5-10-2008

Jill: Welcome to the Breakthrough Addiction Recovery Hour. My name is Jill Mattingly and I’m going to be your host today and I have a special guest and sometimes co-host, Dr. Neal Johnston. He’s the Director of Psychiatric Services at Breakthrough Addiction Recovery. Neal, thank you for coming today, and we do need to mention that Brian Fujii is not going to be here today. He’s actually at a meeting or a conference for his professional, I think he has to get CMEs or something like that, but he’s learning more and I guess he’ll bring that back to the station next week and we’ll talk about what he learned. Or maybe he’s actually just playing hooky, I think that’s what he’s doing, as a matter of a fact.

But anyway, Dr. Johnston, thank you so much for joining me today.

Dr. Johnston: Glad to be here.

Jill: We’re going to have a fun show today because I’m going to pick your brain and, yeah, that’s what I want to do. Anyway, Dr. Neal Johnston, and I’m going to proceed now to call him Neal, because that’s what I’m most comfortable doing, and he is actually an addictionologist and we use him at Breakthrough Addiction Recovery for treating our co-morbid and leading our detoxification services, and I just hope that you can sit back and enjoy our show today. We’re going to talk about a few things in the news and then we’re going to head on back into relapse triggers and drug or alcohol cravings, and like I promised last week, we’re going to talk a little bit about brain function and how the relapse triggers and drug or alcohol cravings arise from the different brain functions. Now, it’s going to be brain function for lay people, I promise you, and if Dr. Johnston gets too technical, I’ll try to explain with this piece over here does this and this, and so I’ll try to bring it down into lay terms.

Dr. Johnston: And she might make a funny look at me, too.

Jill: That’s right, I like to do that. But anyways, I want to once again just say thank you for joining us today and call some people if you think they need to listen in today on this show about relapse triggers and drug or alcohol craving and addiction.

Dr. Johnston: And, please, if anyone has any stories themselves, of their own relapse triggers, how they have gotten around them, how they’ve been able to beat relapse triggers or relapses, we’d love to hear about that, as well. We’d love to hear about your successes as well as any questions that you might have on any aspect of addictions.

Marijuana is addictive, there’s no question, but, no, it’s not as addictive as many other things that are legal. There are more alcohol and nicotine-dependent people in the world than there are marijuana-dependent people in the world. You don’t see many social tobacco users and I just read an article the other day that they were 14 million American workers who are alcoholics, functional alcoholics, that are not in addiction treatment but are apparently drinking, which is to me, kind of scary.

Jill: Well, I think that more study is actually needed, because I would like to see long-term studies in terms of marijuana use and the effect on learning disabilities, and as they go into adulthood, I’m just convinced there is a change that occurs in the brain and I just don’t think they pinpointed it enough to say to these kids that are sporting their pot leafs on their t-shirts . . . I really something’s going on.

Dr. Johnston: I’m certainly not arguing that. If there’s any of you who have smoked marijuana and actually inhaled, would know that it does leave you somewhat unmotivated, chilled out, quiet, and if you do that chronically, not only could it look like depression, but if there’s depression there, as well, it’s going to make it worse.

Jill: Well because we’re talking about relapse triggers and drug or alcohol cravings, some of the marijuana users that we’ve treat at Breakthrough Addiction Recovery; one of the things that I hear over and over is it’s how they chill out, it’s how they approach life, it calms things down, it makes them feel better about the stressful situations they’re going through, or, more likely the fact that they don’t have what they want, which is a good job, or a living situation that they like, and then, using the marijuana makes them feel better about that. So . . .

Dr. Johnston: That’s possible, and then, we’re going to get to some of this later, but also, once they’ve become addicted, the marijuana sorts of hijacks some of those other desires and they’re really more interested in getting high than they are than getting a job. As long as they can get high, who cares if they are working or not.

Jill: Exactly. Well, right next to this little area that was talking about the study in the AJC today, I just have to mention this. I’ve seen this story for a couple of days, and if you haven’t seen this, this is just, it’s horrendous and it’s amazing that this is actually happening, but, it talks about three Texas teenagers that were arrested. They dug up the grave of, I think it was a friend, and actually removed the skull from the coffin and it converted it into a marijuana bong, okay? I just can’t wrap my mind around it, but, reading it out over the air, maybe we can all, just together, have that puzzled look on our face, like, what?
Dr. Johnston: Well, that the first I’ve heard of that, was that by any chance a tribute to the friend who might have also been a marijuana smoker?

