NOVEMBER 15, 2008

BRIAN: Welcome Atlanta to the Breakthroiugh Addiction Recovery Hour, my name is Brian Fujii and my cohost Jill Mattingly with our special guest Dr. Neil Johnston.

Jill: Hey Brian.

Brian: Today we are talking about managing stress and identify what stress produces especially we will review how the brain deals with stress.

Jill: What I want to say before the scientific stuff, you asked the psychiatrist and I take that personally because we were acting up last week? Hope that is not the case,

Brian: I will not say over the air

Neil: I don’t know what she did,

Jill: Just some off the wall comments which have no bearing on my psychological health. Ok, Dr. Johnston thanks so much for coming today and this is down your alley, the swell of stories in the media about stress, it is like Brian and I have a understanding what is going on and we talk about this and six weeks ago with the market and the upcoming election we began to recognize in our clients the stress related problems connected to the alcoholism and we started talking about it and now just last night I think you said that NBC is doing a special on stress and how to handle it.

Neil: I briefly watched and they comment on working hard and stressful jobs are not nearly as stressful as waiting to lose a job, it was a brief segment on the nightly news not an ongoing series, but it is all over the place. You can’t listen to the news or read a paper without the stress of a financial crisis. It is stressful for everyone.

Jill: This is one of the first times that across the board everyone is effected and some manifestation in their lives that result from this problem in the financial markets and even in the post election and there is a let down for some and elation for others. Those working hard for their candidate now have nothing to do once it is over. I read an article about this because so many were invested on both sides and the energy is gone.

Neil: After the party syndrome

Jill: What I want to talk about with you and our listeners, who can call us 770-226-0920 we are talking about stress and how it is effecting you and if you want to call in and tell us how you are working through this and what you have found to work for you that would be beneficial and we are a show about addiction so if you are finding a way to hold on to your sobriety by doing something beneficial when you have stressful moments and we have had some call with job loss and financial difficulty and they are holding on and walking through this, so 770-226-0920. Brian did you have something?

Brian: The idea of stress and those in our programs and I know that when we do the free consults we hear folks saying that they are coming for the first time because of the impending doom of their finances and stress of trying to keep their jobs. Many think of it for a long time and what motivated them was something interesting. The article I read of characteristics of functioning alcoholics and those seeking rehab it goes right in line with those coming in seeking that free consultation and that is when they come in they don’t think they need help and that they aren’t a bum or skid row so I don’t think that alcohol or drugs have impacted them significantly and what we found in ths article is that alcohol and drugs help them to feel worthless and undeserving and low self esteem it begins to make them understand that it isn’t the economy it is because of the abuse of a substance. The feelings of worthlessness come out of trauma and also what we are talking about and that is the economy.

Neil: If you have lost your job you almost have concrete proof and it feels like proof that you are worthless and not as good as someone else. That feeds the feeling

Jill: So many layers there if they are already struggling and then you add job loss and economy and

Brian: Think about this when individuals identify themselves they say what they do. That is their identity, so many times as Dr. Johnston said, when they lose a job and they lose themselves and that is a very traumatic event.

Neil: The trama for me is that when I say I am a psychiatrist they scatter

Jill: I think that is interesting, why are people coming in? How does that apply to what is going on in the economy and how is that effecting the people that we treat? The alcoholics and the drug addicts and if you want to make a comment please give us a call at 770-226-0920 and I just want to say that I looked at the Wall Street Journal and found the picture on the front to be disconcerting showing “Market Mayhem” south Korean investors angry with a huge mob fighting in front of a bank, they were protesting and I find that interesting in what we are talking about that a lot of stress in someone’s life especially over finance and the loss of who they are can lead to a lot of anger and I guess that could lead to violence, right Dr. Johnston?

Neil: It almost makes me violent when I look at my 401K

Jill: My question is what would you do if a patient comes in and it is pretty generic, they have job problems finances and they may not say right away that they are overdoing the drinking and pills but how would you walk through getting to what to do with them. If they just said I am stressed, what would be the next question?

Neil: You get a full exam a full history and generally in treatment we would use psychotherapy and to try and help them with these feelings and often once the anxiety and depression set in, breaking that will work against helping them get out there and find a new job and I am dealing with a patient currently who is in this situation and may have to have suicidal thoughts and may need the hospital or cognitive restructuring trying to change the thinking without naming names and this individual loves the job and now has been put on probation and trying to restructure it could be a good thing because at least you still have your job and also with him his is severe enough that he needed medication.

Jill: Not only who comes in with the addiction but the medications that can be used to help someone through this. We are coming down to our first break so 770-226-0920 is the number to call,. 770-226-0920. We will be right back

Commercial Break

Brian: 770-226-0920 is the number to call

Jill: Talking about stress today and if you are experiencing stress you can call us here today at 770-226-0920 or at our office for a free consult at 770-734-8091. Neil, you know we were bantering about political commercials and Georgia was not spared from the political commercials which make you scared so that you will vote a certain way. Unfortunately we are in a run off on December 2, 2008 so we still have to listen to the commercials and the element of stress is still in the air. I wanted to know more about what would happen if I came to you and said I am stressed out and you just said you would get a history and exam but you also said that you know you would look at meds or other things to help me?

Neil: I would want to know if you had had problems before or if you were doing something on your own to deal with the stress like exercise or meditation or are you doing something unhyealthy like drinking or using meds or something that was not originally prescribed for but I see we have a caller

Jerry: Thanks for taking my call, I have a comment and you were talking about stress, I had something happen with my doctor, he decided that I should go to a stress management class and so I went to the counselor and after telling her what was happening she said it sounded like it would be more stressful to come to the stress management class. So anyhow I thought I would pass that on.

Brian: What are you doing for your stress

Jerry: I am just dealing with it, a lot going on but you know the Lord is able and that is basically how I deal with it.

Neil: Did she give you an alternative?

Jerry: No, she didin’t, I had job stress and I just you know told her what was happening and she said what she did and so….

