May 19, 2020 • 17 mins
A psychiatrist specializing in addiction talks about the unique challenges people in recovery are facing — and shares some advice for anyone worried that their coping mechanisms are doing more harm than good.
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Episode Transcript
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Speaker 1 (00:07):
I'm Danny Shapiro, and this is the Way We Live Now.
Today is day seventy seventy since face masks became ubiquitous
and now seemed to be turning into a fashion statement,
and day of this podcast. I've been thinking a lot
about the jokes that lots of us are making about
(00:28):
numbing ourselves during these terrible times, you know, zooming with
friends over quarantine e's or tweeting about wine o'clock. But
for people who are struggling with addiction or who are
in recovery, it's no laughing matter. My guest today is
Dr Randall Zanger. Randy, thanks so much for joining me
(00:56):
to talk about the way we live now. I'm glad
to be here. Thank you for having me. Let me
begin by asking where are you right now? Like, where
are you sitting, what are you looking at? What does
life look like? Well, I'm in a beautiful place right now.
I'm in um God's Country in the northwest corner of Connecticut,
and I'm literally sitting in my private office right now
(01:19):
looking out on Highway forty four. We call it a
highway here, but uh, just a road. But it's a
beautiful day and I've been uh, telecommuting, doing mostly telephone
sessions and video sessions with patients in my private practice today.
(01:40):
So you're a psychiatrist who specializes in addiction and recovery,
and you're the chief medical officer of Mountainside, which is
a nationally acclaimed alcohol and drug rehabilitation center. It actually
has a cafe connected to it, doesn't it. It does absolutely.
I love that cafe. I've driven by it many times
(02:00):
and once I the first time I pulled in, I
was just a revelation. It's very special place that just
operated or you know, run by people who are in recovery. UM,
you know, in in the rehabilitation center. Yeah, it's so
nice that you mentioned the cafe because it is a
wonderful piece of our It's kind of a work therapy
(02:20):
program that we do for people who have finished our
rehabilitation peace and have continued in what we call extended
care and UM. Being in recovery is so difficult, but
you know, your your addiction has consumed so much of
your life that sort of getting back to those basics
of getting up on time and uh, putting on your
(02:44):
uniform and showing up to work on time is is
a real therapeutic thing for for these young people. UM.
And you know, during this COVID epidemic, the cafe, we're
doing take out to the commun unity curbside pick up. Um.
But you know, it's been a disruption in their lives
(03:06):
as well, and it's been a big challenge for everybody
in recovery. But I think that those those young people
are very, very dear to me, so really, yeah, thanks
for bringing them up. I'm thinking too, I'm remembering the
times that I've stopped in there, and there has been
a quality of just in the in the in the
(03:28):
young people, um waiting on the tables or behind the
cash register or making the coffee, of gratitude and a
kind of um cheerfulness, like a really genuine yeah. I
guess I can only really call it gratitude. And I
can imagine in the early days of kind of becoming
more independent in recovery that, Um, you use the word disruption.
(03:53):
It seems like disruption sort of the order of the
day for many of us right now. And UM, I
want to ask you, what have these months since the
pandemic hit been like in your community? What are you
noticing that people are experiencing? Well, yeah, I mean, if
you think about if you're thinking about recovery, I mean,
what we ask people to do, or what they ask
(04:14):
us to help them do, is to give up their
drug of choice, whether that's alcohol or heroin or xanax
or cocaine, and uh, and what do we replace it with? Right, So,
this is the thing that made them feel good. It
released the dope enming receptors in their brain, and they
felt better than they've ever felt in their lives. And
(04:35):
now we take that away, or they ask us to
help them be without that, and so what do we
replace it with. It's really we replace it with a connection,
a connection with other people. And so I think that
this is um, this socialized isolation and self quarantine, UM,
is just counter to everything we've given them in their recovery,
(05:00):
you know. I mean that's the exact wrong thing to
do in your recovery, right, is to isolate and to
stay inside and um, you know, watch watch videos or
whatever it comes up. So it's been, UM, it's been
a huge challenge and both in the recovery community but
also in the treatment community. How can we how can
(05:21):
we reach these people who are now sitting in their
apartments being told that they can't go out, or they
can't if they go out, they have to wear a mask,
they have to wear gloves. Isolation is the wrong thing
for people in recovery to be experiencing and be exposed to. UM. So,
so this has been a real challenge and UM both
(05:44):
in terms of providing virtual help, whether that's through therapy
or self help groups or virtual online meditation groups where
sober people can get together. We actually are doing this
so Jeopardy group, which has been pretty popular. UM but uh,
(06:05):
but also for those of us that are running a
detox and rehab program, UM making a program that's safe
for people to come and uh and that's that's been
a real challenge too, and really making sure that we
screen things and um, that we have the testing and
the barriers in place so that we're uh so the
(06:27):
people come and do the work they're they're meant to do,
rather than feeling like, Okay, I'm going to get exposed
to this virus because there's strangers coming in every day, right.