Jill: It’s amazing. Actually, no, here it is: Police believe that the grave was that of an eleven-year-old boy that died in 1921. I mean that is an interesting celebration, isn’t it, of marijuana smoking?

Dr. Johnston: Well, I don’t think that this is a typical marijuana smoker, addicted or otherwise, I think that’s just that’s some very twisted people.

Jill: Well, anyways, I just had to throw that in there. If you saw the AJC this morning, you saw that, too, yes. I read it over the air just so that we can all collectively be flabbergasted.

Dr. Johnston: Disgusted?

Jill: Yes! That’s exactly it. But, anyways, as we’re talking about the show today, one of the things that we were talking about at the addiction treatment facility this week is the approaching of Mother’s Day, which is Sunday, so I just want to remind you of that, Neal, and Mother’s Day coming up Sunday, interesting scenarios happen the week before Mother’s Day. You know, you may have people that start to want to do something about their addiction before they go home to face their mother or they’re just not wanting to do anything but, we decided what we would tell everyone is your mother wants you sober, so that was my big tagline for today.

Dr. Johnston: I was going to say just send flowers.

Jill: Yeah! Well, anyways, just Happy Mother’s Day out there, and I hope that you have a wonderful day if you are a mother, and to my mother also, Happy Mother’s Day!

Dr. Johnston: And to mine and the other piece, though, is that it’s also a very sad day for many people because they lost their mothers, it’s a very hard time, and . . . .

Jill: Yeah, and we have a lot of people that come in after that weekend and that have struggled through that weekend, so, what we’re going to talk about today, relapse triggers and drug or alcohol cravings. We’re going to talk a little bit about how the brain gets hijacked by the addictive substances, so it looks like we’re coming down to our first break. We’re going to tell you some very interesting stuff. Has your brain been hijacked? 770-226-0920. Stay with us, we’re going to be right back.

Jill: Hey, welcome back to Breakthrough Addiction Recovery Hour. 770-226-0920. Call in today and tell us your story or get in on our conversation. Ask us a question. We’ll try to give you some answers and it looks like we already have someone calling in. We have Rick from Rex, Georgia. Hey, Rick, thanks for calling.

Rick: How are you doing?

Jill: Doing good today.

Rick: I’m actually from Iowa, but I’m down here working and I have nine years in recovery and I’m in my early fifties, so, I have been through all of the addictions and most of them relate back to emotional. You have a period of like 28 days where you have the physical addiction, that involves the drug or alcohol craving and that drug or alcohol craving dissipates if you believe what medical addiction treatment says and AA and so forth, after 28 days, but that emotional balance, because most people use or drink because they don’t emotionally, they are restless, irritable or discontent, and they want to change how they feel, that’s the only reason. It’s because they don’t like how they feel and the only way to get out of it is to your act your way into a new way of living and thinking. That takes action. And through this action, it can be as simple as starting your day to make your bed it’s a different thing that you did before, and it’s a long, lifetime commitment and you need other people to help you.

Dr. Johnston: I don’t know if you had seen, Rick, the recent commercials that are for smoking again, I just harp on smoking all the time, but it says that if you can start your morning without smoking, if you can drive without smoking, you can become an ex-smoker, that it’s talking about separating the habits that we have with the addiction, separating them and doing them without it and slowly do exactly what you just said. Makes you less likely to want to use.

Rick: Oh, absolutely, and you do need a support system. It’s just, being addictive in any way, it just tells you, there’s a power greater than yourself and that is the addiction. Now you need to substitute that and it couldn’t be of your own nature, but other people that have insights through 12-step programs will help you change your actions. You cannot think your way out of it, you can’t pray your way out of it, you can’t talk your way out of it. It takes many things, and relapse triggers can be just a spot of bubbling beer glass at a bar you see the bubbles, that can relapse trigger a guy, but it’s the emotional part that we have to get the balance and . . . .

Jill: I was going to say, what I appreciate, and what you’re talking about, Rick, is the fact that you’re going through all the different things that are necessary to overcome a dependency or an addiction. You know, you’ve actually, very eloquently voiced all of the different areas that need to be approached and it’s not a magic, there’s not a magic pill, there’s not one person that can pull you out, there isn’t one meeting you can go to that can change it. It’s the combination of all these things and it sounds like you have steadfastly walked through this for many years.

