January 23, 2024 • 46 mins
Maia Szalavitz, New York Times best-selling author of "Unbroken Brain" and "Undoing Drugs," joins Dr. Harrison to help us unlearn tough love, rock bottoms, and autism stereotypes. Deeply passionate about rectifying the inequality in drug policy and harm reduction, Maia gives us a tour of her recovery journey. If you're curious about how to navigate autism, prescribed medication, and sobriety, don't miss this episode.
Check out Maia's books: https://maiasz.com/books/
Find Maia on Twitter (X): @maiasz
Read Maia's New York Times essay from 1/22/24, "After My Heroin Addiction, Would Pain Medicine Set Me Back?": https://www.nytimes.com/2024/01/22/opinion/pain-recovery-drug-addiction.html
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Dr. Nzinga's Harrison's book, "Un-Addiction: Six Mind-Changing Conversations That Could Save a Life" is OUT NOW! Order it here: https://www.nzingaharrisonmd.com/
Find Nzinga on Threads and X (Twitter): @nzingamd / LinkedIn: https://www.linkedin.com/in/nzingaharrisonmd/
Follow us on IG @unaddictionpod.
If you'd like to watch our interviews, you can catch us on YouTube @unaddictionpod.
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If you or a loved one are experiencing addiction, have questions about recovery, or need treatment tailored to you, visit eleanorhealth.com
See omnystudio.com/listener for privacy information.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Welcome to Unaddiction the Podcast. My name is doctor Enzinga Harrison.
I'm a board certified psychiatrist with a specialty in addiction
medicine and co founder and chief medical officer of Eleanor Health.
On this podcast, we explore the paths that can lead
to addiction and the infinite paths that can lead to recovery.
(00:24):
Our guests are sharing their own experiences, the tools that
have helped them along the way, and the formulas that
allow them to thrive in recovery one day at a time.
I am so excited to tell you about my book, Unaddictioned.
Six mind changing Conversations that Could Save a Life, is
now available from Union Squaring Company or wherever books are sold.
(00:48):
Maya Solovitz is the author, most recently of Undoing Drugs,
The Untold Story of Harm Reduction and the Future of Addiction,
which is the first history of the harm reduction move
aimed at focusing drug policy on minimizing harms, not highs.
Her previous New York Times bestseller, Unbroken Brain, A Revolutionary
(01:11):
New Way of Understanding Addiction, wove together neuroscience and social
science with her own personal experience of heroin addiction. It
won the twenty eighteen Media Award from the National Institute
on Drug Abuse, So you can see why we had
to have her on the Unaddictioned podcast. We dive into
(01:32):
everything from why she never went to prison to why
she continues to focus her writing and advocacy on addiction
and harm reduction. Yeah, so glad to have you. Thank
you so much for joining me here on the Unaddictioned podcast.
Speaker 2 (01:48):
Thank you for having me.
Speaker 1 (01:50):
So I'll set it up for you. On the podcast,
I'm talking to a bunch of people who've had their
own recovery journey, and just like hope that people can
hear all of these different pathways to recovery and all
of these different pieces of formulas that people have and
maybe it helps them start their journey, or maybe it
(02:11):
helps them talk to their loved one about it, or
maybe it gives them an idea for something to add
to their own formula. So that's the idea. Do you
mind sharing with us what has your journey been? However
you want to share that with us? Sure?
Speaker 2 (02:27):
So I was basically a very geeky kind of kid who,
you know, just didn't know how to connect to people basically,
and so I was sort of very into like intellectual obsessions,
like starting with like reading when I was like three,
and so I was just I was just weird. I
(02:49):
wasn't interested in the things my peers were interested in,
and I was very oversensitive to lights and sounds and
emotions and all kinds of stuff like this. So I
just appeared like a very strange, smart kid. And so
(03:09):
you know that that was hard because I did really
want to connect to people, but I was just kind
of overwhelmed, and I started thinking that I must be
a bad person because everybody else seems to be able
to do this naturally, and also like I am selfish
because I need to like control things to keep my
(03:31):
sensory stuff manageable. And so I just kind of spiraled,
and eventually I discovered that drugs were a obsessive interest
that people would want to hear me go on about,
and that also were helpful in terms of managing some
of this stuff and allowing me to feel connected to people.
(03:53):
And if I had stuck with like weed and psychedelics,
I would probably have a different career at this time,
And it was the eighties and cocaine was enormously popular,
and so I got involved with that, and that kind
of made me feel like, oh, well, people actually want
me around because I can bring them coke, and everybody
(04:15):
wants to coke, so it's all good. And then by
that point I was at columb University and then I
got well, first I got suspended, then I got arrested,
and I like eventually got into recovery when I realized that,
you know, shooting up forty times a day and being
eighty pounds was really not especially a great way to live,
(04:38):
and I just knew I needed something different. So I
had a court date because I was still facing these
drug charges, and my parents got me. They my dad
went to the court date, he took me to my
mom's house. We went and I got into a detox
and then remember this is nineteen eighty eight, there really
(04:59):
wasn't much.
Speaker 1 (05:00):
Available, yeah, and a maybe right, well.
Speaker 2 (05:03):
Basically yeah, So I went to you know, your twenty
eight day twelve step model program, and I was told,
you know, by these apparent medical professionals, that this is
the one true way and everything else doesn't work and
it's bad. And so I just threw myself into that
and for the first I don't know, five or six years.
(05:24):
I went to twelve step groups daily and I was
really involved in that, and I thought I knew everything
about addiction. And then I started reading some of the literature,
and I had always been a little bit, you know, skeptical. Well,
first of all, I was skeptical of the god thing,
(05:45):
because you know, if you go to treatment for depression,
nobody's going to tell you to like get on your
knees and shut up and pray and find out higher
power and all this stuff, and so that made me skeptical.
But I was just like, okay, whatever, this is what
they say works for this and so lah. But the
part that really sort of raised my hackles was that
(06:07):
somebody had taught me to clean my needles with bleach
when I was injecting drugs, and that basically saved me
from getting hib And I was really outraged that people
in the Ditions area not only were they not like
telling us, use bleach, you'll be safer, they were just like,
(06:31):
don't do that, don't teach these people anything. Let them
die as an example. And these are supposed to be
the people you care about if you work in treatment.
But they were literally out there opposing syringe exchange a
lot of the major treatment people, and they were all
on about enabling people and stuff like this, and I
was like, well, first of all, you guys know that
people relapse all the time. You see this, most of
(06:53):
your people relapse, and so we're supposed to just get
aids like and infect other people like really, you know,
and at that time, it was incurable and mostly fatal.
So you know, so I got very skeptical very quickly.
And I also annoyed a lot of people in the
(07:15):
program because I was like, you know, the gay people
are out there doing stuff, why aren't we, like we're
dying too, and so you know. But anyway, so I basically,
uh decided that the best way to approach this was
to I had always been interested in journalism and the media,
(07:35):
and I was reasonably good at it. So I basically
got into a career in journalism trying to expose the
myths and ridiculous lies that are so prevalent. And you know,
one of the things they like was first very obvious
was just how racist it was, because I mean, you know,
(07:57):
I would go to court when I had this cocaine
case against me, and I was often the only white
defendant and I was not the only white drug dealer,
so you know, I mean, and it was just like
I was just like why, like what is this, Like
why is this this way? So, you know, I just
(08:19):
started reading a whole lot of stuff and just trying
to understand it, you know, because I think like people
come into this area and they think that, you know,
there's some rationality to it that like these drugs are legal,
and these drugs are illegal because like some scientists sat
down and said, like these are safe, right, and no,
it's just like racism and anti immigrant nonsense, so correct,
(08:43):
you know. So I just like, I, you know, it's
it's kind of fascinating to be in an area where
when you're on the street you learn a whole set
of stuff that's not true. You get taught in drug
education a whole set of stuff that's not true, in
rehab that a bunch of stuff not true, and so
the only way in the media.
Speaker 1 (09:03):
On TV and news and movies and documentaries even you
learn a bunch of stuff that's not true exactly.
Speaker 3 (09:12):
And so like I was just like, okay, like can
we do something about this, because if we actually want
to solve this problem rather than like have an excuse
to like lock up black people, then.
Speaker 1 (09:25):
We like we need more excuses.
Speaker 2 (09:28):
But it's just like, you know, I mean, I've just
been like especially ours lately with this debate over decriminalization,
where people are like, oh, you know, well we need
to threat of jail to get people into treatment, and
I'm like, wait a minute, Okay, So this means black
people must get the best treatment and they must have
like the best access to care, and now that they
(09:52):
are less likely to get treatment because they have fewer resources,
you know, again, like it's just none of this stuff
is logical. None of this stuff makes any sense, and
you know it, especially with the arguments over decriminalization lately,
it's just like, you know, wait a minute, okay, you mean,
fentanyl spread all over the country, and everywhere fentanyl goes,
overdose rates rise, but this is suddenly caused, like all
(10:17):
the homelessness in the United States is because there are
hippies in San Francisco and decriminalization in Oregon, and it's like,
you know, we just kind of had a pandemic. Maybe
that has something to do with what's going on, but yeah,
it's like the politicization of this stuff is infuriating.
Speaker 1 (10:38):
Yeah, I love you. I love so many things. Okay,
so I'm gonna try to touch on like all of
the ways. I was over here shouting a man while
you were talking. So like the first starting with your
own journey into drugs, I always say, drugs serve a purpose.