I mean, this is really addressing precisely why I wanted
to speak with you, because I'm so aware that people
are struggling and you know, days blur one into the next,
(06:48):
and folks are more isolated than usual without the mechanisms
that usually keep us busy and distracted and afloat and
and at the same time, in terms of the recovery community,
you know, there are these subliminal and not even so
subliminal messages that are everywhere on social media and in advertisements.
(07:10):
You know, people are making jokes about quarantine ease or
zoom cocktail dates or wine o'clock, and you know, businesses
booming for liquor stores, you know, which were deemed essential businesses.
So for those who are vulnerable to addiction, it just
seems like it's a perfect storm. I mean, I think
it's difficult for even people who are not identifying as addicts.
(07:35):
And you know, of course in person meetings, whether it's
twelve step meetings or therapy or group therapy, have had
to be put on hold. So what are the challenges
of not being able to physically gather, Like, do you
find when you're doing therapy with people are running group
therapy that that it can be effective to be managing
(07:57):
it on screens? Yeah, well, I would have to say
that I've that's been one of the pleasant surprises of
this for me because I you know, I'm a little
bit older, so UM, I uh had not been doing
any skype or zoom calls in my practice. UM, and
(08:18):
I've really found it is a really good way to
connect with people, particularly one on one. I think the
groups are a little more challenging. UM, but I have
a very talented group of clinicians who are pretty good.
We have actually more facilitators in a group in an
online group, so they can help kind of manage the
questions and those sorts of those sorts of things. UM.
(08:41):
But I actually find a really good connection on the
one on one therapy UM and psychiatric sessions that that
we have. But it isn't the same and UM. You know,
as a doctor, you know you like to have that patient.
You like to be able in front of you like
to be able to examine the patient and and have
that connection. UM. I will have to say that when
(09:04):
I go into the when I go into mountainside Um,
you know, we're we're doing doing everything according to the
CDC recommendations. So we're wearing masks. And I find how
how much I miss people's mouths, you know, miss seeing
them smile and that way of connecting with people at
least I'm looking at their mouths when I'm doing virtual
(09:27):
meetings on videos. So UM, I think that's been pretty positive.
That's so interesting. I one of my best friends is
a therapist, and and she was saying that if when
she goes back to being able to be uh, you know,
safely in a room with her patients, if masks are
a requirement of that, that she would actually rather to
continue to zoom with them so that she can see
(09:48):
their faces. There's something that's very disorienting about not being
able to really see one another. I mean for for
all of us, I think, not just um mental health
professionals and and patients. I was actually looking at illustrations
of the masks that doctors were in the fourteenth century.
I don't know if you've ever seen them, but they're
(10:08):
really extorted. They had huge beaks like birds, and the
beaks were there to kind of maintain social distance. They
wouldn't have had that language for it, but I was
just imagining from the patient's point of view, seeing these
these beaks coming at you. I mean, it's just surreal anyway.
But I digress. For listeners out there who are struggling
(10:32):
or worried about substance abuse, who are engine treatment or
but are you know, in this time of so much
social isolation, who are just struggling or noticing that they're
consuming more than they would want to be of whatever substance,
what advice might you have to offer? I mean, I
(10:55):
think that's such a great point because it's it's not
just someone who has already identified that they're an alcoholic
and they need to be in recovery. I think that
this is such a such a high risk and slippery slope,
uh time for people that um, I mean we know
that you know, after nine eleven, there was like a
(11:16):
huge increase in number of people that developed alcohol problems
nine months after nine eleven because they just found themselves.
