4-26-2008

Brian: During our call in show we will be taking in all your calls of interest in areas dealing with alcohol and drug addiction, and today I do have my co-host back with me, Jill Mattingly, after several weeks of absence.

I was so glad to have you back, I missed you tremendously.

Jill: Well, thank you.

Brain: And we also have Dr. Neil Johnston back with us again, back at the mike, and we’re going to be talking about some very interesting topics today. We’ll going to be talking about relapse triggers and cravings, how people begin as they move into addiction, how various people, places and things begin to cause them to crave for their drug or drink of choice.

Jill: Well, thanks for that great intro, Brian. I am really happy to be back. You know, I just want to say out there to the people listening, thank you for our prayers and support, our family went through a real difficult time. You know, spending time, almost a week in the hospital, with my father, and he is, safe to say, doing very well. I am sure he is listening today, that’s why I wanted to say, “Dad, I am so glad you’re home and you’re doing well.” And, I hope everybody out there is doing well today. We are going to talk about something really interesting and if you want to start listening to some of the things we even we talk about in our day addiction treatment program, there, Breakthrough Addiction Recovery, this portion called Relapse triggers and Cravings is a part of the Matrix Model, in which we teach during the day addiction treatment, and Brian, actually, is one of the main instructors, if you will, on this and other licensed personnel, and really, I thought this would be a really neat approach for the radio show, is to start bringing up some information that it’s not cookie cutter, addiction dependency is not cookie cutter, you cannot say, “oh, here’s what happens in everybody and this is what the outcome will be.” It is just not like that and Dr. Johnston is going to throw in his two cents, with that, I’m sure.

Neil: I’m sure eventually I will. I’d like to add if there is anybody out there has stories of their own recovery process, things that have gone on that were relapse triggers for them, that they learned to overcome, we’d love to hear about it. Please call in and let us know.

Brian: Yeah, and that number there is 770-226-0920 and also outside the area is 1-888-920-2665. We’d sure like to here your success story!

Jill: Right! This is a call-in show and so just to introduce this whole section on relapse triggers and craving, one of the things I always heard is that successful recovery involves rewiring the brain. That is an interesting statement and if you want to understand how we come upon that statement, I want you to stay tuned today. Really, there is another way to approach it, too, is just looking at an addiction or dependency is actually a hijacking of the brain and the behaviors that occur are because the substance has produced different behaviors in response to things that are happening, you know, in or outside of the life of that person. And that by combining the evidence-based addiction treatment, prescribed medications, a willing and compliant patient, the brain can actually heal and recover and rewire, if you will.

Brian: I like the way you put it too, and many ways when a person continues to use that medication, it changes all kinds of neurochemistry balance in the brain and so where it is a normal process when without being influenced by alcohol and other drugs, the brain just functions perfectly and it begins to do the things normally a brain is supposed to do but when we start infusing with alcohol and drugs, those neuro-chemical balances get all messed up and as a result there is a kind of a rewiring of the re-circuitry.

Jill: Exactly.
Neil: And all that depends on the individual’s genetic makeup and what their circuitry was to begin with. That’s why you have people who can use cocaine once, set it down and never use it again, or can easily get off of a substance, while another person has a very huge struggle with it.

Brian: Absolutely. And you know, one of the things we talk about, relapse triggers, maybe we ought to give them a definition of what a trigger really is. A trigger is a stimulus that has been repeatedly associated with a preparation for or the anticipation of either alcohol or other drug uses. Now, it is really interesting to note, usually when you talk about these kind of relapse triggers, those are those ‘external relapse triggers’- the people, the places, the things, the events, but you know it’s really interesting, too, is not just the external relapse triggers, but I was talking to my group about the problems about emotional relapse triggers: pain, anger, fear, even celebration, excitement, happiness, experiencing a positive tone, like a graduation. Those are also internal emotional relapse triggers and those are the ones we carry with us wherever we go.

Neil: And much more harder to control. You can control who you have to deal with; where you go, you can’t control all these…exactly what you’re feeling.

Brian: Absolutely.

Jill: Right. And you can’t control the people around you, especially if you come from, you know, if you’re in a setting or family or anything like that, that is actually cues up all those emotional tumultuous times and so you come to a place where, how do you escape that? And this is where you come in, Brian.

Brian: Well, not really escaping, I don’t think. It’s more like, how do I cope with it? And sometimes, it is.

Neil: Uh-huh. But sometimes it is escaping.

Brian: Like, I’m saying, you have to kind of, maybe escape or maybe the better word is: avoid.

Neil: Yeah, yeah.

Brian: Avoid.

Neil: Move out of your family’s house is kind of the problem.

Brian: Kind of hard if your father depended upon them.

Jill: Yeah, that’s true. I mean, not getting a divorce is a good thing, but, you know, understanding that the person closest to you could be your trigger.

Brian: Well, you said it perfectly, right there. You know, so many times, Jill, people in addiction treatment, when they come to day addiction treatment, they’ll say, “well, you know, Brian, I’m trying to stop drinking and my wife still drinks a glass of wine, but she doesn’t have a problem with.” And that is a real challenge because we have to understand that there, as Dr. Johnston just said, there are some people that can drink two or three glasses of wine or maybe a glass of wine and be perfectly fine with it and never have a problem. Those are the users of alcohol; and then you have other individuals who, because of their chemical makeup in their brain, they just can’t do that.

Jill: Well, what about this trigger: when you are actually just sitting around with, you know, friends, and drinking a glass of wine. However, the wine relapse triggers another type of drug use, such as cocaine or, you know, some other type of, you know, tendency to go a little bit further into the web.

Brian: Well, I think that sometimes when we talk about cross-addiction, and again, a lot of times I think only that occurred, and Dr. Johnston can help me with this, but most of the time, if a person is drinking wine and then thinks about cocaine, usually it is because they’ve already had cocaine use in the past and one of the major reasons that that occurs is because that particular drug, the alcohol and the cocaine, follows the same pleasure pathway of the brain, and therefore, it can probably stimulate a thought-process in that particular addiction.

Jill: Well, I just want to bring up the number again, because I feel like there are people listening right now, and they’re thinking right now about their relapse triggers, 770-226-0920. If you want to call and talk a little bit about what relapse triggers you. Now, you may not have a problem with alcohol, you may not even have a problem with any type of drug addiction, but there’s many substances and behaviors that are not exactly the best thing for you if you take it to an extreme, so Dr. Johnston, were you going to talk about some relapse triggers that happen for you?

Neil: I’m happy to share a story, I was going mention first, that, you know, when you’re looking at some of these relapse triggers, one of the most classic ones is: coffee in the morning, cigarette in the morning; cigarette with the coffee, and then evening times: a cocktail and a cigarette. Those are common drug-drug interactions.