Neil: I don’t want to say anything bad but you needed more options. Individual counseling or medications, so that is funny and often times I will say to a patient that anyone would be stressed in their situation but that doesn’t mean we can’t help.

Jerry: Well it was a long time ago

Jill: Well it sounds like you made it. Sometimes stress can be handled naturally so what else would you do for someone Neil?

Neil: Well therapy I always consider to be important and it is proven to be better than meds by itself and by the way meds and therapy are better than either one alone. One way to go I would also look at their history if they have had previous alcohol or substance abuse and then would probably start them on a medication in the category of seratonin reuptake inhibitors such as Zoloft, Paxil, Lexapro, etc., I am not pushing or selling any one of them but

Jill: Those help with stress?

Neil: The serotonin when regulated can calm anxiety and panic disorders. They are equally good at depression and stress. Most people there is cross over between depression and anxiety and vice versa so a lot of people will be under stress for some time then develop hopeless feelings and

Jill: I want to give our number out because I know some have questions and if you want to call 770-226-0920, 770-226-0920 if you have a comment please call. Brining this up Neil, an antidepressant to help through stress, this might have perked up the ears out there.

Neil: The first thing these were approved for by FDA they are chemically similar and have been approved for anxiety, in addition if the patient has no history of substance abuse, I would prescribe a low dose benzodiazepine and that would start immediately and the antidepressant takes some time to work.

Jill: What if I finally as you start to ask questions I tell you that I am already taking Xanax and I take half of a milligram if I need it because of work stress but I have been taking a liitle bit more…

Neil: How much more?

Jill: Two or three doses a day because of getting on line and looking at my 401K and my boss is making job cuts and I have to have the extra, so I have a feeling there are those out there that are going through that type of problem and so how do you back them off or do you take them completely off of that drug.

Neil: I would have them start something else and if they increase their dose is not a good idea and we will continue on the dose that has been effective until the other kicks in and we will taper them off and they can not with me as their doctor continue to escalate without permission.

Brian: What about drinking?

Neil: That is completely different and is more dangerous. They need to be off the alcohol and we would use something else.

Jill: We will go back to that as we come back from the break. Some may not be telling the truth when it comes to just how much they are drinking.

Commercial Break

Brian: Welcome back to the Breakthrough Addiction Recovery Hour, our guest Dr. Neil Johnston is with us today and again if you want to be a part of this discussion on stress and addiction call us at 770-226-0920 that number is 770-266-0920. At the break we were asking the question about people under stress is now increasing the intake of alcohol and as a result moving into alcoholism and so how do we address that issue?

Neil: You need to know quantity, one glass I am not worried about it

Jill: Do they tell the truth?

Neil: No, studies show that people generally minimize the amount that they tell us and clinicians will say take whatever a patient says and double it but I try to trust what they say. If they are at 4 to 6 a day they are in the danger range so they should decrease or detox, or then put them on an ssri for the anxiety. I find it repulsive that I saw a stock broker’s set of tips to get through hard times and put your money into alcohol and tobacco stocks because addicts will keekp using no matter how bad the economy is. I was revolted by that and this captive audience if you will is going to keep using no matter what and so if you are out there and you have a problem, get angry at the fact that someone is making money off of the fact that you have a problem,

Brian: Victimization at it’s prime

Jill: Stock tip of the day is that addiction will make you money, well, that is you know one of the reasons we are doing this and you have to know that there are ways to get help and resources and you do not have to spiral into a place where you are doing what they want you to do in order to make them money and there is a way to get help and get help as easy as seeing Dr. Johnston and he will clarify that you have crossed a line and let’s do this and get you back on course and instead of going all the way down into a severe addiction and you know it could cost your family job and everything else.

Neil: We would want to treat the anxiety as well as an emerging addiction that is the idea, people are self medicating and get them to something safer and more effective and alcohol is not good for anxiety. It makes you feel high but after a few hours you are miserable and when that is over you are back where you started from.

Jill: What I want to know is that if they are taking Xanax or Clonopin or someone has increased their wine from one to six glasses, what about the person that has been laid off and the spouse is upset and I saw my Vicodin and I just you know without thinking found that after those I could cope for the next hour or two or even that night. How would you address that.

Neil: That worries me even more because they do not have an anxiety indication they are simply altering their mood getting high and they use the word stoned wasted etc., for a reason at those times they don’t care about what is going on and that is concerning, at least with anxiety there is an indication they would be confronted on their difficult path and corrected to the right treatment.

Jill: What if they go from two to six pills every day.

Neil: Detox with suboxone and then find the correct best medical treatment as well as psycho therapeutic treatment.

Jill: The benzodiazepines and now vicodin, lortab, oxycontin, all of those can be misused for this time in the world with the economy and personal items going on and stressful things. Let’s leave everyone with hope so after the break we need to talk about how to get treated. If you know you have crossed a line call us. 770-226-0920 if you would like to call in.

Commercial Break

Jill: Welcome back, we are talking with Dr. Neil Johnston, call us today here at the station 770-226-0920 Georgia just one so that should eliminate someone’s stress right? We were talking about the economy and financial news and how the world in general causes stress and were using hypothetical situations and if they are under stress and take too much xanax and are drinking more wine at night because of the boss or they have found an old prescription of vicodin or lortab that takes the edge off at night. There is three substances and obviously Dr. Johnston has a way to treat a person when they are self medicating with those items, what about Breakthrough? What do we do there for those that have crossed the line and need to talk about the abuse of medications or alcohol. Let’s take one at a time and see what we would do.

Brian: This is progressive relaxation, this is simple. Let’s start off with the bottom of their feet they tense the muscle then the calf then the thigh the hands shoulders and then hold that a minute and release and the opposite direction in such a way that when this happens the tension is released and the pressure is released. There are very simple techniques like quiet music relaxation and serenity and they begin realizing that they have control.

Neil: I throw in that I have anxiety problems myself and I have been through this

Jill: Since working with me?

