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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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism treatment, but also just through the medical side and also administrative side of addiction alcoholism treatment.

Lois: Thank you Jill.  I’m glad to be here with you guys.  I actually got into drug and alcohol alcoholism 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 alcoholism 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 alcoholism.  And the mental health grant that we had, we actually brought people into the center, we brought their families after they had been in alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism 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 alcoholism treatment.  Addiction has been around since Jesus was an alter boy and longer, but nevertheless, the alcoholism 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 alcoholism 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 alcohol detox or they’re being alcohol 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 alcoholism 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 alcoholism 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 alcohol 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 alcoholism 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 and Addiction

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 addiction, 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 addiction 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 addictions 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 drug or alcohol detox program that can really help individuals drug or alcohol detoxify off of the alcohol and get them engaged in our addiction 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 drug or alcohol 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 addiction 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 addiction treatment.

Brian: And a lot of people try to do that, where they feel they can just drug or alcohol 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 addiction treatment, ‘Why can’t my loved one just stop drinking?’

Jill: Or ‘Why won’t they go into addiction 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 addiction 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 addiction 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 addictionr, 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 addiction 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 addiction 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 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 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 addiction 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’s recently out called Vyvanse, is a stimulant, but it one that is made to attach to amino acid, your body then cleaves off the amino acid at a specific rate so that you can’t snort it, shoot it up, and get a high off it . . .

Jill: Like from Ritilin, and . . .

Neil: Right, and other medications. There is a lot of concern and rightfully so of students giving their medications to somebody else or trading off medications. So I would encourage parents that if they do have a child with ADD to make sure that they control the medication supply or ask for one of the longer lasting, extended release formulations so that they can give a pill to the child and be done with it.

Jill: You were mentioning Stritera and Vyvanse and what are the other ones?

Neil: There are quite a few. There’s Adderall, Adderall XR, Ritilin, Dextroamphetamine, there’s a whole host, Concerta, Cylert, there are a number of different medications. All of those are stimulant, amphetamine-like.

Jill: Really what it sounds like then, if the parent decides I’m not going to treat or allow the medication to treat my son or my daughter, there can be that they’re putting them more at risk for self-medicating with things like other stimulants which may start out as innocently as a lot of caffeine like you were talking about, now that they can get Red Bull and hyper-hyper-caffeinated drinks at the drugstore and the grocery store, but also that’s going to put them at risk for picking up and experimenting with drugs and alcohol.

Brian: Actually inhalants are one of the things that we find people using.

Neil: Kids are using all sorts of things like that that are incredibly dangerous neurologically to their . . .

Brian: And damaging to the brain itself.

Neil: So I would say that the risks of not treating ADD overall, including substance addiction issues are far less than the risk of the medications they are treated with.

Jill: I think that’s the most important point to get out there. If you are looking at doing something for your son or daughter, it probably would be much better for them to be treated by the professionals, the psychiatrists, rather then going out on their own and trying to find something to help them calm down themselves. Unfortunately a lot of people that come in are the 20-something, 30-something untreated ADD adults and they ended up getting dependent on another substance and that’s what we see them for when they’re 25, 28.

Brian: And I think too what’s in the research is that many times the difference in trying to understand ADD or maybe even someone who may have a bipolar disorder, they’re very close in some ways . . .

Neil: Incredibly hard to distinguish bipolar and ADD.

Brian: Especially a mood disorder.

Jill: Well it sounds like we’re coming down to the end of this segment. Hope this has been informative to you, 770-226-0920. We’ll have time for another phone call or two when we come back from this break. Stay with us.

Jill: 770-226-0920, that is our phone number. If you want to give us one last comment or call, we have a few more minutes left in the show. Thank you so much for listening in today. We’ve been talking about Sunday alcohol sales and we’ve been talking about co-occurring disorders for the about the past four shows. We’ve been discussing ADD today. We’ve been discussing depression, anxiety, and bipolar problems that people can experience and addictions that they gravitate towards because of those co-occurring disorders. All of these things are covered on our website – let me give that to you one more time: www.BreakthroughAddictionRecovery.com. And you can call our office, we are in Norcross, 770-734-8091. And we do offer free consultations. What that means is you’re listening to the show today and you have decided, ‘You know what? So-and-so really does have a problem with alcohol. I never really thought about it, but this has happened where they are stocking up, where they are having withdrawal symptoms.’If you want to bring them or maybe yourself into our office, it’ll be just about an hour long free consultation, you’ll meet with an addiction counselor, medical staff, and basically we kind of nail down what’s going and put out there a flexible way of treating the problem. Not everybody’s the same that walks through that door. It’s not a cookie-cutter addiction treatment facility. We look at the person and everything about them and what the problem is.So that’s what a free consultation at Breakthrough Addiction Recovery is all about. But what I was thinking we might do in these last few minutes of the show is just recap a little bit about the different co-occurring disorders and the addictions that people gravitate towards when they’re suffering from these undiagnosed, untreated disorders. Neil, we we’re talking about ADD today, of course we talked about that they gravitate towards stimulants because of how it calms them down.

Neil: In some cases, yes, in that case they’re self-medicating. They found something that’s helping them symptoms and going for it. As I said, other substances can easily be addictiond with ADD due their impulsivity they get high on something else and the reality is that getting high feels good so they continue to do it. And because of their impulsivity from the ADD, they’re not as likely to have the judgment of thinking ahead – what are the consequences of this behavior? Should I really go down this course, etc.?

And with the other disorders, it’s hard to pin down any one substance that is addictiond exclusively or predominantly by this illness subtype. Alcohol probably is the number one overall, because of it’s availability, because it’s legal, etc., but in bipolar disorders – that’s the same as manic depression – people often times will use stimulants when they’re down and then something to bring them down when they’re up, and when you get into all of this with someone who is poly-substance abusing, they start becoming expert little pharmacologists themselves. They’ll take cocaine, other stimulants, and then they’ll need to even that off. They’ll take some benzodiazapine and some alcohol on top of that. That gets them too down and they want to come up a little, they’ll tweak themselves and they become excellent at knowing just how much of this, and knowing just what to do. So it’s sometimes amazing to see that.

Jill: And with anxiety, that’s mainly going to be something that’s going to calm that down as far as the different neurotransmitters in the brain.

Neil: Yeah, I haven’t seen too many people with true anxiety disorders abusing stimulants or cocaine. That’s a rarity, because that makes them much worse, so I’ve never seen that.

I’d like to mention about the website, I particularly enjoy reading the blogs section of the website. There’s area there for lots of different comments or articles and you can comment there and put your input in the website there, also there’s a section for client testimonials so you can read what other people’s experiences have been. I’ve been with Breakthrough for about 6 or 7 months now, and I’m finding it to be one of the most flexible, easy-going, comfortable addiction treatment settings that I’ve ever worked in. I’ve been in addictions for 15 years.

Jill: So that’s great to know. And just knowing that you’re not treated like – okay, here’s an alcohol person, this is where they go, through that door – I mean everyone is treated very individually when they come through the doors at Breakthrough. Isn’t that right, Brian?

Brian: Absolutely. And again, we get so many calls here dealing with the free consultation, In fact, even at the break we had several that were listening to our show and wanted to do some consultation. Again, we do provide this free help in helping you decide how to get your loved ones into addiction treatment and also finding ways that we can work with them.

Alright, we’re right back to our time. We’ve come to a close and we appreciate all of you listening to us and we hope that you will be back with us next week.

Neil: Take care, have a good week.

March 22, 2008 - Bi-Polar Addiction and Co-occuring Disorders

Breakthrough Addiction Recovery Hour

3-22-2008

Brian: Welcome to the Breakthrough Addition Recovery Hour. My name is Brian Fujii and we have with us today Jill Mattingly, my co-host, and also Dr. Neil Johnston is back with us again and we’re very excited about this afternoon.

Jill: Happy Easter everyone out there, and thanks for joining us today on Breakthrough Addiction Recovery Hour and we are going to talk a little bit later on about bipolar, about co-occurring disorders. And before we go there, I do want to go back to last week again. We started talking briefly about the new legislation about Sunday alcohol sales. We had such a huge response from the listening audience. A lot of opinions out there about this.

Brian: Very strong opinions.

Jill: And it seems like it’s kind of laying low right now. There’s no new movement from what I’ve seen. So when there is, we will be talking about it on our show. However, there’s a couple of other things coming out in the news that you start to see this time of year and it centers on the subject of spring break, and revelry, and binge drinking which seems to be, unfortunately in some cases, a right of passage for several young adults. And I thought, let’s talk about that just for a few minutes. Maybe we give the young adults out there listening, or parents listening, some information about binge drinking and how to educate yourself or your loved ones about this.

Brian: And if you’d like to be a part of this program, we’d love to invite you to call in at 770-226-0920. If you’re outside the listening area, 1-888-920-2665 and join us. We’d love to have your input at this time.

Jill: Right, and so Brian, you have a little bit of a definition there on binge drinking.

Brian: Well, the formalized definition says, and we all know that once you give a definition it doesn’t necessarily mean that was the only definition, but usually the definition is having 5 or more standard drinks on one occasion. What’s the definition of a standard drink? Well it is a shot of whiskey, a glass of wine, or a 12 oz. bottle of beer.

Jill: So 5 beers is binge drinking? I don’t think that that is exactly what is happening down in Florida.

Brian: They do load up with 6-packs though, I don’t see many 5-packs.

Neil: I’m pretty sure that a lot of businessmen go to dinner and over the course of dinner and discussions have 5 drinks at one time. So the binge drinking we’re probably focusing on is more the pint of alcohol, the 10 drinks, 15 drinks, etc., not the 5 drinks a day.

Jill: Filling up your hat with beer and putting a straw into your mouth from your hat, I think that’s probably binge drinking if it’s continuous. But it can be pretty dangerous. In recent years we’ve heard a lot of tragedies that occur because of drunkenness, and unfortunately young women tend to get into trouble because of not being aware of their surroundings or because of the people that they’re with, and finding out that they have made a terrible mistake after coming to. So I think that binge drinking has been something that very much has been on people’s minds, especially if they’re packing up their young son or daughter to go down to Panama City Beach with the guys or the girls for the week. I’m sure there’s a lot of people out there thinking about this.

Neil: And there’s the other worry about absolute alcohol toxicity, where people die from binge drinking. The usual occurrence is that someone will drink to the point that they either vomit and remove the alcohol from their system or that they pass out and sleep it off. But if people are using grain alcohol, which is 100% alcohol or 200 proof, they can drink a sufficient quantity to cause themselves to pass out, to go into respiratory depression, possibly vomit, aspirate it and choke to death from that or just from the respiratory depression from the alcohol itself. So alcohol poisoning is a real concern, both on college campuses during the rest of the year and during spring break when people are drinking more heavily.

Jill: So it’s not just accidents that can occur more readily, but obviously it can be a physiological problem that can happen too. I was reading a little bit about binge drinking in the last couple of days and some people look at it as possibly a reversal of seasonal affective disorder. I think that’s kind of interesting because seasonal affective disorder, Dr. Neil, can you give me a little bit of background on that?

Neil: Well seasonal affective disorder, or SAD, is a depression that typically happens more in the northern latitudes where people become more depressed as the days become shorter and shorter and shorter. And as the days lengthen, people’s moods do generally elevate and improve. Now one thing that would support this hypothesis is the fact that when this occurs in the more northern latitudes, say in Alaska and in the Scandinavian countries, and during their summers they have prolonged periods of sunlight, some of them can actually become manic or hypermanic, their judgment can be impaired, they can be more energetic, they can feel that they’re more invincible. So that might correlate with people drinking more, but also just the environment . . . it’s beautiful outside, you’re outside enjoying yourself with a cocktail in-hand.

Jill: Kind of like a teenage point of view – no parents, nobody telling me what to do, I’m just going to behave accordingly because I’ve been under a lot of pressure in college, school, or something like that. But we do want to encourage you to really think about the changes that can occur with binge drinking. Of course the possibility of alcohol poisoning, but also in looking at some of the research out there, there can be brain changes that occur when an adolescent or young adult is drinking heavily, like say they’re doing it every weekend, like because they are in a fraternity of something like that, that there have been studies that show that they can actually harm the part of the brain, the hippocampus, that is actually important for memory and memory formation. It doesn’t seem to affect them as terribly with sedation and motor control, however the memory is affected. So this could go on into adulthood that there is a problem with memory formation because of damage to the brain from binge drinking. And you had another interesting point about binge drinking and memory also, Neil.

Neil: People don’t realize that the human brain continues to develop and mature well into the early 20’s, so alcohol or any other drug that impairs the functioning of the brain may interfere with the maturation of the brain ultimately. So doing damage to someone when they’re in their prime developmental years is obviously not a good idea. They can recover from it better than older folks, but they’re more susceptible than older folks as well.

Another issue that’s been on the national news recently about binge drinking, is the controversy over people considering trying to lower the age back to 18 for alcohol consumption. It’s something that I feel has always not made sense, that you can be 18 years of age and vote, drive a car – which can be a deadly weapon, especially for some adolescents – and go to war and be subject to all the violence and trauma there, but you can’t legally buy a beer. That just always seems very ironic to me. But the people who are now talking about changing this are hoping that if they lower the drinking age to 18, that college students would then go out to a bar, out to a party, drink legally and not have to do what they’re doing now which is often times stocking up on alcohol, drinking very, very heavily before they go out so that they can be drunk, buzzed, and then go out and then not drink because it’s illegal.

Brian: That sounds like a very interesting point of view and we’ve heard many of those types of argument about lowering the drinking age, if this is a topic that is of deep concern or of interest to you, give us a call at 770-226-0920 or 1-888-920-2665. Jill, it looks like we’re coming up to a break here in a few minutes.

Jill: I do want to say something to Neil just for a minute, and I bet you do too, I taught high school a long time ago and I had 18 year-olds in my class, as seniors, and I don’t know if I’d like to go back to seeing them go out in their jacked-up cars and all that and buy their 6-pack and be going down the road that I’m going down. I just knew too many 18 year-olds who had very poor judgment, and yes they can be drafted into the Army, but still . . . I don’t know Neil.

Brian: Okay, we’re coming up to the break. This sounds almost like Crossfire. So if you want to be part of the discussion, give us a call, 770-226-0920 and we’ll be right back.

Jill: Welcome back to Breakthrough Addiction Recovery Hour. My name is Jill Mattingly, and I’m here with my co-host, Brian Fujii, and our Director of Psychiatric Services, Dr. Neil Johnston is joining us in the studio today. And we’ve been talking a little bit about some interesting subjects, one of which we were talking about before the break about the lowering of the drinking age back to 18 years old and how that could possibly result in a little less problematic behavior.

Neil: I would ask you in retort Jill, let’s say 18 year olds that you don’t feel are responsible enough to drink – and I agree that there are plenty that aren’t, and there are plenty of 20, 30, and 40 year olds that aren’t responsible enough to be drinking and I don’t want them on the highway either, but if that same 18 year old that’s not responsible enough to buy beer and drink, are they responsible enough to be voting on who’s going to be the leader of the most powerful nation in the world? Are they responsible enough to go off to war and make the decision to risk their lives? Are they responsible enough to do all of those things? We can’t do a responsibility test on every individual. So I think we agree ultimately that excess drinking is bad, drinking in moderation is obviously going to be less likely in immature younger people, but where do we draw the line? And that’s something that we could argue about forever.

Jill: Well, I think what I’m going to do right now is give out the number, because if anyone else wants to get in on this discussion or conversation . . . I still do believe that Mothers Against Drunk Driving agree with me that 21 has seen an improvement in highway fatalities and things like that, but I do see your point too. Our number . . . 770-226-0920, and if you would like to call from outside the listening area, 1-888-920-2665. We have a website. We’re not talking about underage drinking or what the drinking age should be on the website, but it is full of information about drug addiction and alcohol dependency, and that website is BreakthroughAddictionRecovery.com, and if you’d like to call us, please do. And Brain, do you have a dog in this fight?

Brian: No, I was very nominal when I was going to college at that time. I think Coca Cola was the only thing I really drunk. Sad isn’t it, sad. Well one of the interesting things about binge drinking, and I noticed one of the statistics that you had shared with us is that it indicates that a lot of folks that have been doing a lot of binge drinking also have a lot of mental health disorders, like compulsiveness, or depression anxiety, and we see a lot of that in the people at our clinic, especially those that are really struggling with alcohol.

Look, we have a call in from Rick in Marietta, Welcome Rick, to the Breakthrough Addiction Recovery Hour.

Rick: Hey guys, I’m 50 years old and I’m just sitting here listening to your show, thinking how when the drinking age was 18, that was when I was first able to go out and buy alcohol. And I used to go on spring breaks . . . we used to go to Ft. Lauderdale rather than Panama City back in ancient history. But binge drinking was when you tried to down a whole pitcher of beer all at one time or what we called punch-punch, when you tried to kill a large quantity in a short period of time. This having 5 drinks, I thought binge drinking was just trying to zap yourself in the shortest period of time possible.

Neil: Well Rick, I agree with you. We academics and we intellectual psychiatrists, we get together and put these arbitrary definitions down, and that’s the professional accepted definition for binge drinking in what we call our statistical manual of diagnostic criteria, but what we’re talking about as far as the college student on spring break is what you’re saying, the drinking of grain alcohol, is incredible volumes of drinking, so that really is what we’re talking about when we say binge drinking.

Rick: Well it is dangerous to drink that much because I can remember, the worst thing that ever happened to me is to get drunk and throw up, but I could remember seeing some people get really sick especially when they would mix different types of alcohol and that’s what my concern is. I hear these stories now about people drinking wine and beer and liquor together, and that’s just under no circumstances, is that a healthy thing for any young person to do.

Neil: Well your body was doing what is healthy by causing you to throw up. We appreciate your call and your comment, and we’ve got other callers, so thanks Rick for calling.

Rick: Thanks.

Jill: Hey, it looks like we have Bill in Marietta. Hey Bill, welcome to the Breakthrough Addiction Recovery Hour.

Bill: My pleasure, very interesting program. I’m a 67 year old father of 3 boys, 2 of which were permanently damaged in drunk driving accidents, and you would think I would be against alcohol in most any form for what we’ve suffered, but the interesting thing was that both my boys were teenagers when they were in the accidents and the harm to them was caused by drunks who were in their 20’s and 30’s. And so it kind of causes me to pause before I have a generalistic view about it, but it came to me conceivably that when we’re talking about the paradigm that’s always used in this discussion . . . are we old enough to sign up for the draft, vote for president, and so on. Those usually are decisions that are made at a conscious level with a lot of thought. My concern is that youngsters, and I think automotive surveys will show you that you don’t have a risk assessment capability until you’re somewhere around 25, fully matured in that ability. But when you’ve had 2 or 3 drinks and you’re down on the beach, your decision-making is impaired. So I think the fact that we’re talking about decision-making, whether it’s valid or not, when you’re sober it’s valid, so those other two areas of argument are ones when they have the best of their faculties to their utilization but when they’ve had 2 or 3 drinks and peer pressure, it’s a totally different story.

Brian: Absolutely, I really agree with that thinking process because when a person is under the influence, and then driving, and them making the other kinds of activity decisions, this certainly is something that’s different than when you’re logically thinking about who to vote for or whether you’re going to sign up for the Army, Navy, or Air Force, or Marines, that’s certainly done on a conscious level and I really understand that. I believe that there is a difference between conscious decision-making when you’re clean and sober versus that when under the influence.

Neil: Bill, and I want to say I’m so sorry for your losses, for what you’ve been through, and I agree with you on a lot of that as well, but before you take that first drink you also have that responsibility to decide whether you’re going to take it or not. And to designate a driver and do all of those types of things as well.

Bill: I agree with you. Good comments, great show, I’m listening to it intently, and I think these are issues of major importance.

Brian: Thanks, Bill. Hey, we’ve got another call. John from Marietta. Welcome to the Breakthrough Addiction Recovery Hour.

John: Hey, how ya doing. I appreciate you talking about this topic. I grew up in New York, an Irish-Catholic family, both parents alcoholics, extended family alcoholics. My mom ended up taking her own life in her 60’s, about 10 years ago, and I actually have the perfect example of why not to drink and I never have really. Once in a while I go out and do a shot or something, but I saw my mom who grew up in the south and never had any emotional or mental illness at all and then started drinking more being around my dad’s family. The whole had this problem. I moved down here about 15 years ago. My father’s family was very wealthy and my mother’s was very poor and the way the alcoholism ran across and I work in a high school now and I see – we just had a prom last week – and I see these kids and how they came to the prom lit up. Like the other gentleman said, it’s a different situation when you’re drinking, you’re judgment is impaired. I tell some of the kids where I teach about the things I went though as a child and sometimes it scares them a little, sometimes they laugh it off, with car wrecks and things, the way it destroys families and things. I wouldn’t be here today if I was drinking.

Jill: And you’re talking about coaching, and I was a high school teacher back when, and I remember a lot of times I said things or just made comments about things and I know that they were listening and I know they wanted to be the person that I saw them as. And so I really do appreciate that you are living your life in front of these young people and letting them know where you came from. I think that is huge because they’re dealing with peer pressure when they leave your classroom, when the leave your field.

John: They don’t see things the way we did though. I’ve got three children, and they don’t see things the way I did. I’m sure a lot of these kids have the same problem.

Jill: Hey John, we are coming down to the end of the segment and I think that is an excellent statement. Thank you so much for calling in. We’re going to continue talking a little bit more about this – this is obviously a very intense topic. But thank you so much for calling. And we’re going to be right back – stay with us.

Brian: Welcome back to the Breakthrough Addiction Recovery Hour. My name is Brian Fujii, and I have with me Jill Mattingly and Dr. Neil Johnston and we’ve been having a lively discussion here this afternoon, especially as it comes to the issue about lowering the drinking age, but one of the things I’d like to segue into is, we’ve said some of the studies indicate that when people get into strong binge drinking that it has some very severe mental health consequences and we begin to see people with high compulsiveness and depression and anxiety and of course what Dr. Johnston also said, alcohol poisonings, and there are some big issues tied around here. And we kind of want to look again at how alcoholism really impacts the body as well as the brain and of course we have a lot of this information on our website at BreakthroughAddictionRecovery.com. If you would like to be part of the discussion, give us a call at 770-226-0920.

One of the things I see, Dr. Johnston, is many of our clients now seem to be having issues with alcoholism and bipolar disorder. And I do know that one of the big issues, especially in being able to accurately diagnose bipolar disorder is that we have to find some way to get them clean and sober so that we can really make an accurate diagnosis. How is that issue when a person is coming in, maybe they need some drug detoxing, but they’re experiencing maybe some mania and when they finally begin drug detoxing, I’d see some severe depression. How do we make that distinction whether it is just alcohol induced depression, or maybe they’re experiencing bipolar?

