November 5, 2024 • 66 mins
This week, we're airing a conversation between Dr. Nzinga Harrison and Casey Davidson on the Hello Someday Podcast.
In this episode:
- Risk factors (learned and inherited) for substance use disorder
- Scripts for talking about substance use
- Stigma and how to minimize the harmful impacts
If you're a sober-curious woman, connect with Casey: @caseymdavidson
___
📞Send us a voicemail! If you are black or brown and want to share how Un-Addiction has impacted your life, leave us a message at: https://www.speakpipe.com/UAPod
📖Dr. Nzinga Harrison's book, "Un-Addiction: Six Mind-Changing Conversations That Could Save a Life" is out now! Order 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. Questions, suggestions, and anything else? Email us at: unaddictionpod@gmail.com
💜If you or a loved one are experiencing addiction, have questions about recovery, or need treatment tailored to you, visit eleanorhealth.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
What does recovery look like when it's not designed for you?
I'm doctor and Zanga Harrison, and in season four of
Unaddictioned podcast, we're featuring black and brown guests sharing their
journeys through the unique barriers to recovery shaped by their identities.
These guests have not only defined recovery on their terms,
(00:22):
but they're also creating pathways and communities that can help
you or a loved one find recovery too. This week,
we're airing an interview between myself and Casey Maguire Davidson,
host of Hello Someday, a podcast for sober curious women.
I break down the learned and inherited risk factors that
(00:42):
can lead to addiction, scripts for talking about substance use,
and important definitions that impact the stigma that people with
substance use disorders face. I hope you enjoy this conversation
and if you're a sober curious woman, definitely go check
out Casey's podcast.
Speaker 2 (01:00):
I also previously talked to in Zinga in episode one
hundred and thirty three. It was an amazing conversation about
how what you need to know about the risk factors
for alcohol use disorder and We're going to take that
conversation further today and so much more. If you're listening
to this podcast, I know you love podcast. So In
(01:22):
Zinga also has a podcast called an Addiction that I
will ask her all about. But in the meantime, welcome.
I'm so glad you're here again.
Speaker 3 (01:31):
Thank you so much.
Speaker 1 (01:32):
And I can't believe that was episode one hundred and
thirty three, Like, how many since then?
Speaker 3 (01:37):
Right?
Speaker 2 (01:38):
Oh my god, I am around two hundred and you
know by the it'll be around two hundred and thirty
three by the time it goes live.
Speaker 3 (01:46):
So incredible.
Speaker 2 (01:47):
I know, it's been crazy. It's been over four years now.
Speaker 3 (01:51):
Wow, I love it so much. That's so cool.
Speaker 2 (01:54):
Yeah, I do too, It's like my favorite part of
the job. Well, so, I this book. I was telling you,
I've been reading through it and I've got all the
notes on it and just to start, tell me about
why you wrote this book.
Speaker 1 (02:10):
Yeah, so you mentioned that I've been practicing medicine for
twenty years and I have always been an addiction psychiatrist.
Speaker 3 (02:17):
Like my passion is people who.
Speaker 1 (02:21):
Are drinking or using other drugs or substances in a
way that they're questioning is this how I want to
be using this or do I think this is helping
me the way it used to type of thing and
really kind of like being a supportive, empowering doc to
help people define what they want out of their lives
(02:41):
and you know, mark out a pathway for how to
get there. And so I had a previous podcast, thank
You for Mentioning un Addictioned, which is the current podcast.
Speaker 3 (02:51):
It was called in Recovery with Doctor.
Speaker 1 (02:53):
Harrison and Jen Keene was a listener and she reached
out through my website and was like, I'm sure you
already have a book agent, but if not, can we chat?
And I was like, oh, why would you be sure
I have a book agent because I'm never, ever, ever,
ever going to write a book.
Speaker 3 (03:09):
And then it's clear who won who won that argument?
Speaker 1 (03:12):
Right two years later, Jen was like, you're obviously passionate
about people with addiction or people who wonder if they
have it or don't. You know, we don't have to
use the word addiction, just like want a different way.
And she was like, this will get your message out,
and that's all she had to say and the rest
(03:33):
is history.