Rick: Oh man, I’ve been to hell, and it’s right here in addiction and this is including meth, crack, alcohol is my big thing, but it takes you to hell and that is all these other addictions that you’re trying to substitute to replace the other, you know? And, so I wish anyone that is listening to this program, the opportunity to reach out to some 12-step or addiction treatment center that you need the lifelong support group. Like, I have a sponsor and I haven’t been sponsoring people lately because I’m traveling, but I do sponsor people and it’s just talking about the things that we do, we all do the same things, because we are trying to act out irresponsible and that allows us to do it, but sometimes you think, ‘Well, I’m invisible, and no one is going to see this if I do that!’ I mean we did crazy thinking.

Dr. Johnston : I don’t know if this helps you at all, Rick, but I have a patient who’s a long-haul trucker and he’s been to an AA meeting in every state in the country, except Hawaii!

Rick: You know? And we did the same thing, that changes how we feel. AA meetings do for me what drugs used to do.

Jill: Wow, wow. Well, I tell you what, I really do appreciate you calling and I love to talk to people from Iowa, I love your accent.

Rick: I thought you guys had it!

Jill: Oh, oh, okay! I gotcha, I gotcha. Anyways, Rick, have a wonderful day and continue listening. Tell your friends and just have a great day, sweetie.
Rick: Alright, well, thank you so much.

Jill: And you know what? That really was something that I love to hear people who have pieced the time together and understand that it is a combination of things that helps you walk through dependency.

Dr. Johnston: Well, he brought up a nice segue into our discussion of it taking over someone’s brain, if you will, the hijacking, and all the drugs act on different neurotransmitters, but cocaine and amphetamines typically hit, well actually what both of those do is cause the nerve cell to release all of its active agents and most of its neuroactive amines into the synapse and the synapse is the area between first nerve cell and the second nerve cell it’s communicating with. It causes that huge dump-out of neurochemicals, which leads to the high. Over time, the other cell, the second cell in that series, the receptors start to down regulate their less of them, taking more and more to get that effect.

Jill: And doesn’t that happen because the body starts to say, ‘Hey, if you’re going to give us a substance that creates a large amount of this neurotransmitter, why should we have a hundred receptors? Why don’t we just have about ten, if we’re going to have a huge dump every time that neurotransmitter goes right into the synapse’, and that dumping of the neurotransmitter into the synapse, the body is trying to save energy and says, ‘Hey, if we only ten receptors, great! We’ll get rid of the other ninety.’

Dr. Johnston: Well, that’s also associated with the fact that the brain learns what’s fun and tries to repeat that and you and I talked earlier about the amygdala part of the brain that is responsible for really connecting some of the sensory pathways, all of the sensory pathways that is directly connected to the olfactory senses, etc., and also is connected to the cortex of your brain. The cortex is where your higher thinking, your higher reasoning is, and there have been studies that have shown that cocaine addicts, either while using or before using, have a smaller amygdala than those who are not cocaine addicts. They need more stimulation there. The amygdala is also involved in fear, there’s been research into using medications to try to help people with PTSD anxiety disorders, things of that nature that would affect the amygdala.

Jill: So, what I’ve come to understand about addiction also, is that it is activating the same circuitry as our survival behaviors. Like eating, sexual reproduction and bonding, and any event that gives you pleasure, the brain will remember and that’s what you’re saying. It’s tied into your memory and then it will look for ways to repeat that activity, to cause the release of those neurotransmitters. So, it’s a very strong circuitry that’s going on when you start to use repeatedly any of these substances.

Dr. Johnston: And the amygdala is another portion of the brain called the hippocampus that deals with unprocessed sensory data, in other words, it hasn’t gone through the cortex. You haven’t thought about it. In other words, you have a pain in your leg, it goes to the hippocampus, etc. The hippocampus is very important to memory, as well, especially converting short to long-term memories. The amygdala deals with the already processed sensory data that you have already thought about, so, if you have taken a drug, felt the good feeling physically, thought about the things that were around you, just like in the Pavlovian dog experiment, you begin associating the two together.

Jill: So, it’s a huge imprint when that happens. And it looks like we’re coming down to the end of this segment and this is really interesting. We’re going to come back and talk a little bit about the brain chemistry and how it works in addiction. 770-226-0920. Call us! We’ll be right back.