Neil: Well that’s a very good question Brian. It is a difficult decision to make in that, which came first – the chicken or the egg? Indeed, the alcoholism or the bipolar disorder. Bipolar disorder just so happens to have its age of onset in late teenage to early 20’s, the same time where the drinking for many people is starting out.

What I tend to is try to ask the patient about their history before they were using alcohol on a regular basis and see if I can glean anything from that. If I can and can substantiate a diagnosis of bipolar disorder, I will go ahead and begin addiction treatment for that while we drug detox them and get them off the alcohol. If once they’re off the alcohol and their moods have evened out – and by the way for those of you listening for the first time, bipolar disorder means “two poles” and it’s synonymous with manic depression – just so you’ll know what we’re talking about there. So I will treat both – drug detox the patient off the alcohol or other substances and treat the bipolar disorder at the same time. If they get better with regards to mood swings from the bipolar disorder, then maybe we’ll pull them off the addiction treatment for bipolar disorder and see how they do off the alcohol and off the bipolar. Bipolar disorder can be such a dangerous disease in some people, I don’t want to leave that for 6 weeks of sobriety just to see if it’s still there, not to mention that it may impairing their ability to stay sober. I think we have a phone call, Jill.

Jill: Yeah, looks like we have Arthur in Atlanta. Hey, thanks for calling the Breakthrough Addiction Recovery Hour.

Arthur: Hi. You talk about youngsters drinking and driving, and you say that they’re not really old enough to make a decision about whether to drive after they drunk or not. Well, these same 18 year olds have going into the military and they’re making that decision at 18 years old, and I’ve spent 20 years in the military both during the draft period and after the draft period, and you watch one of these 18 year olds bleed out after a fire-fight or in a battle zone and there’s nothing you can do about it. And this same kid can’t buy beer legally in some states. I fail to see where there’s a difference between them being mature enough to make the decision to join the military and fight for this country and die, and being mature enough to decide whether or not they want to drink.

Neil: Well you know Arthur, that is exactly the debate that’s going on right now. The legislators are looking at that and people are weighing their opinions on it and in both directions.

Arthur: I feel like if you want to deny them the right to drink, then you should deny them the military at 18, wait until they are 21 before they go off and decide to die for this country as well. Okay, I’m going to hang up and listen to the discussion from this point.

Brian: Thank you for calling, Arthur. When you take a look at the ability for people to make that kind of decision Arthur, about going to war and being able to make that decision to drink, we have to take a look at the way that the mind is being influenced, and I know we have some issues about being able to drink versus being able to go to war, but we also know that so many times, as people tend to drink at an earlier and earlier age, the tendency is that their emotional decision-making process seems to take over more so than probably their logical thought process. And that is always a challenge. There’s not going to be a clear-cut answer to this. That’s why it’s an ongoing concern, and again that’s just my opinion and I certainly know we have others.

Neil: I’d like to comment that we’re coming on a break right now.

Jill: Yeah, we’re coming on a break. Let’s make some more comments when we come back after this break. Stay with us, interesting information coming.

Jill: Welcome back to Breakthrough Addiction Recovery hour. My name is Jill Mattingly, and my co-host Brian Fujii, and we have with us Dr. Neil Johnston, and we’re having a pretty lively discussion and there was another comment I think Dr. Johnston, you were wanting to make for Arthur.

Neil: Yes Arthur, and I do appreciate what you’re saying about the thought that we should wait until people are 21 to allow them to make such an important decision in their life, but for so many people when they are 18 when they graduate from high school, the military is their career choice, and they want to make their life and they go into military wanting to serve their country and I personally think that they are responsible to make that decision. If they are responsible enough to make a decision of which college to go to, I’m saying I think they’re also responsible enough to make a decision about whether to drink a beer. I’m not in any way trying to suggest that we should hold off on the military, but I do understand where you’re coming from and why you’re saying that, because it would have to have been hard to be where you’ve been and go through what you’ve gone through.

We were also talking about bipolar disorder . . .

Brian: Right Dr. Johnston, and one of the things that might be helpful for our listening audience, is we understand that it’s “two poles”. One is feelings of mania and then also feelings of depression. Could you help us define what would be some manic types of behaviors that loved ones would be absorbing, possibly this might be the first time, because we know between like it’s like 18 years old maybe up to 25 or 26 they actually begin to find this being manifested. So if someone is out there with some young family members, what would be some behaviors that they might be observing that could be defined as that?

Neil: Sure, and let me throw out that bipolar disorder can occur even as young as childhood, so that’s just the peak time of incidence of bipolar disorder. But mania is defined as someone who is having expansive, or elated mood, or irritable moods. Those are sort of the threshold symptoms that have to be there. And then some of the other symptoms that people will have are increased energy, decreased sleep, feeling grandiose – in that they are very special in some ways – they’re more talkative, their speech is also very pressured, very fast, sometimes they’re sleeping less, their thought processes sometimes don’t make sense, they will jump from idea to idea to idea and no one can follow what they’re talking about. Sometimes also they will have increase in goal-directed activity, such as working harder, doing more activities at home, cleaning the house, etc. Sometimes they can get caught up into risk-taking or dangerous behaviors, such as excess spending, speeding on the highway, things of that nature. All of those things are tied up in a manic episode. And also we talk about hypomania. The difference between mania and hypomania is that mania is much more severe and tends to interfere with every aspect of life in a very severe way, whereas hypomania tends to interfere with functioning, often times more so with family or mildly with jobs where the individual can be irritable because they’re is talking so much or because they are a little bit more boisterous, etc. So those are roughly some of the symptoms and some of the definitions there.

Brian: That’s great. And again even when people start to feeling that depression, they can be having lack of interest in a lot of things that normally meant something for them, we call it “anhedonia” where they’re not really feeling happy about anything, they start feeling a sense of worthlessness or helplessness. If someone is experiencing some of this, then some of these characteristics could possibly, not that it means definitively, but possibly could be issues of a bipolar disorder. I know our time’s getting real short, but what are some medicines that typically could help an individual who is struggling with this?

Neil: We have a whole gamut of medications. The classic ones are Lithium, Depakote, we don’t always start with those anymore, but Lithium really is the gold standard. It probably works the best. It also has a lot of side effects – can cause damage to certain organs, have to monitor blood levels, etc. It’s a little bit harder to work with. Other medicines include Tegritol, a newer one onto the market is Lamisil that’s showing quite a bit of promise, and the Depakote, Lamisil, Tegritol are all anti-convulsive medications. The theory behind those medications are that they may lower the seizure threshold, or the level at which the brain may experience a seizure at deep levels of the brain which might be affecting those states. Another group of drugs are called atypical antipsychotic drugs, such as Seroquel, Geodon, Risperdal, Abilify. This whole group of medications also helps to stabilize moods and if bipolar disorder has gotten bad enough, and occasionally it can where the patient becomes psychotic and beings hearing voices, seeing visions, etc., it controls those symptoms as well. Studies have also shown that using a medicine such as Lamisil or Lithium or Depakote along with one of these atypicals, improves people’s long-term wellness, because they stay well from the illness longer than just the Lamisil, Depakote or Lithium alone.

Jill: Okay, so when people are coming into Breakthrough Addiction Recovery and they may not even have a diagnosis of bipolar and what are some of the things that you see – I’ll just toss this back to you Dr, Johnston – what are some of the substances that they tend to gravitate towards? Alcohol? Prescription drug use? What?

Neil: It depends on the stages of whether they’re manic or depressed. In the manic stages often times some sort of downer – alcohol, benzodiazapines, things of that nature. In the depressed stage sometimes it will be cocaine, or stimulants. Now throughout all of this, we see alcohol being used as some sort of numbing agent no matter which state they’re in. So it can be any one of the drugs at any time, but that often times will be what they’re doing when they’re trying to treat themselves.

Brian: Well Jill, it looks like we are coming to our last break here. And if you are interested in joining us in this discussion and you might have some questions or concerns to express to Dr. Johnston, give us a call here at 770-226-0920. And we will be right back.

Jill: 770-226-0920, that’s the number to call if you’d like to do one last comment about our show today. It’s been pretty lively here at Breakthrough Addiction Recovery Hour. And we were talking about bipolar disorder and some of the problems with addiction.

Brian: That’s right, Jill. And we had wonderful information here from Dr. Johnston about wonderful new medication that we have in to be able to help people who are suffering from the mental illness of bipolar disorder. We know it’s a very destructive and a disease that disrupts lots of lives, and with the medications we also provide other support systems at Breakthrough Addiction Recovery. We provide things like individual therapy, group therapy, and also a very intensive day addiction treatment program that really helps people understand the disease process of alcoholism and also integrating that with the information related to mental illness. We do know that if people are not addressing both of these issues – the alcoholism or drug addiction along with taking the right medications for their mental illness that usually that’s not going to work very well because so many times people are using their drugs or alcohol to self-medicate and to avoid those very, very uncomfortable feelings.

Neil: And Brain, that’s a pattern that a lot of people have that they continue even into addiction treatment. They continue trying to self-medicate and make the decisions for themselves, feel better and stop taking their medicines. Frankly, if you don’t do what your doctor says, don’t work the program, don’t invest yourself, then you’re probably not going to get better. You got to make a person commitment to do what you need to do.

Brian: Absolutely. And that’s the real challenge that we as therapists have, is constantly trying to remind them that when they come in, ‘Oh this medicine is not working,’ or, ‘I feel real miserable,’ and what we need to say is hey listen – you got to give the medicine some time. And we do know that that is the case with these medications don’t just take perfect action immediately. We really have to educate our clients and help them under that the medication is going to work – you have to give it some time, you may have some side effects, that’s what we need to find out.

Jill: And you think about it, they’ve been drinking alcohol for an immediate effect, to help to medicate the mania or something and then you give them a medication and tell them it may not work for 3 or 4 weeks, you’re dealing with someone that’s going to be at a high frustration level for quite some time. And that makes it a challenge for not only the medical personnel dealing with them, but also the clinical, the therapists.

Brian: Yeah, because we try to help them understand it take time.

Jill: And the family.

Brian: Oh absolutely. How many times do we have family members coming and saying how much longer is this going to take to work?

Neil: Not to be flip, but if we had a pill that worked overnight, we’d all be on an island someplace in Fiji, we wouldn’t be here.

Jill: I really do want to encourage family members, if you are noticing these symptoms that Brian and Dr. Johnston are talking about, it is well worth it to get your loved one to investigate and see if there are some underlying mental health issues going on, and it could be in a young person like we were talking about, you know they’re binge drinking, they’re doing at-risk behaviors, they’re doing things that just seem crazy. But there could be an underlying problem. And that brings us to a good subject we could do next week, which is ADD. I think a lot of parents are out there going, ‘Oh yes, oh yes. Let’s talk about ADD. I need to hear more about that.’

What would you say about that? Would you want to do a show like that?

Brian: We definitely could do that. And again, you’re so right about the way that people are looking a their loved ones and trying to figure out what is happening to them and because at Breakthrough Addiction Recovery, we do offer a free consultation. Because I know people are listening today and they’re going, ‘You know, that’s just sounds just like one of my loved ones out there. I don’t know what to do.’ I get this call a lot. ‘What do I do?’

Bring them in, let’s get a chance to do a free consultation. Let’s get them appropriately screened. Let’s find out what’s going on. And then we can help them provide the right types of support, maybe the right kinds of medications to get them back on track and really help them get their lives back. And again, we have some great information at our website at BreakthroughAddictionRecovery.com, and you can reach us at our local office at 770-734-8091.

It looks like we’re coming to the end of our show, Jill.

Jill: We just want to say from the family at Breakthrough Addiction Recovery, happy Easter, have a wonderful time with your loved ones this weekend and enjoy this fantastic weather.

Neil: And this is a family at Breakthrough Recovery. Anything that Jill and I have said to each other today is all in fun. We’re just trying to get people involved, get them to call in and ask questions.

Jill: Well tune in next week. We’ll be back at 3 o’clock next Saturday, we’re probably going to talk a little bit about ADD and whatever else is in the news that might get people to get in on the discussion.

Brian: See you next week, and thanks for listening.

Jill: Yeah, happy Easter!

March 15, 2008 - Pending Prescription Drug Legislation

Breakthrough Addiction Recovery Hour
3-15-2008

Brian: Good afternoon Atlanta and welcome the Breakthrough Addition Recovery Hour.  My name is Brian Fujii and I have Jill Mattingly as my co-host and we are looking out that window trying to look out for those tornadoes.

Jill: Yes we are.  We’re on the 7th floor out here in Buckhead, and so obviously we are watching this window.

Brian: We all are, very closely.

Jill: Actually during this radio show the National Weather Service will be breaking in if there’s any new warnings and watches so you can stay with us here and be right up to date with what’s going on and we actually have two TV’s going on right now in the studio that we can be watching and warning people if we see something and if they haven’t broken in yet.  Isn’t that right Gene . . . he’s our engineer.

So, interesting day today, but we have some great topics to hit and Dr. Neil Johnston, he’s our Psychiatric Director over at Breakthrough Addition Recovery.  He’s going to be joining us by remote after the first segment and so stay tuned for that too, right Brain?

Brian: That’s correct, and we’re going to have some interesting ideas about this new law that they’re trying to pass here in Atlanta or really Georgia, across the board.  We’re going to see about getting alcohol sold on Sundays.

Jill: Yes, and you know how I love to do the news, I’m a news junkie.  So I have been following this story and actually they have had two large sections in the AJC devoted to this the last 2 or 3 days and it is about the legislation that’s been revived to try to do away with so-called Blue Laws.  I wonder how it came up with that name, Brian, do you know that?

Brian: No, but maybe someone in our audience can tell us.

Jill: Or maybe Dr. Johnston may know also.  He knows all those little details.  But anyways, they are trying to do away with this.  They tried to do away with this before . . . it was voted down . . . but it just got out of committee, now it’s probably going to go to the vote of the Georgia legislature, and basically I’ve been following some blogs talking about the pros and cons . . . you know, why people are for keeping the law of no Sunday sales and why people are against it.  And it’s very interesting.  I’ll tell you some of the things I’ve read.  The people that are against doing away with the law are just basically saying the obvious.  Alcohol is a dangerous intoxicant, it’s a drug.

Brian: Right, and also causes more damage to the body than any other drug known.

Jill: Yes, exactly, and maybe less access really will help.  And it will help people not succumb to using the alcohol in a manner that is going to damage them.  And that brings us to decreased impulse buying.  If it’s not available and you’re not likely to pick up a 12-pack.  This is also kind of the thought of Mothers Against Drunk Driving.  They are very much against repealing this law on Sunday.  However, the other side that is talking in the blogs are like, ‘Well this is like the most old-fashioned thing that I’ve ever heard of.  Why do a bunch of preachers need to tell us that we can’t drink on Sunday?  And it’s not necessarily that they can’t drink, it’s that they can’t buy the alcohol.  And the other thoughts that they have is that it’s legal all the rest of the week and what about personal liberty, where I can choose whether I am going to buy alcohol or not?  Why does the government have to step in and tell I cannot buy alcohol at my grocery store on this day? What is the problem with that?’

So these are like the two sides.  I’ve been watching the blogs and the comments online . . . very, very interesting.  So, we’re just talking about what the law says right now.

Brian: The law basically states that we can use and purchase alcohol every day of the week except for Sunday.  But the odd thing about it is that although you can’t buy individual bottles of beer or wine on Sunday, you still can purchase individual drinks at restaurants and bars.  That sounds so contradictory.  And yet we do understand that they can’t even buy alcohol over the internet and have it delivered to their home.  And so we find out that there are certain kinds of laws that seem to be in contradiction to each other, but you know, I think one of the key things that we’re hearing is, if we can limit it a little bit, at least maybe it gives some people the time to think, ‘Do I really need this drink?  Do I really need this every single day?’

Because we do know that, especially in the work that you and I do Jill, that many time when people move into this area, they begin saying, ‘Hey, I’ve been drinking every day, and not just drinking, but drinking heavily.’

Jill: Yeah, and this may be a little bit of the obstacle that can help.  I want to go back to the thing you said about, that they can buy the drink.

Brian: Yeah, you can’t buy it in the store, but you can go to a restaurant or a bar and actually buy the drink.

Jill: Well that just seems like the opposite there.  Why are they saying you can’t buy it in a grocery store but you can go next door into a bar and buy it by the drink?  Well, you know this makes me think about the last few years that I’ve been working heavily in the addiction field and knowing what it’s like for some of these patients that have alcohol dependence.  Tell me Brian, how many people out there do have the severest form of alcohol dependence?  A lot of people use alcohol, some addiction, but what about the dependency?

Brian: That’s a good point you bring up, Jill.  The research indicates for those that actually experiment with alcohol or other drugs, only about 5-7-10% of the people actually become addicted to that drug of choice.  So it’s not like everyone who tries alcohol or other drugs actually become addicted, or what we call dependent, where there’s tissue dependence with people actually experience tolerance, where they take more and more of the substance to feel the same, or go through withdrawal, and then they’re needing it.  If not, they’re going through some kind of physiological reaction to it, and of course continuing to do the behavior despite the negative consequences.

Jill: Exactly, and so if that person that has that severe dependency, has not stocked up for their Sunday, what I understand about alcohol withdrawal and what I’ve seen in different patients, after 8 hours of not having a drink, they’re going to start experiencing some of the alcohol withdrawal symptoms, so what is that person going to do at one o’clock on a Sunday afternoon?  What they are going to do is get in the car, now they’re not going to go to the Publix and buy a sealed bottle of wine and bring it back home and drink it, now they have to buy it by the drink.  So they’re going to go somewhere, sit at a bar and they are going to take in their prescribed amount, because it is almost like a prescription now, because medically they’re treating themselves with alcohol to not go through withdrawal.

Brian: And that’s why we call it self-medicating.

Jill: Yes, exactly, and so what we’re looking at is that the contraindication here, it’s not letting them buy it at a grocery store or liquor store, but they sure can go to a bar and buy as much as they need by the drink and then go out and hopefully have the foresight to not drive there and take a taxi.

Brian: And I think that’s a powerful piece you bring up, Jill.  And that is we are looking at this potential road hazard for a person who really cannot control his drinking.  And therefore feels it is required for them to go and get this drink and then drive home even with the open container, or to be actually drinking while they’re driving.

Jill: When you want to take the high ground and say let’s just have one day where we don’t have alcohol for sale, and I’m right in with that crowd also but the more I know about the brain disease called alcoholism or alcohol dependence, the more I’m like this doesn’t make sense.  If it’s going to be available, then the person who is heavily dependent is going to seek it out where it is available, whether at a friends, house, or at a bar or at a restaurant.  And so they need to understand this as a disease and then legislate properly.  But we’re talking about the legislature.

Brian: We are, and we’re not legislators.  But as we take a look, I think the key is what you just said.  It is a disease, and we as addiction treatment providers, we have to work with those individuals, regardless of what the law says, because we do know that individuals who come to us, whether they buy it 7 days a week, 5 days a week, or 6 days a week, the point of the matter is they are dependent on this drug called alcohol, and it’s producing significant amounts of damage. 

Jill: Right, and it looks like we’re coming down to the first break.  And when we come back, we’re going to have Dr. Neil Johnston joining us by remote and we’re going to talk a little bit more about this issue and you might have an opinion, an opinion about what your legislature is going to vote.  If you want to call and get in on this conversation and give your opinion, maybe talk a little bit about the history of what’s gone on in Georgia with this law, we would love to hear from you.  It is 770-226-0920, and we will be right back.
Brian: Welcome back to Breakthrough Addiction Recovery hour.  My name is Brian Fujii, and Jill Mattingly is our co-host, and I’ll tell you what . . . the phones lit up during the break.

Jill: Yes they did.

Brian: And we’ve got a call in from Kevin in Grant Park.  Welcome to the Breakthrough Addition Recovery Hour, Kevin.

Kevin: Great, been loving your show so far.

Brian: I hear you may have an answer for us about blue laws.

Kevin: Yeah, and it’s funny because I’m kind of embarrassed that I know it, but I know that this comes from a guy named Samuel Peters, and he wrote “The History of Connecticut” and he also was a historian that wrote a lot about the Puritans in New England, and that the original term “blue law” came from one of this books where he kind of made it up out of whole cloth.  But there was a disparaging term for overly religious Puritans at that time, they were called “Blue Noses”. 

Brian: Blue Noses . . . I’ve heard of blue-bloods, but never blue noses.

Kevin: In the 18th century it was a common disparity, if you wanted to insult someone of higher moral fabric you would call them a “blue nose” and hence when he wrote his history it became “blue laws”.  But it didn’t only deal with substances, it also dealt with morality.

But my question to you guys, and I’m glad you’re being very fair about this, and as we are only one of the 3 states left in the 50 states that still have these Sunday laws, and I think it is fair to say this is a failing on the part of our legislature because I remember hearing the governor last week stating that he didn’t care if the will of the people, meaning that if there was a petition and the majority of the people voted to roll back the blue laws, Purdue personally stated that he didn’t care because he thought it was his moral obligation that there would be . . . now I can’t source it, but I know that I heard it on one of the other talk shows, and it bothered me because here is a guy who was publicly praying for rain a while back, which is a little bit embarrassing to me as a Georgian.

Jill: Well look, it’s raining outside now though.

Kevin: Well, I guess he got the job done, it went through the post office.  But my point is I think you guys are right in pointing out that all this does is put more people who need to drink, not that want to drink, but that need to drink, on the road.  Because believe me, any of us that have known some hardcore drunks know that the people who want to drink alone, that have these substance addiction problems, they’re not social drinkers.  These are the people that, if given the opportunity, would go get their 12-packs and crawl back into their home and wouldn’t be a public hazard.

Jill: Yes, exactly.  And when I was reading blogs on the pros and cons on this legislation, and you see people type out legislating morality, and people throw that out there all the time, and I appreciate you saying this is logical, we’re just trying to bring into it the scientific basis.

Kevin:  There was talk shortly before the Olympics that this came up, because people were a little nonplussed that the world would be visiting here and on Sunday they wouldn’t be able to buy beer and there was talk that within the city and where the venues were, they were going to roll back the blue laws but it still didn’t happen.  That’s one heck of a grip the Southern Baptists have on the legislature.  But I think a lot of this also has to be the hospitality industry, they must have some really good lobbyists, because they’re the ones getting the benefit.

Jill: Yeah, the Atlanta Business Chronicle was very, very adamant about how they were talking about this legislation, but Kevin, we have a bunch of other calls right behind you.  But Kevin, you have been absolutely wonderful and thank you Kevin, for clarifying “blue laws” for the blue noses.

Brian: We appreciate the information,  Keep listening.

Jill: Okay, we have another call?

Brian: We do. We’ve got Alan from McDonough, and Alan, welcome to the Breakthrough Addition Recovery Hour.  How can we help you today?

Alan: I was just curios why you call alcoholism a disease because with all other type medical diseases, if you prevent someone from getting any addiction treatment the disease gets worse. With an alcoholic, if you prevent them from getting any alcohol they get better.  Is it a way of giving them an out, because they don’t want to take responsibility for their own actions?