We use drugs because they serve a purpose. And if
we're trying to help people find their path to recovery
(11:00):
and stay on their recovery path, you have to know
what purpose those drugs were serving, and you have to
get that purpose another way. And so for you, like
in the book and just in life period, in the
way I practice medicine and do my advocacy and all
of this, it's like we are pack animals and we
need that connection, and so drugs became that conduit for
(11:24):
you to make that connection. And then as you get
into treatment, So that's like a huge one. Connection is
the literal cure, right, if we're looking for a cure
for addiction. Connection is the literal cure comes straight into
what you were saying next Maya, which is like you're
in all these rooms and you're thinking about all of
(11:45):
the way we're explicitly excluding people, but then also all
of the way implicitly we're saying we don't care if
you die. Like when I describe harm reduction to people,
I'm like, in a nutshell, harm reduction is like, even
though you use drugs, we don't want you to die.
In a nutshell, that's what it is. And so like,
(12:06):
if you can fix your mouth to look a person's
child in the face who was suffering and say you
should die because you're using drugs, that's what you're doing
when you oppose harm reduction.
Speaker 2 (12:17):
Yeah.
Speaker 1 (12:17):
Absolutely, And I love your love. Your started out before
we were taping. I was like, I'm such a fan
because you take really this what to me, I'm a
lay person, Okay, so like if this is wrong, maya
just be like ending and that's wrong. You don't know
what you're talking about. But to a lay person, what
looks like an investigative journalistic approach, which is like I
(12:42):
call bs on this that you call a fact, Here's
why that's actually not even true. This that you call
a fact. Here why that's bs. This that you call
a fact, here's why that's racism. This that you call
a fact, Here's why that's right. And I'm just like
I follow your writing so close.
Speaker 2 (12:59):
Thank you No, I mean, it's really it's just like
it's so it's so distressing to see so many people
think that they know what's going on and think that
they're doing the right thing and think that they you know,
I mean, I kind of describe it as like, you know,
a lot of journalists who cover this area, like they
have this attitude of everything I need to know about
drugs I learned and dare you know, it's like they
(13:22):
do not like they do not know what they don't know,
and that gets in the way of so many things.
Like when you look at like people trying to cover
harm reduction, they're like, well, oh, but isn't this enabling people? Well,
enabling is a made up thing, like codependence is a
made up thing. Like human beings are interdependent, like you
just said, we're pack animals, Like we are social fundamentally,
(13:45):
and like we're all connected. And so the idea that
like anybody is independent and that any human being can
be happy with zero human connection, it's just not true.
Like we're just not wired that way. Like even people
who are on the authism spectrum like me, who probably
need a lot less social contact than other people, still
(14:08):
need social contact and Yeah, it just is so hard
because when you think you know something, you don't bother
to check it, and yes, to check things, because in
this area, so much of what would be taught is
really not true, and it's just in fact the opposite
(14:28):
to the case, like you know, this whole tough love
thing when we talk about harm reduction, which is kind
of the opposite of that. It's basically like, you know
that you're a human being, and we know that, Like
if we treat you as a human being with like
dignity and respect, you will feel cared for. And if
you feel like worthwhile and cared for, you will be
much more likely to take care of yourself be or
(14:50):
not much more likely to be like yeah, I'm gonna
go like get as messed up as possible, like you know,
because why are people seeking oblivion? Like you know, now,
not everybody was seeking oblivion, Like some people just want
to Like for my case, I didn't want to be unconscious.
I wanted to be like conscious in a better way
and like sort of more safely conscious. Some people, Yeah,
(15:14):
wives are so miserable that they want to be out
and you know, so trying to make their life more miserable.
That is not going to fix.
Speaker 1 (15:23):
That, right, that is going to make it worse. I
heard this beautiful quote. It was twenty nineteen. I was
at a conference in North Carolina, I can't remember. It
was an opioid conference, and Monique Tula at that time
was executive director of the National Harm Reduction Coalition, and
she said, harm reduction is the practice of unconditional love
(15:44):
for people who use drugs. And that just crawled inside
my heart and soul and I have been saying it
ever since, because harm reduction is the practice of unconditional
love for people who use drugs. I recently had a
colleague who was trying to get their head around harm reduction.
So I co founded this company is called Eleanor Health.
(16:05):
We serve people who have addiction at all phases of
the illness, including during active use, which is not heard
of right in a treatment setting typically, So we have
integrated the principles of harm reduction actually into the care
journey that we offer people. And so this person said,
what are your thoughts on harm reduction? And I said,
(16:28):
every day that my child is alive is another chance.
That's my thoughts on harm reduction period, right, And so
like you said, I don't think the people who are
in opposition, I don't think they literally are like just die.
I think they really think they're doing the best. And
to your point, when we have facts that are wrong
(16:50):
that we don't challenge, that's when the danger comes in.
Speaker 2 (16:53):
Yeah. Well, and I mean I do think on you know,
so many people on you're taught in you know, the
twelve step rooms and in popular culture and all over
the place that you know, people don't get better until
they hit bottom. And you know, even AA knew that
that was a problematic idea back in the day because
they have this whole high bottom and low bottom thing, right,
(17:16):
and they were like, you know, on action. And when
you get into that then it starts to become a
very silly concept because you realize, oh, we can only
define this retrospectively when somebody's got better, So their bottom
might be you know, like stubbing their toe or something,
and that's what they decide to recover, where somebody else
is like dead or somebody you know, you just don't
(17:39):
know until they've either died in recovery or died using.
So it's not useful scientifically at all. But it's also
like bad because it sort of brings this idea that like,
negative consequences are ultimately what fixes a dick, And by definition,
addiction is compulsive drug used despite negative consequences, So by definition,
(18:01):
that's not what fixes it. Otherwise, by definition, it wouldn't exist, right, Yeah,
it's so filled with paradox. But anyway, like you know,
some people do get better when things are horrible. But
if you look at it, who's more likely to get better?
A person who has resources or a person who doesn't.
And that's the argument, all the argument you need against
(18:22):
the whole bottom idea. You know, there's no disease where
you are much more likely to get better if you're poor,
and you know, not one. Yeah, you know, I mean
and not addiction especially, you know, and that obviously does
not mean that poor people cannot recover, because we know many.
Speaker 1 (18:41):
It's the system, it's not the people exactly.
Speaker 2 (18:44):
You know, we need to like recognize that, like addiction
is like any other condition, and people respond better to
like love and kindness than they do to humiliation when punishment.
Speaker 1 (18:57):
Yeah, what other illness? So we're like, Okay, you're sick,
you're struggling, you're suffering, So I'm going to be mean
to you, to help you get better. It doesn't make
any sense.
Speaker 2 (19:10):
No, The only other one that I can think of
these days is chronic pain, and we're treating people with
chronic pain at least as bad as we are treating
people with addictions. Case it's you know, and it's it's
like wait a minute, like why can't we hold in
our head? Some people do benefit from opioid, some people
do not. The people who do should be left alone.
The other people should be given help, Like not that hard?
Speaker 1 (19:32):
Yeah, yeah, yeah, So you made me. I always at
the beginning of every show, I say, Enzinga, don't forget
to say and then I never say it because we
just jump right in and I remember at some point
in the middle. So here we are at the point
in the middle where I'm remembering. I'm going to ask
you at the end, what is one thing you want
(19:53):
people to unlearn, or one stigma you want people to undo,
or one conversation you want people to uncover. I'm going
to ask you that at the end. What made me
think of it was you said, you know, people really
think that folks don't recover from addiction, And the current
statistic is that seventy five percent of people recover, and
that's with a system that sucks. So imagine what it
(20:15):
could be. Right, So let me turn this into a
question for you, Maya, when you think about your recovery today,
what are the pieces of your formula that make that
reduced risk of relapse of this illness called addiction for you?
Speaker 2 (20:35):
So it's you know, my friends, my husband, my.
Speaker 1 (20:38):
Cats, connection, connection, connection.
Speaker 2 (20:41):
I love my kitties and my husband and my friends,
my family. Obviously music, just music. Oh oh my god.
What kind of kitty is that?
Speaker 1 (20:52):
This is icy? So we have always been a dog family.
He's a little Siberian kitty. He's like ten weeks old now.
He followed my niece home from the bus stop two
years ago. We've always had dogs and now we have
this little kiddy and he's the love of all of
our lives. So when you said your cat, I was like,
I feel what you mean. He's sitting and he's sleeping
(21:13):
in the chair behind me.
Speaker 2 (21:14):
Gorgeous.
Speaker 1 (21:15):
But I'm sorry, go ahead, your husband and your friends, your.
Speaker 2 (21:18):
Kids, two cats, and the you know music I like
surprisingly these days, like working out, you know, it's just
like and obviously I have to say, like just my
work and the passionate feeling I have around trying to
do something that makes a difference, and you know, being
(21:40):
able to have a voice in this situation to some
extent at least. So you know, all of that is
just really amazing. And it's just been so nice to
you know, be able to realize that, hey, actually people
do like you. You're not a horrible person. You can
contribute to off, you can do stuff that you know,
(22:03):
I mean, sometimes I feel like nobody's listening, but oh
we are listening, thanks, so you know, and yeah, just
to be also just be able to do like fun
things like listen to music. And I'm slowly beginning to
learn to like play music. So this is exciting to
have the opportunities to do these things. And and you know,
(22:23):
I just feel enormously grateful that, uh, you know, I've
been able to sort of find my way to this.