770-226-0920. This is the Breakthrough Addiction Recovery Hour. It is not the Dream Girls revisited. I picked that song because this woman who is passionately singing is saying, ‘and I am telling you I’m not going’, and that is something probably people have experienced when they have experienced addiction or dependency is, for some reason, that relapse trigger, that relapse triggering, that drug or alcohol craving just doesn’t want to go and so, I pulled that out. I don’t know if people got the connection there, but I thought it would be fun just to pull that out. Did you like that, Neil?

Dr. Johnston: I thought that was fine. I think hers was over a man and not over drugs.

Jill: Oh, that’s true, that’s true. Okay. Well but we’re talking the imprintation on the brain when a substance is being used and the different parts of the brain that are becoming more active. The amygdala, the hippocampus. I know some of these terms, you’re probably, like, okay, I don’t understand that, but just try to give me the short story here, and I think you were going to talk a little bit about the mouse experiment that kind of puts it all together and just shows how a drug can hijack and cause the behaviors to change.

Dr. Johnson: Well, if any of you being fortunate like myself to have a mouse or rat infestation in your house, which I have had recently, you know that mice tend to stay in the dark and run into corners, run and hide. In this experiment, when they gave mice cocaine, they would run out into the open, out into the light without thinking about it and that is obviously against their instinctual biological defense against predators. So, they have foregone that instinctual level of behavioral inhibition, and so we’re talking about higher level cortical inhibitions which are much less powerful. I mean, that behavioral ones that I’m talking about are fight or flight, finding food, drinking, reproduction. Those are all very strong impulses. Having a career, getting to work on time, making sure your IRA gets enough contribution, isn’t high on the list there. So, it just gives you an example that it’s not just humans, these drugs can have severe effects on much lesser animals than we. At the same time, their cortex can have a very powerful effect.

A lot of the people that you mentioned that “I’m just not going”, really have not hit what we call rock bottom, have not gotten to the place where the negatives are outweighing the positives. And, again, the amygdala is really something that is associated more with negatives and learning negatives, so that’s why perhaps that the fact that the amygdala is smaller in cocaine addictionrs is that it’s not doing its function.

Jill: It’s not picking up the negatives.

Dr. Johnston: It’s not getting the negatives as well. It’s not processing the negatives as well and I’m just hypothesizing here, I don’t have any research base to back me up, but that plus many other things, obviously, are helping to continue the addiction.

Jill: Well, in a nutshell, I was looking at some of my notes and I had written that addiction involves the same pathways that manage memory and learning and addiction to a substance can move in and undo what the brain knew how to do before. It teaches it something else, entirely, like the mouse running out into the open. It had to learn that behavior and the addiction to the substance made that new behavior start to appear and so that is a hijacked brain, and that is kind of what we’re talking about. Many loved ones will say, ‘Why is my son or my spouse or my friend doing this? Who do they keep going back to this? You know, how come they can come in to addiction treatment and then a month later, they’re back out doing on the part of town that we know there’s nothing else there but to buy and use drugs. How come they’re doing this? What is going on? Why can’t they see what it’s doing to us,’ and I mean, those are the cries we hear almost every day.

Dr. Johnston: Right. If you haven’t been through anything of that nature, it’s hard to understand, but many people are theorizing that either due to genetics, due to early lifetime illness or head injury or something of that nature, even emotional trauma, that the amygdala can be affected and therefore they don’t have the same defenses that someone who could casually use cocaine and then let it go have. Same for people who are addicted to sex, spending, etc. Please give us call if you will at 770-226-0920. We’d love to hear from you, have any questions about what we’re talking about or any question about addictions, please give us a call.
Jill: And just putting this forward, understanding this is brain disease. This is an illness and as families say these types of things, that’s what we do at Breakthrough Addiction Recovery. We sit down with the families with the patient and try to go through the explanation of this brain disease we call addiction. And if you’re not getting that type of information, you’re going to continue looking at that loved one as ‘they hate me’ or ‘they don’t care about me’.

Dr. Johnston: Or they’re weak, or they’re morally problems, it’s none of the above, it’s no less a disease than high blood pressure.

Jill: So, 770-226-0920. We’re talking about relapse triggers and drug or alcohol cravings. The brain. Call us if you want to get in on the conversation. You want to ask Dr. Johnston a question about addiction. We are going to be here when you get back.

Jill: 770-226-0920. Hey, this is Jill Mattingly, I’m the host of Breakthrough Addiction Recovery Hour and my guest today and sometimes co-host, I guess I can call him co-host today since Brian Fujii is not here, is Dr. Neal Johnston, and he is the Director of our Psychiatric Services.