Brian: I think what you probably need to take a look at is, we see it as a disease first of all because it has some very clear symptomatology.  And secondly, if it is left unattended it will get worse, even up to a critical point where they can actually die.  And the other piece is that as you continue to take a look at the disease, it is a chronic but highly manageable disease as long as the individual stops the drinking.  So when you take a look at that first of all from a brain perspective, the way that the external situation, especially when alcohol begins to come into the body, and the brain actually begins to change the way it produces dopamine and serotonin or ephinepherine in the brain, and so in many ways, an external substance is impacting the body in this way.

Jill: So that’s why we’re calling it a disease.

Brian: A disease is something that can be managed, but it is something that has definitive symptoms and a progression.

Jill: What I think Alan is saying. Can I rephrase that a little, Alan?

Alan: And also, to what level of alcoholism are you referring to?

Jill: Well that is what we were talking about at the beginning of the show in terms of the dependency, and sever dependency, if a person starts to enter withdrawals, and that can happen within the 6-8 hours of their last drink, they can actually go into what we call delirium tremens, they can have hallucinations and they can go into seizures.  So a very seasoned, severe, dependent alcoholic will seek out the alcohol as a medication to keep them from going into withdrawals.  And the last caller brought that up too.  They will get into their car, go into a bar and drink until they have their prescribed amount, and get back into their car and be back on the road – with us.  And so if they’re going to leave the bars and restaurants open serving single drinks, there’s a dichotomy there.  There’s a problem with that because the severe alcoholic has to drink in order not to go into withdrawals.  Now there are those for whom a law like this might keep them at home.  They might say, ‘Oh, you what, it’s not open today.”  Or, ‘We can’t get the wine at Publix, we’ll just go ahead and have Coca-Cola with dinner tonight.’  So there are those who use alcohol responsibly and that this would be something a little bit of an obstacle.  But do you understand the difference now what we’re talking about in terms of the severe dependent?

Alan: Well I do, if they drink very much to excess.  But coming at it from a moral viewpoint, there is no one who actually benefits from the alcohol itself except for the people who make it and sell it, and from a monetary standpoint.  With all other people, it creates a negative impact in their lives.  So would it not be better if there was no alcohol whatsoever?

Jill: Well, and there’s a good point.  If we are going to do away with buying alcohol at grocery stores and liquor stores, why are they being able to buy it at a restaurant and bar?  And so we are ending up with a very dangerous situation, because what we know as clinicians about the dependency upon alcohol.  And that’s the point we’re trying to get across today, as people that help alcoholic and drug addicted people every single day.

Alan: Right.  Actually, everyone wants to blame someone else so they’re not taking responsibility for their own actions.

Brian: Well, you just said the words right there - not taking responsibility for your own actions.  And that truly is the issue so many times in addiction, is that we find denial, and a willingness to always place blame and to be able to take the focus off themselves.

Jill: Alan, thank you so much for your call.  I hope it has made sense, what we’re talking about.  We’re trying to bring another way to think about responsible legislation.

Alan: Okay, thank you very much.

Brian: Alright, we appreciate your question.  Keep listening.

Jill: Well, it looks like we’re coming down to another break.  And Dr. Neil Johnston is on the line.  We’re going to being him in when we do come back from this break, and keep with us.  If you’d like to call and give your opinion, our lines are open right now, 770226-0920.
Jill: Welcome back to Breakthrough Addiction Recovery hour.  My name is Jill Mattingly, my co-host is Brian Fujii.  And we are having a lively discussion about the alcohol blue law legislation that’s coming into the Georgia legislation as we speak, and we’ve had some very interesting calls and we also are keeping an eye out on the weather.  Just to let you know, the National Weather Service will break in during this program and give you all the latest warnings and watches.  So you can stay tuned and listen.  It looks like something that may be headed this way, we’re on the 7th floor in Buckhead.  I’m really excited about that, Brian.

Brian: My nose is pressed to the window.

Jill: That’s right.  Well, so we will keep you posted and during the break, Dr. Neil Johnston is on hold . . . hey Neil, are you there?

Neil: I’m here.  How are you all?

Jill: Okay, great.  And Neil is our Director of Psychiatric Services at Breakthrough Addition Recovery and I know he is chomping at the bit.  He wants to give his opinion on what’s going on in the Georgia legislature, so have at it Neil.  What were you thinking as you were listening to us?

Neil: Well, first of all, blue laws are for anything related restricting activities on Sunday.  And so it’s completely bound up in morality and it has nothing to do with science or studies indicating that there are fewer fatalities on Sundays, etc.  And Georgia’s representatives want to pass a bill to allow the new Atlanta Braves triple-A team in Gwinnett County to serve beer at the stadium on Sundays and then they tagged on to allow sales generally across the state.  So that’s that.  And I think it’s called blue laws because it was originally written on blue paper.

Brian: & Jill: Or on blue cloth.  The last time I heard that it was blue cloth.

Neil: The last caller commented that nobody benefits from alcohol, and that really isn’t true.  There are plenty of studies that indicate that moderate consumption, which means that one drink per day for women – sorry, you gals only get one . . .

Jill: And how much is that?  What is a drink?

Neil: A drink is a 4-5 oz. glass of wine, one 12 oz. beer, or one 1.5 oz. shot of liquor.  All those are equal.  So one drink of anything of those, although there is some  evidence that red wine may be better, but one drink of any of those for women and 2-3 for men is considered probably more healthful than none at all.  But once you go beyond that, you get an exponential up-tick in the number of illnesses and in the death rate from alcohol-related conditions.  So it is beneficial in moderation.  It is not beneficial in excess or addiction and you can’t save up your 6 drinks from the week and have them all on one day.

Jill: Oh yeah, that was my next question.

Brian: Neil, what is one of the key health benefits that research is showing why having this one drink per day for women and 2 or 3 for men is beneficial?

Neil: One study that I read indicated that it had to do with elasticity of the blood vessels and that either spirits, meaning liquor, or wine both have the same effect.  They carefully measured out the amount of wine and they carefully measured out the amount of vodka and then filled the glass with water to make sure the volume was the same, and showed that there was an increased elasticity in the blood vessel which would correlate with a lower blood pressure, and would help cardiovascularly, probably mostly.

Jill: Okay, then here is the wrench right here.  What about just using grape juice, which is the . . . I forgot what those chemicals are that are in the grapes that actually benefit.  Are we actually talking about ETOH (ethanol) or are we talking about what’s in the grapes?

Neil: Both.  The phenols that are in the grape and resveratrol which is actually the compound in red grapes, does also have an additional effect in increasing the elasticity in the blood vessels.  So that’s an independent effect, that’s why I said there is some evidence red wine may be better than other spirits, but the other spirits do help as well.

Jill: Okay, well we’re coming down to a break.  There is a lot of activity going on out there, so they are going to come in and give us an update on the weather.  So stay with us, Neil, and keep your weather radio on.  We’ll be right back with the Breakthrough Addition Recovery Hour.

Brian: Welcome back to Breakthrough Addiction Recovery hour.  My name is Brian Fujii, and my co-host is Jill Mattingly, and on the line we have our Director of Psychiatric Services, Dr. Neil Johnston, and we’re having a pretty lively discussion here today related to some law changes that may be going on in the Georgia legislature, and if you’d like to join us this lively discussion, give us a call here at 770-226-0920.

Jill: And you know Brian. people are very passionate about their belief systems and this goes into a lot things in people’s lives.  You know, someone that may have their life ravaged by alcoholism in the family, or see that there is really nothing good that comes out of alcohol addiction and dependency and I can see why people are listening to us today probably have a pretty strong opinion of where they fall on this legislation, and like I said we are welcoming your calls.  If you want to call in and say, ‘Well here’s what I think.’  Or, ‘Here’s where I think this ought to go.’  Please call us at 770-226-0920 and we will talk your call.  And Dr. Neil Johnston, you’re still with us, right?

Neil: Yes I am.

Jill: Great.  And you’re hunkered down because I think something’s heading your way.  Well, we were just talking at the break about . . . if they’re going to do legislation, why not do legislation that helps limit the availability of alcohol that’s easy to grab, get in your car and start drinking while you’re driving?  Here’s a case in point.  I was driving here today, I was on the exit ramp, and I’m sitting there waiting at a light, and I look over on the grass next to the road and there is a small brown paper bag with a huge bottle of beer – of course it’s empty – and it’s laying there as trash.  And I’m thinking, ‘Okay, that means someone bought this at a convenience store or a gas station, got on 285, drank it down, and got up on this exit ramp, threw it out before they got home.  That to me is something that needs to be addressed.  Like single sales, that type of thing.  What do you think, Dr. Johnston?

Neil: I agree, although I’m not sure how you do it, Jill.  You can also buy a pint of alcohol at the package store and go ahead and open that up in the car, or buy a 6-pack from the grocery store refrigerator and take the whole thing and drink part of it on the way home.  But it just points out how absurd it is restricting alcohol sales on Sunday is.  If we were really doing it to honor religions and have a separation of church and state, we’d do it on Fridays and Saturdays too, to honor Muslim and Jewish individuals.  But it’s only on Sundays, that’s because we were founded by puritanicals.

Brian: Hey, we got a call that came in.  Bob from Suwanee, welcome to Breakthrough Addition Recovery Hour.  How can we help you today?

Bob: Thank you.  I think I’ve just been pre-empted by the previous caller.  My comment was going to be concentrating pretty much on the separation of church and state, and the way that is especially in the Bible belt, carrying the ‘no alcohol on Sunday’.  But that gentleman before me was much more articulate.

Jill: Well actually, that’s Dr. Johnston.

Neil: Well, thank you.  This is Dr. Johnston and I’m the one that said that.

Bob: Well good for you then.  Thank you, have a good day.

Brian: Alright Bob, thanks for calling.

Jill: Like I said, people want to weigh in on this.  And the fact that Governor Purdue may not honor it if the majority sees it one way, that may make a lot of people pretty angry.

Neil: And the other issue that kind of irritates me is the so-called “sin taxes” on alcohol and tobacco.  Why aren’t those earmarked for addiction treatment of alcoholism and tobacco use?

Jill: Excellent point!

Brian: Oh, let’s get that on the docket.  I like that idea. 

Neil: Instead it’s used for general uses so that other taxes aren’t fair when in fact if we spent more money on addiction treatment and less on interdiction we’d probably all be better off.

Brian: I like what you said about there too Dr. Johnston, we’re against a lot of things but the idea of being for something in terms of actual addiction treatment and helping those that are suffering because when we take a look at it being a disease, what a perfect way to be able to utilize this particular tax in order to help those who are struggling.

Jill: And you know, one of the callers asked about what about having them stop?  Isn’t that good for them to actually stop using alcohol.  Well absolutely, that’s what our addiction treatment at Breakthrough Addition Recovery is all about is having a person come in and getting them safely off alcohol and onto the road of recovery that really sticks.  Not something that, ‘Okay, stop drinking, we’ll see you once a month,’ or something like that.

Brian: Well you know, that’s the whole idea about addiction treatment.  We know there are people who do drink responsibly, and that’s the key.  And we have others that don’t, and we are there to help them.

Hey, we have a call in from Eric from Fayetteville.  Welcome to Breakthrough Addition Recovery Hour, Eric.

Eric: Hey guys, really enjoying the show.  It’s a good show today.  Hey, I’m a Christian, I love Jesus, I believe in the bible, and I don’t even drink that much, but it’s so frustrating to see the bible misinterpreted and tradition rise up in the place of accuracy because there’s nothing in the bible that prohibits me from having a drink if I’m thirsty, of milk or liquor or whatever I want.  It’s just so frustrating for me even from a purely religious perspective to see that addictiond and then it gives a bad reputation to Christians . . . it makes us look like idiots to me.

Brian: I think sometimes, we’re looking mainly as a addiction treatment provider, Eric, and we do understand this.  There are people out there that handle alcohol very responsibly, and we’re not into judging, we’re here to say, ‘Hey, if you have a problem with alcohol, we have a way that is very unique though the medications we use and the addiction treatments we provide can really help individuals who are struggling.  So the idea is, not that everyone struggles with it, so why is it that everybody thinks that nobody should drink?

Neil: And, Eric, I believe that Christ turned water into wine, not grape juice.

Jill: Eric, I’m right there with you.  I really hate it when tradition and a legalistic rises above what the pure message is.

Eric:  It’s something historically, is spoken out against very heavily.

Jill: Right.  Eric, thank you for your call . . . keep listening.  It looks like we are coming down to another break.  Keep your eye on the TV and be listening for your warnings.  Stay tuned and we will be right back.
Jill: Welcome back to Breakthrough Addiction Recovery hour.  This is Jill Mattingly and it has been an incredibly active hour right now.  I really do appreciate everyone out there that has been listening to us and we’re going to talk a little more about treating alcohol dependency, and Brian, what were you going to say?

Brian: At the end of that last break, we were talking about how important it was to realize that not every person who drinks has a problem. Our focus is on that 5-10% that really are struggling, and I know that Dr. Johnston and the way that medications are being used here at Breakthrough Addition Recovery that we do see that alcohol is a brain disease and that we do actually have medications to help them stop the craving, right?

Neil: Yes, we have medications both to help people get off and get through the withdrawal period and medications to help stop drug cravings and even sub-types of drug cravings.  There are drug cravings are cue induced – sometimes passing by the beer case at the grocery store that they want to drink, we’ve got medications that help with that craving as well as medications that help with general drug cravings and also prevent some of the pleasure if someone were to drink while taking it.

Brian: Especially some that are very aversive.  And another thing is we try to combine this piece with some very strong psychosocial components in day addiction treatment and also in individual and group therapy, and we’re finding this to be so powerful because we find out that even as they are on this medication they are able to at least now stay focused.  Especially if they are coming off a drug detox, and now they’re moving into being able to stay on this mediation so they can think and process and I think one of the key pieces is that they are able to process the emotional content of their addiction.

Jill: And if you’re one of the people listening who is thinking about . . . you know what, I do go the liquor store on Saturday night or to Publix, and stock up for Sunday because I start to get so uncomfortable on Sunday and if I don’t have it, I know I’m in trouble.  If you’re listening and you’re in that situation, we do free consultations for people who are struggling with alcohol dependency, we treat that at Breakthrough Addition Recovery, and you can go to our website, BreakthroughAddictionRecovery.com, and check that out and what we do for the people that are alcohol dependent.

Brian: We also have a blog they can go to also.

Jill: Yeah, we are actively blogging . . . if you want to leave your comments . . . and also if you like to call our office and set up a consultation, it’s 770-734-8091.  And we really do appreciate everyone out there that’s been listening to the show today.  It’s been an active, lively show, and next week we’ll promise to be just the same, I’m sure.

Brian: Thanks again, Dr. Johnston, for being with us and taking time out of your busy schedule.

Neil: And everyone out there be safe.

Jill: Alright, take care everyone and stay safe and watch for yourself.  Bye.

January 5, 2008 Drug Use in Adolescense

Breakthrough Addiction Recovery Hour show transcript

January 5, 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, and welcome to the Breakthrough Addiction Recovery hour. And happy new year to everyone.

Jill: Happy new year.

Brian: Today we have with us, we’re back as a team again.

Jill: Yes.

Brian: We’ve got Jill here, Jill Mattingly, is our physician assistant at Breakthrough Addiction Recovery. My name is Brian Fujii, and I’m the clinical director. And we’re going to be talking about a very current, and very important subject: adolescence and the issue of drugs.Jill: Yes.

Brian: And especially as it relates to pain medications. So I hope that those of you who are listening out there will gather around this radio, and if you have some questions or comments or some concerns, give us a call here at 770-226-0920. Or if you’re outside the Atlanta area, you can reach us at 1-888-920-2665. Well, Jill, you know…

Jill: Brian…

Brian: …we’ve been looking at a few things in the newspapers recently have come up with quite a few situations with high schools and even sometimes in the middle schools where we’re dealing with drug issues. And, you know, most of the schools, in fact all of the schools have zero tolerance for drugs. It’s a drug-free zone. And so we know that this topic is going to be very important for the listening parent.

Jill: Yeah, I think, you know, let’s bring that more… we’ll talk about it a little bit more after the first break. I just want parents to start to think about who they can call, or if they wanna listen to it with their teen, this would be a good time to gather around, like you said, and listen. Cause there’s some very interesting things going on out there in terms of pain medication use and adolescence and as it goes into young adulthood. And we’re going to try to bring out, out from the closet if you will, so people can understand that this is going on and how to deal with it. But, um, it is good to see you, Brian. I haven’t seen you in a while.

Brian: It has. It’s great to be back as a team once again.

Jill: I know.

Brian: We’ve had some great holiday shows…

Jill: Right.

Brian: …and it’s been very exciting.

Jill: Hey, listen, last Saturday you and Terry were talking about resolutions. I thought maybe, let’s talk a little bit about, have your resolutions failed in the last four or five days…

Brian: Already? This is just the beginning of the year, Jill. You know, we did talk about at the beginning that approximately only 3 percent of individuals who make new year’s resolutions actually keep them. But, you know, one of the things we understand is if resolutions aren’t written down, they probably aren’t going to be kept.

Jill: Right.

Brian: And we do know that. And we have to kind of make sure that we choose our resolutions carefully. I know sometimes we get the generic thing, I’m going to lose weight, I’m going to take, study harder at school, I’m going to get better grades, or for adults, maybe I’m just gonna eat better, exercise more… lose weight, yes. For our listeners, drink less, or don’t drink at all.

Jill: Well, that’s why I wanted to bring it up. I’ve noticed that a lot of people that do have a problem drinking get caught up in let’s make a resolution. Maybe this is the year I’m going to stop drinking, and yet they don’t realize the amount that they’re drinking daily can put them at risk if they try to just go cold turkey after January first. I’m sure that those who are daily drinkers, I’m not going to have that bottle and a half of wine every night, and I’m going to start January first, and then probably by today, January, what are we, fifth?

Brian: Fifth.

Jill: …they’ve already experienced withdrawal symptoms, or they’ve gone back to drinking.

Brian: Right.

Jill: And that is when you realize, that there’s probably a problem with the dependency on alcohol, like we’ve discussed in the past.

Brian: Because they are probably at that point going through that withdrawal we know that if they are already experiencing tolerance when they’re drinking more and more, and enjoying it less and less.

Jill: But you know there probably are people who have put down the alcohol and are white knuckling it. You know, it doesn’t have to be that way though. There is help out there…

Brian: They don’t need to suffer. I think that’s really a good point you’re bringing up, Jill. Of course the medications, you help our clients to get on, especially like the naltrexone, some of this new FDA-approved medication that help individuals to decrease the desire and the craving to drink…

Jill: Right.

Brian: And at the same time, on my side of the house, the clinical, they can really learn some really great skills to be able to help them manage and change that lifestyle a little bit.

Jill: And you know historically in what we do in addiction, we find that we don’t really get a lot of calls the first week of the year, where people think, oh, people are going to start calling right after the new year. Actually, we get calls after the resolutions fail

Brian: Well, but it makes sense, doesn’t it?

Jill: …and usually its five to ten days, and then the phone starts to ring, and they say, I tried to stop taking the meds, I tried to stop drinking, you know, or doing something associated with a dependency, and they found out they didn’t have the ability. And that is why, during this radio program, if you want to find out more information, about how to get a free consultation, and come in and really talk about how to put down in writing and put down on your calendar how you are going to work through this dependency.

Brian: I’m glad you kind of did a segueway… let me give them maybe just four, sometimes when you give them twelve or ten, it’s hard to remember. Well, let me give four very concrete ways that people can really work on some goals and make it effective. The first one I said of course is select them carefully, but also write them down. That’s two. Write them down. And tied to that is, when you write them down, be realistic. I love what you just said at the beginning, I’m going to just stop drinking. Well, maybe that’s not realistic. Maybe I need to cut back. Maybe I need to taper off. If they are able to. And in some way, because we understand there are people who use alcohol and do it responsibly. There are others who addiction it, and they’re getting in difficulty, and then there’s the area of dependence where they just can’t quit even if they wanted to.

Jill: Right. And that is definitely the person that can benefit greatly from the programs we have at Breakthrough Addiction Recovery.

Brian: Exactly.

Jill: We have a website. If you’re listening, you wanna go to the website, www.breakthroughaddictionrecovery.com. We addressed just about every substance out there, and how to look at coming out of a dependency or addiction of that substance. This is crucial. You need information and you need help to stop using those substances. And, I mean, once you fail at your resolution, maybe that will, you’ll wake up and say, or a loved one will wake up and say, I need some help, where can I go? Well, we are there. We offer all of that.

Brian: I’m glad you said that too. And we are available not only for the consultation, and then also to really provide addiction treatment options. It’s not always just one way. There…

Jill: Exactly.

Brian: We really try to customize that. And you know also as our listening audience is tuning in today, although our program doesn’t necessarily treat adolescents, we treat adults, but we also know, don’t we, Jill, that, you know, sixteen, seventeen, fifteen year olds, as long as they continue to use, by the time they are nineteen, twenty, twenty-one, they’re really at that point where they’re probably really struggling with either a strong addiction where they are abusing it or actually becoming dependent on it.

Jill: That’s right. And parents, listen, I want you to turn up the radio, get your teenager, talk to your teenager about what we’re going to be discussing today. This is very, very important. Things that you may not even believe are going on in terms of pain medications in high schools, alcohol, marijuana, things like that. You can call us and join in on this discussion, ask questions, tell us we’re crazy, whatever you want to do, you can call 770-226-0920. If you are outside the listening area, or say, your husband is outside the listening area and you want them to tune in also, they can tune in by going online to www.920wgka.com, 920wgka.com, hit listen now, and they can call from the outside area, 1-888-920-2665. I know I’ve given you a lot of info, but we’ll keep giving you that phone number throughout this show so you can join in on this conversation, crucial conversation.

Brian: Jill, I’d like to just give our listening audience a really interesting statistic here. We’re talking about, how do I prevent my child, are they all destined to use drugs or alcohol. Here’s an interesting statistic I just read recently in a brochure: a child who gets through age twenty-one without using illegal drugs, smoking, or abusing alcohol is virtually certain never to do so. So you can almost look at this program as kind of a harm-reduction program.

Jill: Oh, that’s a good way to put it.

Brian: The more the listening audience has information about how to avoid or to address or to be able to confront situations that seem to become problematic, they can the sooner they do it, the less chance that their loved one, that adolescent, or that child, will actually become dependent upon drugs or alcohol.

Jill: So think about this: we are Breakthrough Addiction Recovery. We have free consultations for those of you who want to strengthen your new year’s resolutions to stop using or abusing alcohol or any other type of drugs, and we’ll bring up the number and we’ll bring up the website throughout this program. But when we come back from this break, we’re going to start talking a little bit about a news article that was in the AJC right before Christmas. I wanted to bring it up then, but I just decided, let’s do a whole show around that. So when we get back, Brian, let’s start talking about the adolescence and pain medication use.