Speaker 2 (03:34):
Oh that's fantastic. So getting the message out That's something
that I'm really passionate about too, and I love talking
to people like you who are experts about it. So
much to go through in this book, But one of
the first things that I think will surprise people listening
to this podcast but everyone else as well as you
(03:55):
talk about the seventy five percent success rate in the
context of the impact of long term treatment options for addiction,
Can you tell me about that.
Speaker 1 (04:07):
Yeah, So I'll start with the name of the book
is a word that we made up on addiction, and
kind of how we came up with it was like, Okay,
what are the things we need.
Speaker 3 (04:18):
To unlearn that we think we know about addiction?
Speaker 1 (04:22):
That is like actually one wrong to not helpful? Two,
what are the things what are the stigma that we
need to undo that's like keeping people from getting support
or keeping people from getting better. And then number three,
what are the conversations we need to uncover? And that's
like the tagline for the book, six mind changing conversations
(04:44):
that could save a life. And so the first thing
we have to unlearn is that people don't recover. Yes, right,
Seventy five percent of people who have struggled with a
substance in whatever way consider themselves recovered or in recovery.
Speaker 3 (05:05):
That is three out of four.
Speaker 1 (05:07):
Yeah, that is more than one out of four, and
one out of four is very important because you know,
one out of four is still too high. And if
we can unlearn other things that we need to unlearn
and undo stigma and talk about it, we could get
that one to four even lower. But the medical literature
tells us for any condition that we're dealing with, when
(05:29):
you believe there is a chance for you to recover,
there is a better chance for you to recover. And
so we can't only talk about devastation and people who
are dying and the people that don't recover, we have
to talk about them, but we cannot only talk about them.
Can we start from a place of hope and possibility? Yeah,
(05:53):
then figure out how we get there for some balloons
for more people.
Speaker 2 (05:58):
Yeah. I love that so much because because a couple
thoughts I had when you were talking about this. I
remember being back in my office in my corporate job,
and one of my friends, who by the way, I
loved wine as much as I did. You know, whatever
it was, was like hungover on Monday after some Bunco
(06:19):
game with her girlfriends was talking to me about the
fact I don't drink, and it kind of cracked me up.
She was like, yeah, but you decided to stop. You
didn't have a problem with alcohol. Actually, I think she
put it in the present tense. She was like, you
don't have a problem with alcohol. And that cracked me
(06:39):
up in a few ways. One because why was it
so important to her to make sure I was in
ex category versus why category? And be what I said
to her, I was like, well, yes, I chose to stop,
but alcohol is addictive, and you know it is designed
to take you down the path and becoming more on it.
(07:01):
But be in my mind, I'm eight and a half
year sober now, I was like four years sober at
the time. I was like, I haven't had a drink
it four years. I am zero problem with alcohol. And
Craig Ferguson at one point said like, I didn't get
one really quick, right. But what I loved about that
is in my mind, I'm like, you were hungover on Lunday.
(07:22):
I haven't had a thing to drink in X number
of years. Like it cracks me up that you're like, oh,
but you don't have a prom Like as if if
I had, it would be a lifelong thing. Anyway. I
just I thought that was interesting because now I haven't
had a drink at eight and a half years, and
I don't consider myself to be struggling with alcohol at all.
(07:46):
I just don't touch that.
Speaker 1 (07:47):
That's right, No, you know, I think it's it's this
this human phenomenon of needing to protect ourselves from the scary.
So you are colleagues working in the same job, coming
in on Monday morning, kind of with a life that
is similar in that way, and so it's probably very
(08:08):
scary for her to see you as a person who
had a problem with alcohol, because maybe that means I
could also have a problem with alcohol. And this is
getting to like undoing the stigma. Yeah, I think the
concept that we have of people that quote have a
(08:30):
problem with alcohol is homeless, drinking out of a paper bag,
has lost everything, is begging for money on the street.
And if you think about the whole spectrum of what
quote a problem with alcohol means, it goes all the
(08:50):
way from when I have a glass of wine, I
wake up with a migraine, but I keep having a
glass of wine all the way to that very severe
that I just described, but we've made it so scary
and so dangerous to say out loud, like I don't
think alcohol is doing for me what I wanted to
(09:12):
be doing. So I'm gonna stop, Like, can we just
make that easy? Yeah, I don't drink alcohol, that's awesome,
what's next? Yeah, but it's like, oh, you don't drink alcohol.