Personally, I stopped smoking in November of last year after being an utter fool and started smoking after I’d become an M.D. I consider myself one of the stupidest people on the planet for that, but, it was definitely apparent to me a couple of weeks ago after I had been on a long trip to visit a terminally ill relative that I got home from a long drive, was tired, was frustrated, and that was one of my relapse triggers to smoke and one of the ways, one of the times when I never liked to smoke was after I ate, which is unusual, most people eat and then like to smoke. Not me, so I knew that if I wouldn’t have something to eat, I wouldn’t want to smoke anymore, so that was my way of sort of dealing with it and preventing myself from popping open that carton of cigarettes. There are other simple things. I mean, people get attached, even the process of fixing up their dose of heroin or opening up the box of cigarettes, the ritual of use becomes very important that anything associated with that can lead to it.

Brian: Well, you know, it’s very interesting that you say that, Dr. Johnston, because many of the clients tell us something to that nature, is that, it’s not sometimes at certain points, the actual using, it’s the [inaudible], it’s the idea of getting the drug, it’s the idea of preparing for the drug that really is the high and not the using, itself. It’s all the preparatory things that go along. It’s very interesting how that seems to replace the actual use.

Jill: And if you continue to listen, we are going to get into a lit bit of neurophysiology, and neurophysiology very clearly explains why the ritual can be just as addictive and you can be just as dependent on it as actually the drug use itself. I know, let’s just talk about coffee making. When I make that coffee, that’s just as joyful as the first cup.

Okay, alright, we’re coming down to a break, thank the Lord! And, uh, we’ll be right back, stay with us. 770-226-0920.

Jill: Welcome back to the Breakthrough Addiction Recovery Hour. This is Jill Mattingly, and my co-host today, Brian Fujii, and we also have our psychiatric director, Dr. Neil Johnston, and we are talking about relapse triggers and cravings and how it pertains to addiction and dependency on alcohol and other drugs of addiction.

Now, when I say drugs of addiction, we just left that segment talking about caffeine and nicotine and both of those have something in common with all the other drugs and the alcohol that we’re talking about and that is the change in brain chemistry and what happens in the brain with repeated exposure to these substances. So, what I thought we would do in this segment is take different types of drugs of addiction or even alcohol and talk a little bit about the relapse triggers and cravings that are unique to those different substances, but before we do that, looks like we do have a caller, name is Charles in Atlanta. Hey, Charles, how are you today?

Charles: I’m fine, how are you?

Jill: I’m doing wonderful, thank you for calling Breakthrough. So…

Charles: Yes, I wanted to ask a question on addiction, and it has to do with a spiritual component to it. In other words, let me give you an example, for instance. Sometimes, I think addiction can to like, chemical dependence, can be not the primary thing, it can be what people are using to, using as an anesthetic to kill an internal sense of pain that they might have in their soul, say from a spiritual consequence to sin, for instance. Where they get involved in something that’s, you know, kind of morally destructive and it brings spiritual consequences within their soul and it gives them a sense of tormenting pain and so they turn to alcohol or drugs to kill the pain on the inside, you know.

Brian: Charles, you’re right on target, you know, I hear a lot of that in my own addiction treatment with a lot of clients and, you know, a lot of the folks deal with what you call guilt and shame, when they’re drinking, drugging and the issues that they’re dealing with; they’re feeling about the fact. Maybe they’re breaking some moral values that they feel that are very important to them. And, as a result, they drink as a way to anesthetize or even numb the pain. You know, most of the time, people drink alcohol, they just want to numb the pain. They don’t want to deal with it. And you’re exactly correct. Unless they deal with that guilt or that shame or that frustration or that feeling that they’re being unfaithful to their spiritual values. Many people do use alcohol and drugs as a way to escape.

Charles: One thing, though. Have you ever dealt with it in terms of deliverance.

Brian: In what way do mean that, by deliverance?

Charles: Well, I mean, like, some people will go to church and they’ll have elders and people pray for them and then they’re looking for a spiritual cleansing from God, you know. In Christianity, that’s a common thing, it’s even taught in the bible about, say, deliverance from demonic spirits, for instance. People can have this sense of torment from that and people have obtained that deliverance spiritually in their soul and therefore the addictions are no longer needed because the pain’s gone, if it’s a spiritual thing, you see what I’m saying.

Jill: Yeah, and at Breakthrough, we also look at that as a part of the support system. Having a spiritual program is a very intricate part of your support system, and I belonged to a church in the past where we did practice deliverance and we saw people freed from different addictions and bondage; breakage from bondages to those things, and that was for them, the way that they were able to come out of it and it matched their belief system and hopefully they were getting help in other ways such as cognitive therapy for other issues and possibly medication if they were having problems with anxiety and depression. I mean, all of these things can be a part and not everybody is going to jump up and say, “Oh, that’s for me, right there!” but there are people that I have seen that work for and so, I’m right with you, Charles, it’s a huge component to overcoming problems in your life and many people, that’s how they view this.

Charles: I’m very, very, very interested in your perspective on that. Is there some way I can communicate with you through the website, maybe?

Jill: Absolutely, and if you do communicate through us, I think that you can go to any of our web addresses. Is that not right, Brian, and you can get right through to us.

Brian: That website that we have is BreakthroughAddictionRecovery.com.

Charles: And the lady’s name was…?

Brian: Jill Mattingly.

Charles: Okay. Ms. Mattingly. Okay.
Jill: Charles, thank you so much for calling today and I just hope you have a wonderful day.

Charles: Thank you very much.

Jill: And so back to talking about the different types of relapse triggers and cravings, and the first thing that we were going to discuss was stimulants. Now, stimulant use has very particular types of relapse triggers. So Brian, take it away.

Brian: Well, you know, again, a stimulant would be like, something like cocaine or methamphetamines, and those are very powerful, powerful stimulants, and some of the areas of relapse triggers that can really cause people to look at using cocaine and methamphetamines is the fact of when we take a look at relapse. For example, if a person uses alcohol, that can be a trigger that may also produce some cravings for some additional cocaine or methamphetamines. One of the interesting things that the Matrix Institute has done with some studies about cocaine use and also alcohol. This is a pretty interesting statistic, that if a person uses alcohol and is addicted to cocaine, that there is an 800 percent chance that the person will relapse and begin using cocaine again, and that is a pretty significant number and so that is even using alcohol in a casual way and not in an alcoholic way, but just a casual way. And again, helping people to remember the fact that the cocaine stimulation, the alcohol stimulation, those, I know that the alcohol is a depressant but I am talking about that passes through that pleasure path with the very same pleasure pathway that the cocaine does. It stimulates that same area of the brain and as a result, it really causes individuals to have those cravings. Another issue like we talked about in the very beginning is drug-using friends. That certainly would be a tremendous trigger. Being around people that are using cocaine or methamphetamines, you know, it’s another thing, we talk about alcohol. This probably is more difficult for a person to try to stop using alcohol than maybe even cocaine or methamphetamines, you say, well, how can that be? Well, the main fact is that if you’re trying to stop using cocaine or methamphetamines, you’re not going to go around to the places where cocaine and methamphetamines is being used. But you can’t even go and get gas or go to your grocery store without seeing alcohol. You can’t even turn on the TV without seeing some kind of use of alcohol being done. So, the idea that it could be a tremendous trigger just by the fact of it, first of all, it’s legal, and secondly, it’s so accessible.

