reason and it’s a brain disease and that because of some lowering of the dopamine because they’re drinking so much alcohol, this is the reason why they can’t stop. I’ve heard it so many times in treatment, ‘Why can’t my loved one just stop drinking?’

Jill: Or ‘Why won’t they go into treatment?’ ‘Why are they so resistant?’ That’s what I hear a lot.

We are coming down to the end of the segment, Brian, and what I think we should do, we’re going to go into co-occurring disorders when we come back and talk about ADD, so please continue listening. I want to give you that number, 770-226-0920. Keep listening and we’re going to be right back.

Brian: Welcome back to the Breakthrough Addiction Recovery Hour. My name is Brian Fujii, and with me is Jill Mattingly and Dr. Neil Johnston and we just got done talking about some of the issues about how people move into chemical dependency especially in the area of alcohol and we have been continuing this discussion on co-occurring disorders, and that means an individual who not only has an addiction to alcohol or some other drugs, but who also has a psychiatric condition. It’s a person who may have depression, or they may have anxiety, or posttraumatic stress disorder along with their problems with alcohol or the drugs. If you’d like to be part of the discussion, we’d like to encourage you to call us at 770-226-2690, or if you’re outside the area give us a call at 1-888-920-2665.

So at the break we were getting ready to talk about how attention deficit disorder is another one of those psychiatric conditions that many times people will use alcohol as a way to self-medicate themselves and as a result become more and more dependent upon alcohol. So Dr. Johnston, what are some of the characteristics, or what is it about ADD that usually causes individuals to want to use alcohol or other drugs more extensively.

Neil: First let me talk a little bit about attention deficit disorder and it’s subcategorized into with or without hyperactivity. So attention deficit disorder is characterized by inattentiveness, distractibility, and impulsivity. It usually begins in childhood, definitely can last into adulthood, so children who had it often will have it as adults. Many people are able to compensate and learn how to function without treatment or without medication, so we don’t always see every child that has ADD or adolescent that has ADD, progress to being an adult with it, but often we do.

Jill: That was going to be my next question. Do most children progress into adult ADD?

Neil: I would say yes they do, but some of them have compensated with techniques to learn how to manage their problem. In fact, sometimes folks with ADD are especially good at certain jobs. I have interestingly enough seen people with very bad ADD be very fantastic computer operators and computer workers.

Brian: I think one of the statistics I looked at, they say about 60% of the people who are diagnosed with ADD in childhood usually carry that forward into adulthood.

Neil: That sounds about right to me. And as far as the substance abuse people will have, often times I see folks using stimulants or using cocaine to self-medicate. In fact if I have a patient who is an amphetamine or a cocaine abuser, I will ask them, “How does it affect you? How does it make you feel?”

Because for a person without ADD, it usually hypes them up, gives them more energy, stimulates them, but paradoxically for someone with ADD, it calms them down. They can even feel sleepy or tired from using cocaine or amphetamines. That’s highly unusual, so that can cause some interesting situations.

The other complications with ADD include people who are very intelligent who cannot achieve in school, who are told that they are dumb, or unable or feel that way because they are not able to complete their tasks or projects. That often leads to co-occurring depression and that’s where I would see the alcohol coming in a lot, as far as to sort of numb that pain. And in addition, that impulsivity, sort of poor judgment piece, ADD kids are likely to do things without thinking about it. Anything from jumping off the roof to try to fly – I’m being very serious and literal there – to experimenting with drugs. They’re going to be more likely to be novelty-seeking, wanting to do something of that nature, so the likelihood that they would experiment with drugs at an earlier age would be higher than someone without ADD.

Brian: One of the areas, as we take a look at how that over-stimulation occurs, we know that because of that many people are very creative. I heard they also have a great capacity to take very complex concepts and be able to almost distill them down to something very simple. I’ve seen this with some of my clients where they continue to be very functional but at the same time, have a very difficult time in paying attention to what’s going on in treatment, One of the things I look at too, the way that we treat individuals with alcohol dependency as well as ADD, is that it seems like from both treatment experience and also from the studies is that the cognitive behavior therapeutic approach is far more effective because it is something that’s more focused, it is something that is active, rather than more the passive, more psychoanalytic approach or maybe a Rogerian approach, it probably causes more frustration for them, so the more we can help them to work on particular skills, or help them develop certain types of approaches and give them some homework, it seems that they focus and follow through with those assignments a lot better.