Speaker 2 (09:22):
Yes, there must be summer And I want to be
like back in the day when I was fully immersed
in like wine culture and very you know, all of
my friends drank and everything else. I seriously believed that
the only people who didn't drink were like pregnant, yeah,
(09:43):
had an issue with addiction, aka like they can't drink
or were super bored. And now it cracks up because like,
I know so many people who don't drink who are incredible.
But it is interesting to me. The other thing I
loved that you wrote and I wanted to ask you
about is so we have this seventy five percent success
(10:07):
rate in terms of the context of long term treatment
for addiction and recovery, and I want to dive into
like all every single word and piece it apart. But
those are people who have sought treatment and help and
support for addiction. Now, there are so many people in
(10:28):
this world, including women who contact me every day and
they're already on the path to getting support and resources,
but who really struggle with this every day and don't
seek support, probably because they see it as this futile
I'll never stop anyway, what's the point? My life will
(10:49):
be over, it won't work. But also it is positioned
as this life sentence of deprivation and isolation, and you
know their ness from everyone they know. So I wish
that more people who struggled with addiction, drinking, whatever it
(11:09):
is would seek treatment. Because of seventy five percent recover,
that's pretty fucking awesome, right, I mean, you don't have
to feel that way anymore.
Speaker 1 (11:18):
So true, so true, And these are the conversations that
we have on the Unaddictioned podcast, Like what was the
scariest thing for you about thinking about stopping or changing?
Speaker 2 (11:31):
Right?
Speaker 1 (11:31):
Because I think that's also important is that the definition
of recovery is not abstinence for everyone. For some people
the definition is for apps is abstinence. For other people
the definition is different.
Speaker 3 (11:43):
But like, what was what was the scariest thing?
Speaker 1 (11:45):
And what I hear over and over is like, I
had no idea how was going to have fun if
I stopped using Excellent. I had no idea how was
gonna socialize at work when that happens at happy hour
in a bar, No idea how it was going to
go on a girl's trip with my friends and not drink, right, Like,
(12:07):
it is those things that are very, very very important
to us, and culturally, at least here in the US,
definitely other countries as well. We see alcohol as a connector,
and other drugs also act as a connector for people.
And so yes, I wish more people. I wish it
was safer for me, more people to even say, I'm
(12:29):
not even sure this is a problem, but I think
it might be early intervention, early right, And you don't
necessarily have to like sign up for the life sentence
of committing to never drink another drop ever again. You
might get to the point where you're like, you know what,
I don't need to drink another drop ever again. But like,
let's just start with making it safe for people to wonder,
(12:54):
like be curious, I wonder if I made a change
what I feel differently in XX way that I want
to feel differently, and then just try it. Just try it,
and that doesn't have to be treatment for everybody. Sometimes,
I mean I talk about connection more than I talk
about treatment, and so I think about this the same
way I think about diabetes. The doctor tells you, like
(13:18):
h you know, diabetes runs in your family. Your blood
sugar is a little higher than I want it to be,
even though you don't have diabetes yet.
Speaker 3 (13:25):
Maybe go join the gym.
Speaker 1 (13:27):
The gem is not treatment, but it's a source of
connection and changing a choice that can help prevent an
illness from developing. Right. You know, alcohol use disorder runs
in your family. And I know you're only drinking two
glasses of wine a night, but you're telling me your
(13:47):
mood feels a little crunchy. Why don't we just try
a month with no alcohol and see if your mood
feels less crunchy.
Speaker 3 (13:54):
I wish we could just get.
Speaker 1 (13:56):
To investing in people's curiosity. Yeah, and just trying different things.
That doesn't equal. You have to go see doctor Harrison.
She's an addiction specialist and she's going to make you
vow to never do X ever again in your life, which.
Speaker 2 (14:11):
We're like, diagnose yourself with something, nurse you do.
Speaker 3 (14:14):
You have to get diagnosed. You don't have to get diagnosed.
You don't need a label.
Speaker 1 (14:19):
All you need to know is you're like, I wonder
if you wonder, we have an opportunity.
Speaker 2 (14:25):
Yeah, I love that, And that's the reason that this
podcast is called, you know, the Hello Sunday Podcast for
Sober Curious Women because I love the whole sober curious movement.