Brian: Give us a call, 770-226-0920. We’ll be right back.

<commercial break>

Jill: Yeah, welcome back to Breakthrough Addiction Recovery. We’re going to talk about teens and pain medication addiction and dependency. Last month there was an article in the AJC, and I brought this up in conversation in the last few weeks. A lot of people saw this article about a young woman who was a student at a metro area high school who was actually caught giving a fellow student a hydrocodone and another medication. She was caught doing this on the cameras that are in the hallway, and when they talked to her about it, they decided they were going to bring charges and make it pretty much the zero tolerance you brought up at the beginning of the hour, Brian…

Brian: Right, Jill…

Jill: with the drug zero tolerance, and they also decided, I think, to make it into a felony cause they said she was attempting to sell the medication to a fellow student. Well, as it all comes down, she actually, you know, came clean and said, yes, I was giving this to a student who was in need, in pain, but I bring this up on the air today not to vilify this student, or the student that was in need, but just bring this to the forefront. Parents, if you are listening, I really want you to think about what’s going on in the high schools in terms of pain medication addiction. This young lady was in a passing conversation with another student, and she mentioned her mother was taking hydrocodone, which is what the other student said she was using for her pain, which was not specified what kind of pain it was. The student turned and said, can you get one of your mother’s hydrocodones and bring it to me. And the girl refused, which, you know, most upper-level kids that have a head on their shoulders would say, no way, I’m not going to get my mom’s med for you. And she said, however, I think a few days later, the student called her in the morning, told her she was in pain, she was sick, and, you know, begged her, called her a few times, and then finally the girl relented, went up, took one of her mother’s hydrocodones, also took one of her mother’s fenergans, which, if you don’t know what that is, that is a medicine for nausea, put it in a baggie, dropped it in the girl’s purse during the change of classes. It was caught on tape, and thus the battle begins. Now this was a, you know, people read that and say, oh, wow, I can’t believe she would do that. But what we need to bring up today is the fact this is going on a lot more than what this article is telling us.

Brian: Right, this is just the tip of the iceberg…

Jill: Tip of the iceberg…

Brian: …and all of the schools around. That’s true.

Jill: And, you know, I started thinking about this and I’m like, one of the things that was the red flag in the story is the fact that the girl was in pain, now probably not specifying that this pain is probably related to her not getting the drug, which made her go into withdrawals from opiate, which we’ve highlighted on this show many times. As the girl is going into withdrawal one of the earmark symptoms is to have severe nausea, flu-like symptoms. So her friend who took the, her mom’s hydrocodone, grabbed a fenergan. So that tells me right there that the girl knew she was grabbing something to help get her friend out of withdrawal. You know, she didn’t just grab a hydrocodone, she grabbed a hydrocodone and a fenergan for the nausea. So that tells me there was a lot more than meets the eye in terms of what the understanding was between these students. I believe that maybe this girl did get caught up in I can keep this girl as my friend if I help her out. Or I don’t want to say no because of maybe peer pressures or things like that. I don’t know, Brian, did that kind of strike you that way in that story?

Brian: I think that is true, because remember, in adolescence especially there is a great need for acceptance, and to be part of the group, and that peer pressure is very strong. And given the benefit of the doubt, maybe indeed she thought that she was helping.

Jill: Yeah, and that was her thing she said in the story, I was helping out a friend…

Brian: …I was helping out a friend, but you know there’s one way to help out in a positive way and then there’s another way in which… again, the thinking process, and I think also the article said this, you know, judgment, poor judgment…

Jill: Poor judgment, yeah, and she has a great track record. She had never been in trouble before, and I believe that yes, dropping the higher charges, the more stiffer charges for just, you know, misdemeanor was a good way to go, but I do believe I wish this story would have highlighted more what the problem is in the high schools…

Brian: But, you know, it also goes to show, the article talked about needing more drug education and so forth, and I think what we have to be aware is that many times people don’t listen or hear it until there’s a real need…

Jill: Yes. Exactly.

Brian: …and that can be for adults as well as adolescents. We pick up and we listen to what we want to hear. And so this situation may have had a lot of times where they understood, maybe they had a lot of education about it, but it just went in one ear and out the other, until it really hit home and hey, this gets me really in trouble when I don’t pay attention to the information I have already related to drugs.

Jill: As I read this story I started to do a bit more research on addiction of pain medications, and one of the highest percentage reasons, when asked about why kids were using pain medication, the number one answer was, it’s easy to get from parents’ medicine cabinets. Now parents, if you’re listening, and you know in your medicine cabinet you have 84 vicodin sitting there in your medicine cabinet, because you only used six of them after you got your sprained ankle playing football on the weekend, and you left them in your medicine cabinet, do you know how easy they are to get? And how, what Brian just said, peer pressure, I mean, in passing this child could say to a peer, yeah, my mom, you know, we have vicodin in our medicine cabinet, and the kid by pressure might feel like if they got that vicodin out of the medicine cabinet, gave it to their classmates they’d be cool.

Brian: Mmm hmm.

Jill: Or they’d be accepted. So, I mean, that’s another thing to really think about when you leave these types of medications…

Brian: And I’m so glad you’re saying that too, Jill, because we always think in terms of protecting, you know, we have child-proof lids, right, on so many things…

Jill: …that doesn’t work for fifteen year olds…

Brian: That’s exactly what I was going to say…exactly. We think in terms of three to five year olds… I mean, we’re looking at situations here… so, although that cap is obviously able to be opened by older teens, the idea is that we still need to be protective of the medications we know that can become dangerous toward others. So, as we take a look at what we need to do as protective, sometimes that means locking it up in such a way we have control over that medication.

Jill: Right. And I think let’s bring that up often during the show, in case people are tuning in late. And you can call and join us in this conversation, 770-226-0920. And right now I’m going to bring up to the mike a very special person to me. This is actually my niece. Her name is Jensen Earl, and she is 16 years old. When I started reading about this issue, I said, you know what, I’m going to ask someone who is actually in the high school. You know what, Brian, you might know this about me, but I was a high-school teacher at one time, so I was in the know, but that was ten years ago, so…

Brian: And times have changed.

Jill: I know, times have changed. So I decided, you know what, I’m going to ask someone that’s right in the middle of it, in the high schools, and Jensen agreed to come on the air with us today. And she said, well, what I am going to say? And I said, don’t worry, I’m going to ask you the questions and you’re just going to talk to us about what’s going on in the high school… Jensen Earl.

Brian: Well, welcome to the show, Jensen.

Jensen: Thank you.

Jill: She goes to a metro area high school, and she’s really cool, everybody, so… anyways, Jensen, thanks so much You know, when we talked about this I was so surprised that you said it was a common occurrence in your high school for people to be using pain medication. How did you become aware of this, that it was going on?

Jensen: A situation that happened to me was, I was standing at my locker with some of my friends, and these guys came up asked if we wanted some stuff, and we said no…

Jill: Stuff, huh?

Jensen: And they pulled out a pen, which is the most common way to pass the drugs around, which is normally oxycontin, things like that. And they crushed up the pills, and take out the ink inside of the pen and put the pills inside.

Jill: Ok, so they’re not giving you full, it’s not a full pill…

Jensen: Right…

Jill: …it’s crushed up. And then they just take the guts out of the pen…

Jensen: Mmm hmm.

Jill: Oh, wow. So, I mean, how are they using this then?

Brian: A lot of times they’ll snort it or they’ll put it in their drinks at school and drink the sodas throughout the day.

Jill: Wow. So they’re actually taking it while they’re at school

Jensen: Right.

Jill: And have you witnessed anyone using drugs like this at school?

Jensen: Oh, yeah. In the bathrooms at my high school, there’s girls drinking water out of the sink and putting the pills in and things like that, yeah…

Jill: Oh, wow. Have you ever heard any bad effects from the drugs or anything like that?

Jensen: I’ve walked in the bathroom before and seen girls passed out, or something like that, after using oxycontin and stuff like that.

Jill: Wow, so oxycontin is kinda the drug du jour?

Jensen: Yeah.

Jill: ..in the high school. It just, Brian, this is just, you know, that’s amazing me right there…

Brian: Yeah.

Jill: is that oxycontin, which we know as one of the most potent…

Brian: Addictive…

Jill: …and addictive drugs is being passed around the high schools, and these are for 15 and 16 year old brains that really, you talk about the developing brain being at risk…

Brian: Absolutely. And especially at that age when we know they’re both the thought processes and emotional processes is really at risk.

Jill: Jensen, you know, I was going to ask you, why do you think they’re using at school? I mean, this is kind of an interesting effect, that they’re using right there in the bathroom where people can see.

Jensen: The only thing that I can really think of is that their peers are at school, and its more of a status type of thing, um, popularity and stuff like that, cause they know it’s a way to make friends.

Jill: Ok. And so you think one way to make fast friends in a high school is to tell people you can get oxycontins…

Jensen: Yeah.Right.

Jill: Wow. You know, to me that’s really kind of scary, that it’s oxycontin, like I just said. But let me ask you something, don’t you guys get that classes, and as a high-school teacher back in the day I know that we did a lot of drug awareness, because just say no and all of those things, but, you know, I saw that glazed look in their eyes when we would talk about drugs, but to me are they giving you any type of more information about pain medications or anything?

Jensen: Um, they make you go through a drug awareness program, but they mostly just talk about alcohol and marijuana and things like that, they never talk about pain killers or…

Jill: …the more obvious stuff…

Jensen: Right.

Jill: And so oxycontin, hydrocodone, lortabs, they really don’t talk about the addictive qualities or how dangerous that is?

Jensen: No.

Jill: Yeah. Well, you know what’s interesting is, you know, having an addictive quality like they do, you use those over and over, it does not take long before you will be dependent, tissue dependent, and then start to experience withdrawal symptoms if you stop cold turkey. And that means that if you’re seeing your loved one or your adolescent having the flu four to six times a year, that’s not normal. Now the flu may be if you get it once a year, that can happen. But if your teen is saying, I’m throwing up, I’ve got the flu, I’m sweating, everything else, that doesn’t happen four to five times a year. It’s not possible. So, flu-like symptoms, which are the hallmark of opiate withdrawal are something very important to look at. And Brian, I guess when we come back from this break, you’re going to talk a little bit more about what parents should be looking for, is that right?

Brian: Yes, especially at some of the changes that they can be observing, especially if they see some radical behavioral changes that could be something indicative that something’s going on, maybe they’re doing drugs or alcohol.

Jill: Jensen, you’re so cool, I’m so glad, not just because you’re my niece, but you really helped us out, I hope that people are listening and they can really relate to what you’re saying. Hey teens out there, talk to your parents, tell them what’s going on. Call us, 770-226-0920. We’ll be right back.

<commercial break>

Brian: Welcome back from the break to Addiction Recovery hour, My name is Brian Fujii, and I have Jill Mattingly as my cohost. And today we’re talking on the topic of adolescence and drug addiction. And Jill, we’ve got a call from Lee in Midtown. Welcome, Lee, how are you today?

Jill: Welcome, Lee.

Lee: I’m excellent.

Brian: Great. What’s your comment today?

Lee: Well, I’m thinking about high school today 18 years in recovery.

Brian: Wonderful.

Lee: When I was in high school the level of drug usage was like marijuana and beer.

Jill: Oh gosh. You’re my age.

Lee: And today we’re talking oxycontin, opiates, I mean…

Jill: Yeah, it’s changed.

Lee: There’s not a gateway drug anymore, they’re just going straight to, you know, heroin…

Brian: The hard stuff.

Jill: And you bring up a great point, Lee, because what we are seeing now is who I treat medically at Breakthrough Addiction Recovery and people in their 20s are shooting heroin because they started with oxycontin at 16 and 17. And you’re right, when we were, you know, many years ago when we were in high school, pot was, you know, oh my gosh, don’t start pot and now, you know, they are cutting to the chase, and going straight for it.

Lee: Where are teenagers getting these drugs? Are they most of their supply, like, their parents’ drug, bathroom?

Jill: Exactly.

Brian: And you can buy it on the street.

Jill: Yeah.

Brian: Really can.

Jill: Really.

Brian: And until these people have their own dealers out there, Lee, and its just amazing the connectivity that individuals have even at that young age.

Jill: Plus, internet. Internet’s easy, but a lot of people that age and high school is you get it from your friends, and your friends get it from their friends, or you know, we were talking earlier, and I’ve had hydrocodone in my medicine cabinet before for after I had knee surgery, and I didn’t even think about, you know, that I had half a bottle there, and what if I had had someone, a guest in my house, that was using my restroom.. it’s wide open, it’s right there for them to take. So…

Lee: The other ironic thing about like, doctors, and not all doctors and pharmacies is that you can walk in and get, you know, 50 Percocets or oxycontin in a heartbeat and nobody thinks about it.

Jill: Yeah, exactly. It’s such…

Lee: …Three refills.

Jill: Well, Lee, thanks a lot. You’ve brought up a great point because that’s really what is going on

Lee: It has to start somewhere further up.

Jill: Congratulations on your recovery, too.

Lee: Thank you.

Jill: Eighteen years.

Lee: Take care.

Brian: Thanks for your call.

Jill: Hey, and it looks like we have another call. This is Pam, oh, it’s Pam in Acworth. Hey, Pam. How are you?

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

Pam: Hi.

Jill: And Pam, I’m going to go ahead and tell our listening audience, you and I had had a discussion a few weeks ago about this very issue, and I had asked Pam to call in, and kinda talk a little bit about what she is experiencing in her own family, knowing that we were going to discuss this. You know, Pam, I know that your son I struggling with opiate addiction, and that the most, this is very heartwrenching for you, and I really do believe the parents that are listening out there by hearing a couple of the things that you can highlight for them is going to be very beneficial. Thank you so much for calling.

Pam: Oh, you’re welcome.

Jill: So your son, when did he start to have a problem with substance addiction?

Pam: Um, it started at 16, in high school. And we knew there was some pot involved and some other things and then as we were, of course, asking around what the other friends there was a group, and other parents didn’t think it wasn’t anything they wouldn’t grow out of. But the pattern changed shortly after that, and he wouldn’t come home for three or four days at a time…

Jill: As a teenager?

Pam: As a teenager.

Jill: Wow. Ok.

Pam: At 16 and 17.And there has to be something other than just pot at this point. And we never could find out exactly what it was they were doing. We tried to get help from other parents to professional help. And when we got him professional help, the counselor all he could do is one visit, and all he is doing is pot, and we can’t treat pot. It’s not an addiction.

Brian: Well, you know, it’s really interesting you say that, Pam, but, it’s, I think, a lot of times people think its not really an addictive substance, and yet we know that the substance today, which pot back in the 60s, the intensity and purity of pot today is about 25 times more potent than what you were getting in the 60s, that’s what the most recent things have shown.

Jill: Wow.

Brian: And a lot of people say, you don’t even go through withdrawal. Well, the major reason you don’t see withdrawal immediately is because pot stays in the body for between 30 days or a little bit longer. And as result, it’s only until such time that the body begins to leach out that THC that you actually begin experiencing some withdrawal.

Jill: And it’s interesting that they didn’t say that it was a problem, that they really couldn’t do anything for pot, but you believe there was something else involved.

Pam: Oh yes.

Brian: Oh yeah.

Pam: His personality, the change that I seen in him,

Brian: Yes. And did you find kind of an increased lethargy, we call pot the dream killer, because it really does cause people to just get to the point where they could care less about anything. Their drive just diminishes.

Pam: Right. He was very, always cared about how he looked, how he dressed…

Jill: …and that all changed.

Brian: That all changed.

Pam: Yes. To the day.

Brian: Pam, let me ask you a question, we’re getting close to our break, at this point. Can you hang on the line and just be with us, because we sure want to continue this discussion, but we’re at the break right now. We’d love for you to hang on the line and we’ll be right back. Can you do that with us?

Pam: I will.

Jill: Thank you, Pam.

Brian: That’s great. Alright, we’ll be right back. Give us a call at 770-226-0920. Or outside the Atlanta area, 1-888-920-2665. We’ll be right back.

<commercial break>

Jill: Hey, welcome back. We’re the Breakthrough Addiction Recovery hour. My name is Jill Mattingly, my cohost, Brian Fujii. And we’re talking about adolescence and pain medication us and addiction and dependency. Um, I have on the line right now a friend of mine, her name is Pam. And she is willing to discuss a little bit about her struggle that she’s having with her son who is struggling with a dependency to opiates. And Pam, you talked a little bit about his… hey, Pam, are you there?

Pam: Yes, I am.

Jill: Ok, just making sure I’m not talking into space. Anyways, you talk a little about his teenage years, he had problems, something obviously was going on, you couldn’t find the help. You had said something that struck me about him, or you being told, well, it’s just a phase, he’s going to grow out of this. And that is the scariest thing I think you can believe when you’re a parent. Because what if, he’s forming a dependency. You don’t grow out of a dependency; it worsens. Is that correct?

Pam: That is correct. It is proof as of today, as a 24 year old, young adult. And at the 16, 17 age, we were being told by other parents, um, even professional help that we would seek, what little bit we could find, that calm down, it’s just a phase he’s going through, he’ll grow out of it. And after a while I was told so much I’d think, well maybe it’s me, maybe I’m overreacting. I wasn’t, cause I knew in my heart that I wasn’t right. And if we didn’t try, whatever we could, if we couldn’t get the professional help, you know, or other parents look at this, they’re all hanging out together, there’s just not one doing it. We had, we actually used a little bit of the law of the land to help us, thinking that that would help. We were struggling parents of, this is our son, and we wanted to help him…

Jill: Right.

Pam: …and we told him when he took the car, and he took it again, he could go out, but if he come up missing for days again, I couldn’t go through those sleepless nights and pacing the floor… we’d report the car as stolen. We did. He did it and we reported it. They picked him up. He spent, we left him in there for a few days, four days, and it was very hard not to, as a parent, answer that call.

Jill: Right, I can imagine.

Brian: And you set some good limits. And you know that’s probably one of the best things you could have done, as hard, as difficult as it is as a parent to do, it is something that they need to understand the negative consequences of that behavior. Just briefly, you know you said they saw it as a phase, and that’s where we’re different at Breakthrough Addiction Recovery, Pam, because we don’t see it just as a phase. We see it actually as a brain disease. Something went on as your son kept on taking those opiates. His brain literally got rewired. It changed. And that’s the reason why he couldn’t stop.

Pam: Right.

Jill: When did it become evident that he had a true dependency on opiates?

Pam: I would suggest, say, probably in the last three years we really noticed…

Jill: He’s 24 now?

Pam: Yes.

Jill: Ok.

Pam: About 21 we still knew there was something going on, he did, he does currently live in another state, and when we would see him, it was very obvious he was on something.

Jill: Mmm hmm.

Pam: The pupils were very small, he just relaxed and didn’t care about how he dresses, and currently, recently seeing him this fall, we were there, and he would be talking to you, standing talking to you, and he talks a lot when he’s on whatever, cause he was very comfortable, and he was talking and he was going to sleep as he talked to you.

Jill: Wow. And…

Pam: And… go ahead…

Jill: And have you noticed that he is trying to talk about this addiction, or have you confronted him with this information that you have?

Pam: I haven’t confronted him. He did call me in November… it was a few days… November 2nd. He apparently had taken something. Well, he told me he smoked some bad pot…

Jill: Mmm hmm.

Pam: He was taken to the emergency room. It was considered an OD, him and another friend of his.

Jill: Wow.

Pam: And he was actually in ICU. I didn’t know for three days until he was out, and he called and told me he had smoked some bad pot.

Jill: And that’s probably not what it was, you realize that…

Brian: Right, exactly. I mean…

Pam: No.

Jill: Have you seen him recently, and has he discussed this with you?

Pam: I did see him over the holidays, but he wouldn’t discuss what had happened in November. But I did find out from his fiancée that it was, apparently they had went out of the state where he’s currently living and they bought some Lortab…

Jill: I see.

Brian: Mmm hmm. That makes more sense. Well again, this is where an individual is really in denial about what he’s trying to deal with right here. You know, we hear all these excuses all the time, but they’re not willing to own up. That’s part of the disease. They do not want to be able to own up to what is really going on with them. And I think you can have as much excuses, but until they begin to understand the strong, negative consequences, it’s very difficult. Has he experienced any job problems, additional, additional legal problems, anything that could really motivate him, to be brought to his attention, to maybe seek some help or at least talk to someone about this?

Pam: He has lost some good jobs.

Jill: Wow.

Brian: Mmm hmm. But the consequences haven’t been hard enough, I guess…

Pam: No. I have looked back at the pattern since he has lived out of state, and it’s been a continuous something and he always blames someone else, never him.

Brian: Well, Pam, we really appreciate your call today. And I just know there’s a lot of parents out there listening to what you have to say, and their hearts are broken just like yours, but don’t give up hope. Continue to talk with him, and we’re here. And if some way he might be willing to just talk with us for a few minutes, maybe we might be able to talk some sense into him. Really appreciate your call today. And listening audience, I hope you hear the heartbreak, and if there’s something going on there, out there with you, feel free to take a look at our website, www.breakthroughaddictionrecovery.com. Well, we’re coming up to our break again.

Jill: Pam, thank you. We’ll be back

Brian: We’re coming up to our break. Give us a call, 770-226-0920, or 1-888-920-2665. We’ll be right back after the break.

<commercial break>

Jill: Hey, welcome back. We’ve been talking about adolescence and pain medication addiction and dependency. What a powerful message it is when you hear that this is going on so much more than you ever thought in the lives of the adolescents that you know. I really do want to thank my dear niece Jensen for joining us today as being the voice of the 16 year old and the high school student. And I think, Brian, the most important thing to take out of this is, parents, and grandparents, grandparents tend to have a lot more pain medication on hand. Cause you know what, when we get up there, we get the aches and pains a little bit more, have viable reasons to have hydrocodone or lortab on hand…

Brian: That’s right.

Jill: You know, I want the parents and grandparents to listen: go up to your medicine cabinet, take those medications, and put them in a safe, secure place. We’re not saying your child, or your adolescent, or your young adult is going to be taking those from your medicine cabinet, but there are people that come to your house that may be invited…

Brian: That’s correct…

Jill: …that may have a problem that you don’t know about. They go into your medicine cabinet and they are purposefully looking for a couple lortab here or there.

Brian: Well said. That’s exactly correct. And we don’t have a lot of control over that. But we can certainly make sure they control the access…

Jill: Exactly.

Brian: …controlling the access.

Jill: Safe and secure, keeping those things in a place where a person that is not yourself or another responsible adult can get to them.

Brian: You know, before we, I know we only have about 30 seconds, let me just give three ideas that teens can do to maybe help themselves feel good.

Jill: Ok.