Neil: It did worsen a bit though. The automatic response to contracting a muscle is relaxation and whether you want it to or not it will and so doing it all over the body it can be followed with progressive breathing and then you will find self hypnosis almost. I have heard acupuncture works for some and I am not opposed to that pets, aquarium, these are known to relax. In these times you may not afford a pet but you could always

Jill: I go with crying, that tends to be a stress reliever for me and the good thing is and in fashion are the huge sun glasses so put those on as you drive a cry. At least for women and they know what I am talking about. We are coming to another break. If you have another way of relieving stress call us at 770-226-0920, we are finding alternatives from alcohol and drugs and we will be right back. 770-226-0920.

Commercial Break

Jill: Welcome back to the Breakthrough Addiction Recovery Hour, we are talking about relief from stress in these times and we have a caller, Sidney in Atlanta, Hi there.

Sidney: I am a chiropractor I have a patient involved in a car wreck and a lot of pain but she also has an ongoing condition and I feel like um, based on things she has told me that she is probably addicted to the pain relievers she has been taking and you know when she does come into the office it is because she is taking the meds and she shouldn’t be driving and when she is off of them she is feeling awful, I need to refer her to pain management to work with her with addiction but listening to you I am thinking you are the referral and I will be talking her into doing something and getting her husband involved and give me advice.

Neil: Sidney I agree with you completely and I deal with chronic pain management and I don’t do steroids but if someone does have a chronic pain problem and needs pain medication I will do that for clinicians who are feeling they don’t feel comfortable prescribing in an ongoing fashion, I am very firm about that. If she is using for non pain reasons, then you need to get off of that.

Sidney: She is in chronic pain but from experience I have had patients who I thought they were in pain because they were addicted to the pain meds and I think that is the case with this woman and she has been so injured and at that point you

Neil: I am sure you are aware of non addictive agents like cymbalta etc., I have chronic back pain and I use cymbalta with great success for mine and we try to approach it from the myriad of perspectives and if we feel pain management is needed as well we will work with you to refer.

Brian: Our office number is 770-734-8091 and we would like to help with alternatives.

Jill: Thank God she has someone like you that is thinking outside the box for her. She is in a use abuse cycle and has increased the pain because of the abuse of the opioid. Unfortunately we see this and it is work to get them out of the cycle and it can be done.

Neil: One other suggestion but in trying to talk about it to her you might want to mention that it is hard for you to tell if your treatment is being effective with her opiate use.

Sidney: I thank you very much.

Jill: Have a stress free day, we will see you next week.

Brian: Good afternoon Atlanta, welcome to the Breakthrough Addiction Recovery Hour my name is Brian Fujii with my cohost Jill Mattingly we are all getting ready for Thanksgiving and are going to talk about Families in Recovery

Jill: Hey Bri, a lot of movies come out around the holidays dealing with people getting together with their families and suddenly finding how dysfunctional they are, I suppose a lot of folks will be interested in how they can get the dysfunction out

Brian: Our number here is 770-226-0920 we are talking about how families need to be in recovery as well as the person who is using.

Jill: Before we go into that we will stay on the same vain talking to people about the economy the financial state, their employment, just this week in the AJC many read about companies in Atlanta laying off people and they are hurting today, they don’t know what they are going to do around the holidays and that is a tough time anyway to try and be a job hunter and then on top of that the financial things that occur during the season and also you know a lot of liquor flows at parties and households during the season and it is tempting for some that are struggling to take advantage of the parties and the numbing out if you will.

Brian: You are correct on that Jill, more and more stress facing our job loss and the economy the drinking is the escape and the numbing out so they don’t have to deal with it but the reality is that it will come back. That will be the challenge and during the season it is difficult. What do we do to help you if you are struggling with alcohol or drugs how will you deal with some of the challenges like office parties or family events etc., that you will be attending.

Jill: It is definitely been in the news and we have had so many things come up not just world events and the financial climate our media has caught on to it and a lot of talk about what to do with excess stress from these different sources and struggling with the inevitable and questions about the future and stress can boil up into anger and violence and on a world level the confines of a household can produce violence and families need to reach out now before something goes into a place where other authorities become involved

Brian: We look at this to we have a situation when jobs are lost they lose their identity and that becomes so threatening and if they can’t provide they don’t feel they are anything. Their lives are turned both mentally and emotionally and we know that emotions are strong triggers for drinking and drugs.

Jill: Not just alcohol but also what about a person that has xanax for stress but now with the stress being a daily thing they have gone into 2mg a day and so we have people out there that think because it is a prescription they can up it and however they may be pushing themselves into a dependency and so that is when it becomes a problem and you don’t realize how difficult it is to get yourself out of that hole once you are in it. Opiates, many people have vicodin and percoset sitting there and they wrench the back a bit and take a couple and realize this took the stress away and then they head into dependency. All of a sudden those two pills in the morning become two in the evening too and cold turkey is not going to work because of the withdrawal pain.

Brian: This is a hard topic and if you are identifying with what you are hearing please call us, 770-226-0920 is the number here, 770-226-0920 if you would like to be a part of this discussion and call in and share with us what is going on in your life. At Breakthrough we have some great programs to help you overcome addiction to alcohol and drugs we are an outpatient program and can help you detox from alcohol and opiates and especially if you are medically stable it is a great program and you don’t have to go into a hospital it is a great opportunity to change the situation.

Jill: Or the money could be an issue for hospitalization.

Brian: We would certainly like to share with you the services we have

Jill: Let’s outline the programs that they can get involved in at little financial investment and in some cases for free, there is something for everyone out there. If you have the ability to plop down a card and go in patient to Malibu that’s fine but most are looking at a financial struggle, there are programs that can be tailored to what your needs are and within your budgetary needs so I think if you are listening there is hope and there is a program. Stay with us today and listen to what these programs are and the other resources in the community. There are free resources don’t put off until the money is there, do it now. That is what this show is about we are heading into holiday season and more stress financially and it is time to understand what you can do right now and that is going to be a big thrust of this program. Call people and tell them to listen to what is out there and if you want to call here for specifics you can call 770-226-0920 that is the number ask us a question or share a resource that you have found that has helped you through the tough times.