And I should also mention that antidepressants have been really
helpful to me. And I've been on like prozec and
Walbutrin for like ages. And I have no intention of
breaking messing anything up it's working. I'm not going to
(22:45):
mess with it if it stops working. Then I'll deal.
And I say that because like so many times, like
people on you know, mesadone or people morphine or whatever,
like feel like, oh, I'm not really really recovery because
I'm still taking something, and I'm like the heck with that,
Like I don't see it as being any different, Dislike.
Speaker 1 (23:01):
Yes you are.
Speaker 2 (23:02):
Yeah, this allows me to like not be so overwhelmed
by the sensory stuff that has previously made it very
hard to be me. I don't see that as an issue.
I see that as something that's been very helpful. And
I think that, you know, while it's obviously super important
connection and meaning and purpose and all of that, sometimes
(23:22):
you can't get to that if you don't have the
appropriate therapy or the appropriate medication or whatever it is
for you. So it's it's like, definitely you need love,
but sometimes all you need isn't love. Sometimes you need
a little more And that's okay too.
Speaker 1 (23:39):
Yeah, I love that entire line. I want to go
down it a bit. So we talk about biological, psychological,
and environmental, and the six conversations are like, there's a
set of biological things you're born into, psychological things you're
born into. That's like your early childhood environmental things you're
born into. That's like your zip code where you grow up.
(23:59):
And then there are set of biological, psychological, and environmental
factors as we're adults that we have more control over
to change those because they're happening in real time. But
those things that we grew up with are also still
exerting effect and we have to put pieces in the
formula that address those things. So to your point, we
(24:21):
don't put any stigma around it when love is not
enough for your diabetes, and we don't put any stigma
around it with love is not enough for your asthma. Right, So, like,
if you're on an asthma regimen that's working, and we
know there are biological, psychological, and environmental inputs to asthma,
(24:41):
nobody's going to pressure you to change your medication routine
when your asthma is controlled. To the contrary, they're like,
why would you break it? No, what's the saying, why
would you fix it if it's not broken? And yet
this is what we're doing because people don't understand substance
use just orders an addiction as a chronic medical condition.
Speaker 2 (25:03):
Yes, yeah, no, And I mean I get it that,
Like you know, the way we do medication in this
country is horrible pain in the butt, especially with methadone.
I would really want, you know, I hope that we
are going to begin to reform this system. Yes, it
is ridiculously you know, overregulated, and it is crazy that
(25:25):
people you know, have to go every day for as
long as they do, or like sometimes.
Speaker 1 (25:31):
People with the least resources by the way, right because
people with resources are not taking methadone.
Speaker 2 (25:37):
No, and I mean there's that, and or they're getting
it for.
Speaker 1 (25:41):
Pain from the pharmacy with a prescription.
Speaker 2 (25:46):
Yes, it's crazily over It makes it into basically chemical probation.
And I don't I wouldn't judge anybody for like wanting
to be off of that as quickly as possible, even
though staying on that or UB is the only thing
we know that cuts the death rate in half. What
we should be doing is encouraging people to be staying
on and to be have access that is not stigmatizing
(26:09):
to just go to the doctor, you know, go to
the doctor, go to the pharmacy, get your drugs whatever.
And I get it that, like, you know, when methodone
needs to be prescribed carefully because it is really strong
and it naive. People can die on it quite easily,
and doctors have killed people with it trying to treat
pain and not understanding how to use it. So it
(26:30):
does need a little bit more regulation than well.
Speaker 1 (26:34):
The same is true though for fit Andal.
Speaker 2 (26:37):
Absolutely yeah, no, not like I am not saying that
like that means like we should, Like, you know, if
you get surgery of just jump in a clinic every
I don't.
Speaker 1 (26:45):
Know, you have to show up every day, you know, No,
I mean.
Speaker 2 (26:48):
It's just ridiculous. You know, the understanding how to use
these medications properly is important, not creating situations where doctors
or clinics or whoever just have this horrible power relationship
with patients where you know, it's like, oh, well I'm
(27:09):
in a bad room, so you can't go on vacation.
I'm not giving me take homes like this happens.
Speaker 1 (27:14):
I know. I had a lady that wanted to switch
from methadone to buper norphan. We were able to do
it for her and she ultimately did great, even though
that is a super hard switch to make, but she
had been on methodone completely utterly stable, completely negative drug
screens working grandchildren, the whole I'm talking about, like life
(27:37):
is together minus chronic back pain and chronic sedation from
the methodone. So she wants to make a switch to
buper Norphan. Six years she's been stable at the same clinic.
They still have her on every two weeks take homes,
So every two weeks she has to drive an hour
and forty five minutes there to get a two week
(27:59):
supply an hour forty five minutes back. And she said,
if they knew I wanted to switch to buper Norphan,
they would cut my dosing immediately. So we had to
be so strategic because I didn't want to give her
a break and like have her have withdrawal in the middle, right,
We had to be so strategic. It was like what
day do you pick up your dosing. I had to
(28:19):
try to taper down her Methodone within the two week
dosin that they had given her cross her over to
the Buper Norphan. It was totally not an ideal crossover strategy,
purely because to exactly your words, the system had so
much power over that methodone dosing and she had been
stayable for six years.
Speaker 2 (28:40):
No, it's like I mean, I you know, and I
hear this like with pain patients where I'm a pain
patient that I know like tested positive for heroin and
never did heroin and got like cut off. Yeah, this
woman is an agony for like no reason.
Speaker 1 (28:56):
Yeah, and even if she had done here.
Speaker 2 (28:58):
Exactly, like people still have pain, Like, it's not like yeah,
the whole thing. And I mean, I think this sort
of goes back to that fundamental legal problem that we
have in this country where we had Supreme Court decisions
in like nineteen nineteen and around then where it was
basically like, it is not a legitimate part of medicine
(29:21):
to prescribe opioids to people with opiodus disorder, or cocaine
to people with cocaine or whatever. You know, that is
just we are deciding, because we are white men, that
this is not okay. And literally there was no actual
reasoning in the decision. They were like, well, it's obviously immoral,
and okay, I'll yes to you maybe, but you know,
(29:43):
that decision means that doctors treating pain are always terrified
that the cops are going to come and say, actually,
that person is predicted and now you are doing something
illegal and we're going to take your license and it
put you in jail. And you know, until very recently
there was a Supreme Court decision that said, like, no,
(30:03):
you cannot. If you're going to prosecute a doctor for
over prescribing, you have to prove that they had criminal intent.
You cannot just say that like, oh, they're outside the
CDC guidelines, therefore it's criminal. Like they accidentally name a
drug dealer when their patient was overweight and needed a
hire dose.
Speaker 1 (30:21):
Right, I was getting a license in a state and
there were a couple of different ones, So I won't
call the exact state just in case I get it wrong,
because I wouldn't if I was this state. I wouldn't
want anybody saying this about me wrong. But so I'm
taking like the test that you have to take to
get your license to be a physician in this state
(30:42):
and tells you like about the state laws. And it's like,
if you're treating a person for paying disorder and there
you're in drug screen is positive for an illicit substance
or you have concern that they're diverting medication that you're prescribing,
what are you legally required to do? And I just
(31:03):
refuse to get the question right because I just refused
to put the answer that I knew was the answer.
It was called the police and make a report.
Speaker 2 (31:11):
Are you kidding me?
Speaker 1 (31:12):
Oh my god, I am not kidding. And I was like,
I refuse, like I will just get this answer wrong
because I refuse to say that that's the right answer,
because that's not the right answer. But it is. Literally,
this is the programming. It's coded into the test that
physicians take to get a license in that state to
criminal and out criminalize people that have substance use disorders.
(31:36):
It's wild, Okay, Okay, isn't that crazy? Okay? I want
to change. I want to change Lane. I felt myself
getting on a soapbox and we're going to be on
that the rest of the show. I wanted to click
in Maya, if it's okay, You've mentioned a couple of
times that you have autism spectrum disorder, and you described
it before you called it that as being very sensory
(31:57):
sensitive and having difficulty connecting with people socially and feeling
ostracized even by yourself and by other people, and so
I then you said something that really caught my ear.
When you don't know about it, you don't ask and
so I think one of the assumptions people make about
(32:18):
people with autism spectrum disorders is that you don't need
the connection or you don't want the human connection. And
then when I asked about your recovery formula, that was
number one, two and three. So I think it would
be super helpful for people listening who maybe have had
(32:39):
a similar experience to you, but no one has told
them these are symptoms of autoism spectrum disorder. And you're
wonderful and great and you know to be loved and
we understand this connection. So maybe can you just talk
to us about how you came to understand and that
(33:00):
how you came to be on prozac and Will Butcher
and whatever else went into you being in this comfortable
space with yourself that you seem to be in now.
Speaker 2 (33:09):
Yeah. No, So the I saw an article in New
York Times and it was at the time called Aspergers,
which apparently we now know the guy was affiliated with
the Nazis in some ways, so it should not be
called that anymore. There some people dispute this. Other people
are like, no, he like some people were saying, oh,
he protected the people that he was seeing and tried
(33:30):
to keep them away from the camps or you know,
being killed. Others are like, no, no, he was part
of I don't know.