I mean, and it's everywhere right like New York Times,
Good Morning America. Everybody's talking about it. Yeah, But also
the idea is that to make it more approachable, but
(14:49):
also like try try to see like longer period of
time alcohol free. I recommend one hundred days, That's what
I started with, and then like see because that way
you'll see that you can socialize and you can go
on vacation and you can watch TV, and after a
hard day of work you can try a different coping
(15:09):
mechanism and like at the end of that time, you
feel better. One you know, I have a group of
women who are all, you know, in the process of
going out call free and just the fact that you know,
one of them said, oh my god, I woke up
with like a cold, the flu of migraine. I didn't sleep,
I can't believe I used to feel this way every day.
(15:31):
I can't believe how shitty I felt, and like I'm
having one day of it and I'm just like, now
I know what healthy feels like.
Speaker 1 (15:40):
Yeah, I love that so so so much. And this
is like you said, you recommend one hundred days, which
I love one hundred days because I didn't think I'd
be able to go on the girls trip or live
and all this kind of stuff. The book is called
six Mind Changing Conversations, and there are actually scripts in
the book like how to have this conversation, And one
(16:02):
of them is like, Okay, we're going on a girl's
trip and either I'm choosing not to drink or I
have a friend who's drinking. I'm worried about. How do
we talk about it before we go? Like, what is
your plan for when you find yourself in a situation
you're in a hundred days not drinking, what's your plan
for when you go out to dinner? Yeah, and the
(16:26):
server has great intentions and has been instructed by their
boss to offer everyone a drink.
Speaker 3 (16:31):
And you're gonna say, that's.
Speaker 2 (16:32):
Where they make their profit margin, right, That's where they
make their profit.
Speaker 1 (16:35):
Margin, Right, I was at a business dinner and it
started out with drinks, and so the server came around
and was taking everybody's drink and everybody was ordering an
alcohol drink. And that was back when I was still drinking.
But me and my husband decided to stop drinking. It's
been like a year now.
Speaker 2 (16:52):
Oh my god. The last time we talked, you were like,
I don't drink a lot, but I do barely.
Speaker 1 (16:57):
I barely drink. And then I was like, why am
I been spending money?
Speaker 2 (17:01):
But that's amazing.
Speaker 1 (17:03):
Yeah, So he was actually the one. He was like,
I'm gonna stop drinking. I was like, okay, I'll stop drinking.
So we haven't drunk for like a year. We're like
totally into non alcoholic cocktails. That's oh my god, me too,
Oh my god.
Speaker 2 (17:15):
I love non alcoholic beer. That's my jam.
Speaker 1 (17:17):
Ooh, I hate beer, so I love non alcoholic beer
for other people. But for like the book launch, we
did a total non alcoholic spread. So we had non
alcoholic Heineken, non alcoholic Corona, non alcoholic sparkling wine, which,
like sparkling wine was my jam.
Speaker 3 (17:33):
So now non alcoholic sparkling wine is my jam. I
love it.
Speaker 1 (17:36):
And cocktails. Anyway, before that, I was at this business dinner.
Everybody's ordering a drink, so I was gonna get a prosecco.
Speaker 3 (17:44):
That's what I used to drink.
Speaker 1 (17:46):
But the person before me, so it's like twelve of
us we're on like person number seven, I'm like number
eight six people order alcohol drink. Person number seven says,
do you have anything non alcoholics?
Speaker 2 (18:01):
Like damn, and the.
Speaker 1 (18:04):
Bar happened to have non alcoholic cocktail and they're like, yeah,
we can do a blah blah blah.
Speaker 3 (18:09):
And he was like I'll take that.
Speaker 1 (18:10):
And I was like, I was planning on ordering a prosecco,
but I'm gonna go for the non alcoholic drink he disordered,
And do you know, of the next five people, three
people chose to do a non alcoholic drink and two
other people changed their order they did from alcoholic to
non alcoholic. Like he just unwillingly made it okay.
Speaker 2 (18:35):
When we were all like whispering about, like bring me this,
so people think I'm still drinking or.
Speaker 3 (18:41):
None of that, just as like do you have anything
not alcoholic?