Brian: First of all, let go of that past. If you had a problem, let it go. Let go of that old past. Don’t live in disappointment. Secondly, let go of unrealistic expectations. I think so many times, maybe friends or family put too many high, unrealistic expectations. And then, also, exercise, and if you got a problem, talk to that school counselor. These will help.

Jill: Right. Listen, you can go to breakthroughaddictionrecovery.com and get a lot more information, and we’ll link you up to even more information. We appreciate you joining us today. We’re going to keep going next week.

March 3, 2008 - Co-occuring Disorders

Breakthrough Addiction Recovery Hour

3-8-2008

 

Brian: Good afternoon

Atlanta and welcome the Breakthrough Addition Recovery Hour.  My name is Brian Fujii and my co-host is Jill Mattingly and we have again as our guest Dr. Neil Johnston, an addiction psychiatrist and our Director of Psychiatric Services at Breakthrough Addition Recovery and we’re going to be continuing our discussion about mental illness and substance abuse and how addiction is related many times to this issue of mental illness and I think we have kind of a sub-category called “de-mystified medications.”  Is that right Jill?

 

Jill: That’s exactly right,  You know when you look at psychiatric care a lot of people don’t feel very comfortable with it and there’s a lot of stigma around it, and what we’d like to do today is talk about some of the medication that actually can help with addictions to substances, like alcohol and other types of substances.  So Dr. Neil, which is what I call you at the office – I don’t want to confuse people though, it is Dr. Neil Johnston.  But how are you doing today?

 

Dr. Neil: I’m fine, thank you.

 

Jill: Dr. Johnston, tell me a little bit about the psychiatric problems people have on the spring-forward day.  Is there any diagnosis you’d like to talk about?

 

Dr. Neil: There aren’t any diagnoses, but interestingly enough traffic accidents go up and that sort of thing has been found both in the spring forward and fall back.

 

Brian: I think it’s because people’s schedules are all out of whack, and they are all trying to get to work sooner or to church.

 

Jill: That’s exactly right.  So you know tomorrow we’ll have a lot of people showing up . . . what is it . . . late or early for church tomorrow?  It that . . .

 

Brian and Dr. Neil: Late, I guess.

 

Jill: Yeah, it’ll be late.  Okay, so pastors out there don’t be too hard on your parishioners.

 

Anyways, Dr. Johnston, I came in today wanting to talk a little bit about the medications that are used in psychiatric diagnosis such as anxiety, depression, bipolar, ADD, and how treating efficiently with the medications can actually help someone with a substance dependency.  And the first thing I was going to bring up with you, so just get ready because I am going to start throwing questions at you, is about anxiety medications.  We did a couple of shows last month that covered like the Heath Ledger death and we were talking at length about benzodiazapines, Xanax, Clonopine, Valium, Atavan, we were talking about the benzodiazapines and how many people come in to Breakthrough Addition Recovery with dependencies on these substances or these medications and it’s very difficult to get them off of the medications but then again we have to turn around and say in some cases this medications is a perfect fit for you because of your problems.  Can you tell us a little bit about the medications themselves . . . about the anxiety first?

 

Dr. Neil: Well certainly, you mentioned most of them. There is Valium or diazepam, and that is something that sometimes confuses people because we have the trade names and generics.  Valium, Diazepam, Xanax, Alprazolam, Serax, Oxazopam,  Ativan, Lorazopam . . .

 

Jill:  So these are the “pams”, right?

 

Dr. Neil: Yeah, they’re all the “pams” and some of the “ills” like Restorill, there’s Midazolam, there’s “lams” and “ills”, but the benzos are a large class of medications. They basically work on the gaba-amino-butyric acid receptors.  They are excellent medications, they’ve been around for a long time and work exceptionally well.  What in psychiatry we usually try to do is if someone has an anxiety disorder and that is broad of spectrum of the disorders that includes panic, generalized anxieties, social phobias, etc. What we often times try to do is get patients on a non-addictive medication for that such as one of the serotonergic agent, such as Prozac, Paxil, Zoloft, etc., at the same time we want to put them on a benzodiazapine because often the anti-depressant can worsen the anxiety before it makes it better.

 

Jill: So, I see.

 

Dr. Neil: So the benzodiazapine helps modulate that, helps even people out if they get started, and once they’ve gotten on a full dose or an appropriate amount of time, if their symptoms are under control we begin a slow taper off the benzodiazapine and can hopefully manage them with just that.  Now with the substance abuser, the problem is they are often self-medicating.  It just so happens that alcohol also works on the gaba-receptor in the same area and so someone with anxiety disorders may have become addicted to alcohol because they are trying to treat their anxiety and that kind of situation we would detox them on benzos and also try to start them on SSRI or SNRI  which is a serotonin norepinephrine reuptake inhibitor and those are drugs like Effexor or Cymbalta and then go from there with the treatment as far as first detoxing and then trying to address the anxiety.

 

Jill: A lot of these people are first seen in an internal medicine or family practice and they are describing to their physician or nurse practitioner or PA that, “I’m having a lot of anxiety . . . a whole lot of anxiety and I am depressed and I’ve just had certain things happen with my job,” and they may choose put them on something like Lexapro. “Let’s just see how the Lexapro does.” So what you are saying is that many times the anxiety can worsen after they start the Lexapro or Prozac before it actually gets better.

 

Dr. Neil: Absolutely, especially with panic disorder.

 

Jill: Wow, and what about the fact that some of these physicians and health practitioners are putting them on these benzodiazapines but they are not really watching how these people are using these benzodiazapines . . . they’re not making it a short course.  It’s each month they come back and get their 30 pills?

 

Dr. Neil: Well, I’m not criticizing anyone of a particular specialties group, but often times under the pressure of seeing many patients someone may have been put on a benzodiazapine after the death of a loved one, or work stress, and it works . . . the doctor has the patient coming back feeling well, feeling good. They don’t want to mess that up . . . they just go ahead and refill that.  And unfortunately the reality is if you’re having a baby you are probably not going to go to a primary care doctor, you are probably going to go to your OB-GYN to have that done.  If you are having a mental health problem you should probably see a psychiatrist at least for the initial visit and then appropriate follow-up with your primary care doctor.  Unfortunately, as a psychiatrist many of you may not know after medical school, a psychiatrist spends 4 years in training for psychiatry whereas a primary care doctor spends 3 years of training to try to cover a little bit of everything.  So obviously there’s a big difference there.  Specialists are specialists.  Generalists deal with all sorts of problems.

 

Brian:  That’s great.  You know this is a very interesting topic and I know many of you listening out there are saying, “How can I get involved?”  Give us a call here at 770-226-0920 or if you’re outside the area you can call us at 1-888-920-2665.

 

You know Dr, Johnston, one of the things that we hear about people first of all getting onto the medications, but then they ask the question, “How can I get off the medications and how soon?”

 

Dr. Neil: Well, first let me address getting onto the medications because a lot of people don’t understand that getting onto the medications takes some time itself.  It can take anywhere from 2-8 weeks of being on the full, appropriate dose of the medication for it work . . . for it to be effective.

 

Brian: 8 weeks?  Wow.  That’s really good because many times we see clients not understanding that and they get very frustrated with themselves and saying, “I’m taking this medicine.  Why isn’t it working?”  And that’s a wonderful piece of information to have.

 

Dr. Neil: And the other piece is the appropriate dosage part.  I see a lot of times that non-psychiatric practitioners will prescribe medications at too low of a dose, especially medications like Effexor that really work best at higher doses.  So that’s the first issue is getting onto the medication.  Getting off the medications, there are several, specifically all of the SSRI’s, Prozac, Paxil, Zoloft, etc. that can cause withdrawal symptoms. And they can be uncomfortable at times, they are not life-threatening.  And I think we’re coming down to the break, so we’ll go into that a little more after the break.

 

Jill:  Okay, that will be a good thing to come back and start talking about.

 

 

Jill: Welcome back to Breakthrough Addiction Recovery hour.  My name is Jill Mattingly, I’m the physician assistant at Breakthrough Addiction Recovery.

 

So one question, Dr. Neil, tell me the difference between an addiction psychiatrist and just a regular, general psychiatrist.

 

Dr. Neil: Well an addiction psychiatrist specializes in addiction and has also gone through specialized training or has had specialized experience, and then take a test given by the American Board of Psychiatry and Neurology to be certified as having the sub-specialty of addiction psychiatry.

 

Jill:  Oh, I see.  And it looks like we have a caller.

 

Brian: Yes, we have Debbie from

Atlanta.  Debbie, welcome to the Breakthrough Addition Recovery hour.  How can we help you?

 

Debbie:  Hello!  I just want to make a comment more than asking a question.  My ex-husband began taking Atavan in about 1982 plus he started drinking and he’s still in denial all these years later.  We had the normal confrontations with him and it’s just so sad, and we can’t help him because he won’t admit he has a problem.  I guess that’s a common thing.

 

Dr. Neil: It is.  It’s a very common thing and most of the time you get into that denial because it’s usually because they really don’t want to stop and therefore if someone brings it to their attention they just get really irritated, annoyed and they really think you don’t know what you’re talking about.  What have y’all tried to do as far as helping him break through that denial?

 

Debbie:  Well, I’ve been divorced from him a long time and he lives in another city and he’s living with his elderly parents.  In fact his mother passed away and his father is really old and now his siblings are saying, “What are we going to do with him because he’s not able to keep any job?”

 

My children have already been through therapy trying to get through being adult children of alcoholics and they’ve all offered to give him help, not with money, but will help him find a job, help with this, that or the other.  But they don’t want to take him in because they don’t want to ruin their own little families.  But he says no, he doesn’t need help.

 

Brian:  Well, you know, that situation there, I believe the family members are doing what they need to do.  They are getting the help that they need and they’re trying to stay healthy.  Because many times when an individual is in that much denial, the family is also in a lot of crisis and so therefore the family members are doing the right thing.  They’re actually getting the help that they need to stay healthy,  and many times, Debbie, we find out that unless there’s enough negative consequences that really gets their attention, there’s not much else you can really do.  You can just continue to take care of yourself, be aware of the struggle that he’s going through and attempt to intervene at some point to bring it to his awareness.  But at this point, the family members, friends and so forth are the ones that really have to make sure that their emotional situation is being cared for at this time and it looks like they’re going through therapy and they’re talking to others and they are still not allowing their own self-esteem to diminish as a result of this addiction, then I think they are doing the best they can.

 

Dr. Neil:  I have one question for you Debbie, you mentioned that you all have children.

 

Debbie: Yeah, they’re adults.

 

Dr. Neil:  Adult children, okay.  It doesn’t apply then but what I was going to say that protecting the children from being around him when he’s using is something that’s very important and courts don’t like custody or visitation with intoxicated parents, so that also can be sometimes a pressure point.  But as adult children that wouldn’t apply.

 

Debbie:  We’re just wondering when he’s going to actually reach his rock bottom.

 

Jill:  Debbie, I was going to pose this question of Dr. Johnston.  Would an intervention be appropriate?

 

Dr. Neil: Absolutely.  If you and his family and friends could all come together in a non-threatening way . . . .

 

Debbie:  Well. that’s what they just did recently.  His brother and his son-in-law came together with him, offering him as much help as they could because they could see as soon as his father is unable to stay at home or passes away, what’s he going to do.  Because he doesn’t have a job right now and they said we’ll offer you any help we can give you and you have a problem with alcohol.  And he takes Atavan and he just said. “No, I don’t need your help.”

 

Brian: Well that is a real challenge and as long as he’s in that strong denial . . . he might be in what is called the pre-contemplative stage of treatment where he just doesn’t believe he has the problem.  In fact most of the things I’m hearing is he feels it’s your problem and not his.

 

Debbie:  We’ve been divorced 15 years, so 20-25 years ago he was saying to me, “You know I drink 2 beers and you eat 2 hamburgers.  What’s the difference?” 

 

Dr. Neil:  You don’t get into wrecks on the highway from hamburgers, you don’t usually abuse your wife over a hamburger, lots of things.

 

Debbie: Right, his denial has been going on for years.

 

Brian:  Seems to be working for him, but not for you all.

 

Debbie: Yeah . . . right.

 

Brian: Well, take care of yourself, Debbie.

 

Jill:  Yeah, take care of yourself Debbie, thanks for the call.

 

Debbie: Okay, thanks so much.

 

Jill: Wow, very interesting.

 

Brian: It is.  And we see so much of this going on before people come in to treatment, and even when we do our consultations, there at the office, it’s sometimes a mini-intervention that’s being done where sometimes a person will be bringing in their loved one, whether it be a husband, a son, or a daughter, and that individual just doesn’t want to be there until somewhere along the way we try to emphasize and help them get some clarification about some of the negative impact it’s making on themselves or their jobs or they’re having a problem with the law – that’s always the long-term consequence.

 

Dr. Neil: Another thing that can help with intervention is sometimes is to have a professional who’s an objective third party who’s not involved.  You can’t accuse me of having eaten 2 hamburgers, so I can go after you in a different way that’s more logical.  I don’t have any emotions built up, that you can accuse me of trying to vent on you.

 

Brian:  That’s right.  Well, again, if this type of discussion is striking a chord with you, we encourage you to give us a call at 770-226-0920 or at 1-888-920-2665.  And you know too, we have a fantastic website you can visit and look at all the various programs that Breakthrough Addition Recovery offers and that’s at www.Breakthrough Addition Recovery.com and there’s ways that you might get in touch with us via email.  So be in touch with us and continue to look at this opportunity or getting either treatment for yourself or for a loved one. 

 

Dr. Neil: And I’ll throw in to check the blog, there’s always something interesting.

 

Jill:  Oh, there is very interesting things on the blog. But Dr. Johnston, I want to try to get to the protocol that you advocate for pulling someone off of a benzodiazapine.  We have so many clients that struggle with high doses of benzodiazapines and have tried to stop and the withdrawal symptoms are absolutely atrocious and they have so much difficulty.  Let me know what you advocate in terms of coming off of things like Xanax, Valium, and the others.

 

Dr Neil:  Basically what we do when somebody is on any of those prescription drugs in that class or alcohol or barbiturates – they’re all lumped in together.  What we try to do is figure out first of all how much of the medications they’re taking and how often and then what I call is sort of a ’switch and taper’.  We switch them to a different drug from their drug of choice, and usually it’s one that does not bring about as much psychic pleasure as the drug they were on, and then secondly we slowly taper them off of that.  By doing so, that prevents the medical complications such as seizures, delirium tremens and both of these things can cause death so it’s very important that you be medically supervised when you are coming off either these prescriptions drugs or alcohol and that’s something that we can help out with at Breakthrough and are happy to talk with people when they need to.

 

Brian:  Well this is fantastic as we take a look at people coming off of these and you’re saying that many times it’s so difficult because they’re struggling first of all with the withdrawal they’re having from the alcohol itself and that even raises up their anxieties even more and then we start trying to take them off of their anti-anxiety mediation, benzodiazapine.  I’ve heard that people say that it is just so painful.  And with that pain it makes it more difficult to try to come off and yet we do know that unless they do then the probability of them stopping the drinking is not going to work either. 

 

Dr. Neil: In some of those cases there may be an underlying disorder that needs to be treated and in those cases we like to taper them more slowly off the medication while instituting another psychiatric medication such as the SSRI’s, etc., and that way address both issues.

 

Brian: I like the way you said that, “addressing both the issues.”  And that’s

the key in dealing with people with co-occurring disorders, is dealing with both the psychiatric and chemical dependency simultaneously.

 

Jill: Well, like Dr,

Johnston was saying, we do address this at Breakthrough Addition Recovery and if you’d like to go to our website and look at the information on benzodiazapines, please do BreakthroughAdditionRecovery.com and also we will do free consultations for those of you that might have questions about the medications you’re on.  So Dr. Johnston, when we come back I’d really like to start hitting depression as another co-occurring disorder.  So stay with us.

 

 

Jill:  Welcome back.  We’d love to get you in on the conversation.  We had an earlier call that was fantastic.  If you have a question, comment, or want to kind of get in just talking about or asking Dr. Johnston a question . . . 770-226-0920.  Give us a call and Brian, you were really wanting to ask Dr. Johnston a question.  He is jumping out of his seat right now.

 

Brian: For those just joining in with us, this is a very important topic about the combination of psychiatric illness in relationship also to addiction, and one of the most common things that we come across, Dr. Johnston, at our clinic is the relationship of depression as it relates to substance abuse especially in the area of alcoholism and depression.  So how do we handle that most effectively with medications?

 

Dr. Neil:  Generally we like to find out what’s going on with them.  The first step, generally we like to again treat those problems at the same time.  In many cases it could be that alcoholism has led to depression or vice-versa, the depression has led to the alcoholism.  Finding that out for certain is a near impossibility in a lot of cases, so we treat both at the same time, start somebody on detox to get them off the substance abuse and it could be any of the substances.  Then we would also have them treated with an antidepressant as well and depending upon their exact symptoms, that is how we would choose the anti-depressant.

 

Brian: That’s great.  Many times people think, ‘Well all I got to do is take my medicine and I’ll be fine,’ and they almost kind of see that as the magic bullet, and yet one of the things that I have found especially as the clinical director in working directly with so many of these clients is that they struggle with so many different interpersonal issues that seems to bring about the depression, the desire to use either alcohol or other drugs and it just seems to indicate, and studies have shown that unless you combine both the medications along with good psycho-social support that it really is not as effective.  We know that medications do a wonderful job, but in my work, I just see individuals struggling with issues of self-esteem or feelings of worthlessness or they understand that maybe because they had problems with abuse in their past even as young children, and until we actually deal with these issues, so many times, many of the clients just try to self-medicate or numb that feeling with their drugs of choice.

 

Dr. Neil:  Well there’s no question with regards to depression that all the studies have shown that both together, meaning psychotherapy and medication, work better than either one alone.  It used to be a big fighting war between psychiatrists and therapists over which one was better, but that was pretty definitively settled by studies that show that ‘a pox on both your houses’, the combination together work better than either one by itself.

 

Brian: Well, as I was saying earlier, let’s take a look at the way the medications work as we look at depression.  What other areas do you feel like . . . one of the things I’ve heard so many time is, when does this medicine kick in?  Because they’re on the medicine, they’re in treatment with us in day treatment, and they are still trying to figure out why am I still feeling so bad.  So many times it’s the idea of when does the medication reach some form of therapeutic level and what can we answer to them?

 

Dr. Neil:  Again, once you’re on the correct dosage of the medication, it can be anywhere from 2-8 weeks.  Some people will start feeling better after a few days, but generally give it 3 weeks or 4 weeks on average, but up to 8 weeks. We used to say up to 6 weeks, but recent studies have shown more likely up to 8 weeks for the full benefit of the medication.  But again, I can’t emphasize enough that so many practitioners do not prescribe a full dosage of medication, and that has to be done in order for it to work for any of the medications for any of the disorders.  This doesn’t just apply to depression but also to bipolar, anxiety disorders, etc.

 

Brian:  You know, many folks, when they come in to our program and they’re in day treatment and they are trying to get some support and they get ready to leave, and . . . how does the idea of medications, well sometimes AA says you shouldn’t take medications while you’re trying to come off your addiction.  How do we answer that?

 

Dr. Neil: Well, I consider that to be almost archaic in their philosophy.  If they are saying something of that nature, AA was begun in the 1930’s, about 1935, 70-something years ago.  This is just absurd to tell someone they shouldn’t be on their psychiatric medication.  AA is also run by non-professionals, so having a professional opinion on that is very necessary. 

 

Jill:  Wow, I have some things to say about that.  When we come back we are going to talk about that – medicating for the problems versus non-medication and using other resources, so get ready Dr. Johnston.

 

 

Jill:  Welcome back.  We’re discussing medications, use and co-occurring disorders with substance abuse and Brian, you were just discussing at the break the position of AA and you seem to have a really good comment on that. 

 

Brian:  Yeah, I do.  I want the listening audience not to be thinking that we’re against all these issues with AA.  There is some concern that we do know that many times in this situation where individuals may attend such a group as AA or NA and the individual could have depression so they may be on an anti-depressant and in many groups they say that’s fine, you could be on an antidepressant and still be considered clean and sober.  And the reason for that is that number one, it doesn’t make you high.  And secondly, it’s non-addictive.  However, we do know that many people also suffer from anxiety and we know that some of the best medications that deal with anxiety is benzodiazapines, and we do know that also has an addictive property.  And so many times my clients get into a conflict – how can I stay on the benzodiazapine and yet I’m trying to come off the drug to which I’m addicted?  So what I’d like to ask Dr. Johnston is, so how can I as a therapist answer that question effectively to help the person know that this is a medicine, it’s not something they’re using as a drug in order for them to become even more addicted or for them to become poly-substance abusing.

 

Dr. Neil:  First off, I’ll address what I would do in that situation, which would be to certainly attempt to address their co-occurring anxiety disorder with a non-addicting medication in the anti-depressant realm.  Unfortunately there are even some medications in the anti-depressant realm that are abused by patients – they can get a little buzz off them although it’s dangerous.  However, in resistant cases where the anti-depressants are not working or causing some other sort of problem, will I consider using them?  Absolutely.  Now generally I would not consider using them with someone who is addicted to a substance similar to them, meaning someone who is an alcohol abuser, I’m probably not going to put them on a long-term course of benzodiazapine, but many years ago I had a patient who was a heroine abuser and bottom line was she was having panic disorder – it was very severe – and we got her off the heroine, the panic persisted, the antidepressants weren’t working.  We put her on low-dose benzodiazapine and it worked wonders. She got a job, was able to take care of her kids, never called in early for medication, never lost a prescription . . . the things that people who are addicted to benzodiazapine show, and she did fantastically.  So there are no absolutes, and whenever anyone says that, I take umbrage.

 

Jill:  Do you think the fear of some of these medication has hampered treating addiction? 

 

Dr. Neil: Absolutely. 

 

Jill:  I know of many people that are afraid of something they think will change their brain, and they’re never going to be off of it and they have a lot fear about that.

 

Dr. Neil:  What’s wrong with changing your brain if there’s something wrong with it to begin with?

 

Jill:  Exactly, and you know I am kind of in the vein of, why don’t we try something different before we go to medication?  Why not try something like prayer and meditation, or exercise or getting their nutritional deficits corrected before we start to add a medication?  I understand why a lot of people are kind of shy about just jumping right into a medicine and maybe that’s why these other organizations discourage the medication.

 

Dr. Neil:  Well, I am all for a holistic approach to addiction, there’s no question.  But there haven’t been any placebo-controlled studies that have shown that prayer, for instance, is going to improve addictions, or that a specific nutritional supplement will.  While these are all going to be helpful, there’s just no proof that that’s going to work. 

 

Jill:  So it doesn’t mean that it doesn’t work, it just means there’s no study?