Brian: You are on target and we want them to know that it is not just the idea of the economy but for some just because it is the holidays. Stress for many comes just during the holidays and the expectations. Self imposed expectations that are unrealistic so we want to help you understand the thinking process.and reduce the stress level.

Jill: Last week with Dr. Johnston we talked about personal stress, how do you treat people when they are stressed, what do you tell them in terms of how they can increase exercise and nutrition medication for anxiety and we dealt with personal stress level and this week we are going to deal with stress not only personal but how it effects the home and family and that is so germane to families in recovery and there can be ways to address it and to alleviate some stress within the family when you see the expectations of the holidays and make new plans it doesn’t have to be like last year.

Brian: 770-226-0920 that is the number to call stay with us we will be right back.

Commercial Break

Jill: This is the Breakthrough Addiction Recovery Hour, call us at 770-226-0920 we are stressed out! We are having microphone problems and we won’t let it get to us but we want to talk to you if it has gotten to you so Brian are you stressed

Brian: Deep breathing

Jill: We did talk last week about personal stress and life circumstances causing problems and we spoke of exercise, I know I feel less stressed out when I exercise and eat healthy food I feel a whole lot better. There are many things that can improve our lives and Dr. Johnston was on target but unfortunately the stressors are not always having a bad day they are chronic and heavy and they are putting you in a state of limbo with no relief and that is difficult.

Brian: Chronic stress the longer it goes on without being managed as a result the situation becomes responsive only to stress and so it doesn’t have any way to be relieved and we need to know how we can reduce stress levels and we will activate the part of the brain that continues the vicious cycle

Jill: That is positive feed back system the cortisol released from the adrenal gland gets you ready for fight or flight. The thing is um fight or flight is a very important survival technique for the body and when the stressor is nebulous like job loss or a war started on some other continent, that is the body not knowing the difference and the significance will not be determined by the body.

Brian: You will have anxiety for so long there is no identification.

Jill: Opiates or narcotics like percoset and vicodin and benzodiazepine, xanax and clonopin are designed to work on relieving stress, now we could take lets do a hypothetical a man is 48 years old working in a factory and there have been lay offs in the last week, is he next? That is in his mind, anxiety trigger. He has children one going to college his wife does have a job but not enough to pay bills and take care of the family so he is carrying a significant amount of free floating stress and is looping it around and a lot of cortisol, fight or flight and he

Brian: Emotionally draining no rest and just no energy

Jill: Right, well and so why are we surprised when his one glass of wine sharing with his wife doesn’t cut it so they progress to a bottle and reason it out so it doesn’t seem like a problem and he is also topping off the night with a couple beers and doesn’t realize he has progressed into alcohol abuse or dependency and now we don’t know if he will wake up and realize that until there is an event that causes a problem such as a decision of not drinking and wakes up at 4am with shakes and sweating and is in withdrawal and doesn’t even know he has pushed himself in it. Does he seek treatment or does he drink to make himself feel better. Does he find a doctor.

Brian: Many won’t tell the doctor

Jill: I think this story is happening across the nation and what it is is that if you are relating it is time to start to identify the self medicating for stress and be pushing yourself to the line of alcohol dependency. What are the signs of alcoholism. Most aren’t worrying about alcoholism but there are signs.

Commercial Break

Jill: Welcome back we are talking about stress today and after this I am going for a jog.

Brian: Stress? Take your dog.

Jill: Whatever, we are a call in show and we have a caller, this is Norman in Scottsdale, hey how are you doing?

Norman: Great thanks for taking my call, I am 8 years sober the 25^{th of this month unfortunately this is a hard time of year because I am tempted so much when I go to the grocery and see people putting ribbon on champagne and I know that for myself the problem it would cause and it is only one drink away for me. I don’t go to meetings as regularly as I should. I have a positive outlook and I grew up in Ireland, there was alcohol all of my life and so this is difficult. It is a stressful time of the year like I said to me it seems like everyone drinks and going to parties and when they do that so I try to stay away. I don’t want to be tempted. Brian: You are trying and you are correct. We are talking about the times in the holiday season where you see everyone drinking but reality is not everyone in the word is drinking so you need to be with those that have a sober commitment as you have one and get engaged with an AA group or come to SMART recovery at our office on Thursday nights and Saturdays. What you will be doing is you will develop positive relationships and having time with others like you.Jill: Do you have a home group?}

Norman: A Decatur square group but this year is difficult because my grandson died in a DUI related accident he was 20 years old and I had to pay for his funeral and with the economy it pretty much killed me. I do have a good group though and I do have a firm grip of my belief and I want to say that I understand the stress and others stress.

Jill: I am so glad you are saying that out loud because there are people feeling that like you are and

Norman: There is life after alcohol

Jill: Right, the lie of the ribbon on the champagne you have to get with those that understand the lies of alcohol and then rise above that and say that it is just a lie and is something to pull people back into numbness and I am really standing by you right now. If we can help at Breakthrough we would love to do it.

Norman: I will get the information before I hang up and thank you for taking my call I want listeners not to take that drink because it is not worth it.

Jill: Exactly, you are in our prayers

Norman: Love your program

Jill: Brian that is exactly what this is all about. Having the resolve and having the right information because the messages that the culture gives about it being ok to drink into oblivion is a lie.

Jill: The truth is that alcohol is a thief and it will steal from you any way it can and that is where we want to keep the lies on the forefront. That is what we will do when we return from the break.

Commercial Break

Jill: 770-226-0920 we are going into the last segment and try to hit a few things about our programs at Breakthrough so that if you are struggling with alcohol or drug addiction and you can seek out help this week and this could be a gift this holiday the gift of sobriety and we spoke of SMART recovery on Thursday from 6 to 7 and Saturday from 5 to 6. We have people to greet you and welcome you into a family of people that will support you in your quest for taking back your life.