Jill: That’s incredible. And once again, I want to give out the number again, Brian. 770-226-0920 because we are a call-in show and if you have any comments or anything else that you would like to get in on the conversation, please call us. We’re talking about relapse triggers and cravings right now, and how stimulant, now define stimulants: that’s cocaine and methamphetamines, caffeine is a stimulant, and so these are the things that a lot of times you will see yourself tripping over these relapse triggers to use these substances.

Brian: And again, you know, when you talk about a stimulant in contrast to something that is more of a depressant, like alcohol is a depressant, but to use that, most people are trying to get even a greater high than a normal high that you would get, say, from, just like alcohol. It gives you a greater dopamine release, and that’s why it’s so difficult because so many times, they’re not just getting a feeling of well being, they’re getting an extra euphoric punch that makes them feel very, very good. So, uh, to kind of wrap it up a little bit on this one area that one of the cues, which is very interesting, an amount of stimulant, say like, cocaine, when they were using intranasally, just at the same time that ATM machines were being introduced and many people actually began getting triggered by seeing an ATM machine. Why? Because the fact is, in the past, if you used up your money, you were done for the weekend.

Dr. Johnson: That was part of their ritual.

Brian: That was part of the ritual and so now they now actually saw an ATM machine, well that means, “Hot dog! I’m out of money, but I’ve got a magic money machine right here and I can use all weekend.” So it’s amazing how something that…

Jill: ATM machines can trigger someone to use?

Brian: Yeah, can trigger for someone to…and even an idea of an exit…an exit ramp where people normally go to get their cocaine can be a big one.
Jill. Well, it looks like we’re coming down to the end of the segment. We’ll talk a little bit more about the stimulant relapse triggers and cravings when we come back. 770-226-0920. Stay with us.

Jill: Hey, welcome back to the Breakthrough Addiction Recovery Hour, my name is Jill Mattingly.

Brian: And I’m Brian Fujii.

Jill: There it is! And we have Dr. Neil Johnston with us today. So good to be back in the chair at the mike. Feels really good, you know how this is so much fun to do on the weekend, even though it takes an hour to get here. Anyways, I hope you are listening in. We’re talking about relapse triggers and cravings today and actually, if you’d like to go our website, BreakthroughAddictionRecovery.com. There’s a lot of information. Chock full of everything you could imagine and if you want to look a little bit more into what we’re talking about, you’ll probably be able to find some of this, or at least a link. 770-226-0920. We want you to call in. We want you to get in on the conversation.

Brian: Yeah, I want to hear their stories, I’m sure there’s a lot of people out there that has been….

Jill: Stories of what relapse triggers YOU.
Brian: And also how they overcame it because obviously there’s a lot of folks out there that has been able to take the challenge on and beat it.
Jill: Right and, you know, we are listening out different things that are relapse triggers for different types of drugs, alcohol; however, you may have something very unique and if you want to call in and let us know. And, I’m over here, Dr. Johnston is looking at me, I know you want to say something, go ahead.

Neil: Yes, I had a comment relating to Charles’ question earlier with regards to spirituality and drug addiction. I want to make it clear to everyone that addiction does not mean that you are not right with God or that you are somehow a bad person by any means. An example of that is a century or two ago people thought that epilepsy was demon possession. It’s not been that long since that we thought that schizophrenia was demon possessions. We now know clearly that these are medical illnesses, and addiction is the same way. Now, don’t get me wrong if you’re still listening, Charles, there’s no question that the spiritual approach and the spiritual support and God’s healing can be helpful to people with every kind of illness, whether it would be an addiction or whether it would be cancer or something of that nature, and that’s more of the approach that we would be taking a Breakthrough. We’re not going to be proponents that you have some sort of faith healing or things of that nature. We’re going to use everything at our disposal to help people with recovery and there is a place for your personal religious beliefs in that.

Jill: And I agree with you, Neil, and I think what I wanted to have Charles understand is that there are people that that was the breakthrough if you will, for them, is to go through that type of ritual or to go through something within a counseling scenario and it put them over onto that other side in terms of their recovery.

Neil: And I agree, but if someone is sitting out there listening to us, do not for a second think that we think that you are a bad person or religiously out of line or what not. This is a medical illness that there are medical addiction treatments for.

Jill: And that’s what makes Breakthrough Recovery so different is because we do have a medical approach as well as the cognitive behavioral approach and the Matrix Model and the day addiction treatment that Brian is doing, and we’re still on trigger and cravings.
Neil: I want to add real quickly that guilt does not make someone less likely to relapse or less likely to use. Guilt makes it works. That’s a negative emotion that makes people want to use and numb that emotion. So, even when people slip up, I tell, ‘Okay, that was yesterday. Focus on today and forward’, so I don’t want anyone sitting at home feeling guilty in anyway that will get back to the relapse triggers, but I think we have a caller.

Brian: Yeah, we got David from Atlanta. You got a question, David. Welcome to The Breakthrough Addiction Recovery Hour. You have a question on casual marijuana use. How can we help you?

David: Well, listen. Not necessarily a question on casual use, I used marijuana for twenty years but in the last six weeks, I have given it up. You know, just briefly, I smoked cigarettes for a long time and I’ve been hypnotized to break the cigarette addiction that I thought I had, but when I did that, my marijuana use increased, and I’ve since married and had a family and that’s what is really driving me, I guess to, it was a real struggle. I think what along the lines what I heard you say and I have listened to your program a couple of times and I enjoyed it. Just to not have it, like you were saying, I want nothing more than to, there’s a guy living inside of me that just wants to be high all the time, but the fact of the matter is if I don’t have it, I don’t necessarily have a physical craving for it, but if I have it, I would certainly smoke it without a doubt. But, along the same lines that you were talking about, I use alcohol on a daily basis, you know, I drink a lot of beer and I, you know, I’m what I like to refer to as the worst kind of alcoholic, I’m a functioning alcoholic. I go through my day-to-day activities pretty successful, you know, without, you know, many, what I would consider without any problem. Obviously my wife would have something different say about that, but you know, I go through my day-to-day routine and I do it while I start drinking at noon every day and I go to bed at 9 o’clock every night and, basically….

Neil: Well, David, this is Dr. Johnston talking and you said earlier that you have this person inside that would definitely use and be high all the time if you could.

David: No doubt!

Neil: That is what we were talking about, your cortex of your brain, if you will, that’s the upper layer, the most recent developmental layer in humans has been hijacked by the pleasure centers in your brain that want to use both the marijuana, the cigarettes and the alcohol and it does sound like you have problems with all three, perhaps.

David: Oh, there’s no doubt and along the way, of course, you know, as you state, you know, I have used all sorts of different drugs along the way, you know, and I’ve experimented with all of them, I would venture to say, but, you know, again, it’s a conscious choice to do it and when you say, you know, it’s matter of who you surround yourself with, I know that the pleasure still available is…you know, I try not to associate myself with those people because if I do, if I get presented with that, that’s just makes the temptation that much greater.

