Drugs and Alcohol Addiction - Dr. Ed Jouney

33 المشاهدات· 24/03/22

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Recorded 8/12/2016 at the Great Revelations Academy in Dearborn, MI

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[0:00]so today we're going to talk about something called drug addiction and

[0:05]I'm hoping by the end of the talk you guys are going

[0:07]to walk away maybe knowing something you didn't know when you came

[0:09]in okay start off by asking a very simple question how many

[0:16]people had dinner yet did you guys eat how many people didn't

[0:19]eat how many people are really hungry okay I was just curious

[0:28]so okay um oh I didn't okay so they were supposed to

[0:30]wait for me to ask for the slot he put it up

[0:33]already that's okay all right so if you can just wait for

[0:36]me to ask for the slides that'd be great so before we

[0:38]get started I want you guys look at these two pictures let's

[0:46]start with the first picture what are your thoughts about that does

[0:49]anyone have a thought on the first picture what's kind of first

[0:52]thing that comes to mind you don't have to raise your hand

[1:00]just go ahead and speak yummy okay filling okay yummy filling what

[1:06]else fattening okay Cassidy's okay what about the second picture cheese carbs

[1:18]fatty YUM okay delicious okay let me ask you something if you

[1:26]had this in front of you let's we're going to go with

[1:29]the first one if you had the first thing in front of

[1:33]you do you think you'd eat it okay do you think you

[1:36]would take one bite your do you think you would take two

[1:42]fair enough let's look at the second one let's say for those

[1:45]of you they didn't have dinner yet but it's time for dinner

[1:48]you want to have a piece of pizza how many of you

[1:49]eat one piece of pizza well I've been alive for well I've

[1:57]been alive a long time so the thing I'll tell you is

[2:00]throughout my lifetime I have never ever sat down in a one

[2:05]piece of pizza I always go for that second one ok can

[2:13]I the next slide please ok we're going to go with the

[2:16]first picture on top does anyone have any initial thoughts about that

[2:21]what was that I'm sorry a treat anyone else nutritious what healthy

[2:28]what about the second picture is going to react to things that

[2:32]we find satisfying and we find rewarding okay so I wanted to

[2:37]keep that in mind the difference in the way that you reacted

[2:40]to the picture the ice cream and the pizza versus the way

[2:44]you reacted to the broccoli in the peas because there is a

[2:47]difference can I the next slide please does anyone know who this

[2:54]is extra credit points nobody knows who it is okay this gentleman's

[2:59]name is dr.

[2:58]William Halsted is anyone here in medicine is interested in going into

[3:03]medicine ok William Halsted was one of the founders of johns hopkins

[3:10]university has anyone here not heard of johns hopkins university for those

[3:13]of you that have in johns hopkins university is one of the

[3:16]premier medical institutions in this country they're known for premier medical care

[3:20]the best researchers in the world go there the best researchers have

[3:23]trained there okay dr.

[3:27]Halstead pioneered what is called a septic techniques during surgery what that

[3:31]means is is that performing surgery while making sure that your hands

[3:38]were clean and there weren't any bacteria I mean now we think

[3:40]of it as that's just common practice right but back in the

[3:42]time when he was practicing they didn't know about bacteria but this

[3:48]guy knew about it so he pioneered clean surgical procedures and he

[3:51]was one of the founders of one of the most prominent institutions

[3:54]in this country can I have the next slide please so we

[3:58]have here he was one the founders of johns hopkins hospital he

[4:01]was a pioneering surgeon just like i told you he developed a

[4:04]septic techniques for surgical but this man struggled with severe drug addiction

[4:08]ok can I the next line this is written this was a

[4:15]biography about him for somebody that knew him and in the first

[4:18]I didn't put the first part of this but the first part

[4:21]of this basically states what an amazing man he is what an

[4:23]accomplished surgeon he was and what just an amazing doctor he was

[4:27]let me read what this says Halstead the addict was a mess

[4:32]he would disappear for long stretches the summer vacations routinely last five