Brian: Aftercare on Monday and Wednesday nights a group setting for those in recovery led by a therapist and family education on Wednesday nights and a way to get families involved and help them understand addiction and also we have Intensive Outpatient and Ambulatory Detoxification.

Jill: Yes from opiates and alcohol. If you meet the criteria and then go into an intensive program, not a lock down situation and good psycho-education and cognitive based therapy.

Brian: This Tuesday we will start Families in Recovery and we will be doing this for those out there that are wanting help even if the addict doesn’t. I want to highlight a couple of things that families struggle with is that sometimes they don’t know what normal behavior is because all they have seen is dysfunction and can’t follow through and the addict causes chaos and disruption and thus their lives have no balance. Finally just being able to tell the truth. It is difficult to tell the truth because you are always making excuses for the loved one with the problem.

Jill: One thing about Families in Recovery will be therapist led and a group therapy situation and a lot of education and that is so important and people need to realize that person that needs help won’t get it but you can and if you are not someone who wants to go to AA then this is maybe what you need.

November 8, 2008

Brian: Good Afternoon Atlanta to the Breakthrough Addiction Recovery Hour my name is Brian Fujii and my co-host Jill Mattingly is back with me

Jill: Hey Brian

Brian: And you had a wonderful restful weekend last week with the beautiful weather and the trees,

Jill: Yes and today is just as beautiful so if you can today take your radio with you and get outside and enjoy the fall weather it is beautiful

Brian: We are going to be talking today about stress and addiction. You know we know that many many times folks will end up using alcohol or drugs to cope with stress in their lives and let me tell you we have had a lot these last few weeks with the economy and the job stress or lack of

Jill: Right now the Georgia and Tech fans are under a lot of stress because they are both losing. We have two TV sets and we are watching the scores and if you want the scores call us and we will give them to you

Brian: We are looking at some events going on in the nation and your own home dealing with the economy many people are looking at their 401K

Jill: Or something big that happened this week what was it? Oh yeah it was the presidential election and that created some stress and so many are relieved or many are not coping. But, today some people are sitting back going I can breathe now. Some are still struggling.

Brian: Glad you brought that up. There are different types of stress. Stress is part of human life. There is good and bad stress. Hans Selier a doctor many years ago said used stress is good, it keeps you on your toes and keeps you creative and then there is distress and that is the stress that causes a lot of people to have difficulty in relationships and sleeping and anxiety so we will talk today about stress and we do know that it is a major issue everywhere. Stress is in your job your home and teenagers. We know that it is out there and we will talk about it and how it impacts addiction. IF you want to call us at the show 770-226-0920 again that number is 770-226-0920 and get in on the conversation. You may be going through tough times and need a stress reliever and we will at the end of the show talk about some specific things you can do to help relieve stress and we will talk about the seasonal change.

Jill: It doesn’t involve Krispy Kreme doughnuts. Just to pull it into my realm the biological the neurobiological stress is something that the body is designed to you know experience and it gets you out of bed in the morning and drives you to eat but the thing is that the brain is set up in such a way for normal amounts of stress and to keep the entity out of harms way and so it all goes back to that fight or flight thing. You will bite or you will try to run away. All of this comes from something deep in the brain and that is the hypothalamus it is a feedback loop and the deep part of the brain it gets your pituitary pumped up and that gets sent down to the adrenals and that releases cortisol and that released in the blood stream causes things to happen to the metabolism. If it is going to fight or have to flee and that is a reason stress is good, it keeps the entity alive. That is why it was put there. So, then that cortisol in the bloodstream will effect the deep part of the brain that responds to it being enough and the loop stops and everything returns to normal. Unfortunately if the stressor is ongoing and too large, then it will override the system shutting down and the loop keeps happening over and over again and then we start to see the damage from ongoing high stress.

Brian: Wouldn’t that be from people experiencing various crises in their lives so that if it does not subside, this show is important because we think there will be reprieve from stress just when you think the economy is better then there is family stress or something other than that.

Jill: Some stressors are natural life events, losing a loved one, an event that has a progression and it has a beginning and if you are healthy and look at it with support it has an end point too and so having a baby the baby will grow up unless, well I don’t know why but it is like I told someone, a monkey is a perpetual baby and you will have life long stress. A friend of mine put on facebook that as long as the nightly news was off she was a lot happier. And I started thinking about it that we can find a stressor every time we turn on the TV. They have to sell advertising.

Brian: Makes good conversation.

Jill: The election was a stressor and it is over and now everyone is back into what does this mean for my 401K. And so now it starts to subside but we are in a time where it seems there is overlap of so many stressors and

Brian: That is where the problem comes in and if we can have some breathing space it is just like you said we have no freedom or option there is always one layer after another and we see it happening more and more and we have clients at Breakthrough that there are some in that realm and they are facing stressors one after another until it becomes unmanageable.

Jill: We need to bring this back around, I can imagine the overlap of so many stressors

Brian: It would be great to have some breathing space but our society has no freedom or option or benefit it is usually one layer after the other and we see this happening so much more and we have clients that truly are in that realm

Jill: Exactly, and I think we need to bring this back around to what we talk about but I can just imagine everyone out there even if there is not a dependency in their lives they are hearing what we are saying and identifying. If you want to call and share with us about how you have had to cope or some ongoing problems please call 770-226-0920 if you would like to talk to us and ask questions or Brian is a wonderful therapist he could do some advice giving, no maybe not, but he is wonderful if you want to come in for that free consultation and talk about what is going on in your life. We are close to a break

Brian: We have Jane in Acworth, How can we help you?

Jane: It is not so much the stress about me but it has been created in our home as a result of my husband thinking that his alcohol best friend or his stress being solved by alcohol. We have two grown children and we need help for the whole family as a result of my husband’s drinking. We need a place, people to talk to people in the same boat. My husband won’t but we need to.