I just want to say a few things about Breakthrough Addiction Recovery. We’re located up in Norcross and we are an outpatient addiction treatment facility. If you want to learn a little more about us, you can go to our website, BreakthroughAddictionRecovery.com, you gotta type a little bit to get that one in, but it’s well worth it, it’s chocked full of information about all different types of addictions and dependencies and is being added to almost daily. We do have a blog site and we have information about our radio show and if you just want to come in and do maybe a free consultation with us for yourself or a loved one, we do that all five days a week and you can come in, sit down with the addiction counselors, the medical team and we do free consultations just to look at where you are, or where your loved one is in the dependency that they’re struggling with and then try to offer a really good way to approach this since we’re an outpatient facility, we do have a lot of different programs that are offered during the week and we also do ambulatory detoxification if the patient meets the criteria and Dr. Johnston helps to oversee that for both opiates and alcohol and our number up there if you want to call, someone’s on call 24/7 and that is 770-734-8091 and I just really do appreciate everyone listening in today, we’re talking about relapse triggers and drug or alcohol cravings and we got a call.

Dr. Johnston: One more thing about Breakthrough is I’ve been working addictions for 13 years and Breakthrough is wonderful because of the wide diversity of providers that we have. We’ve got myself as Psychiatric Director, we have another M.D., Dr. Richards as the Medical Director, Jill’s our Physician’s Assistant who is wonderful and we also have psychologists, addiction counselors, Brian Fujii, the other gentleman here, has a Masters in Divinities. We’re not a 12-step program, but we don’t ignore the spirituality issue at all. I’m very happy working with this group of people.

Jill: I think with Rick’s call a few segments ago when he started talking about all the things he had to walk through in order to become successful in his alcohol dependency and walking in sobriety or recovery. He actually mentioned all the different things that we try to approach at Breakthrough, which is not only the psychiatric and medical, which are very important for co-occurring disorders and maybe even medical disorders that can cause problems with addiction and dependency, but the psychological, the social and the support that is needed and also our psycho-education is actually equal to none. And I’m only saying that because that’s based on the people that come through our program that have been in many different programs. If you would like to check us out once again, it’s BreakthroughAddictionRecovery.com and we would love to meet you and talk to you if you have any questions. But you can call right now and ask us questions. It’s 770-226-0920 and we’re talking a little bit about relapse triggers and drug or alcohol cravings and when Rick called, he brought up something really interesting, Neal, and that was, he said something about seeing a beer sitting on a bar with the foam bubbling and that could be a huge relapse trigger. He sees that and it starts to bring back memories of drinking days and things like that, so obviously, watching commercials or being with friends, people, places, things can definitely be relapse triggers. But what about the subconscious relapse triggering?

Dr. Johnston: Well, there was a study done where two groups of cocaine addicts were shown a series of slides. One slide was shown so rapidly that it was not able to be consciously seen and it was a slide of a crack pipe. The other one, the slide was of a bunny or something of that nature. The group that saw the crack pipe came out reporting much higher level of drug or alcohol craving and desire for something than did the ones who saw the neutral cue.

You mentioned the visual cue of bubbles, there’s the olfactory cue of smelling something, whether it would be smelling cigarette smoke that makes you want to drink, smelling something else in the bar that makes you want to drink, there’s the sound, that lovely sound of a cap of a beer popping off. All of these things are processed through the amygdala, as well, especially olfactory smelling sensations. So all of these can go in there as cues, as well as emotional or cognitive cues, such as being tired, being anxious, being frustrated, being lonely, all the different emotional cues that could lead someone to use as well. So you really have to build up an armamentarium of how to deal with cues and relapse triggers, how to have a relapse prevention plan and then a plan for what to do if you do relapse. Without those, most people don’t succeed long term. People who really into get that are more helpful, that is, the caller earlier said having a support group. Having someone you can call when you’re feeling like, oh I want that drink. If they can talk to you for a while, oftentimes the drug or alcohol craving will go away. The cue’s gone, the drug or alcohol craving will go away.

Jill: I think they call that, like, a thought-stopping technique, and if you can engage that prefrontal cortex, that executive or directorial brain, which is right beneath your forehead. If you can engage that when the amygdala and the other pleasure centers of your brain are starting to fire and causing you to start to feel the need to carry out behaviors that lead to using, the action of engaging your executive brain can actually halt or stop that actual drug or alcohol craving and learning that is a very important technique in relapse prevention, from what I understand.