[4:37]months no one knew quite where he went his behavior was erratic

[4:41]friends and colleagues and patients one moment and hostile the next okay

[4:46]he would bow out of operations at the last minute in his

[4:51]residence those are the people that were trained with him and pretty

[4:53]much ran his services without him the professor was often missing in

[4:57]action okay apparently to the way the reason why I bring this

[5:03]up is it just show you the power of what happens when

[5:05]people are afflicted with this illness and it is an illness and

[5:08]we're going to talk about that a little bit kind of the

[5:10]next slide please so we're going to go through some questions I

[5:12]know I'm sorry school hasn't started yet but did you guys hit

[5:17]the scantrons they were handed out up front you got number 2

[5:19]pencil No okay so here which of the following best describes drug

[5:28]addiction so one is a character flaw and a personal choice B

[5:32]can often be healed without treatment c is a disorder of the

[5:35]central nervous system or d only only is acquired through poor social

[5:40]interactions how many think a how many think be how many think

[5:51]see how many think d how many aren't listening and are looking

[5:55]at their watch every five minutes waiting to leave no okay good

[5:58]okay oh I was I was wondering if someone's gonna raise our

[6:04]hand the correct answer is C okay so see so addiction is

[6:08]characterized by disorder that flex affects the central nervous system and have

[6:13]next slide please another question which of the following are addictive meaning

[6:18]which of the following can you have a drug addiction to hook

[6:22]is a prescription painkillers marijuana all of the above and none of

[6:26]the above how many say a how many say b c d

[6:32]or e the answer is d very good we have the next

[6:39]one there's there's only 26 questions so we got 24 more left

[6:44]no I'm just kidding this is actually the last one so which

[6:46]of the following is true doctors prescribe medications that are addicting be

[6:52]a person can die for medicines prescribed the doctor see doctors and

[6:56]general lack sufficient knowledge about addiction d some doctors function as drug

[7:01]dealers to their patients in e all of the above are true

[7:05]for the sake of time I'm just going to tell you the

[7:06]answer this question is e so all of those statements are true

[7:10]ok and I'll be happy to answer any questions as we go

[7:13]along can I have the next slide please so when we talk

[7:18]about addiction what is it so what I'm going to do for

[7:22]the next few minutes is that we're going to talk about what

[7:24]this is okay so addiction as I said here in the PowerPoint

[7:29]it's an illness that you know we have it has a biological

[7:30]basis meaning that there is biology behind it meaning that there are

[7:34]reasons why people are afflicted by these behaviors it can be life

[7:39]threatening meaning that this is something if somebody has the illness that

[7:42]can actually take their life from them and it can cost significant

[7:45]emotional and psychological problems and when somebody has this problem they will

[7:52]try and hide it from those that care about them and for

[7:57]those that are treating them can I have the next slide please

[7:59]we're going to skip that can I have the next slide please

[8:06]okay so when we talk about drug addiction we often talk about

[8:08]the four C's so for people that are interested in kind of

[8:11]understanding this a little bit think of what it is so we're

[8:15]going to go through the four C's so the first C for

[8:18]people that have drug addiction is loss of control so what does

[8:21]that mean it means that the individual has lost their ability to

[8:25]control their use of drug X so somebody pick a drug that

[8:31]you know is addictive heroin so if somebody has a heroin addiction

[8:36]and they're using heroin they have lost their ability to control that

[8:39]use okay and the reason why I'm spending time this I want

[8:45]you to think about that they have lost their ability to control

[8:48]their utilization and drug think about it you have a behavior that

[8:52]you engage in but you can't it controls you okay compulsive use

[9:02]does anyone want to take a stab on what compulsive use means

[9:07]it means you do it over over and over again okay it's

[9:16]done compulsively and you can't stop use despite consequences okay so some

[9:23]more audience participation does anyone want to share what maybe that means

[9:28]yes that's exactly right does anyone have another example of what that

[9:42]might mean of what that may mean yes right so let me

[9:51]why don't I give an example let's say you have somebody that

[9:54]is utilizing alcohol and alcohol is bad for you and the person

[10:02]goes their doctor and the doctor tells them they say you know

[10:06]mr.