Neil: What makes you want to quit now, David?

David: Again, I have a family and my wife detests the whole idea of any of it.
Neil: And you don’t want to lose them.
David: You know, and I love my children, I have beautiful children and now I want the best for them but I would never intentionally do anything to bring detriment to my family and that’s where the whole outside pressure came from my family.

Neil: David, I would really encourage you to take a look at website and we do free evaluations at Breakthrough so that you can come in and talk with us about how we might be able to help you out and…

David: Yes, I did. I went to your program. I’ve thought about it before. It’s an interesting idea of treating it medically, the alcohol, you know…

Neil: That’s right. Well, it’s absolutely essential that we treat that medically because if you were to stop the alcohol use immediately, David, you could actually die from withdrawals.

David: And again, I probably consumed, you know, a minimum of a dozen alcoholic beverages a day for the last twenty years.
Neil: Yeah, you would definitely want medically supervised drug and alcohol detoxification.

David: You know, and again, I don’t know when you start to talk about relapse triggers and things like that, it seems to me that I don’t make a conscious effort to start drinking every day, it’s just part of the routine at this point, you know, and then, and it’s…

Jill: Well, you know, David, first of all, I just want to commend you because you really have entered into a place where you see that this is not working for you and you’ve made this phone call and that is really one of the first steps that you can make towards actually getting a hold of this and like Dr. Johnston, I want to encourage you. Look at the website, call us on Monday, come on in, we’ll sit on the couches, we’ll talk a little bit about what’s going on and try to give you a way to look at yourself moving through this and out of this but right now, Dave, we are coming to a break, but I want to just thank you so much for this call. You have probably helped many people. Our office number, 770-734-8091 if you want to give us a call. And David, have a wonderful day. I hope to here from you next week.

Brian: Good luck.

Neil: Take care, David.

Brian: Welcome back to the Breakthrough Addiction Recovery Hour. My name is Brian Fujii, and Jill Mattingly is my co-host, and with us is Dr. Neil Johnston, our Director of Psychiatric Services at Breakthrough Addiction Recovery and today we continue….

Jill: Today is Draft Day. NFL Draft Day. I just have to tell everybody…

Brian: Oh, who cares, Jill.

Jill: Hey, but no, wait a minute! Wait a minute! We’ve got the third pick. Atlanta has the third pick. If you want to call in and talk about that, Ill talk to you about that.

Brian: What a perfect lead-in, because she says ‘Draft’ and I’m talking about alcohol addictionrs.

Jill: Oh, okay, well that’s not too good, then.

Neil: We’ll get to steroid addiction on another day.

Brian: You know, we’ve been talking about how relapse triggers and again defining relapse triggers, any particular people, place, or thing, or maybe even an emotion that causes a person to want to drink or to use their drugs of choice and we were talking initially about stimulants, which was alcohol, something like cocaine and methamphetamines and now let’s take a look at the some of the issues that are related to alcohol. You know, alcohol is one of the most common of drinks of addiction and we know because of its commonalities that it’s being addictiond, as well as people becoming dependent on it almost daily, and one of the key interesting things about one of the relapse triggers that causes people that struggle with alcohol is their negative affective state, now the affected state are emotions. Now, it’s interesting to note that especially anger and depression are one of the key causes for relapse for alcohol and you know, when you think about the fact that alcohol already is a depressant, and people continue to use alcohol as a way to fight depression, I find that to be a very interesting situation because it seems like it only exacerbates the problem. It makes it worse.

Neil: Yes it does, very sad. Cyclically downward spiral.
Brian: And yet it only gives them that little buzz and a lot of times what I hear my clients telling me is I just gotta have that, just to get that buzz-on, just to feel okay, and I keep asking, okay, why do you need anything just to feel okay because most of us in life, you know, we have good balances, somehow, we don’t need to have stimulants or alcohol to make us just feel okay.

Neil: That’s why I’m at Breakthrough is because many folks in that situation have an underlying medical health problem that needs to be addressed along with the alcohol. So, if you’re in that situation that you’re having to use a substance to feel “normal”, that’s a real sign that you need some help.
Jill: And, you know, that’s a slow journey. You have to uncover that, you have to get to the correct addiction treatment for that and then we address that. But, what comes first is very hard to determine. Did the dependency create the problem or the problem created the dependency. You know, when I think about relapse triggers for alcohol, that internal anger/depression is interesting, but I think about just sitting down to watch TV and seeing commercials for alcohol. You know, I remember when they changed the rules and they couldn’t show a person actually drinking and putting alcohol to their lips and drinking it. So, every beer commercial, every liquor commercial does not show people actually putting it to their lips, if you haven’t noticed that.
Neil: Well, if you’ve noticed the one for Di Soronno Amaretto, and a very handsome bartender gives the very sexy woman the drink and she’s finished and she doesn’t let him take it away and she licks the gorgeous ice cube.

Jill: Oh, that’s right. That’s as close as they can come.

Neil: And, you know, that brings in the association with sex and drugs, as well.

Brian: Oh, absolutely.
Neil: That often times go together using alcohol to feel less anxious, more sociable as a social lubricant. Obviously, everyone probably realizes that alcohol causes people to do things sexually that they might not otherwise do. Some people use stimulants to enhance sexual pleasure and all of these are being awarded through a dopamine pathway in the brain and so they do become associated and they’re hard to separate at times.

Jill: Well, I tell you what. I mean, this, it goes so deep, here. We can just uncover one layer after another and talk about these relapse triggers and cravings, it looks like, though, we are coming to the end of the segment, so, uh, stay with us. We may not talk about the sexual part of this but we will continue to talk about relapse triggers or cravings. 770-226-0920. Dr. Johnston, just don’t look at me like that, okay? We’ll be right back.

Brian: Welcome back to the Breakthrough Addiction Recovery Hour, my name is Brian Fujii, and Jill Mattingly, my co-host, and Dr. Neil Johnston, our Director of Psychiatric Services, and today we have been talking about relapse triggers and cravings, what a comment at the end of that show.

Neil: I would just like to say that my lawyer will be contacting Jill very soon. Ms. Mattingly had been trying to get me to talk about stimulants and sex earlier and then when she said that we weren’t going to be discussing it at the next segment, I gave her a dirty look, not a lascivious one, so, just so we understand where we’re at, here.

Jill: Yes, I forget we’re on radio, you know, they can’t see our faces, so, anyway, we had a good giggle in the break there, but we were talking about alcohol and the relapse triggers and cravings that go along with alcohol and I brought up the thing about the commercials on TV and how, I mean, I cannot even imagine if you are trying not to partake of alcohol and just turning on a football game and all of the beer commercials and everything that is associated positively with the drinking and how that is such is a strong pull for us in our society.

Brian: You know, one the things that a lot of the clients in our program do a lot of traveling. In fact, business owners, executives and they travel a lot. You know what they tell me the biggest trigger is? Delta Crown Room.