Brian: You have asked the right question and we have family education and families in recovery and one is educational and it really helps the family member to understand the causes of addiction and how addiction progresses and also what needs to be done in order for the person to deal and cope with the addiction and not only for the one going through the addiction but how the addicted individual is impacting the family and your lives are being impacted because of the drinking and you need a place to understand the process and a place where you can discuss in a confidential atmosphere.

Jane; Well my kids are angry and I am in the middle,

Jill: Jane can you hold through the break and let us talk more.

Jane: Sure

Jill: Hold on we will be right back this is real important to talk about in light of the stress that he is causing and so stay with us.

Commercial Break

Brian: Welcome back to the Breakthrough Addiction Recovery Hour and before the break we were talking to Jane in Acworth and Jane again for those just joining us I will highlight you have a husband drinking heavily a business owner and causing stress in the home along with you and your children and you want to begin getting some help for you and your kids to talk about some of the stressors going on and coping with them.

Jane: Yes, not to be rude but you said family education, and I know my kids won’t be thrilled with that because they are in college and they will roll their eyes and hang their heads and say no. We know what is happening and they think they know everything so I am saying we need to be somewhere in a room with someone and talk about what is going on so that we don’t feel like we are the only ones.

Brian: You may want to look at your options as a family or marital counseling or even

Jane: I think it is more the effect that his drinking what his drinking is doing to us. And if he is not going to get help the kids and I are willing. I maybe I could call it something that doesn’t say education I just know that we are ready to do something not to give him a pass but for our survival.

Brian: You don’t have to have your husband there,

Jane: He won’t come

Brian: Therefore, what might be helpful to be able to come in with the adult children and into our family education or call it family help whatever works but the point is that the information that you need to understand like what Jill what saying from a physical view point and behavior.

Jane: My daughter is in nursing so that will work

Brian: We will be right up her alley and for you not the kids we have families in recovery and this is just for the spouses of those who are suffering , and you can discuss your own concerns as it relates to the pain and stress with others who are in the same situation. IT is a therapist led group.

Jane; What happens if the kids and I are coming and all of a sudden he says he wants to come um, do we still get to come?

Brian: He will have his own place and like I said he would have his own group and as far as rehab we have day rehab and intensive outpatient and he may like something more conducive for professionals.

Jane: Ok,

Jill: Talk a bit about the families, these are once a week and they are therapist led and there is a certain finite amount of classes

Brian: They hit on specific topics are not regimented it expands upon conversation.

Jill: There are other programs in the community like Alanon and lateen I think your kids are older though but Alanon is usually within a community and is peer led and is not therapist led.

Jane: I am liking what I hear you guys talk about, the election really threw him over the top. So, this you know like I said we are desperate and we will do what it takes

Jill: Welcome back the number is 770-226-0920 again the number is 770-226-0920 please call and get in on the conversation. So the AJC got in on the seasonal stress and just saying AJC stresses me. I still have it in my driveway every morning. Monday morning it came out in the living section it was called de-stress for the season. Signs of the Season would be a good title for this show and not just for the holidays or daylight savings time, but also because of the stock market and the election and job loss and things like that so this definitely is a timely article in the paper and it was great it maybe will save a life this year just to read it and gives great ways to fight stress and before the break we said you will look for coping mechanisms and they can be negative and we don’t want you going in that direction and so

Brian: Sometimes people overdo and they move back into depression as a result of stress and the other side is some pick up the bottle and maybe going and doing illegal drugs or smoking pot and that does not help you de-stress. It just increases it. That is the irony of it all and so many try to decrease and use different types that only increases the problem

Jill: Right, exactly the feed back systems in the brain that allow us to deal with stress, there is something that works real well and that is drugs or morphine which can come in a few shapes and sizes legal and illegal. Vicodin and heroin and it actually will bind to the drug receptor and short circuit the stress loop and give you immediate stress relief and when it wears off you can have more feelings of stress than what you took it for and it doesn’t make sense to go to a coping mechanism that will bring worse stress. Alcohol and Xanax. So, this article was pretty timely and I think that people need to understand there are natural ways to de-stress and if you do get caught in the negative coping skills or pain medication you have to nip it in the bud. You have to do something about it before it results in something worse or increased it for. The number is 7709-226-0920 again 770-226-0920. If this is hitting a cord with you and you are driving pull over and give us a call.

Brian: I know we talk a lot of seasonal effect it produces depression and anxiety abut you know many times people come to us to they find out they have a lot of what we might call post traumatic stress and this is something we see more frequently and that can be an occurrence as a result of a trauma many coming home from war or their families.

So many times there are subtle things that we don’t think about and we see it happening more and more and sexual addiction or physical addiction as children and that becomes very problematic and many times in our clinic that adults are using alcohol or as you said Xanax usually it is a result of past addiction.

Jill: Definite brain changes will occur and there is a lot of research under way with that and especially with soldiers returning and there is a big push for a deeper understanding of PTSD without putting soldiers on medications that they can become dependent upon.

I would love to talk about some natural de-stressors so let’s talk more when we get back

Commercial Break

Jill: Welcome back 770-226-0920 again 770-226-0920, if you come to see us at Breakthrough we will sit down and talk very comfortably and then we hear the familiar family stories, we have heard many say here is the event that got me on this slippery slope and a lot come in that have had years and years of sobriety after going through rehab or ALCOHOLICS ANONYMOUS and then something triggered and created the slippery slope all the way down and that is usually stress.

Brian: Many times unexpectedly and they are now having family members say that they need to deal with it. Stress is a key factor in dealing with depression and addiction.