[10:07]Jones your alcohol use is really causing damage to your liver in

[10:11]fact we think you might have cirrhosis which is a bad liver

[10:16]disease and you really need to stop drinking so the person knows

[10:19]that the alcohol use is causing cirrhosis but they can't stop so

[10:23]they know that their utilization or the use of this drug is

[10:29]causing them to become ill but even despite that knowledge they cannot

[10:32]stop okay so this is what we mean by use despite adverse

[10:34]consequences the last thing here is craving so what is craving mean

[10:41]craving is basically what I showed you in the first slide meaning

[10:44]that when you saw the picture of the ice cream sundae and

[10:46]you saw the picture the pizza for those of you that didn't

[10:50]eat dinner you were craving that I'll be honest with you I

[10:52]hate dinner and I was craving it okay so when you see

[10:57]something like that when we when we talk about drug craving whether

[10:59]it's for alcohol or whether it's for other drugs there's something called

[11:03]drug craving and it's very similar to hunger to a hunger and

[11:09]thirst when you're fasting and it's a hot summer day like we

[11:12]had during this during this last holding worth of Ramadan at the

[11:16]end of the month or excuse me at the end of the

[11:17]day you're thirsty you're craving water you're craving that beverage you're hungry

[11:22]you're craving food you want to eat okay for people that suffer

[11:27]with drug addiction they experience the same thing except they're craving whatever

[11:29]drug they're using so it could be alcohol it could be heroin

[11:34]it could be marijuana it could be something else so the reason

[11:36]why I go over this is just to give you a general

[11:40]idea of what it is so this is just a very kind

[11:44]of the core concept of what this illness is okay does anyone

[11:48]have any questions before we go on no okay next slide please

[11:55]some statistics for you so 23.5 million persons ages 12 or older

[12:03]needed treatment for illegal drug use alcohol problems in 2009 that's nine

[12:09]point three percent of the US population as one in ten okay

[12:13]that's a lot one in ten people in this country suffer with

[12:20]this illness that's huge how many of those people get treatment not

[12:23]a lot so if we look at those that get treatment only

[12:29]2.6 million or only 11.2 percent of the nine point three percent

[12:33]actually got into a treatment program next slide so what I want

[12:38]to talk about now is things that are called painkillers so when

[12:43]we're in pain our doctors often prescribe painkillers and these are often

[12:49]called opiates or opioids and I'm going to throw out some common

[12:52]names these include things that are known as morphine or vicodin or

[12:57]Norco okay and what this little chart is showing you it's showing

[13:01]you how much pain medicine has been prescribed in this country over

[13:04]the years so let's take a look at back here in 1997

[13:10]the year I was born no I'm just kidding so you see

[13:16]a pretty dramatic increase in the amount of pain medicine that's been

[13:20]prescribed in this country over the last 20 years it's very concerning

[13:23]because pain medicines are very addictive now it's beyond the scope of

[13:27]this talk of why this increases happen but it's important for you

[13:31]to know that there is a huge increase in pain medicine prescribing

[13:34]in this country and this is a United States thing if you

[13:38]look at the way that pain is managed in other parts of

[13:41]the country it's completely different excuse me in other parts of the

[13:45]world it's completely different the United States is something like fifteen percent