You know that this is their cope, this is the
way that they were coping. And and I think, particularly
when you have all this time in front of you,
you see yourself, you know, drinking earlier in the day.
You know, cocktail hour moves earlier, and the bottle of
(11:40):
wine that used to last three and four nights now
is uh you're opening up the second bottle of the
second night, and um, you know, so I think that
it is a time to self reflect and look at
how much you're drinking, whether or not you if you
tell yourself, I think I should probably cut down. You
(12:00):
should probably cut down if people get annoyed with you
because of your drinking, or start feeling guilty because of
how much you're drinking, or you know, if you find
yourself having to drink in the morning to treat withdrawal symptoms.
I mean, this is somebody who's getting themselves in trouble
with alcohol and probably should be looking at at getting
(12:20):
some support and getting some treatment. Um, because it's a uh.
You know, withdrawal from alcohol can actually be deadly, so
you want to make sure you have the proper support
before you get that far, right, So you're also really
talking about reaching out and asking for help. I think
absolutely that, uh, and there is there is a lot
(12:41):
of help out there, not just from Mountainside but online
support like your primary care doctors. People are not seeing
their primary care doctors because you know, they're involved in
other things, and a lot of those appointments are also
being done virtually. So I definitely think to reach out
for some support, but also use the time to do
(13:02):
some self reflection. What's bringing you hope or solace during
this time that can often feel so hopeless or difficult
times for globally for everyone. Sure, so you know you
kind of mentioned it when you're talking about the cafe.
I work with an incredible group of people, not just
(13:23):
my coworkers who I UM. This group of nurses and
clinicians and even the housekeepers and the people and food
services are so dedicated to what they do UM in
helping and helping people with addiction UM, but also the
clients themselves that I work with. UM. When you mentioned
(13:46):
that sense of gratitude, I have this great job because
people actually do express gratitude for UM, for the things
you do for them and and how their lives might change.
So so I think that my hope comes in in
very individual ways, you know, is that if I can
help one person that day, then I've had a good day.
(14:10):
I realized I'm not going to change the entire global
epidemic of opioid addiction. By the way, opioid addiction, that
epidemic has not gone away during this whole pandemic, just
that sense of I mean, the last kid I talked
to today said, I'm so content with my life right now,
(14:31):
it's ridiculous, and you know, it's just like, what a
great feeling you know that, Uh, And this is somebody
who had opiate addiction and has has really been helped
by by our program and and and all the skills
that he's learned. That must be an amazing feeling. It is.
It's it's worthwhile. My last question to you is have
(14:54):
you reflected at all about what you hope we might
learn from this time, you know, this time when we
are like it or not really being forced into a
place of slowing down and of self reflection, of kind
of meeting ourselves wherever we are because there are no
tent poles of our plans or distractions. Do you have
(15:17):
any thoughts about that? Well, yeah, so a couple of things.
I think The first thing that came to mind was
we really need to listen to our scientists. We really
need to follow the guidance of science and use common
sense in this. I think that that's gonna prevail, and
because I think we're going to be be in this
(15:38):
for a long time. But probably the thing that I
also thought of is one of the places I do
take out um in New Marlborough, Massachusetts. She Uh, the
host added a packet of the cookies to our last
order with a handwritten notes that be safe and be
(16:01):
kind and and I think that that's what what I
want us to get out of this, you know, a
sense of kindness for each other. And I think that's
going to get us through. That is a beautiful note
to end on. I'm so thankful to you for making
the time to talk to me about you know, such
(16:22):
such important issues. I think this will resonate with lots
of listeners, So Randy, thank you for um, thanks for
everything you do and for taking the time. And thank
you for what you're doing. Danny. I think it's a
great project. Thanks, good luck, jo all take care. Thanks
(16:46):
for listening to the Way We Live Now. Tell us
the way you're living now. We want to hear call
us on. You might want to a pen for this
nine O nine three that's nine O nine seven eight
nine nine five and record your story and we might
just use it on the pod. Also, you can join
(17:07):
our Facebook group at facebook dot com slash groups slash
the Way We Live Now Pod. We are creating a
community here and we would love for you to join us.
You can find me on Instagram at Danny Ryder. The
Way We Live Now is a production of I heart Radio.
It's produced by a Low Brulante. Bethan Macaluso is executive producer.