Speaker 1 (18:44):
And I was like, oh, I'm just seeing you role
model how I plan to be going forward it was incredible.
So back to Sober Curious as like you Hello Someday podcast,
all of the people in New York Times, all of
the people on the web that are like, yeah, I.
Speaker 3 (19:02):
Just decided to stop drinking.
Speaker 1 (19:04):
You're making it safe for somebody else to say, I'm
gonna try it, like I love it so much.
Speaker 2 (19:09):
I mean, I love it too, And it's become such
a thing with like dry January, dry July like this,
the younger generation not drinking as much. Like there's a
zero proof cocktail menu or a non acolic beer that's
actually good, that's not crap right on almost every single menu.
And I mean when I quit drinking eight years ago,
(19:32):
I actually tried for the first time eleven years ago.
That was not a thing.
Speaker 3 (19:36):
Yeah, it was not a thing. It was not a thing.
And it's so good.
Speaker 2 (19:40):
I mean.
Speaker 1 (19:42):
I talk about the cultural pressures, yes, right, I love
the face, and this is one of them. I mean,
we basically you and I are the same age. We
were just talking about that.
Speaker 3 (19:58):
We're the same age.
Speaker 1 (19:59):
And when we we grew up, I think we pretty
much started getting programmed with just wait until you can
get smashed when you turn, when you get to high school,
in elementary school, we're seeing that on TV, right, And
so you just grow up with this concept that there
is no life without alcohol, and there's amazing life yeah,
without alcohol. And for some people there's amazing life with
(20:23):
alcohol before a lot of people there's not amazing life
with alcohol.
Speaker 3 (20:28):
So how do we create space?
Speaker 2 (20:30):
Yeah? And the way it works too, from my experiences,
it starts very innocuous, and it starts because of your culture.
And you know, although the first time I got drunk,
I like blacked out in this stuff, but that I
was doing that on purpose for summer. I mean, I
didn't want to blackout, but I wanted to get super
(20:51):
drunk because you know, opportunity. But you know, when I
was growing up, it was like there was a bottle
of wine on the dinner table night because that's what
adult strength. My grandparents had like happy hour before dinner.
And we're going to talk about all the risk factors.
Nobody in my immediate family meaning like parents, grandparents, sibling, whatever,
(21:14):
struggles with alcohol. I definitely did, but you know, the
underlying stuff of like anxiety or you know, you various
things were going to talk about. But also when I
went to college, I joined the women's rugby team, and
I had a very big keg college culture. And the
(21:35):
rugby team was like a four year crash course on
problematic binge drinking and blacking out and throwing up and
like that was like I was like, oh, this is
what we do, right, that's where you talk about culture
to everyone. I knew bene strength, you know, all the
(21:57):
time it was like the purpose of drinking was to
get so drunk that anything could happen. And you know it,
it does skew the way your brain works. You know
it does.
Speaker 3 (22:09):
It does.
Speaker 1 (22:09):
And you mentioned nobody else in your family has struggled
with alcohol. I imagine someone else in your family has
struggled with anxiety or digression, or cigarettes or other thoughts
or suicidal thoughts, or food addiction or work addiction. Right, Like,
(22:30):
all of these are running through the same pathways in
our brains. And so that you experienced anxiety yourself made
you particularly vulnerable to that keg culture in college.
Speaker 2 (22:44):
Right. Okay, I want to dive into the conversations and
the factors. But the one thing I also wanted to
ask when we talk about that seventy five percent recovery rate,
is everyone talks about relapse, and I absolutely love that
you talk about that. Relapse is not a part of
the IT film. God throw it in of people with
(23:08):
substance use disorder recover and return to use in the
first couple months, in the first year, where's the tipping point?
Can you like teach us all of that stuff?
Speaker 3 (23:20):
Totally?
Speaker 1 (23:21):
So I'm going to go a little medical here, and
what i want people to know about the book is, yes,
I'm a doctor.
Speaker 3 (23:27):
This is not a textbook.
Speaker 1 (23:28):
I wrote this book lack a conversation, or at least
that was my goal, right, But I'm gonna get a
little textbooky doctor it here for.
Speaker 3 (23:38):
Just a minute.
Speaker 2 (23:39):
Facts, right, that's what you talk about on versus Reality totally.