Speaker 1 (33:39):
All I know is that I had no idea that
was why we stopped calling it Asperger's Like I knew
we stopped, but I did not know that. Yeah, so
oh now I gotta go check the facts.
Speaker 2 (33:50):
But the funny thing, yeah, I like, I mean, there's
definitely still some dispute over this, although I think side
that says he's actually a Nazi is winning the the
So there was this article New York Times about this condition,
and it stuck with me in part because there was
a very silly part of it where like this wife
was married to the guy with it, and when he
(34:13):
would be acting particularly asked, being a very kind of
anti social way, she would call him an ass burger,
and it was it was a little joke between them.
But anyway, like I was just like, wow, like that's me,
Like I have like all that stuff. I'd maybe heard
about autism before, like maybe you know, in this sort
of stereotypical like rain Man thing or just like somebody
(34:36):
who is like just very very severely disabled. So you know,
I was just like, oh wow, that's like interesting, and
then like the antidepressants didn't explicitly get prescribed for the
sensory stuff, it was because I actually was depressed, probably
in part from all the self hatred this other stuff.
(34:57):
But it seemed to me that like it just like
like one of the things that I found really helpful
with the opiates was like it just turns the volume
down and it's like less, you know. And and with
SSRIs in particular, I found that like, yeah, it's just
like I'm less anxious for one, but I'm just like
(35:19):
not also so like you know, vulnerable to like sounds
and lights and just intensity. I always get into arguments
with people who are like, you know, oh, like, look
the data shows that the SSRIs are all Perceibo now,
and I'm like, you can't tell me it's Perceibo on
the sensory stuff because it just isn't. But also, like
(35:39):
you know, you first told me when this stuff first
came out, it was like this miracle drug and made
me better than well then you told me about no.
But wait, then I was supposed to be making made
into a serial killer or mass shoot or something, and
you know what the thing is, I actually think it
can be all three, like, because people's responses to these
(36:01):
things are so varied, and I have seen people on
the wrong medication like they might become suicidal or even
like homicide, you know, and I've seen people on the
right medication is just oh it works, like you know,
and I've seen people have just nothing effect. So I think,
I am I am not a doctor, but I imagine anybody
(36:24):
in practice who like sees a lot of people on
these different psychiatric medications just knows how widely individualized the
response is. And so when you have to look at
like clinical trials, it makes analyzing the data really hard
and like you know, when you you know, but I
think what sometimes happens is like you get like a
(36:45):
large proportion doing better and a large proportion doing worse,
and looks like placebo because by the numbers they average out.
So but the individual people are experiencing harm or benefit.
And so you know, that is where I guess medicine
has a bit of an art as opposed to just science.
But yeah, so I mean, but so that was basically
(37:05):
for me, and I just like, over time, just read
a lot and talked to a lot of people, and
you know, began to understand that. Yeah, Okay, as like,
because I had just had all these other diagnoses like
OCD and like depression and addiction, and I even once
got bipolar, which I don't think was correct, but but
(37:27):
this one like actually made sense of all the weird
symptoms like as well as some of the you know,
I'm usually like you know, very early reading and being
very intellectual, you know, very obsessive, but also like I
probably could also be called ADHD. I have a lot
(37:48):
a lot of focus on the stuff that I'm focused
on though, so that had been like really disability for me.
I can see how in different circumstances that might have
become that way, especially if I didn't have something that
I was sort of obsessively interested in.
Speaker 1 (38:02):
Yeah. I really loved the way you told that story,
because I think this is why this book is about
having conversations and this podcast is about having conversations. Because
even though that New York Times article wasn't a person
you talked to, so not you know, quote unquote a conversation,
(38:23):
it was somebody talking about an experience, and you saw
yourself in it, and that was the beginning of like
a journey to healing and recovery. And so that's why
stigma is so deadly when we stay silent the way
we used to stay silent about AHIV. We started talking
(38:44):
about HIV, we got to a cure. We used to
stay silent about epilepsy. We started talking about epilepsy, we
get to treatment. We used to stay silent about suicide.
We're talking about suicide. We're still at all time highs,
but at least we're talking about it in practicing prevention
so that we can start going the same way. And
so like same thing that I'm hoping for addiction, And
(39:08):
I think we have started talking about addiction in a
way we weren't before, and the people with addiction in
a way that we weren't before. That I hope is
like going to help us set on a different trajectory. Yeah,
so God bless that New York Times ar No, No, I.
Speaker 2 (39:22):
Mean I should look it up, you know. I do
think also one of the things that actually makes on
twelve step programs and just anywhere where people just share
their personal experiences about things really powerful for a lot
of people is that you get to hear, you know,
other people on you know, who've been through things that
(39:44):
you might have been through or have looked through things
in a slightly different way. And you know, I definitely
benefited from hearing people in twelve step meetings just talk
about like the ways that they saw themselves that were
completely we obviously wrong from the outside. All right, right,
(40:04):
so you were a gorgeous model. You are not ugly
like you know, and I'm like, well, then maybe I'm
not a horrible person the way I think I am either.
You know, I came to the conclusion that the wrong
people hate themselves.
Speaker 1 (40:19):
Oh, I'm just gonna let that one lay right there.
It took me a second. I was like, oh, I
get it. Yes, so this is so wild. Okay, we're
forty seven minutes in, which means we're at the end.
(40:40):
So thank you for like being such an amazing conversation
that it's already over when it feels like it just started.
So let's roll into what I promised would be the
last question, which is, and it doesn't have to be
one thing. You could tell us whatever you want to
tell us, maya, but something we need to unlearn, or
(41:02):
some stigma we need to undo, or some conversation we
need to uncover that based on your personal and professional
experience would get us on the right track.
Speaker 2 (41:11):
Well, there's a couple of things here, and I've stressed
them a little bit earlier, but I still think it's important.
Tough love, uh uh love love.
Speaker 1 (41:20):
You know, oh zero stars.
Speaker 2 (41:24):
Secondly, and I mean again, this doesn't mean that you
don't hold people accountable when they need to be held accountable.
It just means that you don't be mean to somebody
as a way of helping them. Like that does not help.
Similarly with enabling, like you know, if prescribing heroin, we
looked at the data. When you prescribe heroin, it does
not keep people in active addiction longer than if you
(41:46):
just leave them alone. So therefore enabling cannot be true
because free heroin like that should you know, be the
most enably enabling thing.
Speaker 1 (41:54):
You could do, the most enabling.
Speaker 2 (41:58):
I know, I just made that up.
Speaker 1 (41:59):
You know.
Speaker 2 (42:00):
No, it's just like and hitting bottom. All of these
things have got to go. These are not useful to
helping people get better, Like what is useful to helping
get people get better from addiction is what is useful
to helping people get better from just about anything, which
is like support and resources and kindness and you know,
figuring out why people you know, you started with this
(42:21):
like this idea that like, you know, people take drugs
for reasons, why what is this doing for them? Or
what were they trying to get from it? Maybe they're
no longer getting it now, but what were they trying
to get from it? And how do we get them
to have that? Because you know, the reason that we're
having so much addiction now and such crisis with like
a really unequal world is that this you know, inequality
(42:46):
like tears us apart from each other and polarizes and
it even makes rich people unhappy. It doesn't like it's
not healthy, and so you know, we shouldn't be surprise
like if we lose our middle class that we are
going to like have a lot of unhappy people and
they're going to use drugs. So we need to like
(43:09):
make this place better by making it more equal, by
you know, spreading the wealth a little bit, because this
is absolutely concentration is just crazy, and you know, I
just sometimes think about it. It's like, you know, some
people like they could like literally give every person one
hundred dollars and they'd still have money. Like that's like
(43:30):
nobody should have that amount of money. I know that
sounds kind of disconnected from this, but it isn't because
when when we let things go to the point where
that like they are now, our politics gets into this
horror that we're seeing now are and we can't deal
with the environment, We can't like our medical system is
falling to pieces.
Speaker 1 (43:50):
You know.
Speaker 2 (43:50):
Meanwhile, it's like, and what's so annoying about it is
that like we actually know how to solve a lot
of these problems, actually know what could help, and it
actually wouldn't even there would still be rich people, you know.
I mean, it's just like you just want it to
be that greedy, right. This is a little bit oversimplified,
but I think that we can do a lot better
(44:13):
in the way that we structure our society in order
to have it be a kinder place that produces lessening.
Speaker 1 (44:23):
I love it. I love it. So I would recap
that as you were talking, I like envisioned a big,
huge burning trash can that you were throwing things in,
and you're like, we're throwing tough love in the trash,
replacing it with compassion, throwing this concept of enabling, like
(44:49):
you have to disconnect from people throwing it in the trash,
replacing it with connection, throwing rock Bottom in the trash,
set fire on it. I guess that it makes sense.
It set it on fire, whatever order the words are
supposed to come in. Yes, it's in the trash, it's
burning right, It's like get to the root cause, which
(45:10):
I think was your last sentence, which was so beautiful,
and we can end on it, which is we have
to restructure these communities we're living in and these cultures
we're living in to be kinder, and that would produce
less addiction. I would say they heard it here first,
but you've been like so vocal in writing about this
all day every day that that would just not be true.