Jill: What is Delta Crown Room?

Brian: Or, flying first class. Where they go to those particular rooms where they can get free liquor, you get into first, they said, “what do you want?” and it’s a tremendous challenge for individuals who do a lot of traveling and who have those high flyer miles and to be able to fly and do their business without having alcohol literally flowing across your lap since they’re sitting next to the window, I’m assuming it’s going past them or if they’re sitting in the aisle. That’s a real challenge. If you imagine, you know, if chocolate was your addiction and you had to work inside of a bakery all day long, can you imagine what that would do for your thoughts?

Jill: Well, what struck me is we have many clients that have tried other addiction treatment facilities, the ones that you go into the mountains for 40 days and there’s no alcohol, there’s no relapse triggers, there’s no problems. They come through and they have to fly back to Atlanta and they end up relapsing right there in the airport because it is so plentiful and available after they’re supposedly, you know, cured from their alcoholism.

Brian: Well, again, and you see that other piece, too, and not only is it those special Crown Rooms or first class but where are all the bars located? At the gates. So, I mean, this is, that’s why we’re saying, I believe it is far more difficult to try to come off of alcohol addiction and dependence than just about any other because it’s everywhere and it’s challenging them at every point because it’s in their awareness.

Neil: Well, it’s one of the reasons that the Feds cracked down on cigarette advertising so that you don’t see that on television anymore and, and here on the radio, you see it on print and that’s it.

Jill: Yeah, that was back in the 60’s, wasn’t it? I remember the Winston commercials when I was really little.

Neil: Yeah, I was only two.

Jill: Oh.  Okay, we won’t go there. But we want to go into just a little bit more before the end of the show. Heroin, an opiate addictionr, some of the main relapse triggers that they or a person who that is struggling with that might feel. The first one that jumps out at me is stress, and, of course, heroin or any type of opiate is going to calm that down and so I can see how stress would be a main trigger for most people and also for alcohol. The five o’clock after work, you know, the stress, you need the stress relief. So, that’s a huge trigger across the board is what I can see.

Brian: Well, again, you know, the fact that the way that the studies have shown, these are actually, opiates and alcohol, it is kind of descending order, so when you take a look that for alcoholics, it’s anger and depression, the number one reason for individuals to relapse on opiates. Again, opiates are any type of, even prescription medication, like your pain medications, of course, heroin is illegal, but the idea is that we also have things like Oxycontin, Percocet, Loratab, those particular are also opiate-based medications.
Neil: And much more addictiond now than heroin.

Brian: Absolutely. Right, And we see this so much and so we understand and we have people in our program and the kinds of jobs that they carry have a lot of stress and it’s interesting when you hear this, ‘Well how much do you take?’

‘I don’t know, I just try to keep it just so the stress level is at a manageable. So you’re talking sometimes, what 10-15-20 pills a day they could be, and they’re not even sure how much they’re taking.

Jill: Exactly, and what it looks like is coming down to the end of the show, there is so much more to talk about. We want to talk a little bit about marijuana, as well as the other prescription medications. But next week….

Neil: We can do part 2 next week.

Brian: Yeah, next week.

Jill: Yeah, next week, I think what we’ll do is we’re going to connect this into some of the recent brain research and how these relapse triggers work. What’s going on in the brain to make these relapse triggers work.

Been a great show, you guys. I have enjoyed this.

Brian: Look forward to seeing our clients and our listening audience next week and we hope you have a wonderful weekend and thanks for listening.

Neil: Take care.

4-12-2008

Brian: Good afternoon Atlanta and welcome the Breakthrough Addition Recovery Hour. My name is Brian Fujii and today we have our guest with us again, Dr. Lois Dutton, and she is working with us at our program and she is doing a fantastic job in doing some nursing and also to be able to bring in some of our clients and giving them the medical attention that they need. My co-host Jill Mattingly is away and will be away also next week, and so I hope that you will be calling us and also to look forward to having her back, probably in about two weeks.

So Lois, welcome again to the Breakthrough Addiction Recovery Hour, and you know last week we were talking about a very important subject and this was how has drug addiction treatment changed over the last 25-30 years? And we are looking over the spectrum and we have really seen some very dramatic changes. Last week we talked about how initially we saw drug addiction treatment being basically seen as like a sin, where people came in with a lot of guilt, a lot of shame, a lot of condemnation, and very, very low self-esteem as a result of that, and really not being able to find addiction treatment modalities to really help them improve.

And we see this happen even today. Many times people still see themselves as fractured, they see themselves as not having enough character, not enough will power. All of these things that are really self-devaluating, and it really impacts the ability for people to try to find addiction treatment. And I know we here at Breakthrough Addiction Recovery really try to work on that self-esteem piece, to really help them to understand it’s not really a character defect, we see it as an illness.

Lois: That’s right. When we talk about substance addiction as being a sinful behavior, built into that is the condemnation and the judgment that goes along when you begin to look at people as being weak in character, not having enough faith, not praying hard enough, not having what it takes from a spiritual point of view – to bind the spirit of addiction, if you will. And the other folks in the church really viewing them, pretty much that way, makes it very, very difficult to pull yourself up by the bootstraps when you don’t have that starch in your system that’s left because of the condemnation and the judgment. It gets to be a very heavy-duty thing for a person to walk around carrying. And that’s not to say, you and I both are very, very much strong, strong believers and have our own personal spiritual programs and know how vital that is to our lives and would never ever say that resorting to the God as one understands him, is not a part of a whole recovery program, but it’s not the only part of it. It’s very important for people to understand that it’s not because you have not been on your knees enough hours, it’s not because your faith is lacking, it’s not because you are a weak charactered person, that you’re not able to get on top of your addiction and stay there.

Brian: Again as we take a look at people’s thoughts about themselves, I know one of the areas that we try to help people to really strengthen their- areas of life is that many times if people are going to change their behavior, they get into a lot of this ‘the shoulds’ or ‘the oughts’, all of these words that really put them into a place. The definition of a ’should’ is the unrealistic expectations that we place upon ourselves and other people. And when you think about this idea that many times people who are having this real internal struggle with alcoholism or drug addiction, they’re seeing themselves as if they’re fractured, that they are damaged individuals.

Lois: Broken, completely broken.

Brian: And totally irreparable. And when you think in those terms, it really begins to eat away at that self-esteem that’s already is low as it is. But when you start then putting these unrealistic expectations, “I should not be doing this.” Or, “I ought not to be gong and doing this.”

Now these expectations begin to even lay a heavier burden on themselves and therefore they don’t seek help.

Lois: Absolutely. I think that many people do, from that very strong legalistic background, that many of us grew up with in our churches, where there’s so much of our lives that have been given to us as absolute. You do not do this; you don’t do that; you should do this; you ought to do that; and if you do not do as it’s dictated and prescribed for you, then you are less than everybody else who can live according to those dictates. And that is very damaging to all of us. Not just individuals who then go on to become addicted.