Speaker 1 (23:44):
And so in medicine, when we talk about chronic conditions,
we talk about relapse and remission. When you get diagnosed,
that is because you meet diagnostic criteria for fill in
the blank, diabetes, high blood pressure, alcohol use disorder, if
we're talking about alcohol addiction. When you go into remission,
(24:07):
that means your symptoms have come down below the threshold
that meets diagnostic criteria for active illness. When you have
a relapse, that means symptoms of the illness have come
back above that threshold. We talk about, like that person relapsed.
People do not relapse illnesses relapse. We talk about, you
(24:31):
had one drink, that's a relapse. One drink does not
meet diagnostic criteria. That is not a relapse, right, And
so what is so critically important when people say relapse
is part of the disease.
Speaker 3 (24:46):
I hate it. Throw it in the trash.
Speaker 2 (24:51):
Because that like plants that seat when you talk about
planting the.
Speaker 3 (24:54):
Seed, like there's no other totally.
Speaker 2 (24:57):
And you're just like, like it's inevitable.
Speaker 3 (25:00):
Yeah, like it's inevitable.
Speaker 1 (25:02):
That would be like if I diagnosed you with breast
cancer and I said, I'm diagnosing you with breast cancer.
We're gonna do everything we can do to get you
in remission, seventy five percent chance that you're gonna recover.
But relapses part of the disease. I just told you, Like,
no matter what you do, cancer is coming back. That
is awful and it's not even true, right, And it's
(25:24):
not even true. Okay, So what we have to say
instead is, you know what, I'm really concerned about your
alcohol use. It meets diagnostic criteria for alcohol use disorder
mild moderate or severe. Right, you have seventy five percent
chance of recovery from this illness, and based on my
medical knowledge, these are the things we can do to
(25:46):
give you the best chance to be in that seventy
five percent. Now, there is a chance of relapse with
this illness, and what relapse means is these are the
diagnostic criteria and the risk factors that drive your risk
for relapse are xxxx and X.
Speaker 3 (26:05):
So we're going to make a plan for XXX and
X so that hopefully relapse does not become part of
your illness process. Yeah, that's the way to have the conversation.
Speaker 2 (26:16):
Yeah, absolutely, And so let's first talk about what are
the things that will say you've stopped drinking, say that
previously you met the diagnostic criteria, or you didn't, or
you did. Curious like fuck, that's right, but like you've
stopped drinking, your intention is to not go back to
(26:39):
it because you feel like shit and it you pick
up all your thoughts and whatever it is. What are
the things that you would do to make sure that
you're in that seventy five percent.
Speaker 3 (26:50):
The first thing is understanding your risk, right, and so
this book is divided into six chapters, and each one
of the chapters is dedicated to a certain type of risk.
So you can think of this framework in the first
bucket for any chronic condition. There are biological reasons why
(27:11):
you develop it. There are.
Speaker 1 (27:15):
Ecological reasons why you develop it. There are environmental reasons,
and the environment splits into two. That's the cultural environment
as well as the physical environment.
Speaker 3 (27:24):
You're born into a biological set of risk factors. That's
your DNA.
Speaker 1 (27:28):
Right, So people don't know forty to sixty percent of
your risk of developing addiction is coded in your DNA
the day you're born.
Speaker 2 (27:34):
Is that because of family history or because people in
your family have also had those biological things? Like it's
is it passed down or you happy to have smilary?
Speaker 1 (27:48):
Okay, It is DNA that has passed down to you,
just like DNA for a high blood pressures passed down
to you.
Speaker 3 (27:55):
DNA for cholesterol has passed down to you.
Speaker 2 (27:57):
Okay, So got it.
Speaker 1 (28:00):
Of your risk for developing an addiction coded in your DNA,
higher than diabetes, higher than an asthma, higher than high
blood pressure. Okay, born with it. But that means sixty
to forty percent because we add up to one hundred
is psychological and environmental. You are also born into early
childhood experiences psychological risk factors. You are also born into
(28:24):
a cultural and physical environment. So I call that inherited
biological risk factors. That's your DNA, inherited psychological risk factors,
that's your childhood inherited environmental risk factors. That's the culture
and physical environment you grow up in. That's one, two, three,
Repeat those three again as you become an adolescent, young adult,
(28:46):
older adult, whatever's in the middle, just adult.