(45:32):
But I'm so so grateful that you came on, Maya.
This was amazing.
Speaker 2 (45:37):
That was thanks No, really great to talk to you
as well. We should do this again sometime.
Speaker 1 (45:40):
We should thank you. Thank you so much for tuning in.
And if you like this episode, please check out my
book on addiction, Six Mind Changing Conversations that Could Save
a Life, available at Barnes Andnoble, Bookshop, dot Org, Union
Squaring Company, Amazon, and wherever books are sold. If you
(46:01):
liked this episode, please share it with someone you think
may need to hear it. Also, please subscribe to this
podcast and leave a five star review that helps us
reach any and everyone who may be looking for support
in the face of addiction.
Welcome to Unaddiction the Podcast. My name is doctor Enzinga Harrison.
I'm a board certified psychiatrist with a specialty in addiction
medicine and co founder and chief medical officer of Eleanor Health.
On this podcast, we explore the paths that can lead
to addiction and the infinite paths that can lead to recovery.
(00:24):
Our guests are sharing their own experiences, the tools that
have helped them along the way, and the formulas that
allow them to thrive in recovery one day at a time.
I am so excited to tell you about my book, Unaddictioned.
Six mind changing Conversations that Could Save a Life, is
now available from Union Squaring Company or wherever books are sold.
(00:48):
Maya Solovitz is the author, most recently of Undoing Drugs,
The Untold Story of Harm Reduction and the Future of Addiction,
which is the first history of the harm reduction move
aimed at focusing drug policy on minimizing harms, not highs.
Her previous New York Times bestseller, Unbroken Brain, A Revolutionary
(01:11):
New Way of Understanding Addiction, wove together neuroscience and social
science with her own personal experience of heroin addiction. It
won the twenty eighteen Media Award from the National Institute
on Drug Abuse, So you can see why we had
to have her on the Unaddictioned podcast. We dive into
(01:32):
everything from why she never went to prison to why
she continues to focus her writing and advocacy on addiction
and harm reduction. Yeah, so glad to have you. Thank
you so much for joining me here on the Unaddictioned podcast.
Speaker 2 (01:48):
Thank you for having me.
Speaker 1 (01:50):
So I'll set it up for you. On the podcast,
I'm talking to a bunch of people who've had their
own recovery journey, and just like hope that people can
hear all of these different pathways to recovery and all
of these different pieces of formulas that people have and
maybe it helps them start their journey, or maybe it
(02:11):
helps them talk to their loved one about it, or
maybe it gives them an idea for something to add
to their own formula. So that's the idea. Do you
mind sharing with us what has your journey been? However
you want to share that with us? Sure?
Speaker 2 (02:27):
So I was basically a very geeky kind of kid who,
you know, just didn't know how to connect to people basically,
and so I was sort of very into like intellectual obsessions,
like starting with like reading when I was like three,
and so I was just I was just weird. I
(02:49):
wasn't interested in the things my peers were interested in,
and I was very oversensitive to lights and sounds and
emotions and all kinds of stuff like this. So I
just appeared like a very strange, smart kid. And so
(03:09):
you know that that was hard because I did really
want to connect to people, but I was just kind
of overwhelmed, and I started thinking that I must be
a bad person because everybody else seems to be able
to do this naturally, and also like I am selfish
because I need to like control things to keep my
(03:31):
sensory stuff manageable. And so I just kind of spiraled,
and eventually I discovered that drugs were a obsessive interest
that people would want to hear me go on about,
and that also were helpful in terms of managing some
of this stuff and allowing me to feel connected to people.
(03:53):
And if I had stuck with like weed and psychedelics,
I would probably have a different career at this time,
And it was the eighties and cocaine was enormously popular,
and so I got involved with that, and that kind
of made me feel like, oh, well, people actually want
me around because I can bring them coke, and everybody
(04:15):
wants to coke, so it's all good. And then by
that point I was at columb University and then I
got well, first I got suspended, then I got arrested,
and I like eventually got into recovery when I realized that,
you know, shooting up forty times a day and being
eighty pounds was really not especially a great way to live,
(04:38):
and I just knew I needed something different. So I
had a court date because I was still facing these
drug charges, and my parents got me. They my dad
went to the court date, he took me to my
mom's house. We went and I got into a detox
and then remember this is nineteen eighty eight, there really
(04:59):
wasn't much.
Speaker 1 (05:00):
Available, yeah, and a maybe right, well.
Speaker 2 (05:03):
Basically yeah, So I went to you know, your twenty
eight day twelve step model program, and I was told,
you know, by these apparent medical professionals, that this is
the one true way and everything else doesn't work and
it's bad. And so I just threw myself into that
and for the first I don't know, five or six years.
(05:24):
I went to twelve step groups daily and I was
really involved in that, and I thought I knew everything
about addiction. And then I started reading some of the literature,
and I had always been a little bit, you know, skeptical. Well,
first of all, I was skeptical of the god thing,
(05:45):
because you know, if you go to treatment for depression,
nobody's going to tell you to like get on your
knees and shut up and pray and find out higher
power and all this stuff, and so that made me skeptical.
But I was just like, okay, whatever, this is what
they say works for this and so lah. But the
part that really sort of raised my hackles was that
(06:07):
somebody had taught me to clean my needles with bleach
when I was injecting drugs, and that basically saved me
from getting hib And I was really outraged that people
in the Ditions area not only were they not like
telling us, use bleach, you'll be safer, they were just like,
(06:31):
don't do that, don't teach these people anything. Let them
die as an example. And these are supposed to be
the people you care about if you work in treatment.
But they were literally out there opposing syringe exchange a
lot of the major treatment people, and they were all
on about enabling people and stuff like this, and I
was like, well, first of all, you guys know that
people relapse all the time. You see this, most of
(06:53):
your people relapse, and so we're supposed to just get
aids like and infect other people like really, you know,
and at that time, it was incurable and mostly fatal.
So you know, so I got very skeptical very quickly.
And I also annoyed a lot of people in the
(07:15):
program because I was like, you know, the gay people
are out there doing stuff, why aren't we, like we're
dying too, and so you know. But anyway, so I basically,
uh decided that the best way to approach this was
to I had always been interested in journalism and the media,
(07:35):
and I was reasonably good at it. So I basically
got into a career in journalism trying to expose the
myths and ridiculous lies that are so prevalent. And you know,
one of the things they like was first very obvious
was just how racist it was, because I mean, you know,
(07:57):
I would go to court when I had this cocaine
case against me, and I was often the only white
defendant and I was not the only white drug dealer,
so you know, I mean, and it was just like
I was just like why, like what is this, Like
why is this this way? So, you know, I just
(08:19):
started reading a whole lot of stuff and just trying
to understand it, you know, because I think like people
come into this area and they think that, you know,
there's some rationality to it that like these drugs are legal,
and these drugs are illegal because like some scientists sat
down and said, like these are safe, right, and no,
it's just like racism and anti immigrant nonsense, so correct,
(08:43):
you know. So I just like, I, you know, it's
it's kind of fascinating to be in an area where
when you're on the street you learn a whole set
of stuff that's not true. You get taught in drug
education a whole set of stuff that's not true, in
rehab that a bunch of stuff not true, and so
the only way in the media.
Speaker 1 (09:03):
On TV and news and movies and documentaries even you
learn a bunch of stuff that's not true exactly.
Speaker 3 (09:12):
And so like I was just like, okay, like can
we do something about this, because if we actually want
to solve this problem rather than like have an excuse
to like lock up black people, then.
Speaker 1 (09:25):
We like we need more excuses.
Speaker 2 (09:28):
But it's just like, you know, I mean, I've just
been like especially ours lately with this debate over decriminalization,
where people are like, oh, you know, well we need
to threat of jail to get people into treatment, and
I'm like, wait a minute, Okay, So this means black
people must get the best treatment and they must have
like the best access to care, and now that they
(09:52):
are less likely to get treatment because they have fewer resources,
you know, again, like it's just none of this stuff
is logical. None of this stuff makes any sense, and
you know it, especially with the arguments over decriminalization lately,
it's just like, you know, wait a minute, okay, you mean,
fentanyl spread all over the country, and everywhere fentanyl goes,
overdose rates rise, but this is suddenly caused, like all
(10:17):
the homelessness in the United States is because there are
hippies in San Francisco and decriminalization in Oregon, and it's like,
you know, we just kind of had a pandemic. Maybe
that has something to do with what's going on, but yeah,
it's like the politicization of this stuff is infuriating.
Speaker 1 (10:38):
Yeah, I love you. I love so many things. Okay,
so I'm gonna try to touch on like all of
the ways. I was over here shouting a man while
you were talking. So like the first starting with your
own journey into drugs, I always say, drugs serve a purpose.
We use drugs because they serve a purpose. And if
we're trying to help people find their path to recovery
(11:00):
and stay on their recovery path, you have to know
what purpose those drugs were serving, and you have to
get that purpose another way. And so for you, like
in the book and just in life period, in the
way I practice medicine and do my advocacy and all
of this, it's like we are pack animals and we
need that connection, and so drugs became that conduit for
(11:24):
you to make that connection. And then as you get
into treatment, So that's like a huge one. Connection is
the literal cure, right, if we're looking for a cure
for addiction. Connection is the literal cure comes straight into
what you were saying next Maya, which is like you're
in all these rooms and you're thinking about all of
(11:45):
the way we're explicitly excluding people, but then also all
of the way implicitly we're saying we don't care if
you die. Like when I describe harm reduction to people,
I'm like, in a nutshell, harm reduction is like, even
though you use drugs, we don't want you to die.