 

Dr. Neil:  There’s no proof. AA was developed before we had any modern psychotropics, and it has become the standard of care and they have been sometimes reluctant to incorporate the newer medications.  I will say with regard to exercise, there are studies that have shown that exercise, in depression at least, that exercise can be as effective as Zoloft at 6 months.  They weren’t very well controlled studies, but they’re out there and there’s something probably to do with the endorphins released during heavy exercise that’s useful.  Now don’t get me wrong . . . all of the above are useful.  If somebody has cancer, prayer is a tremendous support for them.  Good nutrition is going to be important for their strength in general – all of these are important.  But to depend on them solely without the scientifically proven medications that we have just seems . . .

 

Brian:  That’s a scientific approach.  We’ve got a call here from Ruth in Avondale.  Good afternoon, Ruth.  Welcome to the Breakthrough Addiction Recovery hour.  How can we help you today?

 

Ruth:  My son is in his 50’s and he has suffered from anxiety attacks and he is taking Paxil and has for a number of years and he is also using nicotine gum that he started using when he gave up smoking.  However, right now he is experiencing very frightful dreams and he wakes up screaming and asking for help and it’s a little difficult for his wife to wake him up.  And I was wondering if that had anything to with the use of Paxil.

 

Dr. Neil:  It is possible it is due to Paxil.  Paxil has a very short half-life, and one of the things he could explore with his doctor is going onto an SSRI that has a longer half-life such as Zoloft or Prozac because these tend to have fewer side effects, but Paxil definitely has more than the other ones do.  Also the nicotine, as he’s coming off of that, that can cause abnormal dreams quite frequently.  I’ve been off cigarettes now for 3 months and I can assure you I’ve had some unusual dreams. So just that as well can be causing problems. There are so many other treatments out there for depression and anxiety, Ruth, that if it’s even thought that the Paxil is causing side effects that it would be worth to try switching to something else.

 

Ruth:  Okay, now he’s been taking this nicotine gum for a couple of years.

 

Dr. Neil:  Then it could very well be the Paxil.

 

Jill:  We have to take a break, but hey Ruth, could you hang on?  And let’s address nicotine when we come back from this break.

 

 

Jill:  Welcome back, and we’ve got Ruth on the line.  We’ve got about 50 seconds and Dr. Johnston wanted to address the nicotine issue for the last two years.

 

Ruth:  Okay.

 

Dr. Neil:  Ruth, the nicotine gum . . . and if he’s still smoking as well,

 

Ruth:  Oh no, he’s not still smoking.

 

Dr. Neil:  He’s just using the gum . . . okay.  Nicotine can have effects on the central nervous system of course, it’s a very, very addicting substance, and the dreams could be from that, they could be from the Paxil, again with regards to that I would definitely suggest that you have him see someone, there are new drugs out to help with nicotine withdrawal, one called Chantix, and it works very well, much better than anything we’ve had before to help someone get off of nicotine and we can help you at Breakthrough, our number there is 770-734-8091 and we would be happy to do a free evaluation with you there.

 

Ruth: Okay, well I’ll pass this information on to him.  And thank you so much.

 

Jill:  Thanks for calling, Ruth.

 

Brian:  Alright, sounds like we’re getting close to the end of our show, and Dr. Johnston, we’d like to have you back again.  I heard you have some time and we look forward to it.

 

Jill:  I’d like to go one better on that.  Dr. Johnston, we’d like to have you in as much as possible.  Would you commit to coming back at least once or twice a month?

 

Dr. Neil:  Sure.  You’ll have to pay me something, Jill. 

 

Jill:  Ha-ha . . . I’ll take you out to Starbuck’s afterwards,.  You are a fantastic addition to the show and if we could have you on once or twice a month I know our listeners probably would appreciate it too.  And one thing, Dr. Johnston may sound young on the radio, however in college he did follow the group Police and went to a concert, so just do the math on that one.  And Brian, what were you saying we are going to do next week?

 

Brian:  Next week we’re hoping to look at bipolar disorder and also the area of ADD, attention deficit disorder, and a lot of times we think people only who are adolescents have this, but we see this happening all across the adult spectrum too.  And so I’m really excited about this opportunity where we’ll be able to talk about how bipolar disorder which is probably one of the most misdiagnosed, and most hard to identify disorder, and how that gets impacted when a person is trying to deal with addictions because so many times they’re trying to use the alcohol to calm the feeling and reduce the anxieties and we do know those mood swings are really, really, devastating to so many people so it’s a great thing and we really appreciate Dr. Johnston being with us here today and we look forward to having you coming  back and discussing these two particular areas.

 

Dr. Neil:  I’ll look forward to it.

 

Jill:  And if you want to come up with any information that you want to share or a topic, please let us know Dr. Johnston, we will be happy to go over a topic that’s near and dear to your heart.

 

Dr. Neil:  I’d love to get the audience involved in more discussion about AA.

 

Jill:  I do want to say we do have a great website.  It is chock full of information, and that is BreakthroughAddictionRecovery.com.  Our office right up in Norcross, and our office number is 770-734-8091.  We’ve had some great calls today and please plan on being with us next week.  Please call into the show, that’s part of the bread and butter of this show – just reaching out to the listening community and if you’re interested in ADD, that’s attention deficit disorder, or bipolar disorder – a very misunderstood illness, please listen next week and be ready with your questions and call your friends and family to listen too.

 

Brian:  Alright Jill, thanks a lot.  And again, this is a talk show and we’re just so excited about those that called in today.  And again, we do offer free consultations.  So if you and family members are struggling with the issues of addiction and/or issues dealing with mental disorders, give us a call at 770-734-8091.  And again, thank you for listening.

 

 

January 26, 2008 - Paul’s Story of Prescription Pain Pill Addiction

Breakthrough Addiction Recovery Hour show transcriptJanuary 26, 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: Welcome to the Breakthrough Addiction recovery hour. My name is Brian Fujii, and with me, my co-host, is Jill Mattingly.

Jill: Hello.

Brian: And we have our special guest, Paul. Really glad to have you here again, Paul. For those of you just joining in with us, Paul was with us last week and we were talking about opiate addiction. And Paul is telling us his life story, about how he moved into really just starting using pain medication as something that was helpful for something that he was experiencing physically. And today we’re going to try to carry on this discussion to really help the general listening audience to really understand how people can so easily move into using pain medication as a prescription, and then, inadvertently through the use become more and more dependent upon that particular drug.

Jill: And I also want to point out that we are actually offering Paul’s story, if you contact us here at the station, 770-226-0920, we will actually send out his story in written form. It’s very informative and very impactful if you have a loved one that is struggling or if you want to understand what this journey into pain medicine addiction is like. You want to read his story. It’s fantastic. And Paul, thank you so much. It’s not snowing, so I knew you’d be here…

Brian: Yeah, welcome back, Paul.

Paul: Thank you. It’s good to be here. I appreciate you guys having me.

Jill: Yeah. You know, what we wanted you to do since there’s a lot of people tuning in that didn’t hear the beginning of your story last week. If you want to just recap a little bit, telling us about, you know, from when you were a kid and how you progressed into this unfortunate journey into pain medication addiction.

Paul: Sure, sure. Yeah, just to quickly recap: I was raised in a great family a Christian home, grew up in the church, went off to college, and started the party scene, drinking, got into marijuana on a daily basis, and then slowly but surely experimented with a couple of other things, never got real deep, and then, um, got married, and stopped smoking marijuana, decided it was time to grow up. Was going to raise a family, and really didn’t touch anything for about seven years. And then I had a root canal, and started taking, the doctor prescribed some Vicodin for me. And for the pain What I really didn’t see at the time was really my first red-flag moment was when I came home from work, had no dental pain anymore, it was healed up, and there was some medication left, and I looked at it, and I associated it with pleasure, the side effects, cause it made me feel, have a good sense of well-being, chatty, I just liked the way it made me feel. So that was a red-flag moment for me there, for the very first time. That’s what I would caution anyone, definite red-flag moment, is if you have this medication and there is no medical reason to take it, and you reach for it, please realize that that is something, it may not be a huge deal, it doesn’t mean you’re an addict at that point, anything like that, but that is a red-flag moment, where you are associating medication for pleasure and not what it was designed for.

Brian: You know Paul, I really appreciate you saying that because, you know, typically that’s what happens so many times, why can one person take a pain medication and, first of all, some people sometimes take pain medication, they hate it because it doesn’t do anything for them, it either makes them sick, and yet in your situation you took it and you realized, wow, this feels great. And I think that’s one of the major reasons we understand why only about 5 to 10 percent of the general population that actually tries different types of drugs really becomes dependent on it, because there is something in the brain that really reacts positively. We know that with alcohol, some people can drink alcohol and they’ll get sicker than a dog. And yet at the same time, there are others who drink it, wow, what a feeling… exactly, that trigger that kicks in.

Paul: And that leads right in to the next part, is that I finished that medication and it was gone, so be it, it was gone and a few months later, my wife, at the time, had to have back surgery. And the pain medication that she was prescribed after the surgery made her sick. So now she’s got all these back issues and she’s trying to heal from surgery, and he gave her Vicodin and it made her sick. So then he tried Percocet, and that made her sick. So here I had a steady supply of pills coming in the house that she had no interest in, and I had a great interest in.

Jill: And she did not know you had an interest in them.

Paul: No, she filled the prescription, took one, hated the way it made her feel, and it went in the back of the medicine cabinet, you know.

Brian: And she didn’t think anything else about it…

Paul: Never even thought about it. And so it’s just sitting in there, and slowly but surely, at the time, you know, I wasn’t taking them all day, it was one pill, after work, you know, and I’d relax. It was my glass of wine at the end of the day, so to speak, or whatever..

Brian: Good point.

Paul: So, you know, she had the back surgery, eventually her back healed up, and those prescriptions stopped. And then my next encounter was getting a horrible cough, went to the doctor, and he prescribed a big old bottle of cough syrup, which was Tussinex. Took it home, looked at the active ingredients and saw hydrocodone, and I realized, wow, it’s not only a painkiller, it’s a cough suppressant. So then I, you know, thoroughly enjoyed my cough syrup. And the next major red-flag moment, went back for my follow-up visit, my cough was gone, the doctor asked me how I was feeling, I said fine, and for the first time in my life, I lied to the physician. I told him that I had this dry, hacking cough, that I couldn’t sleep at night, and that, he said, well, did the medication work that I gave you? I said, oh, yeah, that was the only way that I could sleep. So this was another red-flag moment, that I would encourage everybody, if you’ve ever given misinformation to a physician to get a medication that you don’t need so you can experience the side effects from it… that, you know, looking back, a lot of these things, they happen so gradual… and we can justify anything as humans when we’re doing it, that, well, I just, it’s not a big deal, I’ll do it this one time, and all this while my body was growing more and more accustomed to it. So now, you know, I couldn’t get the desired effect from one or two pills, I needed three or four… or not one teaspoon of cough medicine, I needed three or four or five, you know, because I wasn’t getting the desired effect, you grow so tolerant to it.

Jill: That is exactly right.

Paul: You know, then eventually it would run out, and I started experiencing withdrawal symptoms, and…

Jill: Was that the first time you experienced withdrawal?

Paul: No… I would say before the cough syrup, back when I was taking them for about a month straight from my wife’s supply, she ran out. And I thought I was getting the flu or something. I was a little achy, I felt grumpy, and my nose was running… I thought I was sick. And I realized that, you know, it was a shocker to me, because I thought, withdrawal, that’s something that a heroin addict goes through. I’m not a druggie.

Jill: I bet that was really surprising to you…

Paul: It was probably one of my first wake-up calls that I might have an issue.

Jill: Uh huh…

Paul: But then I would go through, you know, a couple days without feeling well and I’d forget about it… not completely forget about it, but it wasn’t that big a deal. Then I, the next thing was that I started having some back issues myself, and I went to the doctor, and of course he prescribed… and what I was doing through all this is that now I knew the exact symptoms to describe to a physician in order to get him to prescribe the medication that I wanted.

Jill: Wow.

Paul: And it just became a regular thing for me. That was my means of getting it was to give false information.

Brian: And that’s part of that creativity seems to be constantly moving… that part, a time when you are looking at your need for that drug, but now you’re finding new ways to get that drug and having to be very creative in the way that you obtain it. And I think that’s part of the thing for our listening audience, this is such an important part because we know that manipulation and trying to get what they need for that particular drug is so important. I like what you said, you began realizing that you needed this, Paul, but at the same time you began also realizing I had to find different ways to get this, even if it meant lying to my doctor. And that’s got to be a very, very powerful piece for you. I know that you mentioned you come from that kind of home or value system, how I related to that. So that must have been a real stab at the heart in that respect.

Paul: It was. I would leave the physician offices very torn,

Brian: Sure.

Paul: You know, a prescription in my hand, so ecstatic about that, but feeling, you know, the guilt of, you know, I was doing something that was wrong, I was doing something that was illegal. But you justify your mind begins to justify it because what it becomes is a chase to avoid the withdrawal symptoms. And that’s what gets so exhausting.

Jill: Perfect.

Brian: Indeed.

Paul: It’s not the actual medication, it’s the chase.

Brian: Right, it’s no longer that fact that you wanted to feel good, for the high, it was, avoid the withdrawal.

Paul: Exactly.

Jill: This is probably really touching a nerve out there. And if you’d like to call and have comments or questions for Paul, or Brian and I, you can call 770-226-0920, and you can go to our website to get more information on opiates. That’s breakthroughaddictionrecovery.com. There’s a lot of information about what Paul is talking about today. And I hope that if you are listening, and this is touching a nerve, that you do call us and let us, you know, maybe field some questions that will help you through this, if you’re going through something like what Paul was experiencing. And also if you want to listen online, we are www.920wgka.com. And I do want to throw one thing in before the break. I want to talk about Suboxone and how to get Suboxone addiction treatment through Breakthrough Addiction Recovery. And I know Paul’s story is going to end up on a very, very positive note, so keep tuned in today. But we are going to talk about how you can get help for this problem of opiate dependency. So if you’ll stay with us and we’ll be right back.

<commercial break>

Jill: Welcome back to the Breakthrough Addiction Recovery hour. Well, if you feel like you might be experiencing life in the fast lane right now because of opiate dependency, you can call us at Breakthrough Addiction Recovery, and we can help you with that dependency. We’re talking to Paul today, and he had that journey in the fast lane. He’s just about to get into more of the fast lane in just a minute. He actually got into a circle of trying to find doctors that would give him these pills that made him feel better and kept him from going through withdrawals. And as were saying Paul, it can become a real merry-go-round that you get on. You just don’t get off and its easy to get off, you have to really keep going and keep looking and like Brian said, you have to be creative about finding that drug. When you left, just in this last segment, you were talking about that you had a real back issue though, and you were starting to find doctors that would give you pain pills for this back pain. Can you tell me a little bit about what happened from the back pain?

Paul: Well, fortunately it wasn’t anything serious. I had a degenerative… I had an MRI done, because the doctor suggested it, so here I was getting sucked in further and further. Now I have to go, you know, in for an MRI when I was I had some back pain

Brian: So that was legitimate back pain?

Paul: It was legitimate, but I was exaggerating it to get what I wanted…

Jill: Ok.

Brian: Sure.

Paul: So I went in, I got an MRI, and they diagnosed me with a degenerative disc. Nonsurgical, it’s something that’s going to bother you here and there, which all that did was it gave me, that was my ticket to pain pills. Now I was diagnosed with something. So, you know, whenever I felt like it, but eventually what happens is any responsible physician, which most of them are, for the most part, they’ll start referring you out, to pain clinics and things like that. It’s just this vicious circle… The back pain went away, I, uh, that was my ticket to get more. So I basically was on this circle jumping… I had different doctors that I was going to and I was juggling between back pain and the cough. It was amazing how creative and, you know, you think you’d get confused who you told what, but it was amazing how strategic that you get…

Jill: And don’t we call that doctor shopping, right?

Paul: Yes.

Jill: And it’s not necessarily that you’re going in for a specific, for something real and legitimate, but how many doctors did you have at your height? How many doctors were you working?

Paul: I don’t know at one point, but I can tell you when I finally got clean I got down and I had a good chat with myself and did dig deep into my memory and I wrote down everybody that I had gotten a prescription from, and it was in two different states and it was about twenty-eight different prescribers.

Jill: Wow.

Brian: Twenty-eight different doctors?

Paul: And this also, I don’t know if we’re going to get into this or not, this also includes the internet.

Brian: The internet. Oh yeah.

Jill: Oh yeah.

Paul: Because I discovered, it’s a joke. They give you a five-minute phone consult that basically says, what are your symptoms? Have you taken this before? Ok, I approve it.

Brian: It is so easy to obtain.

Paul: I mean, yeah, it is. It’s not difficult, it just takes time. It’s a lot of time invested its ridiculous how much time I spent, wasted…

Jill: Right. And what I want to say about physicians also. I did internal medicine for eight years and I know when someone’s coming in and they’re looking. You can kind of tell. And there are manipulations you can do and tests you can do to make sure that you have the data that say, this person really does have the problem. But, you have five minutes to spend with the patient, or ten minutes, and sometimes it’s a lot easier in certain offices to write out that hydrocodone, instead of saying, let’s start with an anti-inflammatory and work our way… I’m sure you would’ve walked out of that office if you would have seen me, because I would have started you with naproxen and worked on. But, you know, the thing is, is that, the doctors, a lot of the times, are crushed for time and they really are trying to follow that scenario, and the referral out is actually to try to keep from, in some cases, feeling like they are giving you medication that they shouldn’t be giving you. But you went on to have some things done…

Paul: I did, actually. I…

Jill: ….for your phantom back pain, didn’t you?

Paul: Yeah, I actually went and had an epidural shot in my back that was very painful, and I was doing it all to justify getting the pills. So… But the other legitimate thing that I had was that I had severe, people’ve probably heard of reflux. You’ve seen the ads on TV for the purple pill, all that kind of stuff. You know, I had it very, very severe at a young age, and the doctor suggested surgery to correct it, because it can lead to esophageal cancer, so I said I’ll go ahead and do it. And so I went ahead and had the surgery and I left that surgery with a prescription for oxycontin. He wrote me the oxycontin for surgical pain, and the pain wasn’t that bad, I did have some… but what was going on in my life at the time was my marriage was falling apart at the same, while this was happening. I had found out that my wife was having an affair. And I had oxycontin, and desperate times call for desperate measures, or so that was my logic. And I had known that the oxycontin could be crushed and snorted. So there’s another of my major red-flag moments was that this was the first time I crushed a pill and snorted it. And this was, this oxycontin I loved because the thing was my tolerance had gotten so high that I needed to take a fistful of Lortabs in order to get the desired effect, or Vicodin, or whatever…

Brian: And that has high acetaminophen in it…

Paul: Exactly. And that’s the problem, I knew that, that I was putting… You take high amounts of acetaminophen and you’re risking damaging your liver.

Jill: Absolutely.

Paul: And so I knew that. Not that it stopped me from taking a fistful of pills. I was still taking it. But I liked the oxycontin better because I knew that it didn’t have the acetaminophen in it; it only had the narcotic. So now, you know, I had another means, you know, juggling all these different things, you know, it didn’t really matter what I got, I would take it, whether it was oxycontin, Lortab, whatever. I had found means to buy it on the street at one point, through people that I knew…

Jill: So, you were…

Brian: Listen, audience, if you are really getting into this discussion, please give us a call here at 770-226-0920. If you are outside the Atlanta area, give us a call at 1-888-920-2665. I know this must be stimulating a lot of thoughts in many people’s minds…

Jill: Absolutely.

Brian: and you know we were talking about this earlier, Jill, when we said to parents and to others who were having some problems about keeping their medications in their medicine cabinets, you know, please monitor those, because you just never know who might be looking, or even having adolescents going into those medicine cabinets and using those pain medications to either self-medicate or maybe give to others.

Jill: Right. And it’s not just pain medication anymore. We’re finding out that people are pretty savvy, if they’re looking for something, they know what the names are. Things like Xanax and other benzodiazepines are being taken out of medicine cabinets. But Paul, it sounds like you got into a real spiral. This is when things started really going south in your life, and not that they weren’t already, but this was the time, you know, with the marriage falling apart, and you were starting to find different sources. What else was happening at this time, when did you start to finally have your ah-ha moment, I’ve got to do something?

Paul: Well, I had quite a few ah-ha moments, but I mean, you know, it’s not normal to take ten to twelve pain pills at a time, you know, I mean…

Jill: That’s an ah-ha moment…

Paul: Yeah, and I started realizing it wasn’t just after work anymore, you know, it was during work, because I felt up, and I had energy and things, and um, so it got to the point where I was taking fistfuls of these pills, two, three times a day in order to maintain… it almost is like, it becomes, uh, like you’re having a relationship with, like, the substance is your significant other or something You know, it’s a very strange position to be in, but I knew I had to get help, cause I tried several times on my own…

Jill: Mmm hmm.

Brian: It’s interesting, you say this too, that in spite of even knowing the dangers related to the acetaminophen and the levels you were taking…

Jill: or Tylenol…

Brian: …it’s just really, you disregard it, all of those real danger signals for you…

Paul: Just to get the desired effect.

Brian: …just to get the desired effect, that’s how powerful this pills really are.

Jill: Well, let’s do this, we’re going to come back from our break in just a moment. I’d like to start talking about when you started making that choice, to turn this around, and I really do appreciate you, Paul, for being here. I know a lot of people are listening here today…

Brian: Your candor is wonderful.

Jill: 770-226-0920. Stay with us and we’re going to be right back.

<commercial break>

Jill: Welcome back to the Breakthrough Addiction Recovery hour. We’re here talking with Paul about his journey through opiate dependency. He had an addiction, pain medication addiction. And it looks like we do have a caller. I’m going to go ahead to that call. This is Lori from Atlanta. Hi, Lori.

Brian: Hey, welcome to the show.

Jill: How are you today?

Lori: Fine, how are you?

Brian: Fine. How are you today?

Lori: Great. I have a question for Paul. I’ll just quickly tell you that I had a brother who did commit suicide as a result of drug addiction to cocaine.

Jill: Mmm hmm.

Lori: In fact it was me he called, of everyone else, to tell me that to say goodbye to me before he took all the pills. It resulted in a massive heart attack and he died, he was not even thirty-four years old. And of course it affected me tremendously. I thank Paul for coming on your show and talking about this because I believe that drug addiction is more prevalent than what we want to admit in America. I know because I also have a sister who’s in her late fifties and she’s very ill, and she doesn’t realize that, or will not admit to, but she is addicted to prescription drugs. And she lives in another state, I live here in Atlanta, and when I go to visit her it’s painful for me to watch, that she has pills to excess. And Paul, what I want to ask you is, how did you lick this? How did you do it?