Brian: I really appreciate you saying that too, because when you take a look at a healthy spirituality, I think so many times a lot of folks have a toxic faith, a kind of belief that they only see condemnation rather than seeing assistance and support and help, and I think many times if we can begin looking at one’s spirituality. One of the things I try to do when I’m doing addiction treatment, is I ask the people, you know we’re talking about spirituality, but we’re talking really a lot about our value clarification – values – and when we begin looking at these values such as truth, and honesty, and openness, and compassion, all of these play a vital role. In fact many, many times, when people are in addiction, the value systems begins to degenerate as a result of the addiction because they’re trying to solve some kind of either emotional issue or maybe some physical issue. We see so many people, probably 95-98% of the individuals who come into our programs have a psychiatric condition - major depressiveness, bipolar disorder, anxiety disorder - so they’re not only coming in seen using alcohol, but no we got them coming in using Xanax, or Valium, on top of that trying to calm themselves. And as a result, it really complicates, so if take a look at the values, many times our clients say, ‘Yeah, that’s right, I gotta use my alcohol but I can’t let anybody know what I’m doing.’

So now they’re into lying, now they’re into hiding, and we have a saying, “We are as sick as our secrets.” And secrecy plays a big, vital role in maintaining addiction and certainly not getting rid of addiction.

Lois: Absolutely, perpetuating it farther and farther down the road. Most of us, Brian, in our world, our values are rooted in our spiritual journey and we draw from that, but when it begins to come back and really bite us because of the misconception we have about those values and what all of the ’shoulds’ and ’shouldn’ts’ really translate to us, then we end up having yet another “monkey on our back” to deal with, and that’s that whole spiritual condemnation piece that many, many people that come in to see us struggle with.

Brian: And that’s how we can help them. If this is a topic that is really getting a thought through your mind or something you’d like to participate in, we’d like for you to give us a call here at 770-226-0920, or if you’re outside the area it’s 1-888-920-2665, and we’d love to hear your opinions and thoughts. And Lois, as we continue here, we do know, as you said, when spirituality is used in a positive, affirming, gracious way, we know how powerful and how healing that can really be because it really does boost the self-esteem, it helps confidence, it reduces self-condemnation, and it really produces hope. So when you look at those positive boundaries in spirituality, we know that that particularly part is very, very powerful.

Lois: Absolutely, and for people who have a strong spiritual program and a spiritual belief that guides their life, to bring that into their recovery as a very powerful tool that’s going to stand them in good stead down the road as they really try and heal from what is a very complex, very devastating, very baffling, cunning disease that has developed over time. That spiritual background will definitely be a strong support for anybody who’s trying to recover. By the same token, it can also be a stick to beat somebody down even further, and that’s part of what we try to do in our Breakthrough Recovery orientation toward addiction treatment is for people to take the tools they have in their lives and get them to be very positive, positive steps toward helping them in their healing process.

Brian: I like what you said there, it is a tool. I want to help our people to realize that. Well, we’re coming to a break already. We’re going to continue this when we get back. We’ll try to help you understand how this spiritual tool can really be a powerful influence in recovery. We’ll be right back.

Brian: Welcome back to the Breakthrough Addiction Recovery Hour. My name is Brian Fujii, and my special guest today is Dr. Lois Dutton, and she is a colleague there with me at the Breakthrough Addiction Recovery Center. We’re glad to have Lois here, and we are talking today about the ways substance addiction addiction treatment has evolved over the last 25-30 years.

Lois: Yeah, the kind of thing that sustains you over time. When for 24-hours a day you don’t have your physician or your therapist or your confidant there, but you always have your spiritual program. For us, it would be God who’s always with us, 24/7, a lot of people have that same basic belief and it’s a positive experience that we recommend that folks really evolve into in their spiritual side of recovery.

Brian: As we take a look at this next section, as we move now from this area where we used to see it only as sin, but now society began realizing as people began to experience alcohol addiction, cocaine addiction, or heroine addiction, many times because of that feeling that they weren’t worthy and they didn’t seek the help, then it began moving into anti-social behavior. That’s when the individuals began to not know where to go, where to turn, where to seek help, and so as a result, instead of their addiction diminishing, it only accelerated. It became worse and worse, and now they had to turn to criminal behavior in order for them to maintain their habit, not realizing that it was causing a burden for society. That’s when we started having violence, we begin having things like robberies going on, or people becoming involved in family violence. It’s really interesting to note that one study that shows about people incarcerated, especially for those domestic violence, it’s not so much the illicit drugs that produces the problem, it’s alcohol! Alcohol, which is a legal drug, at the same time it produces more domestic violence, the cause of more domestic violence than any other illegal drug.

Lois: Absolutely, and the spiraling of people’s lives as a result of alcohol and other drugs, but predominately alcohol where we watched people, Brian, lose everything in the world to them and end up in the streets, on skid row, and then their intoxication became public. So there was even a charge that we called “public intoxication” that would get people incarcerated and have them thrown into jail for no other reason than being drunk. Over time, we began to see the notion in our society that these folks need to be separated from the rest of us. So we incarcerated . . .

Brian: They were different.

Lois: They were different. They were incarcerated, they were labeled, and they were thrown away in society or in the back ward of a state hospital somewhere and out of sight, out of mind. You have some statistics with you and so do I where we now know that untreated substance addiction in our criminal system is rampant where I read one study that said something like 52% of incarcerated women and 44% of incarcerated men actually qualified by the DSM-4 Diagnostic Manual, as substance dependent. Now that’s a staggering statistic.

Brian: I’m glad you said it. Let me clarify again, there is a difference between using and abusing and being dependent. What Lois is saying here is that these individuals not only were abusing it, which meant they were actually having difficulty now with their drinking or drugging, like with a DUI or domestic violence, or maybe they were having problems with their work, but these individuals now actually had problems with tolerance, meaning they need more and more in order for them to get the same effect. They were experiencing withdrawal if they weren’t using, and then using in spite of known negative consequences. So that means they were truly out of control, they had no control because most individuals, if they knew that they were going to get into trouble, they’d stop. And that’s what I hear so many times from the families of my clients. ‘Why can’t they just stop?’ And that’s because we know it’s an illness. But somehow in society we find out that there’s a big rift, there’s a real desire for us to not to look at this as an illness, we always want to see it as a character defect.

Lois: ‘Well Uncle Joe set his bottle down 25 years ago and never picked it up again. Why can’t you do that?’

Brian: Oh have we heard that often?

Lois: We hear that all the time, don’t we?

Brian: That’s right, we do. And they would try to make that the standard, the gold standard. And unfortunately that is really an aberration more than a standard. In fact the majority of people are individuals who are struggling every single day, trying to stop, trying to get off this wagon. I’ve heard so many times my clients say to their family members, ‘If I knew how to stop, don’t you think I’d have done it earlier?’

And how true that is. So we really need to help families try to understand it. I think this is where we moved into self-help programs. Self-help programs really began around . . .