(17:28):
Special thanks to Tristan McNeil and Tyler Klang. For more
podcasts from I heart Radio, visit the I heart Radio app,
Apple Podcasts, or wherever you get your podcasts.
I'm Danny Shapiro, and this is the Way We Live Now.
Today is day seventy seventy since face masks became ubiquitous
and now seemed to be turning into a fashion statement,
and day of this podcast. I've been thinking a lot
about the jokes that lots of us are making about
(00:28):
numbing ourselves during these terrible times, you know, zooming with
friends over quarantine e's or tweeting about wine o'clock. But
for people who are struggling with addiction or who are
in recovery, it's no laughing matter. My guest today is
Dr Randall Zanger. Randy, thanks so much for joining me
(00:56):
to talk about the way we live now. I'm glad
to be here. Thank you for having me. Let me
begin by asking where are you right now? Like, where
are you sitting, what are you looking at? What does
life look like? Well, I'm in a beautiful place right now.
I'm in um God's Country in the northwest corner of Connecticut,
and I'm literally sitting in my private office right now
(01:19):
looking out on Highway forty four. We call it a
highway here, but uh, just a road. But it's a
beautiful day and I've been uh, telecommuting, doing mostly telephone
sessions and video sessions with patients in my private practice today.
(01:40):
So you're a psychiatrist who specializes in addiction and recovery,
and you're the chief medical officer of Mountainside, which is
a nationally acclaimed alcohol and drug rehabilitation center. It actually
has a cafe connected to it, doesn't it. It does absolutely.
I love that cafe. I've driven by it many times
(02:00):
and once I the first time I pulled in, I
was just a revelation. It's very special place that just
operated or you know, run by people who are in recovery. UM,
you know, in in the rehabilitation center. Yeah, it's so
nice that you mentioned the cafe because it is a
wonderful piece of our It's kind of a work therapy
(02:20):
program that we do for people who have finished our
rehabilitation peace and have continued in what we call extended
care and UM. Being in recovery is so difficult, but
you know, your your addiction has consumed so much of
your life that sort of getting back to those basics
of getting up on time and uh, putting on your
(02:44):
uniform and showing up to work on time is is
a real therapeutic thing for for these young people. UM.
And you know, during this COVID epidemic, the cafe, we're
doing take out to the commun unity curbside pick up. Um.
But you know, it's been a disruption in their lives
(03:06):
as well, and it's been a big challenge for everybody
in recovery. But I think that those those young people
are very, very dear to me, so really, yeah, thanks
for bringing them up. I'm thinking too, I'm remembering the
times that I've stopped in there, and there has been
a quality of just in the in the in the
(03:28):
young people, um waiting on the tables or behind the
cash register or making the coffee, of gratitude and a
kind of um cheerfulness, like a really genuine yeah. I
guess I can only really call it gratitude. And I
can imagine in the early days of kind of becoming
more independent in recovery that, Um, you use the word disruption.
(03:53):
It seems like disruption sort of the order of the
day for many of us right now. And UM, I
want to ask you, what have these months since the
pandemic hit been like in your community? What are you
noticing that people are experiencing? Well, yeah, I mean, if
you think about if you're thinking about recovery, I mean,
what we ask people to do, or what they ask
(04:14):
us to help them do, is to give up their
drug of choice, whether that's alcohol or heroin or xanax
or cocaine, and uh, and what do we replace it with? Right, So,
this is the thing that made them feel good. It
released the dope enming receptors in their brain, and they
felt better than they've ever felt in their lives. And
(04:35):
now we take that away, or they ask us to
help them be without that, and so what do we
replace it with. It's really we replace it with a connection,
a connection with other people. And so I think that
this is um, this socialized isolation and self quarantine, UM,
is just counter to everything we've given them in their recovery,
(05:00):
you know. I mean that's the exact wrong thing to
do in your recovery, right, is to isolate and to
stay inside and um, you know, watch watch videos or
whatever it comes up. So it's been, UM, it's been
a huge challenge and both in the recovery community but
also in the treatment community. How can we how can
(05:21):
we reach these people who are now sitting in their
apartments being told that they can't go out, or they
can't if they go out, they have to wear a mask,
they have to wear gloves. Isolation is the wrong thing
for people in recovery to be experiencing and be exposed to. UM. So,
so this has been a real challenge and UM both
(05:44):
in terms of providing virtual help, whether that's through therapy
or self help groups or virtual online meditation groups where
sober people can get together. We actually are doing this
so Jeopardy group, which has been pretty popular. UM but uh,
(06:05):
but also for those of us that are running a
detox and rehab program, UM making a program that's safe
for people to come and uh and that's that's been
a real challenge too, and really making sure that we
screen things and um, that we have the testing and
the barriers in place so that we're uh so the
(06:27):
people come and do the work they're they're meant to do,
rather than feeling like, Okay, I'm going to get exposed
to this virus because there's strangers coming in every day, right.