[13:49]of the world's population but we utilize eighty percent of the world's

[13:54]supply of pain medicine okay the way we treat pain here in

[13:58]this country is we give morphine and vicodin if you go to

[14:00]China you go to France you go somewhere else it's completely different

[14:03]so it's a problem we have here we have to deal with

[14:07]them can I the next slide please next slide don't make me

[14:16]come over there do it myself okay okay um so the other

[14:20]thing that oh this is on tape is that crap ok the

[14:24]next thing that we want to look at is the rates of

[14:29]overdose and death because something I need to tell you is that

[14:32]the pain medicines although they're very good at treating your pain and

[14:34]they can certainly make pain go away but the unfortunate thing is

[14:39]if you're used too much of it they can kill you if

[14:40]you use too much of it you're going to shut down your

[14:43]breathing you're going to go to sleep and you're not going to

[14:47]wake up so remember those four C's that I showed you if

[14:49]you have somebody that's using morphine or norco or vicodin they're using

[14:53]those in the compulsive way they can't control it they're having craving

[14:56]they take more than they can what's going to happen they're going

[15:02]to overdose and they're going to die look it's what's happening if

[15:05]we go from 1971 all the way through to that and this

[15:10]is nine years old trust me the graph is still going up

[15:12]look at the number of deaths that have happened look at how

[15:14]this is dramatically increasing this is now a national epidemic the number

[15:24]of deaths related to pain medicine overdose is something it's over 15,000

[15:32]annually it's huge okay between 15 and 20 thousand a year do

[15:36]the math that's over a thousand per month okay so this is

[15:39]a huge problem and this is why we're talking about it today

[15:41]because I need to share with you our community is not immune

[15:45]to this this is affecting our country it's affecting our country it's

[15:50]affecting our community and we need to talk about it right because

[15:56]if somebody is struggling with this we want to help them I

[15:59]don't want anyone here in this room or anyone in your family

[16:04]to be one of these statistics so we're talking about it and

[16:08]we're going to talk about it more in more and more until

[16:12]the community becomes comfortable talking about it and even then we're going

[16:20]to talk about it even more okay next slide next slide okay

[16:23]so the thing I want to talk about just to help you

[16:27]understand drug addiction a little bit better is that let's talk about

[16:31]natural rewards okay so these are reward but remember I said that

[16:34]you remember one of the questions I said that addiction was a

[16:37]disease that affect the central nervous system right do you remember that

[16:42]for those of you that aren't on your smartphones ok so the

[16:46]reason why that happens is we have something in our mind that's

[16:50]responsible for processing natural rewards what are natural rewards food water intimacy

[16:57]and nurturing these are all very pleasurable for us so we have

[17:01]a circuit in our brain that allows us to that allows us

[17:08]to experience pleasure right for people that have drug addiction there's something

[17:13]going wrong in that area and they experience the same pleasurable sensations

[17:18]from a drug but on exponential on a much greater scale that's

[17:24]exponentially greater can have the next slide please um I drew this

[17:30]last night I hope it's okay I'm just kidding I got it

[17:36]off the internet but this shows you again the names aren't important

[17:39]but the reason why I'm showing this to you is just to

[17:41]illustrate is to show you that this is your brain so if

[17:46]i take your brain and if i cut it in half and

[17:50]we look at it from like a side profile this is basically

[17:52]what it is so those areas that i'm talking about this is

[17:58]what's responsible for what we call the reward pathway that's responsible for

[18:03]giving you pleasure and when we're working with chemical substances that cause

[18:08]addiction this is what's involved this is why i told you earlier

[18:10]that this is a problem that affects the central nervous system and

[18:12]your brain is part of that the next slide please okay what

[18:19]is addictive so these are the drugs that the most common ones

[18:23]that are addictive let's go over them shall we we have opiates

[18:29]or painkillers these include things like heroin morphine something called hydrocodone which

[18:36]is vicodin and others ok we have sedatives that are used to

[18:41]sedate people these include things like valium xanax ativan and another medicine

[18:47]called klonopin we have things that are called stimulants these are commonly

[18:52]prescribed medicines like adderall ritalin concerta we have obviously alcohol we have

[19:02]nicotine this includes hookah everybody together this includes hook okay now just