Paul: Well, I, you know, its an ongoing thing, and, that’s the thing, I came to realize its going to be an ongoing thing for me, but actually, its ironic that you called because that was the next thing I was going to talk about, what really got my attention was I got a phone call a couple years ago… no, I guess it was about a year ago now… that I had a very good friend, close friend, college roommate, who died. I went to his funeral, and he died from an overdose, and he was, you know, thirty-five years old, and had two kids, and I knew what he was doing, and I knew that I had a lot of things in common with him. And it did get my attention because I have a kid, and you know, I need to be there for him. I realized that it was spiraling out of control. And so I basically at that point, so to speak, faced my demons and I needed to get some help.

Lori: Mmm hmm.

Paul: So what I did first was, I had a friend that was addicted to heroin at one point in his life, and he was sharing with me about methadone addiction treatment. And I sought out methadone addiction treatment, did the counseling part a little bit, but went to get on methadone and, you know, I’m not going to bash any kind of addiction treatment because I know methadone does work for some people… I did not do well with it at all. It made me horribly ill. And I had people telling me, all I was doing was, you know, the very few people, I didn’t have a lot of people who knew what was going on, but the couple that I did tell, they said that you’re just trading one addiction for another. People are on methadone their whole life, its just as bad getting off methadone as anything else…But I couldn’t tolerate methadone myself. So I had heard about, what Jill was just talking about, Suboxone. Somebody had told me about it; I did some research on the internet, and found, decided to go ahead and start that. And really, I know Jill’s going to get into it, but what the Suboxone did for me was, it allowed me to seek out the counseling aspect of it, and figure out why is this part of my life, why am I turning and work on myself cause what the Suboxone did was take away the physical part of it that I didn’t go through withdrawal and I wasn’t feeling that, the physical drive that drives you, just like when you’re hungry and you go to your refrigerator, once your body is used to that opiate, you’ll do anything to get it. So the Suboxone took away the physical part of it, and I was able to focus on the counseling and getting help.

Lori: Now is that the number, uh, is that that a eight number that they give out, for that addiction treatment you’re talking about?

Jill: Well, actually, yeah, actually the Suboxone addiction treatment we do right at our office in Breakthrough Addiction Recovery. Its outpatient, it’s very reasonable, it takes about two days to safely get someone on to the Suboxone. And it is actually a lifesaver. I’ve seen so many people come in, desperate, and leave with so much confidence and the ability, like he said, to start looking into their lives, why this happened in the first place, and really respond to counseling. But, we’re up in Norcross, and we have a very successful Suboxone addiction treatment. And anyone listening out there, including, you know, Lori, if you have family members that are struggling with this, it is an absolute lifesaver.

Brian: And you know, Lori, I heard what Paul was saying, and it’s a combination of the two that I think really makes it very successful. It’s putting together not only the Suboxone, and you heard what Paul said, that it really helps you, or your loved one, to be able to think clearly, be able to understand, and as a result be able to do the addiction treatment. So the counseling is so important tied together with the medication.

Jill: Absolutely.

Lori: Ok, but does this exist nationwide?

Jill: I’m sorry, say that one more time?

Lori: Do you have these kinds of clinics nationwide?

Brian: No, we’re only located currently in the Norcross area.

Lori: Oh.

Jill: Yeah.

Brian: But yet at the same time we have people coming from all over the United States…

Jill: We sure do.

Brian: …as they take a look at our website. You certainly can have her or him look at that, and give us a call, and we’d be happy to arrange it. We have a lot of different arrangement for people outside. Listen, we’re coming to our break right now…

Lori: What’s the website and then I’ll just hang up.

Brian: Ok, alright, we’ll give you that website and also the phone number.

Jill: Hey, hold on, Lori. I’m going to get you on the phone right after the break.

Lori: Ok. Thanks.

Brian: Alright. Well, listen, if you’re listening in and this is really a stimulating discussion, call us at 770-226-0920. We’ll be right back after the break.

<commercial break>

37:40

Brian: Welcome back to the Breakthrough Addiction Recovery hour. My name is Brian Fujii, and we have Jill Mattingly with us.

Jill: Hello.

Brian: And also our special guest, Paul. Paul’s been discussing his journey into addiction and now he’s going to be sharing with us some things with us about how he came to realize that he needed help. You know, Lori, just the last caller, wanted to find out about our programs and about how Suboxone works and I really appreciate when Paul mentioned that when he finally began realizing that he was having this issue and now he’s wanting to get on to Suboxone and get the help, and Paul, you were so eloquent about the idea how this Suboxone helped you to stay focused and you could get the counseling that you need. You know, you talked about all the ways you manipulated, but now you felt a need to come clean and tell somebody about what was going on in your life. Tell us something about what motivated you now after you started the addiction treatment and realizing, hey, you know, I need to share this with people who really care about me. And you began realizing some things about the loved ones in your life.

Paul: Well, I think that’s the biggest hurdle is that, uh, you know, you allow yourself to get so far into this and there, I know I’m not alone. I mean, if you’re out there and you’re in a situation, there’s a certain amount of shame involved in it. It’s embarrassing to admit that you’re addicted to something. It’s shameful that you are lying to people to get what you need. You know, so I had gotten to that point where I knew I had to do something. And somebody told me one time that the definition of insanity is to do the exact same thing over and over again and expect the turnout to be different. So I knew that I had to do something different if it was going to work this time. So when I went in for the Suboxone addiction treatment, I was sitting there, going through outpatient detox, thinking about, ok, how is this going to be different from all the other times I tried to stop. And the one thing that was exactly the same, every time that I tried to stop on my own and failed, was that nobody knew what I was going through. And I decided, I said, you know what, if I mean it, I need to do this to prove to myself that I mean it, I need to call all the people that are closest to me in my life, that I know care about me, and come clean. And tell them how bad my problem was, and what I was going through.

Brian: What was the fear that really, again that stopped you, prevented you from wanting to share? I know it may seem obvious, but some people may not even think about that. What were some of the things that were going through your mind… you felt that, you know, if I told somebody they might think what? What was going through your thoughts? That prevented you from wanting to tell…

Paul: Well, you know, it’s embarrassing. They might think that, you know, I’m weak.

Brian: Indeed.

Paul: And I’m failing them. You know, I’m selfish, I’m a liar… you know, all those things that are associated with trying to maintain this habit. You know, it was amazing. I encourage, I guarantee anybody out there that has this issue is that I was absolutely floored by the response that I got from the people that loved me. And how they,

Jill: Wow.

Paul: …they just were saying how proud they were of me that I was going to do something about this. There was no condemnation from any of them, they weren’t, there wasn’t… they understood and they have been fully supportive. And now I’ve proved to myself that I was serious about it, because I came clean. So that helps me to stay clean, to know that I have the support and that, you know what, I’m not just, if I screw up, I’m not just letting, I’m not just screwing up myself I’m letting all them down. I just had gotten to a point where I realized this started out with one pill, one night, it’s innocent, nobody’s getting hurt, it’s only affecting me. You know what, when I saw my buddy lying in that casket at thirty-six years old…

Brian: Mmm hmm.

Paul: …and looked at his kids, and at his mom, and you know, I couldn’t sit there and tell myself anymore that I wasn’t affecting anybody else.

Brian: That’s true.

Paul: Because my son deserves to have his father around. And that’s what it took for me. And, just, uh, it was amazing how my loved ones reacted, and I’d be willing to bet anybody else’s loved ones would react the same way.

Brian: That’s a very strong story there, Paul, because you’re exactly correct. And that’s what people think, I’m just doing this to myself. I’m not hurting anyone else. But as this progresses, we begin realizing how many people we are isolating, how many people that we’re, like you said, not sharing yourself, your real self, and trying to hide, and avoid. And so this has to be a tremendous pain that you’re going through, but also the pain of others. They’re saying, what’s going on, I don’t understand. And they feel too also isolated and alienated, don’t they?

Jill: Right.

Paul: Absolutely.

Jill: How are you doing on the Suboxone?

Paul: I’m doing great. I mean, you know, it takes away the physical craving part so I can focus on the things that I need to focus on. You know, I grew up in a Christian home, and that’s the foundation for me, and I know that God is forgiving and he’s given me strength and its just, you know, I know that it’s something I’m going to have to have in the back of my mind at all times I have a tendency to get addicted. So I know that I need to be careful.

Jill: Mmm hmm.

Paul: But the Suboxone has been an amazing help to me, because it just took away the physical part of it.

Jill: That’s exactly what a lot of my clients, when they come back, say, I didn’t know there was so much I could be doing during the day other than trying to find the next prescription. And it frees you up, because the alcohol cravings are gone, and you’re not having to look for the next bottle. And so Suboxone, like I was saying before, is a medication that someone can be started on over the course of about two to three days, and it’s very specific the way though that a person needs to be started on this medication. At Breakthrough Addiction Recovery, it’s very reasonable, and we also are different in that we offer good psychological counseling and assessments. And we really try to help you get to the bottom of why were you doing this type of thing in the first place.

Brian: You know, Jill, you’re so right.

Jill: That’s real important.

Brian: …about that combination…

Jill: Mmm hmm.

Brian: It is a combination, we heard this from Paul, and we hear this so many times from all of our clients, that it’s when they use the medication along with the counseling that it really benefits.

Jill: Right.

Brian: It looks like we’re coming in to our break, so if this topic is hitting a nerve, call us at 770-226-0920, and we’ll be right back after the break.

<commercial break>

Brian: Welcome back from the break to the Breakthrough Addiction Recovery hour. My name is Brian Fujii, and with me is Jill Mattingly, and our special guest is Paul, who is talking about his road to recovery from opiate addiction. And Paul, at the last break, he was talking about how he had learned as a result of using his Suboxone to be able to think clearly, and be able to get the help that he needed. And so, Paul, I’m very excited about this and I’d like for you to continue that piece as you were talking about how this was really working for you to be able to talk through and really understand what were some of the reasons that you were using your drug of choice.

Paul: Absolutely, it did. It really freed me up physically, that I didn’t have the alcohol cravings. And that’s what I want to say, you know, I wrote this, about what happened to me what I went through, for the sole purpose of, if it can help one person out there that’s in the position that I was, if one person gets help from it, then it was worth it for me to have gone through it. And I just want to encourage you, the biggest thing for me was that once I got rid of the physical craving, and then it freed me up, and now I don’t have to spend my days, every waking moment, chasing to fulfill that need that I created for my body. And then the other part of it was coming clean with all my loved ones, so I didn’t have anything to hide anymore. And I’m telling you it was the hugest, biggest weight in the world off my shoulders, once I was freed up in those two areas: not hiding anything and not having to chase anymore.

Brian: Wow, that’s liberation.

Jill: Looks like we have a caller. This is Leonard in Atlanta. Hi, Leonard.

Brian: Hey, welcome to the show, Leonard.

Leonard: Yeah, thank you very much, thank you very much.

Jill: You have a comment for us?

Leonard: Ah, yes, I was just listening to the young man talk about his addiction and I heard you make a comment, um, when you talked about the physical piece. The psychological piece is so imperative…

Jill: Absolutely.

Leonard: …and the past. And what we try to do is help people to resolve whatever the problem was led to the use and the addiction.

Jill: Mmm hmm.

Leonard: …so they can go ahead and recover themselves, get themselves back, and learn how to live a productive life and…

Brian: Absolutely.

Leonard: I’m really enjoying what you are saying. I wrote your website down. I’m going pull it up when I get to the computer…

Jill: Mmm hmm.

Brian: Mmm hmm.

Leonard: …kind of get some more information, because we deal with homeless individuals and it might benefit them for us to know what we might be able to refer them, if they need this type of addiction treatment. Just keep doing the good work that you’re doing for the Lord.

Brian: Well, thank you, Leonard. Appreciate that comment.

Jill: Thank you, Leonard. Thank you for your call. And I do want to say that we are going to continue the discussion on pain prescription addiction next week. We’re actually going to have a special guest; tell us a little about that, Brian…

Brian: Right. Jennifer DeValence is going to give us a call from Washington. She’s with the White House, and the Office of National Drug Control Policy, and she’s going to be talking to us about this new initiative that’s being taken by the federal government, especially as the campaign to prevent prescription and over-the-counter drug addiction by our nation’s teenagers…

Jill: Finally…

Brian: …and adults.

Jill: Finally, we were on top of this way before the White House, I think. Actually, they’re previewing and debuting ads. They’re going to have it on Super Bowl Sunday about how kids are getting oxycontins and hydrocodones from their parents’ medicine cabinets. And it’s the things we’ve been talking about, they’re finally catching up. This is a big issue, everyone. You know, this is going to destroy lives if we don’t start to take notice that this is happening to our teenagers and our young adults. And hopefully this show has helped you understand the devastating journey that someone has to go through in terms of opiate dependence and pain prescription medicine addiction.

Brian: And you know, Jill, we have, you have such a great program with the Suboxone, and I know…

Jill: Oh absolutely…

Brian: …with the counseling component that this combination is so helpful. And we see this every day as we work with our clients…

Jill: Mmm hmm.

Brian: …the way the medication is helping them to stay clean and sober as well as what Paul said, it just keeps their mind clear and gives them the ability to really stay focused, like what Leonard was saying, on the real issues and trying to get their lives back. And I think that’s a powerful combination. And so if you’re looking for a addiction treatment program like this, we offer a free consultation. And give us a call at our office, 770-734-8091, and we’d be willing and happy to set up a free consultation to talk about how we can help

Jill: It’s so easy, it’s so easy, yet most people don’t know it’s available, and that’s why we’re doing this radio program, right, Brian?

Brian: Indeed.

Jill: We are really trying to make people aware and help them find the help that they need.

Brian: You know, I can’t really over express my gratitude to you, Paul, and…

Jill: Oh, Paul…

Brian: …for what you have done for our listening audience these last two weeks. And your story is powerful, and you have written it down, and we’re going to encourage our listening audience to call us at our office at 770-734-8091, if they would like a free copy of this story. Paul has allowed us to share this with the general population, and we’re so excited about it, because we know it will help you or your loved one to be able to understand this.

Jill: Thanks, everybody. Thank you, Paul. See you all next week.

January 12, 2008 - Opiate Addictions in Adolescents

Breakthrough Addiction Recovery Hour show transcript

January 12, 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: Welcome to the Breakthrough Addiction recovery hour. My name is Brian Fujii, and, our colleague here is Gail Mattingly, and we are going to be talking today, a little bit of a continuation on our…

Jill: Did you just forget my name, Brian? (laughs)

Brian: No.

Jill: It looks like you just forgot my name. Well, I’ll wear a nametag.

Brian: Jill Mattingly.

Jill: Ok, thank you, thank you.

Brian: We’re going to be continuing our discussion on the topic of opiates, and especially as it related to adolescents. And then we’re going to be looking at how we can deal with addictions and opiates and how we might be able to truly get through some problems about maybe even outpatient detoxing and hopefully be able to help people letting people know there are some ways that people can overcome the addiction to opiates.

Jill: Yes.

Brian: So what did we talk about last week? We had some situations with an adolescent who was stealing stuff out of their mom’s cabinet.

Jill: Yeah, there was a story in the AJC back in Dec. and I brought that in and I was kinda thinking about it for almost 2 to 3 weeks and thinking I really need to address this, because at Breakthrough Addiction Recovery we see the fallout from a person that has started abusing opiates such as pain meds in high school, you know, or college—adolescence. So I decided to bring that story in and we started talking about it and I actually brought my niece in last week You were here. And she did a great job.

Brian: She did a fantastic job.

Jill: But she actually opened my eyes quite a bit to what was going on in the high school and how easy it is for you to find oxycontins, hydrocodones, vicodins, xanax, those types of things. While you’re standing at your locker someone might offer something to you. And we also brought up the fact that if you’re a high-school student and you have a parent or grandparent that you know has a huge big gigantic bottle of 120 of these pills in your medicine cabinet at home, what a great way to make friends, to say, hey man, I can get some of those for you and bring them to school.

Brian: Exactly. And you know, that’s where we were talking about last week is, it’s so easy to for some of these young people, even down in probably the middle school, not only just the high school, but how people are approaching them. I was very amazed, uh, when you know your niece was saying, hey, they approached me at my locker.

Jill: Yeah. Mmm hmm.

Brian: And we’re sitting there, my goodness, using a pen as a way to pass off that drug.

Jill: Right. Yeah, they clear out the inside of an ink pen and crush up oxycontin, put the oxycontin in there. They actually snort it while they’re at school. Ah, my niece was saying, you know, she’s seen girls leaning over the sinks in the bathroom taking a pill, you know, even found one of her classmates passed out in the bathroom, which was probably not necessarily an overdose, but too much oxycontin can make you very sleepy and depress your respiration to where you don’t feel like you can get up off the floor. So obviously this is a very big problem. We talked about this last week, we started to look at the fact that maybe parents need to take a look at what’s going on in their own home. Now, it doesn’t mean it’s just teenagers. Not at all. And what we’re finding out is that, uh, most people, they go to the doctor, they’ve pulled a muscle, you know, maybe they’re cleaning out the garage, pulled a muscle and…

Brian: Right.

Jill: The doctor…

Brian: Weekend warriors…

Jill: Right. The doctor, the doctor offers them, lemme give you a 90 Lortab to help you thru that, and just take this many and taper off them over the next couple day. Take a long hot bath and get massage and things like that. And you go home and you take one, and you realize it makes you a little nauseous. So it doesn’t really help; you just decide I’m gonna take naproxen instead. But, um, you leave that bottle in your medicine cabinet, and you know, maybe you have a dinner party where there’s 8 to 10 couples there at your house, and it’d be interesting to know if someone was looking in your medicine cabinet when they were in your bathroom.

Brian: Indeed… not just your family but your guests…

Jill: That’s right. And you know what’s interesting is that a lot of our clients have told me that one of the ways that they got their Lortabs and hydrocodones and oxycontins is they’d have a friend that would say, yeah, my girlfriend just had surgery and they would say, hey, I’ll come over and watch the game with you, and you know, they go to the bathroom and they raid the girlfriend’s oxycontins or lortabs in their bathroom. I mean they’re always looking for someone… or grandparents, that’s a very, very commonplace… you know older people have a lot of aches and pains and doctors don’t have a problem giving oxycontins, Lortabs, hydrocodones to older people if they’re complaining of severe arthritic pains. So that is something that sends a red flag up for a lot of people who are addicted to these. Who can I go to their house and without them knowing, just take maybe a handful, you know.

Brian: Well, you know, especially you mentioned that Jill and that is so many times, one of the things we do forget maybe there are a lot of people out there trying to sell their homes, for example.

Jill: Mmm hmm.

Brian: And you know it really behooves those individuals to put those medications up in a very safe place because who knows based upon what you were saying they could be going through someone’s medicine cabinet as they’re trying to figure out whether they like this bathroom or not…

Jill: You know what, I need to use the bathroom.

Brian: That’s right, that’s right.

Jill: They probably… That’s a great place to go and try to figure out you know if you can get a few more oxycontin, lortabs in a person’s home. A lot of times you know a real estate agent will ask you to lock those types of things up, but what we want to do today, as in the start of this show, as a recap of last week’s show everyone out there within this listening range if you have a opiate medication, pain medication in your bathroom, you know in a place where it’s obvious you are keeping your medicines and things like that.

Brian: And has easy access.

Jill: And easy access.

Brian: Mmm hmm.

Jill: It is a very good idea to take up those medications… you can leave the Tylenol and the Advil and things like that in the medicine cabinet, but take the medications, take the xanaxs, the klonopins, the even some muscle relaxers people look for.

Brian: Right.

Jill: And all of your pain medications and put them in a separate, locked area, especially if you have teenagers. Now we’re not saying your teenagers are taking your oxycontin, no, not at all, but don’t teenagers have friends over quite a bit, and it takes one comment at school for your teenager to say, hey, my mom takes that, just like that article we looked at to have the other kids say, ah, yeah, you know, let’s go do homework at your house, you know, that kind of thing. So never know, so hopefully this will changes people’s habits, you know, of keeping medications in their bathrooms and things like that. And then we’ve done our job, if people go home and change that, Brian.

Brian: That’s right. That’s exactly correct. You know as we take a look at these situations…I know you say something very interesting on the TV show…

Jill: Oh yeah.

Brian: It was interesting about how this mother ended up selling her son’s car because she found some alcohol in it.

Jill: You know this is a parent who is really on top of it. She is saying, ok, I know what it is like to be a teenager and I know what my son is going to be offered and I know what we may do to get friends and keep So this kid it looks like got a car and she soon found some alcohol under the front seat and she put an ad in the paper to sell this car. But the best part of it, and the reason she was on Good Morning America is the ad and the way it reads. I’m going to read it over the air right now: This is an ad in the for sale section, and it says, Olds 1999 Intrigue, totally uncool parent who obviously don’t love teenage son, selling his car. Only driven for 3 weeks before snoopy mom who needs to get a life found booze under the front seat. $3,700 offer or best offer. Call the meanest mom on the planet and then gives her number. (laughs)

Brian: (laughs) That’s fantastic. They probably got $307 for the car.

Jill: I know…

Brian: Listen, if this particular topic is touching a nerve and really something that you’ve been thinking about and you have maybe teenagers or maybe young adults in your home and this is troubling you, give us a call here at 770-226-0920, and if you’re outside the Atlanta area, 1-888-920-2665. You know, as we continue we know many times this is not just for children. Obviously we’re seeing a tremendous epidemic of the use of pain medications as ways that people use to get high.

Jill: It’s huge.

Brian: Both those that are legally prescribed medication as well as the ones that are being obtained through illegal means. And so as you take a look at we look at some of these issues maybe it’s a little more technical, but sometimes parents when you’re out there you see some strange things going on with your child or perhaps even with one of your loved ones, you might wanna take a look and say maybe something’s going on. You know, uh, if you’ve see a person this could actually be going through withdrawal, couldn’t it? For example, if they’re having flu-like symptoms, all the time, and like you said last week, you shouldn’t be having the flu once every two weeks. (laughs)

Jill: Yes. Yeah, you should not have the flu more than one time a year.

Brian: That’s right. So just some things, to be observant, to look for, or maybe if you’re seeing watery eyes or runny noses, or constant yawning or sweating, things like that, that may be coming about because perhaps you might wanna be asking some questions…

Jill: Right.

Brian: …about what’s going on.

Jill: So let’s talk a little more about the withdrawal symptoms. I think that’s really good for someone to understand, what a withdrawal really is.

Brian: Mmm hmm.

Jill: Because if you don’t know, you really do think someone’s just got the flu.

Brian: Just being sick.

Jill: Let’s, when we come back from this break, let’s talk a little bit more about this… 770-226-0920. Stay with us, we’ll be right back.

<commercial break>

Jill: Hey, welcome back to breakthrough addiction recovery hour. My name is Jill Mattingly.

Brian: and I’m Brian Fagee.

Jill: Yes, he is. And we are talking about pain medications, and especially addiction and dependency to pain medications such as opiates. And we really have a lot to talk about and helping the general public how to spot what’s going on that might even be happening in your household where someone is using pain medication not just using it, I want to clarify that, but abusing it to the point of being dependent on it. And one of the things I noticed in my research was we talked about this before was the sale of narcotics, of drugs for pain, such as opiates, has just skyrocketed…

Brian: Yes.