I mean, this is really addressing precisely why I wanted
to speak with you, because I'm so aware that people
are struggling and you know, days blur one into the next,
(06:48):
and folks are more isolated than usual without the mechanisms
that usually keep us busy and distracted and afloat and
and at the same time, in terms of the recovery community,
you know, there are these subliminal and not even so
subliminal messages that are everywhere on social media and in advertisements.
(07:10):
You know, people are making jokes about quarantine ease or
zoom cocktail dates or wine o'clock, and you know, businesses
booming for liquor stores, you know, which were deemed essential businesses.
So for those who are vulnerable to addiction, it just
seems like it's a perfect storm. I mean, I think
it's difficult for even people who are not identifying as addicts.
(07:35):
And you know, of course in person meetings, whether it's
twelve step meetings or therapy or group therapy, have had
to be put on hold. So what are the challenges
of not being able to physically gather, Like, do you
find when you're doing therapy with people are running group
therapy that that it can be effective to be managing
(07:57):
it on screens? Yeah, well, I would have to say
that I've that's been one of the pleasant surprises of
this for me because I you know, I'm a little
bit older, so UM, I uh had not been doing
any skype or zoom calls in my practice. UM, and
(08:18):
I've really found it is a really good way to
connect with people, particularly one on one. I think the
groups are a little more challenging. UM, but I have
a very talented group of clinicians who are pretty good.
We have actually more facilitators in a group in an
online group, so they can help kind of manage the
questions and those sorts of those sorts of things. UM.
(08:41):
But I actually find a really good connection on the
one on one therapy UM and psychiatric sessions that that
we have. But it isn't the same and UM. You know,
as a doctor, you know you like to have that patient.
You like to be able in front of you like
to be able to examine the patient and and have
that connection. UM. I will have to say that when
(09:04):
I go into the when I go into mountainside Um,
you know, we're we're doing doing everything according to the
CDC recommendations. So we're wearing masks. And I find how
how much I miss people's mouths, you know, miss seeing
them smile and that way of connecting with people at
least I'm looking at their mouths when I'm doing virtual
(09:27):
meetings on videos. So UM, I think that's been pretty positive.
That's so interesting. I one of my best friends is
a therapist, and and she was saying that if when
she goes back to being able to be uh, you know,
safely in a room with her patients, if masks are
a requirement of that, that she would actually rather to
continue to zoom with them so that she can see
(09:48):
their faces. There's something that's very disorienting about not being
able to really see one another. I mean for for
all of us, I think, not just um mental health
professionals and and patients. I was actually looking at illustrations
of the masks that doctors were in the fourteenth century.
I don't know if you've ever seen them, but they're
(10:08):
really extorted. They had huge beaks like birds, and the
beaks were there to kind of maintain social distance. They
wouldn't have had that language for it, but I was
just imagining from the patient's point of view, seeing these
these beaks coming at you. I mean, it's just surreal anyway.
But I digress. For listeners out there who are struggling
(10:32):
or worried about substance abuse, who are engine treatment or
but are you know, in this time of so much
social isolation, who are just struggling or noticing that they're
consuming more than they would want to be of whatever substance,
what advice might you have to offer? I mean, I
(10:55):
think that's such a great point because it's it's not
just someone who has already identified that they're an alcoholic
and they need to be in recovery. I think that
this is such a such a high risk and slippery slope,
uh time for people that um, I mean we know
that you know, after nine eleven, there was like a
(11:16):
huge increase in number of people that developed alcohol problems
nine months after nine eleven because they just found themselves.
You know that this is their cope, this is the
way that they were coping. And and I think, particularly
when you have all this time in front of you,
you see yourself, you know, drinking earlier in the day.