[19:08]the people on this side no just getting but understand so nicotine

[19:11]is a highly addictive substance and nicotine is and obviously it's in

[19:16]cigarette smoke it is in hookah pipes it is in any method

[19:21]of nicotine ingestion is a form of drug addiction okay and obviously

[19:25]we have marijuana so this is what we commonly see with regard

[19:32]to substances that are highly addictive does anyone have questions so far

[19:35]I want to make sure that we're around the same page and

[19:37]I'll be happy to answer questions later nothing so far okay can

[19:41]have the next slide please so one of the key points that

[19:45]I want to make is that many of the addictive drugs including

[19:47]painkillers and sedatives are prescribed by physicians and they may be in

[19:54]your home you know when I was growing up when we heard

[19:55]drug addiction we were only thinking about illegal drugs we were only

[19:59]thinking about things like heroin or things you would buy off of

[20:02]the street like cocaine or something like that so that's when I

[20:06]was growing on but things have changed things have changed a lot

[20:09]and one of the things that have changed is is that the

[20:12]drugs that are highly addictive the ones that are causing the most

[20:16]human suffering are prescription drugs drugs you get from a doctor now

[20:21]certainly the illegal drugs are still a problem but the bigger issue

[20:24]that we're seeing more and more in our clinic are people coming

[20:30]in with prescription medication problems okay next slide okay so what I

[20:38]want to do now in up and how is your it please

[20:42]keep me updated on time I want to be respectful of time

[20:44]so let me know when I'm running out okay we're going to

[20:48]talk about some of the characteristic behaviors that we see with people

[20:52]that have this problem so one of the things that I want

[20:56]to share with you is that for individuals that have drug addiction

[20:59]it's just not compulsively taking a drug it's a lot more than

[21:03]that one of the biggest things one of the biggest struggles that

[21:06]patients their families have is is that those are the those that

[21:13]are afflicted with the problem engage in very unhealthy behavior in addition

[21:18]to the compulsive drug use what are those behaviors we're going to

[21:25]talk about it now they lie okay there's recurrent lying they're stealing

[21:31]leaving home for no reason giving suspicious answers when questioned mom dad

[21:37]I'm going up for a little while where are you going I'm

[21:40]going to the store what store ah this store down the street

[21:47]why because I need stuff okay appearing Pope's could you go back

[21:51]to thank you very much appearing poorly groomed and not tending to

[21:56]one's personal appearance people may appear what we call very disheveled or

[22:00]they're not taking care of their own personal grooming okay relationship turmoil

[22:06]with loved ones this is a huge one large amounts of money

[22:09]missing you're asking tube our money for suspicious reasons and abrupt changes

[22:13]in school or work performance unfortunately those that are struggling with the

[22:18]problem we're not going to come out and tell you they're not

[22:20]going to come out and say mom I'm strong with this problem

[22:23]mom you know something Johnny gave me some vicodin the other day

[22:27]and you know something something strange happened I took it and it

[22:30]did something to me I felt something like I never felt before

[22:37]and I wanted more and now I can't stop taking it I

[22:41]would love if that's what happened and people would come in and

[22:47]say that but unfortunately they don't what happens is is that they

[22:51]can seal the problem they hide it and one of the things

[22:54]we say is that they protect their relationship with a drug because

[22:59]they want to deflect anyone intervening okay can I have the next

[23:03]slide please so I'm staying here so they will minimize or deny

[23:11]the problem this is a symptom of the illness in itself this

[23:14]isn't somebody that's trying to be difficult oftentimes if you're suspecting somebody