In a nutshell, that's what it is. And so like,
(12:06):
if you can fix your mouth to look a person's
child in the face who was suffering and say you
should die because you're using drugs, that's what you're doing
when you oppose harm reduction.
Speaker 2 (12:17):
Yeah.
Speaker 1 (12:17):
Absolutely, And I love your love. Your started out before
we were taping. I was like, I'm such a fan
because you take really this what to me, I'm a
lay person, Okay, so like if this is wrong, maya
just be like ending and that's wrong. You don't know
what you're talking about. But to a lay person, what
looks like an investigative journalistic approach, which is like I
(12:42):
call bs on this that you call a fact, Here's
why that's actually not even true. This that you call
a fact. Here why that's bs. This that you call
a fact, here's why that's racism. This that you call
a fact, Here's why that's right. And I'm just like
I follow your writing so close.
Speaker 2 (12:59):
Thank you No, I mean, it's really it's just like
it's so it's so distressing to see so many people
think that they know what's going on and think that
they're doing the right thing and think that they you know,
I mean, I kind of describe it as like, you know,
a lot of journalists who cover this area, like they
have this attitude of everything I need to know about
drugs I learned and dare you know, it's like they
(13:22):
do not like they do not know what they don't know,
and that gets in the way of so many things.
Like when you look at like people trying to cover
harm reduction, they're like, well, oh, but isn't this enabling people? Well,
enabling is a made up thing, like codependence is a
made up thing. Like human beings are interdependent, like you
just said, we're pack animals, Like we are social fundamentally,
(13:45):
and like we're all connected. And so the idea that
like anybody is independent and that any human being can
be happy with zero human connection, it's just not true.
Like we're just not wired that way. Like even people
who are on the authism spectrum like me, who probably
need a lot less social contact than other people, still
(14:08):
need social contact and Yeah, it just is so hard
because when you think you know something, you don't bother
to check it, and yes, to check things, because in
this area, so much of what would be taught is
really not true, and it's just in fact the opposite
(14:28):
to the case, like you know, this whole tough love
thing when we talk about harm reduction, which is kind
of the opposite of that. It's basically like, you know
that you're a human being, and we know that, Like
if we treat you as a human being with like
dignity and respect, you will feel cared for. And if
you feel like worthwhile and cared for, you will be
much more likely to take care of yourself be or
(14:50):
not much more likely to be like yeah, I'm gonna
go like get as messed up as possible, like you know,
because why are people seeking oblivion? Like you know, now,
not everybody was seeking oblivion, Like some people just want
to Like for my case, I didn't want to be unconscious.
I wanted to be like conscious in a better way
and like sort of more safely conscious. Some people, Yeah,
(15:14):
wives are so miserable that they want to be out
and you know, so trying to make their life more miserable.
That is not going to fix.
Speaker 1 (15:23):
That, right, that is going to make it worse. I
heard this beautiful quote. It was twenty nineteen. I was
at a conference in North Carolina, I can't remember. It
was an opioid conference, and Monique Tula at that time
was executive director of the National Harm Reduction Coalition, and
she said, harm reduction is the practice of unconditional love
(15:44):
for people who use drugs. And that just crawled inside
my heart and soul and I have been saying it
ever since, because harm reduction is the practice of unconditional
love for people who use drugs. I recently had a
colleague who was trying to get their head around harm reduction.
So I co founded this company is called Eleanor Health.
(16:05):
We serve people who have addiction at all phases of
the illness, including during active use, which is not heard
of right in a treatment setting typically, So we have
integrated the principles of harm reduction actually into the care
journey that we offer people. And so this person said,
what are your thoughts on harm reduction? And I said,
(16:28):
every day that my child is alive is another chance.
That's my thoughts on harm reduction period, right, And so
like you said, I don't think the people who are
in opposition, I don't think they literally are like just die.
I think they really think they're doing the best. And
to your point, when we have facts that are wrong
(16:50):
that we don't challenge, that's when the danger comes in.
Speaker 2 (16:53):
Yeah. Well, and I mean I do think on you know,
so many people on you're taught in you know, the
twelve step rooms and in popular culture and all over
the place that you know, people don't get better until
they hit bottom. And you know, even AA knew that
that was a problematic idea back in the day because
they have this whole high bottom and low bottom thing, right,
(17:16):
and they were like, you know, on action. And when
you get into that then it starts to become a
very silly concept because you realize, oh, we can only
define this retrospectively when somebody's got better, So their bottom
might be you know, like stubbing their toe or something,
and that's what they decide to recover, where somebody else
is like dead or somebody you know, you just don't
(17:39):
know until they've either died in recovery or died using.
So it's not useful scientifically at all. But it's also
like bad because it sort of brings this idea that like,
negative consequences are ultimately what fixes a dick, And by definition,
addiction is compulsive drug used despite negative consequences, So by definition,
(18:01):
that's not what fixes it. Otherwise, by definition, it wouldn't exist, right, Yeah,
it's so filled with paradox. But anyway, like you know,
some people do get better when things are horrible. But
if you look at it, who's more likely to get better?
A person who has resources or a person who doesn't.
And that's the argument, all the argument you need against
(18:22):
the whole bottom idea. You know, there's no disease where
you are much more likely to get better if you're poor,
and you know, not one. Yeah, you know, I mean
and not addiction especially, you know, and that obviously does
not mean that poor people cannot recover, because we know many.
Speaker 1 (18:41):
It's the system, it's not the people exactly.
Speaker 2 (18:44):
You know, we need to like recognize that, like addiction
is like any other condition, and people respond better to
like love and kindness than they do to humiliation when punishment.
Speaker 1 (18:57):
Yeah, what other illness? So we're like, Okay, you're sick,
you're struggling, you're suffering, So I'm going to be mean
to you, to help you get better. It doesn't make
any sense.
Speaker 2 (19:10):
No, The only other one that I can think of
these days is chronic pain, and we're treating people with
chronic pain at least as bad as we are treating
people with addictions. Case it's you know, and it's it's
like wait a minute, like why can't we hold in
our head? Some people do benefit from opioid, some people
do not. The people who do should be left alone.
The other people should be given help, Like not that hard?
Speaker 1 (19:32):
Yeah, yeah, yeah, So you made me. I always at
the beginning of every show, I say, Enzinga, don't forget
to say and then I never say it because we
just jump right in and I remember at some point
in the middle. So here we are at the point
in the middle where I'm remembering. I'm going to ask
you at the end, what is one thing you want
(19:53):
people to unlearn, or one stigma you want people to undo,
or one conversation you want people to uncover. I'm going
to ask you that at the end. What made me
think of it was you said, you know, people really
think that folks don't recover from addiction, And the current
statistic is that seventy five percent of people recover, and
that's with a system that sucks. So imagine what it
(20:15):
could be. Right, So let me turn this into a
question for you, Maya, when you think about your recovery today,
what are the pieces of your formula that make that
reduced risk of relapse of this illness called addiction for you?
Speaker 2 (20:35):
So it's you know, my friends, my husband, my.
Speaker 1 (20:38):
Cats, connection, connection, connection.
Speaker 2 (20:41):
I love my kitties and my husband and my friends,
my family. Obviously music, just music. Oh oh my god.
What kind of kitty is that?
Speaker 1 (20:52):
This is icy? So we have always been a dog family.
He's a little Siberian kitty. He's like ten weeks old now.
He followed my niece home from the bus stop two
years ago. We've always had dogs and now we have
this little kiddy and he's the love of all of
our lives. So when you said your cat, I was like,
I feel what you mean. He's sitting and he's sleeping
(21:13):
in the chair behind me.
Speaker 2 (21:14):
Gorgeous.
Speaker 1 (21:15):
But I'm sorry, go ahead, your husband and your friends, your.
Speaker 2 (21:18):
Kids, two cats, and the you know music I like
surprisingly these days, like working out, you know, it's just
like and obviously I have to say, like just my
work and the passionate feeling I have around trying to
do something that makes a difference, and you know, being
(21:40):
able to have a voice in this situation to some
extent at least. So you know, all of that is
just really amazing. And it's just been so nice to
you know, be able to realize that, hey, actually people
do like you. You're not a horrible person. You can
contribute to off, you can do stuff that you know,
(22:03):
I mean, sometimes I feel like nobody's listening, but oh
we are listening, thanks, so you know, and yeah, just
to be also just be able to do like fun
things like listen to music. And I'm slowly beginning to
learn to like play music. So this is exciting to
have the opportunities to do these things. And and you know,
(22:23):
I just feel enormously grateful that, uh, you know, I've
been able to sort of find my way to this.
And I should also mention that antidepressants have been really
helpful to me. And I've been on like prozec and
Walbutrin for like ages. And I have no intention of
breaking messing anything up it's working. I'm not going to
(22:45):
mess with it if it stops working. Then I'll deal.
And I say that because like so many times, like
people on you know, mesadone or people morphine or whatever,
like feel like, oh, I'm not really really recovery because
I'm still taking something, and I'm like the heck with that,
Like I don't see it as being any different, Dislike.