Lois: . . . 1935, with Bill W., the AA program, the basis of which was very well-grounded, Brian. We both agree with that.

Brian: We know that works for many, many people, but we know it doesn’t work for everyone. And we know many times the recidivism rate or that relapse rate is very high, but for many years because there wasn’t anything more than that, that’s the reason why we began to say, ‘Is there something else?’ And as we begin to look at the system, we began to realize there’s more than just high confrontation and a lot of self-demeaning. And I know it’s better now, but in the early stages that’s all it was. People were being put down and then because they thought the tough way was the best way, and we know different in many ways.

Lois: And that’s when we had the programs develop like Synanon and Daytop and some of those really harsh, confrontational programs.

Brian: Okay, looks like we’re coming to a break again. If you are us interested in being a part of our discussion, give us a call at 770-226-0920, and we’ll be right back.

Brian: Welcome back to the Breakthrough Addiction Recovery Hour. My name is Brian Fujii, and my special guest with me is Dr. Lois Dutton. Jill Mattingly is away today and we’ll look forward to having her back next couple of weeks, hope she’s enjoying her vacation.

We’re talking today about how drug addiction treatment has changed over the last 25-30 years. In the very first part of our program we talked about how people used to look at drug and alcohol addiction as bring a sin which really put a lot of condemnation and guilt and shame, and now we begin moving it toward seeing it as a crime, where now people were being incarcerated because of their addiction, and as a result now receiving a label as a criminal. We do know that how this has really impacted negatively so many individuals because they’re self-esteem already is low, and now they’re seeing themselves as criminals as a result of this addiction. And so now they’re being placed in jails and in many ways not getting any help. For a long time we had the old drunk tank which you talked about last week, and so we saw people being placed in these kinds of facilities more as punishment rather than as rehabilitation.

Lois: Absolutely. We went from people being sinful and being condemned to being criminals, being really aberrant people in our society and they needed to be punished for the crime of addiction, if you will. Because that’s exactly the way it plays out, Brian. When somebody is thrown in jail for whatever the offensive behavior is, and that’s not to say again, that we believe that addiction is an excuse for anybody’s behavior . . .

Brian: I’m glad you said that – that’s right, we don’t.

Lois: We don’t believe that at all.

Brian: People need to be accountable.

Lois: They need to held accountable for breaking the law and doing things like that. We’re not saying that at all. What we are saying is that there is an underlying cause, many, many times, for why people do the things they do. And for a lot of the individuals who are incarcerated today, drug use and alcoholism are very much a part of that underlying causation for the criminal behavior, and if that underlying causation is ignored, then what we have is people come out and the recidivism rate is very, very high, so it’s a revolving door. It’s going in and out, in and out, in and out, with nothing ever changing except that the behaviors, the criminal behaviors get more and more egregious as we go along.

Brian: That’s right. If this subject is really touching your heart and you’d like to give us your opinion, we’d certainly love to hear it – 770-226-0920, and if you’re out of the area, it’s 1-888-920-2665. My special guest today is Dr. Lois Dutton. She is one of our clinicians and nurses there that works with a lot of our clients in areas of trying to do drug and alcohol detoxification from alcohol and opiates, and Lois, do talk a little bit about the area of medications. We’re going to get into more detail, but tell us something at least about how we do the drug and alcohol detoxing. We do ambulatory drug and alcohol detox, do we not, for alcohol?

Lois: We do with alcohol. Our mainstay in the withdrawal of alcohol, we know that alcohol withdrawal is probably the most devastating of all withdrawals.

Brian: And dangerous.

Lois: And dangerous. We use Phenothiazine that’s been around for a long time. We use Librium, and then we do a taper program so that we prevent the withdrawal symptoms from actually showing themselves in these individuals. Our belief is we want to stay on top of the symptoms and not get behind, so that we’re chasing the symptoms with individuals who are withdrawing, because then we lose people in addiction treatment when that happens. Because we’re an outpatient program, we don’t have people 24/7 under wrap and key with us. They’re in their homes or they’re being monitored in a private suite, and if we let those symptoms get ahead of us, and we’re constantly chasing them, then our clients and anybody else knows that there is a ready solution to that impending feeling that they’re getting and we’ll lose them in addiction treatment. So we’re very aggressive with our drug and alcohol detox program and we stay on top of those symptoms and we just don’t let people hurt in that withdrawal process.

We our opiate users, we substitute with Siloxone, and we’re able to do it. It’s not a substitution drug at all. What it does is replace the opiate in the brain chemistry and gives us an opportunity for that individual to gradually come down and gradually pull their brain back into some kind of a normal semblance. When they’re using the Siloxone they don’t get the same feeling that they get when they’re using the other opiates – heroine, Oxycotton, the Vicodin, or some of the others. So we’re able to do that in a very safe, very medically stable way. And it works.

Brian: And that’s what we say. We say that we are a medically managed program, where we take this medication – and it is medication – and I hope that our listening audience is hearing that.

We’re coming to a break again Lois, and I want to continue this discussion because as we take a look at how we move from criminality to addiction treatment, we’re going to really spend some time with that.

If you’re listening out there and really want to get into this discussion, call at us 770-226-0920 or 1-888-920-2665. We’ll be right back.

Brian: Welcome back to the Breakthrough Addiction Recovery Hour. My name is Brian Fujii, and with me is Dr. Lois Dutton. And we’re talking about how addiction treatment has changed over the last 25-30 years, but Lois it looks like we have a call from Robert from Newnan. Welcome to the Breakthrough Addiction Recovery Hour, Robert.

Robert: Hey, thanks very much. I appreciate you taking my call. I wanted to throw a different spin on the incarceration of drug addicts and the crazy circle of addiction. As a recovering addict myself, who’s actually a patient of Breakthrough, something kind if clicked as I was listening to your discussion today which is pretty awesome. I think a lot of people wind up in jail in the middle of their recovery. I think that when you take away their drug, it creates this huge void inside of them and a void that can be filled with something positive like spirituality which has really helped me out quite a bit, I think they maybe choose to fill with some kind of negative behavior which leads to their incarceration and going to jail, something that creates a chemical response in their bodies, sort of an adrenalin rush or what-not.

I remember a story my dad told about coming out of Vietnam. He said there were a lot of guys coming out with a really bad heroine addiction and they couldn’t get a hold of their drug of choice, so they chose to go out and rob banks instead. It created such a huge rush inside of them. These guys wound up in jail in the middle of their recovery and not actually taking their drug at all.

Brian: That’s a very good example about how – and you said “a void” – and that is such an accurate description, Robert, because that’s what we have. When you choose to start getting clean and sober, one of the things in addiction treatment we always say is, “How many hours a day do you spend in either obtaining your drug of choice, using your drug of choice, overcoming the effects of using your drug of choice and figuring out how you’re going to get some more?” And some people told me the other day. “Every waking hour.”