[23:18]is actively struggling with us and you confront them with the issue

[23:22]if you say Johnny I want to talk to you about it

[23:26]you know i think you're struggling with alcohol yes you're right you

[23:28]hit it on the head that's absolutely what's going on I'm so

[23:31]glad you talked to me that sounds going to happen they're going

[23:35]to say you're crazy I don't have an alcohol problem you're the

[23:39]one with the problem okay you're crazy for even thinking that that

[23:43]was going to happen it's very common so this is considered to

[23:47]be a symptom of the illness itself as I told you before

[23:49]they will protect their relationship with the drug and they will block

[23:51]interventions for those that trying those I want to help them what

[23:57]I have here is a big word I'm saying personality metamorphosis basically

[24:01]what that means is the person changes their behaviors dramatically the way

[24:06]they interact with others the way they interact with family is dramatically

[24:10]changed so again the point that I want to solidify by going

[24:15]over these last couple slides is it is not just using a

[24:17]drug compulsively there are profound personality and behavioral changes that that happened

[24:23]and are very toxic to the individual and very unhealthy for the

[24:28]family around them drug addiction does not affect an individual alone for

[24:35]an individual that is struggling with this problem it affects everybody with

[24:42]in touch mother father spouse brother sister anybody that has a relationship

[24:46]with that person is going to be affected this is not just

[24:52]something that the single person deals with this is the one individual

[24:56]may struggle with the problem but it becomes a family issue because

[24:59]everybody that has a relationship with that person is going to be

[25:07]involved okay so some key points so basically let me kind of

[25:10]summarize what I talked about one of the things need to understand

[25:15]is that for Pete and this is probably when I give talks

[25:17]like this one of the most difficult things for people to understand

[25:20]is the first point that I have here it isn't that the

[25:27]individual doesn't want to stop they can't stop and that's so hard

[25:29]for people who aren't afflicted with a problem to understand it isn't

[25:33]a it isn't an issue of wanting to its that they can't

[25:39]and that's very hard for people to understand asking somebody to stop

[25:43]or cut down without being engaged in treatment is an unrealistic expectation

[25:48]notice I have that underlined I wonder why okay often times people

[25:53]will say can you just stop can you just stop drinking please

[25:58]stop taking xanax please stop taking vicodin just stop it's not going

[26:02]to happen if somebody is dealing with this problem in order for

[26:05]them to stop in order for them to cut down they need

[26:09]to get involved in treatment so it's unrealistic for us just to

[26:12]the thing that they're going to stop just because we told them

[26:15]to I wish it was that simple I really do but unfortunately

[26:18]it's not can you go back to the other slide please just

[26:26]the one previous thank you you cannot talk somebody out of the

[26:29]problem the best way you can help somebody is to refer them

[26:31]to a professional treatment center if you know somebody okay and if

[26:38]you guys are within earshot of me please listen to me if

[26:42]you know somebody that is struggling with this the best thing you

[26:45]can do for that patient is every to me for that person

[26:49]loved one family member who ever it is please get them into

[26:54]a treatment center do not take this burden on yourself do not

[26:56]try and fix the problem you're not going to be able to

[26:57]fix it this is this is a medical issue and they need

[27:02]to be cared for by appropriately trained medical personnel I'm going to

[27:07]say it again because it's important if you know somebody that is

[27:11]struggling with this please refer them or please work on getting them

[27:17]to an appropriate treatment center I'll stay here a little while afterwards

[27:21]you have any questions talk to me we have an organization the

[27:23]community that's called safe sa Fe one of our representatives God Abdullah

[27:28]is here today she's a clinical pharmacist working on in Grosse Pointe

[27:32]her and I together with many other people were working on a

[27:36]community coalition and we're working on helping people that are struggling with

[27:40]this okay unfortunately i don't have flyers but i will try and

[27:43]have flyers available next week so those of you that are here

[27:44]today hopefully you can pick up flyers next week okay I'm sorry

[27:50]can you go back to the previous slide that I finish everything

[27:54]there yes I did thank you clear the next slide okay so

[28:00]when we talk about treatment there are various week all levels of

[28:04]treatment there's outpatient treatment there's inpatient treatment one of the things we