Speaker 1 (23:01):
Yes you are.
Speaker 2 (23:02):
Yeah, this allows me to like not be so overwhelmed
by the sensory stuff that has previously made it very
hard to be me. I don't see that as an issue.
I see that as something that's been very helpful. And
I think that, you know, while it's obviously super important
connection and meaning and purpose and all of that, sometimes
(23:22):
you can't get to that if you don't have the
appropriate therapy or the appropriate medication or whatever it is
for you. So it's it's like, definitely you need love,
but sometimes all you need isn't love. Sometimes you need
a little more And that's okay too.
Speaker 1 (23:39):
Yeah, I love that entire line. I want to go
down it a bit. So we talk about biological, psychological,
and environmental, and the six conversations are like, there's a
set of biological things you're born into, psychological things you're
born into. That's like your early childhood environmental things you're
born into. That's like your zip code where you grow up.
(23:59):
And then there are set of biological, psychological, and environmental
factors as we're adults that we have more control over
to change those because they're happening in real time. But
those things that we grew up with are also still
exerting effect and we have to put pieces in the
formula that address those things. So to your point, we
(24:21):
don't put any stigma around it when love is not
enough for your diabetes, and we don't put any stigma
around it with love is not enough for your asthma. Right, So, like,
if you're on an asthma regimen that's working, and we
know there are biological, psychological, and environmental inputs to asthma,
(24:41):
nobody's going to pressure you to change your medication routine
when your asthma is controlled. To the contrary, they're like,
why would you break it? No, what's the saying, why
would you fix it if it's not broken? And yet
this is what we're doing because people don't understand substance
use just orders an addiction as a chronic medical condition.
Speaker 2 (25:03):
Yes, yeah, no, And I mean I get it that,
Like you know, the way we do medication in this
country is horrible pain in the butt, especially with methadone.
I would really want, you know, I hope that we
are going to begin to reform this system. Yes, it
is ridiculously you know, overregulated, and it is crazy that
(25:25):
people you know, have to go every day for as
long as they do, or like sometimes.
Speaker 1 (25:31):
People with the least resources by the way, right because
people with resources are not taking methadone.
Speaker 2 (25:37):
No, and I mean there's that, and or they're getting
it for.
Speaker 1 (25:41):
Pain from the pharmacy with a prescription.
Speaker 2 (25:46):
Yes, it's crazily over It makes it into basically chemical probation.
And I don't I wouldn't judge anybody for like wanting
to be off of that as quickly as possible, even
though staying on that or UB is the only thing
we know that cuts the death rate in half. What
we should be doing is encouraging people to be staying
on and to be have access that is not stigmatizing
(26:09):
to just go to the doctor, you know, go to
the doctor, go to the pharmacy, get your drugs whatever.
And I get it that, like, you know, when methodone
needs to be prescribed carefully because it is really strong
and it naive. People can die on it quite easily,
and doctors have killed people with it trying to treat
pain and not understanding how to use it. So it
(26:30):
does need a little bit more regulation than well.
Speaker 1 (26:34):
The same is true though for fit Andal.
Speaker 2 (26:37):
Absolutely yeah, no, not like I am not saying that
like that means like we should, Like, you know, if
you get surgery of just jump in a clinic every
I don't.
Speaker 1 (26:45):
Know, you have to show up every day, you know, No,
I mean.
Speaker 2 (26:48):
It's just ridiculous. You know, the understanding how to use
these medications properly is important, not creating situations where doctors
or clinics or whoever just have this horrible power relationship
with patients where you know, it's like, oh, well I'm
(27:09):
in a bad room, so you can't go on vacation.
I'm not giving me take homes like this happens.
Speaker 1 (27:14):
I know. I had a lady that wanted to switch
from methadone to buper norphan. We were able to do
it for her and she ultimately did great, even though
that is a super hard switch to make, but she
had been on methodone completely utterly stable, completely negative drug
screens working grandchildren, the whole I'm talking about, like life
(27:37):
is together minus chronic back pain and chronic sedation from
the methodone. So she wants to make a switch to
buper Norphan. Six years she's been stable at the same clinic.
They still have her on every two weeks take homes,
So every two weeks she has to drive an hour
and forty five minutes there to get a two week
(27:59):
supply an hour forty five minutes back. And she said,
if they knew I wanted to switch to buper Norphan,
they would cut my dosing immediately. So we had to
be so strategic because I didn't want to give her
a break and like have her have withdrawal in the middle, right,
We had to be so strategic. It was like what
day do you pick up your dosing. I had to
(28:19):
try to taper down her Methodone within the two week
dosin that they had given her cross her over to
the Buper Norphan. It was totally not an ideal crossover strategy,
purely because to exactly your words, the system had so
much power over that methodone dosing and she had been
stayable for six years.
Speaker 2 (28:40):
No, it's like I mean, I you know, and I
hear this like with pain patients where I'm a pain
patient that I know like tested positive for heroin and
never did heroin and got like cut off. Yeah, this
woman is an agony for like no reason.
Speaker 1 (28:56):
Yeah, and even if she had done here.
Speaker 2 (28:58):
Exactly, like people still have pain, Like, it's not like yeah,
the whole thing. And I mean, I think this sort
of goes back to that fundamental legal problem that we
have in this country where we had Supreme Court decisions
in like nineteen nineteen and around then where it was
basically like, it is not a legitimate part of medicine
(29:21):
to prescribe opioids to people with opiodus disorder, or cocaine
to people with cocaine or whatever. You know, that is
just we are deciding, because we are white men, that
this is not okay. And literally there was no actual
reasoning in the decision. They were like, well, it's obviously immoral,
and okay, I'll yes to you maybe, but you know,
(29:43):
that decision means that doctors treating pain are always terrified
that the cops are going to come and say, actually,
that person is predicted and now you are doing something
illegal and we're going to take your license and it
put you in jail. And you know, until very recently
there was a Supreme Court decision that said, like, no,
(30:03):
you cannot. If you're going to prosecute a doctor for
over prescribing, you have to prove that they had criminal intent.
You cannot just say that like, oh, they're outside the
CDC guidelines, therefore it's criminal. Like they accidentally name a
drug dealer when their patient was overweight and needed a
hire dose.
Speaker 1 (30:21):
Right, I was getting a license in a state and
there were a couple of different ones, So I won't
call the exact state just in case I get it wrong,
because I wouldn't if I was this state. I wouldn't
want anybody saying this about me wrong. But so I'm
taking like the test that you have to take to
get your license to be a physician in this state
(30:42):
and tells you like about the state laws. And it's like,
if you're treating a person for paying disorder and there
you're in drug screen is positive for an illicit substance
or you have concern that they're diverting medication that you're prescribing,
what are you legally required to do? And I just
(31:03):
refuse to get the question right because I just refused
to put the answer that I knew was the answer.
It was called the police and make a report.
Speaker 2 (31:11):
Are you kidding me?
Speaker 1 (31:12):
Oh my god, I am not kidding. And I was like,
I refuse, like I will just get this answer wrong
because I refuse to say that that's the right answer,
because that's not the right answer. But it is. Literally,
this is the programming. It's coded into the test that
physicians take to get a license in that state to
criminal and out criminalize people that have substance use disorders.
(31:36):
It's wild, Okay, Okay, isn't that crazy? Okay? I want
to change. I want to change Lane. I felt myself
getting on a soapbox and we're going to be on
that the rest of the show. I wanted to click
in Maya, if it's okay, You've mentioned a couple of
times that you have autism spectrum disorder, and you described
it before you called it that as being very sensory
(31:57):
sensitive and having difficulty connecting with people socially and feeling
ostracized even by yourself and by other people, and so
I then you said something that really caught my ear.
When you don't know about it, you don't ask and
so I think one of the assumptions people make about
(32:18):
people with autism spectrum disorders is that you don't need
the connection or you don't want the human connection. And
then when I asked about your recovery formula, that was
number one, two and three. So I think it would
be super helpful for people listening who maybe have had
(32:39):
a similar experience to you, but no one has told
them these are symptoms of autoism spectrum disorder. And you're
wonderful and great and you know to be loved and
we understand this connection. So maybe can you just talk
to us about how you came to understand and that
(33:00):
how you came to be on prozac and Will Butcher
and whatever else went into you being in this comfortable
space with yourself that you seem to be in now.
Speaker 2 (33:09):
Yeah. No, So the I saw an article in New
York Times and it was at the time called Aspergers,
which apparently we now know the guy was affiliated with
the Nazis in some ways, so it should not be
called that anymore. There some people dispute this. Other people
are like, no, he like some people were saying, oh,
he protected the people that he was seeing and tried
(33:30):
to keep them away from the camps or you know,
being killed. Others are like, no, no, he was part
of I don't know.
Speaker 1 (33:39):
All I know is that I had no idea that
was why we stopped calling it Asperger's Like I knew
we stopped, but I did not know that. Yeah, so
oh now I gotta go check the facts.
Speaker 2 (33:50):
But the funny thing, yeah, I like, I mean, there's
definitely still some dispute over this, although I think side
that says he's actually a Nazi is winning the the
So there was this article New York Times about this condition,
and it stuck with me in part because there was
a very silly part of it where like this wife
was married to the guy with it, and when he
(34:13):
would be acting particularly asked, being a very kind of
anti social way, she would call him an ass burger,
and it was it was a little joke between them.