You know, cocktail hour moves earlier, and the bottle of
(11:40):
wine that used to last three and four nights now
is uh you're opening up the second bottle of the
second night, and um, you know, so I think that
it is a time to self reflect and look at
how much you're drinking, whether or not you if you
tell yourself, I think I should probably cut down. You
(12:00):
should probably cut down if people get annoyed with you
because of your drinking, or start feeling guilty because of
how much you're drinking, or you know, if you find
yourself having to drink in the morning to treat withdrawal symptoms.
I mean, this is somebody who's getting themselves in trouble
with alcohol and probably should be looking at at getting
(12:20):
some support and getting some treatment. Um, because it's a uh.
You know, withdrawal from alcohol can actually be deadly, so
you want to make sure you have the proper support
before you get that far, right, So you're also really
talking about reaching out and asking for help. I think
absolutely that, uh, and there is there is a lot
(12:41):
of help out there, not just from Mountainside but online
support like your primary care doctors. People are not seeing
their primary care doctors because you know, they're involved in
other things, and a lot of those appointments are also
being done virtually. So I definitely think to reach out
for some support, but also use the time to do
(13:02):
some self reflection. What's bringing you hope or solace during
this time that can often feel so hopeless or difficult
times for globally for everyone. Sure, so you know you
kind of mentioned it when you're talking about the cafe.
I work with an incredible group of people, not just
(13:23):
my coworkers who I UM. This group of nurses and
clinicians and even the housekeepers and the people and food
services are so dedicated to what they do UM in
helping and helping people with addiction UM, but also the
clients themselves that I work with. UM. When you mentioned
(13:46):
that sense of gratitude, I have this great job because
people actually do express gratitude for UM, for the things
you do for them and and how their lives might change.
So so I think that my hope comes in in
very individual ways, you know, is that if I can
help one person that day, then I've had a good day.
(14:10):
I realized I'm not going to change the entire global
epidemic of opioid addiction. By the way, opioid addiction, that
epidemic has not gone away during this whole pandemic, just
that sense of I mean, the last kid I talked
to today said, I'm so content with my life right now,
(14:31):
it's ridiculous, and you know, it's just like, what a
great feeling you know that, Uh, And this is somebody
who had opiate addiction and has has really been helped
by by our program and and and all the skills
that he's learned. That must be an amazing feeling. It is.
It's it's worthwhile. My last question to you is have
(14:54):
you reflected at all about what you hope we might
learn from this time, you know, this time when we
are like it or not really being forced into a
place of slowing down and of self reflection, of kind
of meeting ourselves wherever we are because there are no
tent poles of our plans or distractions. Do you have
(15:17):
any thoughts about that? Well, yeah, so a couple of things.
I think The first thing that came to mind was
we really need to listen to our scientists. We really
need to follow the guidance of science and use common
sense in this. I think that that's gonna prevail, and
because I think we're going to be be in this
(15:38):
for a long time. But probably the thing that I
also thought of is one of the places I do
take out um in New Marlborough, Massachusetts. She Uh, the
host added a packet of the cookies to our last
order with a handwritten notes that be safe and be
(16:01):
kind and and I think that that's what what I
want us to get out of this, you know, a
sense of kindness for each other. And I think that's
going to get us through. That is a beautiful note
to end on. I'm so thankful to you for making
the time to talk to me about you know, such
(16:22):
such important issues. I think this will resonate with lots
of listeners, So Randy, thank you for um, thanks for
everything you do and for taking the time. And thank
you for what you're doing. Danny. I think it's a
great project. Thanks, good luck, jo all take care. Thanks
(16:46):
for listening to the Way We Live Now. Tell us
the way you're living now. We want to hear call
us on. You might want to a pen for this
nine O nine three that's nine O nine seven eight
nine nine five and record your story and we might
just use it on the pod. Also, you can join
(17:07):
our Facebook group at facebook dot com slash groups slash
the Way We Live Now Pod. We are creating a
community here and we would love for you to join us.
You can find me on Instagram at Danny Ryder. The
Way We Live Now is a production of I heart Radio.
It's produced by a Low Brulante. Bethan Macaluso is executive producer.
(17:28):
Special thanks to Tristan McNeil and Tyler Klang. For more
podcasts from I heart Radio, visit the I heart Radio app,
Apple Podcasts, or wherever you get your podcasts.
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