[28:08]do is that when somebody says you know something I need help

[28:12]the first thing we do is we need to assess we call

[28:15]a level of care what level of care does this person need

[28:17]can they just come into an outpatient clinic or do they need

[28:23]to go into an inpatient program so there's various care so somebody

[28:26]can just come in they can meet with a therapist every week

[28:27]or on the more extreme on they need to go into the

[28:31]hospital for a week or two and sometimes we have something called

[28:34]long-term residential programs these programs can last anywhere between 30 and 90

[28:40]days and sometimes longer than that okay there's so anyway so just

[28:45]so you know so when your loved one if you know somebody

[28:46]when they're coming in for an assessment when they're coming for help

[28:50]the first thing that needs to happen is is that we need

[28:55]to decide what level of care does that person need okay there's

[28:59]also something called community support meetings this is like Nara how many

[29:04]have heard of Nara a before okay most most people have these

[29:10]are community support meetings these are not professional treatments okay these are

[29:15]run by individuals that have been reflected by the illness it is

[29:21]a support group it is not treatment very different I when you

[29:24]guys understand that so again it is not treatment it is support

[29:30]let's make a contrast let's say somebody has cancer you go to

[29:34]your cancer doctor for treatment you go to a cancer support group

[29:37]for support okay it's the same thing they are very effective and

[29:42]they're very helpful many people utilize these meetings on a daily basis

[29:48]there are people that struggle with alcohol addiction they've been sober for

[29:51]20 years they go to a meeting every day of their life

[29:53]and they will continue to go to a meeting until the day

[29:57]they die this is their lifeline this gives them the support and

[29:59]it helps them stay sober I'm an advocate of community support meetings

[30:02]such as na NAA i think they do a great job but

[30:06]the thing I need to tell you is that if you know

[30:08]somebody that is struggling with either an alcohol or drug problem simply

[30:11]asking them go to any or AAA is not going to fix

[30:15]the issue it's not it's going to give them support but it's

[30:18]not going to treat the problem ok can I the next slide

[30:24]we already talked about that kind of the next I please ok

[30:27]that's it so I think I covered everything and I don't know

[30:33]what the time frame is I'm happy to answer questions if you

[30:37]guys have any questions ask questions about the presentation or just questions

[30:41]in general anybody anything I don't need my glasses on so yes

[31:14]what a fantastic question thank you for asking that did everybody hear

[31:19]that for those who didn't hear it I'm going to repeat it

[31:21]the young sister asked if you know somebody that is struggling with

[31:24]addiction they're over 18 and they won't go into treatment what do

[31:29]you do very common occurrence we deal with this every day in

[31:32]our clinic it's a tough situation I'll tell you what I do

[31:39]and hopefully this will help you out understand is that this type

[31:44]of resistance is common for individuals that are struggling with this we

[31:47]often try and get them into treatment and they will either deny

[31:49]they have a problem are they will be to basically state that

[31:51]they're not in need of treatment so what do we do we

[31:55]have somebody that's struggling with what can be potentially life-threatening issue and

[32:01]they're not going into treatment so one of the things we do

[32:07]is that we try and get leverage what I do is that

[32:12]if I can't get them into treatment I try to find somebody

[32:15]that can so i will find somebody who has a close relationship

[32:19]with that person let me give an example let's say that you're

[32:24]working with the family member and they don't want to go to

[32:27]treatment who has the power to leverage that person into treatment often

[32:33]we do an ultimatum and that ultimatum is this first we find

[32:41]somebody that has leverage leverage meaning is the individual that may be

[32:46]providing this person with shelter money food and we get that person

[32:50]to align on the side of treatment and that person will say

[32:54]to the person that's struggling you have two choices you either go

[32:58]to treatment I love you I help you I will help you

[33:02]pay for your treatment if you don't want to go to treatment

[33:03]you need to move your stuff you need to get out of

[33:07]my house okay I know that's tough love but when we're dealing

[33:09]with something like this oftentimes it comes to that the other so

[33:12]that's a more severe end of it meaning that you want to

[33:18]give them a choice a or b either you go to treatment

[33:23]where this is going to happen if that's not the route that

[33:26]wants to be taken by the family we do have certain we

[33:29]call psycho therapeutic intervention something called motivational interviewing where the individual meet