Jill: …in the past ten years. And a lot of that has to do with our aging population, has to do with, you know, the philosophy of pain, taking care of pain, and doctors, you know, are encouraged to keep people out of pain, so much more liberal riding practices are out there with many doctors. But I actually spoke to a pharmacist that I use and we started discussing this and he’s like, oh, Jill, you just don’t understand, I actually have friends that have these small pharmacies and if it wasn’t for the sale of oxy, not oxycontin, but hydrocodone, they wouldn’t be able to stay in business. They literally order barrels of…

Brian: Barrels?

Jill: (laughs) Yes, of hydrocodone, and usually have it, you know, fill prescriptions with it and it’s gone in less than a week.

Brian: That’s a lot of pain out there…

Jill: And a lot of cash, because a lot of people are coming in paying cash, and we know that probably why they’re doing that is because they want the insurance companies to see how much, how many prescriptions they’re filling of the pain medication. Because that’s going to go in to that insurance company, raise a flag, and they’re going to see that you’ve gotten three hydrocodone prescriptions filled in the last twenty days… something’s up.

Brian: Right.

Jill: They’ll send letters to your doctors and to the doctors prescribing it, so interesting little aside from the pharmacists out there and what actually is happening. But anyways, we were going to just talk a little bit maybe about how to recognize if a loved one or coworker or someone is struggling with addiction.

Brian: That is true. And there are some basic things to look for, and this doesn’t mean you have to be a psychologist to know this. If you begin to see some really major changes in the behavior of your loved one, something such as they start isolating a lot more…

Jill: Mmm hmm.

Brian: Or they actually start they find that the relationship is starting to diminish in the home… whereas maybe at one point they were talkative and engaged in conversation, and now they’re less talkative, or maybe they’re becoming more irritable…

Jill: Right.

Brian: Or they’re becoming more argumentative. These are some very clear signs that something is going on, doesn’t mean that’s the case, but it certainly might be something. Certainly find out if they had enough sleep the night before.

Jill: Mmm hmm.

Brian: Or if this keeps going on for a period of time. Or you begin, especially with an adolescent, finding things missing in your home, it could be that they may be taking things and selling it in order that they might be able to obtain their drugs.

Jill: Mmm hmm.

Brian: So these are some of the behaviors that parents or also husbands and wives can begin looking for, because we know that when people are moving into the area, especially of addiction, or they’re moving into addiction or also dependence, obviously they are spending more and more time trying to find their drug of choice, using that drug of choice…

Jill: Yeah, so preoccupied.

Brian: …and overcoming the issue. Preoccupation is a big issue.

Jill: You know, I had one of our clients that came through and went through outpatient detox, got on Suboxone, was doing very, very well, and one of the things he came in and his follow-up, he was so excited because for the first time he didn’t have to concentrate on where his next bottle of pills was going to come from, and he was going to be able to see his son, have his, he must be divorced, and his wife was going to let him have his son for the weekend, and he was so excited, he goes, for the first time I’m not going to be afraid my son’ll find the stash, and I’m going to play with him, because I won’t be preoccupied. I won’t be on the phone. I won’t be checking emails, so that I thought was a very interesting thing to say too.

Brian: It is. Hey, we got a call from Judy in Acworth.

Jill: Oh great.

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

Judy: Thank you.

Brian: And you have a comment.

Judy: Well, I do. I, uh, you mentioned some of what I had said to your screener. I don’t live here, we are going to relocate eventually, but I had surgery over a year ago and I was sent home with some Vicodin for pain, but it made me sick. So my husband strained his back doing some yard work and I gave him my Vicodin. And there must’ve been fifty-million pills in that bottle…I have no idea how many were in there… but he began to like it very much, and the next thing I know the bottle is empty because it wasn’t just straining his back doing yard work, it was then the excuse of something else. Whether it was a wrist, or an ankle, or his back or his head. And I guess in all honesty I just went along with it, and he began I guess to go thru some type of withdrawal because he didn’t have any anymore. And then he got hold of some, and he, it was very obvious that he was an addict. And it was having a serious effect on our marriage, and the work that we do. We do church work. So everything was falling apart. And we sought some help in our town… you mentioned Suboxone?…

Jill: Suboxone, mmm hmm…

Judy: So that is what he did. We sought out addiction treatment. They sent us to an addiction addiction treatment facility and he received the Suboxone addiction treatment. But that alone wasn’t enough, because we needed counseling.

Brian: That’s so true.

Judy: So he found out it was behavioral and he was predisposed in so many ways in his life to be an addict. And, um, I never looked at it that way, you know. He didn’t buy just one pair of sneakers; he’d buy three. He didn’t have one beer; he had five. As I look back on it now, it’s just been a very freeing experience for us. We’re coming up on a year that he has been… well, he had a small relapse, but we didn’t panic. And it was like a bump in the road, we felt like because that was exactly what we needed to do.

Brian: Is he getting some support now?

Judy: Absolutely.

Brian: Seeing a counselor, and working through that?

Judy: And we don’t hide about it. He doesn’t hide. He’s not ashamed. Because we found out there are so many other people, even in our church, that have been dealing with this type of problem.

Brian: It is.

Jill: Wow.

Judy: So we’ve got the help we need, you know, we have the doctors that we need, but we also have the support of family and friends. But I would say to your listeners the behavioral counseling was key for us.

Jill: Wow.

Brian: You know, that’s so true, because so many times, Judy, that after a person actually comes off and gets outpatient detoxed, off that opiate, the psychological dependence is very complex and also lasts a long time… can be up to maybe a few months, up to maybe a year or two. They really do need that support.

Judy: And now when I look at labels, you know, it does mean take it if you need it for pain, don’t just take it. And, uh, we have found out there are things you can take for pain that are over the counter that work sometimes just as well. But we’ve also found that he doesn’t have as much pain as he used to think he did.

Jill: How has this been for you, Judy? I mean, the family member goes through it as well as the person who’s dependent.

Judy: Well, I saw myself as part of it. I mean, truly, I knew he was taking them, how could I not?

Jill: Mmm hmm.

Judy: But, if it was making him feel good, and that’s terrible, but I just went along with it. I had no idea what was happening to his body.

Brian: Well, you know, that is the big thing, Judy, is that many times people look at it that way. Well, it was prescribed by a doctor, it’s filled by a pharmacist…

Judy: Absolutely.

Brian: …and it’s paid by insurance, why not take it? It’s legal.

Judy: Well, I’ll be honest, and when you see…

Brian: It’s so easy.

Judy: …them starting to go through some type of withdrawal… now we didn’t call it withdrawal, I had no clue what was going on, but I did get a refill.

Jill: Mmm hmm.

Judy: I did get some more so, and he took them and then I knew exactly what we were doing.

Brian and Jill: Right.

Judy: And then I was, you know, I guess, enabling, if that’s the word, him to do this. And I needed help. Because I was afraid to not let him take it.

Brian: Well I’m really glad you said that too. We’re coming up on the break, close on this one, that’s why Breakthrough Addiction Recovery, Judy, we offer a program called family education, because it really helps the family to understand what the person who is addicted is going through, and how the family, as you said, sometimes enables, and also really causes the person, or allows the person, to continue to use their drugs of choice.

Judy: That’s right. Oh, so do you, ok, I don’t know about how you do it, but where we are, we can go, um, now, if we need a meeting, we go.

Jill: Yeah.

Brian: Oh, that’s great.

Judy: We call them and say we’re coming in. (laughs)

Jill: Yeah, that s good. And that’s very much how we work also. We use the Suboxone specifically for outpatient detox off of …

Judy: That is phenomenal.

Jill: Yeah. It is. And that is what everyone comes back and says, is that, thank God for Suboxone. Judy, you’ve opened up a whole new topic. We’re going to talk about Suboxone when we come back.

Judy: Well it saved our marriage.

Brian: Keep it up.

Jill: Well, thank you so much for calling in and telling your story.

Judy: Ok. Good luck.

Brian: Have a great day.

Jill: And it looks like we’re coming up on a break, so we’re going to be right back. We’ll talk a little bit more about the medication, Suboxone.

Brian: Indeed.

<Commercial break>

Brian: Welcome back from the break to the Addiction Recovery hour. I’m Brian Fujii.

Jill: And I’m Jill Mattingly.

Brian: And we’re talking today about opiates and the problem of addiction and how people are getting into people’s medicine cabinets and trying to get that drug of choice to be either used personally or shared with others. We got an interesting call just before the break…

Jill: Right…Mmm hmm…

Brian: And I thought Judy did a wonderful piece here in telling us about how she and her family literally moved into this addictive process and we do know it is a family issue. It certainly isn’t just only the person who is having the addiction.

Jill: Absolutely.

Brian: And at that break you mentioned about Suboxone… maybe the group is very interested in learning more about Suboxone. So if this topic is really hitting a nerve, give us a call at 770-226-0920, and outside the Atlanta area, 1-888-920-2665.

Jill: Right, and if you are someone listening to our previous segment and you decided to go to your bathroom and take your pain medications out of the medicine cabinet and put them somewhere else, I want to hear from you. Let us know that you did that. And encourage other people to do the same.

Brian: What a new year’s resolution.

Jill: Absolutely. So we were going to talk a little bit more about how the opiates work. And some of the other things that you know maybe people can be looking for.

Brian: Exactly. Well you know that’s why we here at Breakthrough Addiction Recovery don’t look at addiction just as a problem with will, a problem with character, but we do understand that it is indeed a brain disease.

Jill: Yes it is.

Brian: And we do know the reason is for that is because we understand how the medications work. So especially like with opiates we know that they basically impact one of those major receptor sites. They call it the mu receptor site. That’s because it deals with pain. And so with this medication when people are using it, if they’re having physical pain, then we know that’s going to be a perfect medication to use. However, many people because of longevity years, I’ve heard that people shouldn’t use pain, these types of pain medications for more than 14 days, such as after surgery or if they have a major accident or injury, but yet they continue to use it because it makes them feel so much better.

Jill: Mmm hmm.

Brian: And when you take a look at the fact that brain pathway, which is part of that limbic system, or that lower brain, it’s below that big part of the brain that makes us think logically, you know, when I ask you what time it is, you don’t tell me that the sky is blue.

Jill: Yeah.

Brian: So… if they do tell you the sky is blue when you ask them what time it is, you better send them to us.

Jill: Send them to us…

Brian: Indeed. But, we do understand that that is a major issue, that the brain has now been impacted in such a major way, that no longer is there a rational control of the use. So now the brain is automatically craving and desiring the use of that medication. And there is no choice. So if someone says, why can’t my loved one stop, it’s because they can’t stop, because their brain won’t allow them to.

Jill: Yeah, there’s a couple issues going on… like before you said, because it makes them feel good. And that, a lot of times that’s how you get yourself kind of in a fog in thinking well I’ll just keep using these because they make me feel good. Work is very stressful, my home life is stressful, when I take a couple Vicodin, you know, I start to feel a little bit better, I’m on, I’m performing. And then when you decide, ok, I don’t want to do that anymore, and you start to decrease the use, or stop, you find out that you become in intense pain, which is the withdrawal symptoms. Then the issue becomes, I’m taking these medicines because I don’t want to be in pain. I don’t want to go through the withdrawal pain.

Brian: That’s right.

Jill: And so, I mean, it can start off really rosy, and feeling good, but it is very crucial to know that this medication will imprint itself in your brain function so that you cannot easily come off of it.

Brian: I’m glad that we said that too, Jill. That is so true, because people begin using this, and then the brain literally changes. It’s just kind of a rewiring of that brain.

Jill: But, you know, Brian, everyone is different. You know, the way they respond to medication. I for one had knee surgery, tried one oxycontin and, you know, was physically ill and nauseated for the next two or three hours. So it didn’t appeal to me at all.

Brian: Oh, I’m glad you said that. And that’s kind of the reason why that only five to ten percent of the people who actually try or experiment with drugs actually get into dependence, for exactly the same reason you said…

Jill: Because it just doesn’t appeal…

Brian: It doesn’t work for them. Could you imagine if someone was drinking and every time they drank they had a hangover and they threw up all the time? They probably would not look at alcohol as being a fun thing to do.

Jill: It’s all in the positive reinforcement. Or negative reinforcement.

Brian: That’s right.

Jill: But I think that’s interesting in the fact that not everybody that is taking medications is going to slip into this, and not everyone is going to feel effects if they’ve taken it longer than two weeks. They’ll be able to stop. They might feel a little more pain in the area that they were taking it for, but probably using Naltrexone, not Naltrexone, sorry, naproxen or Advil or something like that, they will feel better.

Brian: A lot better.

Jill: If you want to know what type of medications fall into pain medications, like opiates that we’re talking about, our website is chock full of information about these medications. And our website is www.breakthroughaddictionrecovery.com, and there’s extensive information on not just our program, but all of these drugs of addiction that we talk about. And links to more information that you may be looking for. Please take a look at the website, and if you’re interested in a program with us, with a problem with pain medication, you can also come into our program for a free consultation.

Brian: A free consultation any time. If this program is really striking you, 770-226-0920.

Jill: Stay with us.

Brian: We’ll be right back.

<Commercial break>

Jill: That’s right, 770-226-0920. Call us if you want to comment, question, get in on the conversation that we’re talking about opiate dependency and addiction. Call me if you’ve locked up your bottle of pain pills in the last twenty minutes after what we’ve been talking about. Tell me where you put…no, no, wait a minute, um, but let us know if you’ve really responded to some of the things we’re talking about. Hey, and we also have a line that people listening to us on streaming internet can call, 1-888-920-2665. We’re on www.920wgka.com every Saturday at 3:00. And I promised to talk about Suboxone that Judy that called in earlier talked about. I want to talk about it in terms of some of the clients that I’ve treated at Breakthrough Addiction Recovery with Suboxone. Most people what happens is they’ll call and say, hey, I’m taking twenty to twenty-five Percocet a day…

Brian: That’s a handful

Jill: Yeah, that’s a handful… no, I’m sorry, um, yeah, twenty to twenty-five Percocet a day, and some people even call in saying I’m taking ten to fifteen pills every eight hours, or every six to eight hours. And, you know, you think, ok, how can you take that many pills? Well, it doesn’t take long for tolerance to develop once you’ve started on these medications. You know, so that’s a typical call I get. And we talk about the efficiency of Suboxone in letting you come off of all the other medications, getting on to Suboxone, without the withdrawal that is so painful

Brian: It is.

Jill: And so difficult.

Brian: And that’s one of the major reasons why people have a hard time coming off of those opiates…

Jill: Exactly.

Brian: …because the withdrawal is so miserable. It won’t kill them, but they feel like dying.

Jill: Yes. And sometimes it can last, you know, three to four days, the symptoms. So obviously they are taken out of life for three or four days; you really can’t function when you’re withdrawing from this. So Suboxone becomes a really good tool to help people go from the dependency on the opiates, pain medication, over to functioning. With the medication, Suboxone is a long-acting opiate, but it is much different in the way that it functions in the brain, so it doesn’t allow withdrawals and it allows you to taper it without having problems.

Brian: Mmm hmm.

Jill: And I want to talk a little bit, one of my clients came through in the last few months and I’ll just call him Paul, ok… lemme just call him Paul… well Paul came in and he had gotten to the point where not only was he taking the handfuls every four to six hours, but he was using all of his waking hours trying to find when his next bottle of pills and where it was going to come from. And so he was the type that got on medication because he had a dental procedure, and it was normal, I mean, you get on this pill because dental procedures are very painful. And once he was on the medication he found out how good it made him feel, and then it turns out that the loved one in the house had had surgery so they had bottle of pills so he just decided to take some of theirs. Before he knew it, he was trying to figure out how to go to the doctor and get his next bottle. Well, you know, if you go to one doctor, you’re not going to be able to go back 14 days later and say, I just used the month’s worth, so can you write me more…

Brian: But was he doctor shopping…

Jill: Yeah, so what he started to do, was finding doctors, telling the story to, and kind of not letting each doctor know he was seeing other doctors for his prescription. This is commonly known as doctor shopping and it is illegal to do so. And so you have to be very careful if you’re going to play that game because you can definitely get caught. He said when he had come to see me; he had gotten more than twenty doctors around the area to write him these prescriptions. And he had them all, neither; none of the doctors knew that the other ones existed. So it was very, very dangerous, but not only that, and this is one of the things I want everyone to hear today, is he fell prey to thinking, well, here’s an easy way to get the prescription filled, I’ll do it online. I see those little ads on the internet saying, any pill you want, all’s you need to do, click here, give us your information, we’ll get a doctor to ask you a few questions, and then it’ll get filled in another state and UPS will bring it to your door.

Brian: You know I had one person actually tell me the UPS truck was a real trigger, every time they saw it…

Jill: Oh, absolutely. Well, he started to order this. Now, if anyone has tried that, they’ll find out it is very expensive to do it that way. So a $150 bottle of pills is going to be almost $300. So he started doing that. Now, finally, I think, after a few years he realized this is no way to live. I have no life. And he decided to get help. He had tried methadone, and methadone being the other way to try to come off opiates, it had not worked for him. Suboxone has worked wonderfully. Now here’s the reason why everyone listening should never order pain medications online: once they have your information, there is no way to stop them from contacting you if you do not renew your prescription with them. So, um, I ordered ninety hydrocodone, and I decide I’m not going to do this anymore, I get help. I’m off of the hydrocodone, but then one day my email says, hey, do you want to order more? And then they start to call me on my phone and say, hey, you haven’t refilled, do you want to order more? My client Paul said they were calling him three to four times a day…

Brian: That doesn’t sound like a doctor’s office

Jill: No, no…

Brian: That sounds like someone trying to push something…

Jill: It didn’t sound like an American voice either…

Brian: No, it certainly wasn’t.

Jill: And what had happened was, he really had a lot of hard, hard times with these calls. These calls coming through every single day, emails, his Blackberry going off, telling him he needs to reorder. Talk about triggers and alcohol cravings. He was having a very tough time.

Brian: You know, it’s interesting you mention about that trigger, and talking about having a tough time, I’m sure he was under a lot of stress. And you know if anyone tries to stop using especially opiates, do you know what the number one trigger is to use? Stress. So can you imagine if someone is constantly badgering you about wanting to use, you’re sitting there, and you’re getting these email flashes and all these phone calls, you can imagine that is going to be a significant trigger to use.

Jill: Well, I want to talk a little bit more about Paul and these triggers that can come from unexpected places, even when you are off the medication. Call us if you want to join in on this conversation. 770-226-0920. We’ll be right back.

<Commercial break>

Brian: Welcome back to the Breakthrough Addiction Recovery Hour. I’m Brian Fujii, and I have with me Jill Mattingly. And today we are talking about opiate, opiate addiction, and addiction treatment At the break we just got through talking about Suboxone, and how that impacts a person’s ability to overcome the issues of opiate addiction. What we’re trying to do now is really help us to understand something about the Suboxone is a wonderful drug that really helps people to overcome the addiction to opiates but at the same time, it’s not a silver bullet. And we do know that people do need some other kinds of addiction treatment. We heard this earlier from Judy when she said that she and her husband was involved with some form of addiction treatment. And we understand that if a person’s going to really be able to get through addiction, it is more than just medicine. And we understand that persons do need to be involved in some kind of addiction treatment of psychosocial support. I know one of the things that we do, Jill, at our office is when we work with individuals, we help them to understand that many times they are dealing with feelings of guilt, or they’re dealing with shame, and they’re also trying to deal with some self-esteem. And I know that many times when people are using drugs, they are trying to find some way to overcome that emotional pain.

Jill: Absolutely.

Brian: You know, well, look, we got a call here from Louise, from Tucker. She’s asking the question about what causes pain. Welcome to our show, Louise.

Louise: Uh, yes, thank you. I don’t catch your show often, but I did this afternoon. I was fifteen years old when I lost my dad, so I became a hypochondriac. I have visited every doctor, every hospital, whatever, but as time went by, I realized it was the attention I needed. The pain was, you know, severe at times, when I was just sick, but it was because of the loss. Yesterday I was visiting Krispy Kreme Donut on Ponce de Leon, and there was a young man, a man who obviously stayed in the woods, he’d lost his mind…

Jill: Yeah, I’ve seen a couple of those there too…

Louise: And so I had this great interest in what causes pain. I know that if you cut your hand, you’re going to have pain. But where does it start?

Jill: You have nerve endings that, you know, your a survival machine, your body is and when nerve endings tell the brain that there’s a threat to the survival of the organism, then you have many different releases of hormones and what we call neuropeptides or neurotransmitters. One of the neurotransmitters or one of the substances that transmits pain is called substance-p. Very interesting to look at that if you have access to a computer or a textbook to look at substance-p, and the presence of substance-p allows, if you will, like gates to open up and that causes the brain to become very much aware that there is a problem. And it’s mediated as what we feel as pain. Now opiates close those gates and don’t allow that substance-p to cause that type of situation. But you know it doesn’t work, you know, one dose is not going to work indefinitely. You will find that it takes more and more and more. A lot of the people you see down there on Ponce de Leon Avenue, because a lot of people that are addicted to these substances, you know, cocaine, crack cocaine, and heroin, frequent those areas, and you can tell if they’re in a state of withdrawal, in a state of intoxication, I mean, it’s very difficult to see that, but it’s very interesting. You can tell where their body is at any certain time.

Brian: You know, it’s interesting too, Louise, you mentioned this idea about pain, and many people who are on opiates, especially like the oxycontin and so forth, they not only have a problem with just physical pain, they also have a low tolerance for emotional pain.

Jill: Yes.

Louise: Exactly. Emotional thing and that’s my, that’s what I’m so interested in is the emotional pain, because, see, I’m a practicing Christian, so what I do is I practice renewing my mind, if you will. Because my understanding of Christianity is my identification with Jesus has already taken the pain.

Jill: And a lot of people use that as a very important support system for them. And Louise, we have someone else wanting to ask a question. Thank you so much for calling in and I hope I answered your question.

Louise: You sure did and I appreciate it.

Jill: Yes, and have a wonderful day. It looks like we have Kelly in Marietta. Kelly, you have a question?

Kelly: Yes, I’ve been taking hydrocodone and I don’t take it while I’m working, but on days off I take it. It’s sort of my way of kind of controlling it. But I think I have more of a mental addiction to it, and…

Jill: Kelly, let me do this, I want to talk to you. Can you hold on, we have to stop the show, but I’m going to talk to you off the air. Would you hold on and let me talk to you off the air about this issue?

Kelly: Yes.

Jill: And Kelly, hold on, we so appreciate your call. This is a big issue. Everyone out there listening, thank you, thank you for listening, and join us next week. 3:00, Breakthrough Addiction Recovery. I’m going to go talk to Kelly, Brian, so…

Brian: Have a great afternoon.


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