But anyway, like I was just like, wow, like that's me,
Like I have like all that stuff. I'd maybe heard
about autism before, like maybe you know, in this sort
of stereotypical like rain Man thing or just like somebody
(34:36):
who is like just very very severely disabled. So you know,
I was just like, oh wow, that's like interesting, and
then like the antidepressants didn't explicitly get prescribed for the
sensory stuff, it was because I actually was depressed, probably
in part from all the self hatred this other stuff.
(34:57):
But it seemed to me that like it just like
like one of the things that I found really helpful
with the opiates was like it just turns the volume
down and it's like less, you know. And and with
SSRIs in particular, I found that like, yeah, it's just
like I'm less anxious for one, but I'm just like
(35:19):
not also so like you know, vulnerable to like sounds
and lights and just intensity. I always get into arguments
with people who are like, you know, oh, like, look
the data shows that the SSRIs are all Perceibo now,
and I'm like, you can't tell me it's Perceibo on
the sensory stuff because it just isn't. But also, like
(35:39):
you know, you first told me when this stuff first
came out, it was like this miracle drug and made
me better than well then you told me about no.
But wait, then I was supposed to be making made
into a serial killer or mass shoot or something, and
you know what the thing is, I actually think it
can be all three, like, because people's responses to these
(36:01):
things are so varied, and I have seen people on
the wrong medication like they might become suicidal or even
like homicide, you know, and I've seen people on the
right medication is just oh it works, like you know,
and I've seen people have just nothing effect. So I think,
I am I am not a doctor, but I imagine anybody
(36:24):
in practice who like sees a lot of people on
these different psychiatric medications just knows how widely individualized the
response is. And so when you have to look at
like clinical trials, it makes analyzing the data really hard
and like you know, when you you know, but I
think what sometimes happens is like you get like a
(36:45):
large proportion doing better and a large proportion doing worse,
and looks like placebo because by the numbers they average out.
So but the individual people are experiencing harm or benefit.
And so you know, that is where I guess medicine
has a bit of an art as opposed to just science.
But yeah, so I mean, but so that was basically
(37:05):
for me, and I just like, over time, just read
a lot and talked to a lot of people, and
you know, began to understand that. Yeah, Okay, as like,
because I had just had all these other diagnoses like
OCD and like depression and addiction, and I even once
got bipolar, which I don't think was correct, but but
(37:27):
this one like actually made sense of all the weird
symptoms like as well as some of the you know,
I'm usually like you know, very early reading and being
very intellectual, you know, very obsessive, but also like I
probably could also be called ADHD. I have a lot
(37:48):
a lot of focus on the stuff that I'm focused
on though, so that had been like really disability for me.
I can see how in different circumstances that might have
become that way, especially if I didn't have something that
I was sort of obsessively interested in.
Speaker 1 (38:02):
Yeah. I really loved the way you told that story,
because I think this is why this book is about
having conversations and this podcast is about having conversations. Because
even though that New York Times article wasn't a person
you talked to, so not you know, quote unquote a conversation,
(38:23):
it was somebody talking about an experience, and you saw
yourself in it, and that was the beginning of like
a journey to healing and recovery. And so that's why
stigma is so deadly when we stay silent the way
we used to stay silent about AHIV. We started talking
(38:44):
about HIV, we got to a cure. We used to
stay silent about epilepsy. We started talking about epilepsy, we
get to treatment. We used to stay silent about suicide.
We're talking about suicide. We're still at all time highs,
but at least we're talking about it in practicing prevention
so that we can start going the same way. And
so like same thing that I'm hoping for addiction, And
(39:08):
I think we have started talking about addiction in a
way we weren't before, and the people with addiction in
a way that we weren't before. That I hope is
like going to help us set on a different trajectory. Yeah,
so God bless that New York Times ar No, No, I.
Speaker 2 (39:22):
Mean I should look it up, you know. I do
think also one of the things that actually makes on
twelve step programs and just anywhere where people just share
their personal experiences about things really powerful for a lot
of people is that you get to hear, you know,
other people on you know, who've been through things that
(39:44):
you might have been through or have looked through things
in a slightly different way. And you know, I definitely
benefited from hearing people in twelve step meetings just talk
about like the ways that they saw themselves that were
completely we obviously wrong from the outside. All right, right,
(40:04):
so you were a gorgeous model. You are not ugly
like you know, and I'm like, well, then maybe I'm
not a horrible person the way I think I am either.
You know, I came to the conclusion that the wrong
people hate themselves.
Speaker 1 (40:19):
Oh, I'm just gonna let that one lay right there.
It took me a second. I was like, oh, I
get it. Yes, so this is so wild. Okay, we're
forty seven minutes in, which means we're at the end.
(40:40):
So thank you for like being such an amazing conversation
that it's already over when it feels like it just started.
So let's roll into what I promised would be the
last question, which is, and it doesn't have to be
one thing. You could tell us whatever you want to
tell us, maya, but something we need to unlearn, or
(41:02):
some stigma we need to undo, or some conversation we
need to uncover that based on your personal and professional
experience would get us on the right track.
Speaker 2 (41:11):
Well, there's a couple of things here, and I've stressed
them a little bit earlier, but I still think it's important.
Tough love, uh uh love love.
Speaker 1 (41:20):
You know, oh zero stars.
Speaker 2 (41:24):
Secondly, and I mean again, this doesn't mean that you
don't hold people accountable when they need to be held accountable.
It just means that you don't be mean to somebody
as a way of helping them. Like that does not help.
Similarly with enabling, like you know, if prescribing heroin, we
looked at the data. When you prescribe heroin, it does
not keep people in active addiction longer than if you
(41:46):
just leave them alone. So therefore enabling cannot be true
because free heroin like that should you know, be the
most enably enabling thing.
Speaker 1 (41:54):
You could do, the most enabling.
Speaker 2 (41:58):
I know, I just made that up.
Speaker 1 (41:59):
You know.
Speaker 2 (42:00):
No, it's just like and hitting bottom. All of these
things have got to go. These are not useful to
helping people get better, Like what is useful to helping
get people get better from addiction is what is useful
to helping people get better from just about anything, which
is like support and resources and kindness and you know,
figuring out why people you know, you started with this
(42:21):
like this idea that like, you know, people take drugs
for reasons, why what is this doing for them? Or
what were they trying to get from it? Maybe they're
no longer getting it now, but what were they trying
to get from it? And how do we get them
to have that? Because you know, the reason that we're
having so much addiction now and such crisis with like
a really unequal world is that this you know, inequality
(42:46):
like tears us apart from each other and polarizes and
it even makes rich people unhappy. It doesn't like it's
not healthy, and so you know, we shouldn't be surprise
like if we lose our middle class that we are
going to like have a lot of unhappy people and
they're going to use drugs. So we need to like
(43:09):
make this place better by making it more equal, by
you know, spreading the wealth a little bit, because this
is absolutely concentration is just crazy, and you know, I
just sometimes think about it. It's like, you know, some
people like they could like literally give every person one
hundred dollars and they'd still have money. Like that's like
(43:30):
nobody should have that amount of money. I know that
sounds kind of disconnected from this, but it isn't because
when when we let things go to the point where
that like they are now, our politics gets into this
horror that we're seeing now are and we can't deal
with the environment, We can't like our medical system is
falling to pieces.
Speaker 1 (43:50):
You know.
Speaker 2 (43:50):
Meanwhile, it's like, and what's so annoying about it is
that like we actually know how to solve a lot
of these problems, actually know what could help, and it
actually wouldn't even there would still be rich people, you know.
I mean, it's just like you just want it to
be that greedy, right. This is a little bit oversimplified,
but I think that we can do a lot better
(44:13):
in the way that we structure our society in order
to have it be a kinder place that produces lessening.
Speaker 1 (44:23):
I love it. I love it. So I would recap
that as you were talking, I like envisioned a big,
huge burning trash can that you were throwing things in,
and you're like, we're throwing tough love in the trash,
replacing it with compassion, throwing this concept of enabling, like
(44:49):
you have to disconnect from people throwing it in the trash,
replacing it with connection, throwing rock Bottom in the trash,
set fire on it. I guess that it makes sense.
It set it on fire, whatever order the words are
supposed to come in. Yes, it's in the trash, it's
burning right, It's like get to the root cause, which
(45:10):
I think was your last sentence, which was so beautiful,
and we can end on it, which is we have
to restructure these communities we're living in and these cultures
we're living in to be kinder, and that would produce
less addiction. I would say they heard it here first,
but you've been like so vocal in writing about this
all day every day that that would just not be true.
(45:32):
But I'm so so grateful that you came on, Maya.
This was amazing.
Speaker 2 (45:37):
That was thanks No, really great to talk to you
as well. We should do this again sometime.
Speaker 1 (45:40):
We should thank you. Thank you so much for tuning in.
And if you like this episode, please check out my
book on addiction, Six Mind Changing Conversations that Could Save
a Life, available at Barnes Andnoble, Bookshop, dot Org, Union
Squaring Company, Amazon, and wherever books are sold. If you
(46:01):
liked this episode, please share it with someone you think
may need to hear it. Also, please subscribe to this
podcast and leave a five star review that helps us
reach any and everyone who may be looking for support
in the face of addiction.
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