[33:36]with a therapist and even though on day one they may not

[33:40]be interested in going into treatment the therapist will work with them

[33:44]and through the course of time will hopefully get them to change

[33:47]their perception of the issue and hopefully get them into a treatment

[33:50]program so there's a spectrum either we can work with that patient

[33:54]in psychotherapy ultimately motivate them to get into treatment or on the

[33:57]other end of the spectrum is that you get family together you

[34:00]get you get you have somebody that has leverage over that person

[34:05]and you basically state you need to choose treatment versus this bad

[34:09]consequence here it's a great question we can on it we can

[34:11]probably talk about that for an hour I want to thank you

[34:14]for bring it up I hope that was at least modestly helpful

[34:40]yeah it's a really well I think there's always help for somebody

[34:55]I don't like to say that a situation is hopeless because I

[34:59]don't think that that's a case I think there was always hell

[35:02]for somebody for that individual maybe he or she hasn't hit the

[35:05]rock bottom yet sometimes people have to hit their rock bottom before

[35:08]they realize is that they need to get help in most cases

[35:12]if a B and C is happening nothing's happening that its individual

[35:16]continues to engage in these behaviors may be going to jail is

[35:23]what they needed to have happen maybe this consequences what they needed

[35:28]before they actually turn the corner but it's hard you know you're

[35:31]talking about a very common scenario there's a lot of different ways

[35:34]to handle it the tough love thing may not work it doesn't

[35:39]work in some cases but we never give up hope okay I

[35:41]want to ensure that we have time for other questions again a

[35:57]very good you guys are asking really really good questions um this

[36:02]is a big misconception a lot of people feel that if you

[36:05]take a certain medicine long enough you're going to become addicted to

[36:09]it that doesn't necessarily happen because of somebody's what I call their

[36:14]biological vulnerability or their genetics they're what we call very highly predisposed

[36:20]to this problem let me give an example in the most severe

[36:24]cases true story had a lady normal teenage life graduated high school

[36:34]went to undergrad did really well gala cottage got a college degree

[36:39]and a dental problem social into the demo she had to have

[36:42]a tooth taken out the dentist gave her tylenol with codeine for

[36:45]the pain she took one pill one pill of tylenol with codeine

[36:54]and that triggered a life-threatening drug addiction for her she took the

[37:00]one pill and she could not stop and it's interesting when you

[37:02]talk to people that have such high sensitivity that's what they tell

[37:05]you is they say the minute i took that I knew and

[37:10]this is exactly what she told me she said the minute i

[37:12]took that i knew something was wrong they know because the reinforcement

[37:18]that the drug provides is so profound to some people okay now

[37:22]that's an extreme example we have examples that are less dramatic it's

[37:27]usually a multitude of things it's not just one I think you

[37:31]have people that have an underlying biological sensitivity to it and if

[37:36]everything goes well in their life it likely won't manifest themselves the

[37:40]disease won't come about but if you have somebody that has the

[37:46]underlying susceptibility then you tag on a psychiatric disorder then you tag

[37:53]on social stress then you tag on financial stress and then all

[37:57]these things coalesce and come together then they get into a car

[37:59]accident they break their leg and now they're prescribed vicodin yes that

[38:02]can trigger the illness so to answer your question it's a variety

[38:08]of factors but the underlying theme is that usual people have an

[38:15]underlying biological sensitivity I'm sorry I'm sorry oh one more question no

[38:26]okay this was fun I'll hang out I'll answer questions you guys

[38:33]have been a great audience thank you so much

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Drugs and Alcohol Addiction - Dr. Ed Jouney

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Drugs and Alcohol Addiction - Dr. Ed Jouney

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