Jill: 770-226-0920 we are coming into our last segment and there is so much more to say but I would like to talk specifically to those listening and thinking about how stress effects their lives to where they have increased their white wine by three glasses a night or am I taking my Percocet when I don’t need to or I have asked the doctor for Xanax because I don’t know how to get through the day and even those looking at Ambien every night for sleep so your mind doesn’t race, these are all things that you need to be honest about right now and that is one of the best situations I can offer you is to come in for a free consultation and call us If there is a program that we can fit you to we will do it. If you just want to come in and not sign up but just talk to someone. You can come sit with those struggling like you

Brian: SMART recovery and it is for the peer led group it is a way to help prevent relapse and it is a cognitive behavior approach and supervised by staff Thursday evenings at 6pm.

Jill: The programs we offer go from individual therapy to ambulatory detox and intensive outpatient rehab and if you do need inpatient we can refer you and get you the help you need so please call us. Our office number is 770-734-8091 and we can give you the referrals and the information that you need during that phone call and get you set on a different thinking.

Brian: Thanks for listening and we are different and we can help…

NOVEMBER 1, 2008

Brian: Welcome to the Breakthrough Addiction Recovery Hour my name is Brian Fujii I am the Clinical Director at Breakthrough and during this hour we are going to discuss Aftercare and the importance of individuals that have gone through alcohol addiction treatment and their road to recovery. My special guest today is one of our voices of recovery his name is George and we welcome here today.

George: Thank you Brian.

Brian: George is going to share his history and sharing his recovery experiences and how they have made a difference in this life and career. It helps people understand that recovery is the way to go and life can get better. Jill is not with us today and I hope she is enjoying this fall day and she will be back next week and we will team up again.

What does it mean to be in recovery and the importance of aftercare. It is defined as a way that individuals who have been in alcohol addiction treatment can continue their work as far as being able to help them understand alcohol addiction treatment modalities and helping them with their relapse prevention and develop new relationships as far as helping them keep on that road of recovery. This is a call in show so please participate with us today and if you are in the listening area and you want to call the number is 770-226-0920 and if you are outside the area it is 1-888-920-2665.

Before getting into the part of what aftercare means I want to share some statistics of how people move into the area of alcohol and other drug addiction and some studies recently indicate that high school age are already engaged in alcohol and drugs. A study done recently showed 8^{th graders, 52% had already tried alcohol and in fact one out of four 8th graders had actually be experiencing inebriation and binge drinking is 4 to 5 drinks in any one given event and so students are using alcohol and it is not only illegal but being used in very inappropriate ways. As adults you have a responsibility and we know that many parents are in denial and therefore are part of the problem. I do know we look at statistics and we know that people are actually starting to drink at such young ages and more than likely the children get it at home. The study goes on to say that 10th graders, 71% of them have already tried alcohol at some time. Children have brains that develop from the back to the front and that is the frontal part of their brain and it is not getting the development that they need in those early years and so is there a reason why our children can’t understand things in school? We find out that 25.6% in the 10th grade level had experienced binge drinking, so that is a significant result. George, one of the things we talk about in alcohol addiction treatment is why it is important for us to be able to look at our drinking patterns and so we are talking about some, how old were you when you had your first drink?George: I was young and had tasted beer by the age of 13. You know about the age of 16 you know the driving period that is when it started. You know the same old thing getting together with friends in somebody’s basement and drinking.}

Brian: A lot of times in that basement. Parents think that if they are at home and aware of what the kids are doing, do we really know? If you are aware that they are drinking what kind of pattern are we sending to young kids about tasting beer and wine at young ages. So as we begin looking at the statistics let’s look at 12th graders, when you begin looking at the pressure the high school kids have with image and being able to tell their friends that they aren’t weak and they want to be identified with the gang. If you are a parent with a child in middle to high school and you don’t think they are exposed to this I would like you to give this a second thought and find out what is really going on in the arena of the school. 770-2226-0920 is the number to call here or if you are outside Atlanta, 1-888-920-2665 we would love to hear from you and give us your input.

We work with adults and many times the children too become deeply involved and possibly can be influenced and there we are trying to struggle to help the adults understand how they can fight this problem with alcohol. George, one of the things we teach at Breakthrough is that addiction is when the brain chemistry really changes and when we spoke before we know that people begin wondering if they are a bad person or because they have poor moral character or not enough willpower but at Breakthrough we talk about how the brain changes and the more alcohol a person drinks it causes the brain to really change. I know one of the things we see so much is the problem of blackouts and blackout is defined differently than passing out, when you pass out you are unconscious but a black out it means that they are still conscious but they are not remembering what is being said or what was ..has that ever happened to you George.

George: Yes I experienced it quite a bit before stopping drinking. It was difficult to remember anything the day prior and it was pretty common and uncomfortable and you wake up and someone is talking to you asking you questions and you want them to ask more questions to help you remember.

Brian: What kind of embarrassment and doesn’t it produce confusion and maybe also what obligations did I commit myself to, this again becomes a highly problematic area when people are struggling and they are this is how alcohol impacts the brain and we talk about the way that people can identify whether or not they have a problem so when you were struggling did you think you could cut back did you try?

George: Sure that is common uh and I did, there was a few times I would say that this is the day and I am not going to do what I always do and by mid day I was at the liquor store.

Brian: It looks like we are at a break right here so as we look at drinking patterns give us a call at 770-226-0920. We will be right back

Commercial Break

Brian: Welcome back to the Breakthrough Addiction Recovery Hour and my special guest is George and we are talking about alcoholism and aftercare and finding ways to continue on the road to recovery and I want to share some ideas with our listening audience and as we take a look at alcoholism we find many young children beginning to drink and so beginning at that young age they will develop a pattern and that is not a healthy one and 9% of the adult population meet the criteria for alcohol dependence and addiction. Aftercare is a program that we offer at Breakthrough we meet on Monday and Wednesday nights from 5 to 6 and is therapist led and we try to help people understand their triggers and cravings and prevent relapse and they can change the way they behave and that is the whole idea and that is to change behavior. What we find is that there is a relapse rate of more than 50% or more at the two to four year after alcohol addiction treatment event. If a person is not constantly engaged in trying to stay focused on their recovery there is a 50% chance of a relapse and I make a distinction between a slip which is a sip of something and they realize this is not what they want. The habit is so real and pick up a drink and then become conscious of what they are doing. George is that something you had happen?