Dr. Johnston: And alternative rewards, I noticed in Rick as I have noticed in most recovering addicts a pride in saying how long they have been sober, that feels good. Bathe in it, enjoy it, enjoy that feeling, because that’s replacing the alcohol.

Jill: Right, and 770-226-0920. You got us for a little while longer if you want to call and ask a question. Get in on this conversation. 770-226-0920. Myself and Dr. Johnston, we’ll be right back.

Jill: Hey. 770-226-0920. The word of the day: armamentarium. I think that Dr. Johnston threw out a word on the radio that probably isn’t said many times, so I really want to commend you on that, Dr. Johnston. Arma-mentarium. Okay! Anyways, we’re talking about relapse triggers and drug or alcohol cravings today and addiction and dependency and we were discussing over the break drug or alcohol cravings are very difficult to control and for relapse prevention, learning techniques like thought-stopping, but also as part of the medical team at Breakthrough Addiction Recovery, we use anti-drug or alcohol craving medications and I thought this would be a good time coming towards the end of this show in just discussing those briefly with the audience, and the first of which, the one that has been around a little bit longer, Naltrexone, and how that is an anti-drug or alcohol craving medication, which actually started out being used for a much different reason.

Dr. Johnston: Right. Naltrexone is an opiate antagonist-agonist, meaning that it both binds the receptor and has some effect and that it also blocks further effect on the opiate receptors. Now, exactly why that helps with alcohol is not completely worked out. It is felt that much of the pleasure system goes through opiate pathways but not quite sure, now the studies show that it clearly does work and it’s clearly effective and unfortunately, like many of medications that we use in mental health, we don’t always know exactly why they’re working or how they’re working, because it’s hard. You can’t open up a human’s brain and brain studies on people and examine things of that nature and graphics not a great substitute so it makes it a little bit more difficult. The one before Naltrexone is called Antaddiction. That’s not an anti-drug or alcohol craving drug, but actually an almost punishing drug, if you will. You take that and you drink on top of it, you get very sick, violently ill. It helps some people, especially who are very impulsive, because if they take their morning Anaddiction, they basically made the decision for the day and for the next day, ‘I can’t drink or else I’m going to be vomiting, feeling horrible, headache, etc.’

Then, the third drug is called Campral and that works by readjusting two neurotransmitters that become mal-adjusted, if you will, in an alcoholic two neurotransmitters are gaba and glutamate. When an alcohol or anyone drinks, they’ll feel calmer and more sedated, that’s because the alcohol is affecting the gaba system and increasing the gaba system’s activity. Over time, the brain compensates and increases glutamate, which is a stimulant in the brain. Then, when they stop drinking, suddenly the balance switches and they’ve got too much glutamate and not enough gaba. Campral works to help try to balance that back out and does have very good studies showing it’s effectively at 60 and 120 days. Unclear how well it works in a year or two years or that far down the line.

Jill: And also, you can use those in combination. You can use the Naltrexone and the Campral together. I have seen in some of our patients coming through a great response to the combination of the two and especially in women, and I know there’s no studies out, gender studies in the use of these medications, but it’d be interesting to see how women and men respond to these anti-drug or alcohol craving medications. Just let me say one more thing about Naltrexone. I had read that they were looking at Naltrexone in use with gambling and with things like eating disorders. Have you heard anything about that?

Dr. Johnston: Not a whole lot, but it would make sense and there are other things in the pipeline. There’s a vaccine for cocaine. There’s Cannabinoid, there are actually naturally existing cannabinoid or cannabis or marijuana receptors in our brains naturally and there’s a cannabinoid blocker that’s coming out. So, there are several things on the horizon that are going to be coming out.

Jill: That’s why we’re doing this show. We’re doing this show to keep people posted on what is the cutting edge in the science of addiction and how can you approach your or your loved one’s dependency or addiction.

And I really do appreciate everyone that has tuned in today. I hope you’ve gotten a lot out of this. There’s a whole lot more on the website, BreakthroughAddictionRecovery.com and if you need a free consultation about a dependency for yourself or a loved one, please feel free to call us anytime.

And Dr. Neal Johnston, thank you so much for your conversation today, very informative.

Dr. Johnston: Thank you for having me.

Jill: And we just hope everyone out there has a wonderful day. Watch the weather reports, looks like something is heading towards us. So, have a wonderful day and God Bless and Happy Mother’s Day, Mom.

Dr. Johnston: Take care.