Jill: This seems to be one of the areas in addiction treatment where it just makes sense to identify that underlying problem such as ADD or ADHD and get that taken care of either through a medication regime or as you know I like to do things a little more holistically at times, if we can use nutrition or exercise, but do something to get that under control and then bring in the cognitive behavioral therapy to help with the person’s thinking about life and walking through life – helping with the depression that may have come along with it. So an addiction treatment for someone with this co-occurring disorder, the multi- approach is so important. I can’t see it working, just someone going in and sitting for 30 minutes listening to someone talk and then leaving, how that’s going to change if we don’t get the ADD under control somehow.

Neil: There are now non-addictive, non-abusable medications to treat ADD. So if there is someone who has both.

Jill: Red Bull?

Neil: I was thinking more of one called Stritera and something called Vyvanse. But it looks like we up to a break again.

Jill: Yeah, we’re coming down to a break. I’m going to give you the number again, 770-226-0920. Maybe you’re someone struggling with ADD and want to ask a question or have a comment, please call in. And we’re going to be right back after this break.

Jill: Welcome back to Breakthrough Addiction Recovery. We are talking a little bit about co-occurring disorders, we’re talking about ADD and we’re going to talk a little bit more about that this segment, and once again, if you’d like to call and get in on the conversation, question, comment, anything about addiction you might want to talk about, 770-226-0920.

And I just want to refer you to our website, www.BreakthroughAddictionRecovery.com. We have a lot of information about all the different types of addictions, dependencies and issues, and if you want to do some heavy reading or light reading, it’s all there at the website, www.BreakthroughAddictionRecovery.com.Once again, Dr. Johnston is going to talk to us a little bit about ADD. We’re talking about the fact that the brain is under-stimulated, and that may be one of the foundational problems going on with a person diagnosed with ADD.

Neil: That is the current or accepted theory of ADD and it’s based upon the fact that stimulant medications, amphetamines and the like, tend to focus patients with ADD. You can have an ADD child who is literally bouncing off the walls, give them a dose of the medication and within an hour they’ll calm down, playing quietly, and even sometimes fall asleep. It’s amazing when you see that. That tests, if you will, the diagnosis, but that’s sort of the theory because give you or I stimulants, and we’re going to be bouncing off the walls from that.

Jill: The Starbuck’s, right?

Neil: Right. These patients, give them the stimulant and they calm down. And mentioning Starbuck’s, I’ve even seen patients who have tried, or have attempted to treat their attention deficit problems by drinking up to 3, 4 pots, not cups, pots of coffee a day. And that stimulant effect, while dangerous on certain other organ systems with all that caffeine, does tend to help them to focus.

Jill: You’re bringing up a little bit about medications and self-medicating, there’s a mother out there listening and she has an 8 year old, a 9 year old son, and he’s exhibiting the attention problems, he’s being talked to at school, and she’s about to take him to the pediatrician, but there’s a lot of things in the back of the mind. ‘If I get him on medication, will he be addicted to the medication?’ Because she understands that it will be possibly an amphetamine that he will be placed on in order to calm him down, and I can just see the wheels turning in her mind, ‘Am I going to addict my son to a stimulant for the rest of his life?’

Neil: I wouldn’t call it an addiction even if the child was on the stimulant for the rest of his life. Now will that child become chemically dependent upon the amphetamine? Yes. If they were to abruptly stop it, would they have withdrawal symptoms? Yes.

Now we do have other options right now for treatment. One called Stritera that is a non-stimulant medication. The nice thing about that medication is that when it is effective, it works 24 hours a day – it works constantly. And ADD doesn’t just affect school performance or work performance, it also affects social interactions. A lot of the other kids don’t like the hyperactive kid and will avoid them, so that impedes their development socially as well. Another medication that’