George: No, I would have had it and drank it.

Brian: I have had clients tell me they were at the grocery store and put a six pack in their cart and not notice until check out, the unconscious level of thought when you try to stop using alcohol, 50% or more with relapse means there are still those who won’t. The difference is the need to continue working on your recovery. We know the brain can heal because if you don’t drink the neurochemicals are restored to normal levels and we know that recovery is a lifetime event and is something you will be doing for the rest of your life and you know you can not drink again.

George: Well, I did have some efforts prior to the Breakthrough program and yet unsuccessful but the cognitive approach at Breakthrough had a great effect on me and I had no idea of the components into the disease and the time that it takes organs to heal and the brain I am at the healing point now. That is mind boggling when you see what you are doing to your body as you addiction alcohol.

Brian: Again, what we are talking about is physiological damage and we teach that alcohol does more damage to the internal organs than any other legal or illegal drug. The liver, heart and the brain. So many don’t understand that because it is legal we make it sound like it is ok and we know some individuals can get in trouble if they are not careful. 770-226-0920 again 770-226-0920. As we take a look at addiction being more than alcohol or cigarettes and a whole lot of other substances if we take a look at this we do know that it impacts not just the person but do you find that alcohol has impacted career family friends and other areas of your life so let’s talk about this George.

George: Well alcoholism effects every person you come in contact with a tremendous strain on the family, your job and everything you do. It is not quite as noticeable until you stop. It changes everything you do, um, basically your life’s goal every day is where the next drink will come from. It is subconscious and basically until you get the drink that is the functionality of your day to day existence.

Brian: True, because the brain as it has been impacted can only think about the next drink and this is when we talk about the neurochemicals as we drink more and more and then we get more and more dependent for alcohol. 770-226-0920 again that is 770-226-0920 if you have any questions for George especially if you are struggling today with alcohol or opiates and any of the types of mood altering substances we want you to call us today and be a part of this conversation and this is a great time for you to understand from a person in recovery and the struggles they face and also they can identify with what is going on with you. At Breakthrough we offer a free consultation for anyone, we will give you the information to help you understand the programs we offer. We have evening programs for those that work every day and that is on Monday Tuesday and Thursday nights. If you would like information on the free consultation call us at 770-734-8091.

We are at another break in our show and we want you to participate so please call us as we talk with George. Stay with us we will be right back.

Commercial Break

Brian: So many folks we talk about hitting bottom and not everyone lowest level is the same. We have seen this in so many ways. We have different stages, the introduction; not really a problem, then as it progresses there are more negative then positive. Many find they are not happy with what is going on and there are families out there driving down the road and you know of someone in your family a husband or wife or an adult child and you know this is hitting home and it is something you have been thinking about for a long time. 770-226-0920 because this is the kind of discussion that needs to get started, we always say that many people and not just the person struggling, the family are the ones also that are in denial or maybe minimizing and this means it just doesn’t seem bad. The point is it is a big deal and the longer you wait the longer you procrastinate the longer you decide that it is not a problem, you participate in that individuals looking for help. They need someone there to give them a shove or a boost to get them moving in the right direction and you can be that instrument and be that person that helps the individual the husband, wife or child and just like what George said it came to a point that his life was falling apart and you don’t have to wait that long. If you see that it is a problem.

Please hang in there and we want to share some more information with you and we will be back after the break. George would be able to give you or your loved one the information and insight that you need to get the help you need.

Commercial Break

Brian: We are sharing our ideas about the support you receive after alcohol addiction treatment. People who have never gone through alcohol addiction treatment say they don’t know what it means. At Breakthrough there are reasons we encourage our clients to continue support and it helps individuals to stay sober. If someone leaves alcohol addiction treatment with no aftercare plan the chances of relapse are very high. I think it is very important to understand that aftercare is a very important part and is critical. We talk about the difference between abstinence and sobriety. Abstinence is stopping and many can we also have medications at Breakthrough to help decrease craving and opiates there are also medications to help you with those also but at t he same time abstinence is different. Sobriety is reclaiming those values of life that went out the window when you started using alcohol and drugs. Learn how to be honest again, talk to the important people in your life and share your feelings. One thing we find in recovery is that when people start using alcohol and drugs, the biggest struggle is dealing with the feelings instead of numbing out. We understand that addiction is truly a brain disease and so the benefits of aftercare are developing additional relapse prevention skills while going through our alcohol addiction treatment programs. A second is that it is a place to process the psychosocial stressors such as relationships and job stress, boredom and isolation and we know that boredom and loneliness are keys for people struggling with alcohol and thirdly exposure to those whose goals are living a sober lifestyle. It is also a place to reclaim values in your life. We see this happening as people stay sober and they start talking to each other without arguing and they are actually solving problems. These are the benefits we find as we get engaged in a program. George I know you have 5 months of sobriety, there are people out there struggling with alcohol how can you live a life without alcohol. It is the most important things someone can do, I always ask how many hours a day do you spend thinking about drinking?

George: I was going to say 24 hours a day, all of the above. The big difference is that once I got sober in the program and this by far is the best. I tried AA and it works for some but not for me, I needed the cognitive approach because I needed to understand the physical and the mental and that is what I needed. It is basically the same thing, staying sober is big part of aftercare and I am a social animal uh, you know that time I spent going to the local pub to shoot the breeze and have a few beers and start off drinking has been replaced and I will go to the aftercare with my peers and help someone else get over the hump. Basically the thing is the phrase I use is “I got the monkey off my back but the circus is still in town.”

Brian: That is so true and we are about to break so hold on to that thought and we will be right back. 770-226-0920 again 770-226-0920.

Commercial Break

Brian: George thank you so much for sharing and we just want to wish you continued luck on your road to sobriety. We will see you next week, if you have any questions about what we do at Breakthrough you can contact us in Norcross at our office and the number is 770-734-8091.