When you think about that, when you stop and you choose to say, ‘I want to be in recovery,’ if we don’t replace some positive activities in the void, we will go back to using. You’re exactly correct. It’s one of the things we got to figure out. What are some of the positive things we can do. But you said the word. They got a real adrenalin rush by doing these other negative behaviors, and I think that’s what addiction treatment is really all about.

Lois: Right. Hi Robert, this is Lois. How are you?

Robert: Good, how are you?

Lois: I’m fine, thank you. I think it’s extremely important Robert, what you just said that spirituality has been a big part of your recovery. I think that a lot of individuals who do not find something to put in the void in their lives will resort to all kinds of behaviors that normally they may or may not have even though about. I think you have a very valid point. And I think you’re right, there’s a lot of people who get into trouble after they’ve even been in addiction treatment, even if they’ve learned some things about the addictive process, and yet they choose to go out and do things that they normally probably wouldn’t do.

Brian: And if they don’t learn some new behaviors, in fact that’s one of the things we do at Breakthrough Addiction Recovery, and that is, we do we call cognitive restructuring. What in the world does that mean? It just means we help them think differently. And if they can think differently and begin to feeling differently about their new behavior, typically they’re going to stay with that new behavior, and that’s the positive reinforcement that we can do. Not only help them feel better, but really start doing something better.

Robert, we appreciate your call, keep listening. If you have another question later on, give us a call back.

Robert: Thanks a lot.

Brian: Alright, thanks for your call. Well that’s a great call. And you know that is so, so true. Many, many people who spend literally hours every day using their drugs of choice, find it very difficult to find some other positive replacement for their drinking and drugging and so we have to really sit down and go over a lot of different alternatives. That part we call ‘coping skills’.

Lois: And the time we spend a lot of times Brian, in day addiction treatment, asking basic questions, “What do you really like to do?” And it’s been so long since many of our clients have done anything that’s really been fun for them that was not related to their drinking and drugging that they no longer remember the kinds of fun things that they used to do. And it’s really heartwarming to watch this group begin to share with each other and the light go on, ‘Oh yeah, I can get into an exercise program.’ Or ‘I can do this,’ or ‘I can do that.’ Taking some of that creativity that they used to apply to finding their medications, finding their drugs, hiding their alcohol, all of the very creative ways that these individuals manage to perpetuate their addiction. They now have that same creative juice flowing in terms of replacing those behaviors with something that’s going to be very positive in their lives.

Brian: That’s so true Lois. And when we take a look at most individuals, especially many of the alcoholics that I work with, they are very high functioning. And as a result of that high functioning capacity, most people who observe their behavior go, ‘My goodness. What’s wrong with them? There can’t be anything wrong.’ Because they do very well in the work environment, they will always say, ‘Never miss a day of work!’ ‘Got all the projects done.’ And we begin realizing that’s a great cover, but we also know that they use that as a coping skill so they can continue to use.

Just a follow-up from the time of the break, you mentioning about the way that the drug and alcohol detox goes and how we need to make sure that the medication is helping to stabilize them, they don’t go into the DT’s, having a seizure, or a stroke, making sure that they’re very stable. Now we know that we’re moving from that sinful component where they’re seen as having all the guilt and shame, moving now into incarceration where they saw it as a crime and then they got labeled. Now we take a look at this piece called ‘medical’, because now we understand that addiction is an illness, not just a sinfulness, not just a crime, it truly is a treatable, however chronic illness. Long term, long term. And so what I’d like to do is once they get stable, what typically do we now do once they’re able to think through. Most of the time the drug and alcohol detox is about 3-5 days for alcohol, and about 2 or 3, usually just about 2 days for opiates. What do we do from there?

Lois: Well, before they even get completely through their drug and alcohol detox, we go ahead and start the whole addiction treatment piece of it by putting them in day addiction treatment or individual therapy, or putting them into group, whatever they need,. And the beauty that we have, is that we’ve got individuals who are going each and every day after they come to addiction treatment, back to their own environment. So we’ve got an opportunity to really work with the real honest-to-goodness, day-to-day problems that they face.

Brian: Well listen, we got a call from Mike, but we are coming to a break. So Mike, hang on and we’ll be right back with you at the break. Give us a call at us 770-226-0920. We’ll be right back.

Brian: Welcome back to the Breakthrough Addiction Recovery Hour. My name is Brian Fujii, and my guest is Dr. Lois Dutton. And we have a call from Mike in Snellville. Mike we only have a few minutes left so we look forward to your call and what’s your question.

Mike: I was really glad to hear your topic today. I belong to a religious community that teaches against all kinds of health things, including tea and coffee, but I really like your approach because I’m uncomfortable with incarcerating people for doing things that primarily hurt themselves. They’re doing other crimes, but just for the crime of addiction I don’t believe they ought to be incarcerated. But from an economic standpoint, I think it would cost us a lot less, on a purely economic standpoint, if that’s your only consideration, to treat people rather than putting them in jail for that. I wonder if you have some statistics that bear that out. I believe that’s true – that’s it’s cheaper to treat people and give them some help than it is to throw them in jail.

Lois: Oh absolutely, absolutely Mike. I’ve got a statistic right here that says that untreated substance addiction adds tremendous cost, and it’s estimated that $181 billion dollars we spend every years in drug addiction and $107 billion of that is associated with drug-related crime. We know that successful drug addiction addiction treatment in the criminal justice system can help reduce crime, it can reduce diseases, like HIV, like tuberculosis, like some of the other diseases that we see when people are incarcerated or they’re out on the street. So you’re absolutely correct. It is far more economically feasible for us to treat addiction than it is to incarcerate because then the incarcerated individual goes in, does his time in jail, comes back out on the street, begins to use again, goes back into the system, pays his debt to society, comes back out, so it’s a revolving door and that is very, very costly.

Brian: And that’s where the cost continues to increase. Well we appreciate your call Mike, we’re really glad you’re listening and call us back again. Love to hear your questions.

Mike: Will do.

Brian: Alright, thank you.

Mike: Okay, bye-bye.

Brian: That was an excellent question and again, cost is on people’s mind but Mike is exactly correct. If we don’t treat people, and this is also what we’re finding not only through our drug courts, but now we actually have programs that are being utilized in various communities here in Georgia, called Mental Health Courts. That they’re realizing that they’re needing also the assistance. Because we also know don’t we Lois, that between 95-98% of the people that we see usually have co-occurring disorder. That means they have a psychiatric illness along with the drug addiction. And so many times what? It’s usually that psychiatric illness that is in some was perpetuating the drug addiction because they’re trying to feel better.

Well again, our time is gone and we have just touched the tip of the iceberg, but I hope that our listening audience has been feeling informed and also finding it a stimulating discussion. We have wonderful website that you can go to, it’s www.BreakthroughAddictionRecovery.com. We offer always a free consultation for any individual or family member that would like to get more information about addiction treatment for their loved one, and so we invite you to visit that website.Now Lois, I appreciate you being here. We’re going to probably get you back here real soon. And we’re looking forward to looking to having Jill back within the next couple of weeks. I hope you join us again, and thank you for listening.