Speaker 3 (28:49):
I think me and you right now are just adults.
Speaker 1 (28:51):
Right when you grow into that, you start to acquire things,
things start to happen to you in life that can
also be risk factor. So Biologically, maybe you get a
car accident and break a bunch of bones, that's a
biological risk factor. Maybe a doctor writes you a prescription
for opioids, that's a biological Respector for people who are
(29:11):
alcohol sober curious, maybe a doctor writes you a prescription
for xanax. Yeah, and xanax is alcohol and pill form
works on the exact same receptor in the brain. Right,
that's a biological risk factor. Psychologically, you develop the.
Speaker 3 (29:25):
Stress of.
Speaker 1 (29:28):
Racism, the stress of discrimination, the stress of gender discrimination,
the stress of being the only woman in the workplace,
the stress of being the only mom who's not a
stay at home mom, or the only mom who is
a stay at home mom in your needs kids or
high kids are divorced, right whatever, use of relationships, all
(29:49):
of those things. Environmentally, cultural environment. You go to a
school and join the rugby team, and it's the keg
culture physical environment. You live in a place where all
your kneedes are not being met, right, and so that biological, psychological,
environmental repeats. Again, these are the six buckets. So your
question was, how do you know what to look for?
(30:09):
First is knowing what you have in each bucket. So inherited, biological,
do your addiction family tree have the conversations. There's a
script in the book to help you have the conversation.
Inherited psychological, you're aces adverse childhood experiences, know what they are,
(30:30):
put a plan in place to start dealing with the
impact they are still having on you.
Speaker 3 (30:37):
Environment.
Speaker 2 (30:37):
Can you give it just a couple example of aces
in case someone doesn't know what those are totally?
Speaker 1 (30:43):
And also you can google aces adverse childhood experiences and
you'll find it. I do not recommend that you just
google it and take it without having a support system
in place for yourself. And the book goes through this,
but ACES are for example, did you experience emotional abuse
as a child, did you experience physical abuse as a child.
(31:04):
Did you have a parent who had a mental health
condition or addiction? Did you have a parent who left
the house because of divorce. Did you have a parent
who was incarcerated?
Speaker 2 (31:17):
Right?
Speaker 1 (31:17):
And so there are ten there are ten questions and
if you get a one for every yes question, and
if you have a score four, higher your risk for
developing all sorts of chronic conditions adulthood, including addiction, premature birth, obesity,
cigarette smoking, premature I mean, asthma, HIV cancer, like literally
(31:41):
all kinds of things are associated with this.
Speaker 3 (31:44):
My ACES score is five.
Speaker 1 (31:48):
My inherited biological risk is probably closer to that sixty
percent because I have addiction both on my mom's side
and on my dad's side to different substances.
Speaker 3 (31:56):
Right.
Speaker 1 (31:57):
That allows me to understand my risk, but also allows
me to start having a conversation with my kids about
their risk. And then same thing biological, psychological, environmental when
you grow up.
Speaker 3 (32:10):
So, Casey, what is your biological risk.
Speaker 1 (32:15):
If you've decided you don't want to drink again, then
I need to look at how much biological risk we
have because that means I have to do even more
with your environment to try to undermine that risk. What's
your ASIS score? We need to address all those experiences
that you have. What environment are you currently in? What
(32:35):
are the people places, emotions, physical sensations.
Speaker 3 (32:42):
How are you going to talk to your friends? What
are you going to say at work when your boss
says come to happy hour?
Speaker 2 (32:47):
Right?
Speaker 1 (32:47):
Like we have to make a plan for all those
risk factors to increase the chance that you're in the
seventy five percent.
Speaker 2 (32:55):
Yeah.
Speaker 3 (32:55):
Yeah, that was the longest answer, and I love it.
Speaker 2 (32:59):
It's so important. And that, like that last piece, other
than the hope and the curiosity, is a lot of
the work that I do is Okay, you want to
stop drinking, but you keep going back to it, Like
what is your home environment? Like what conversations have you had?
How can you have them without it being scary or
(33:20):
getting pushed back? Like how do you go to dinner
with your spouse? What do you say it happier? How
do you go on a business trip? All of those
things because for me, it was one the fear that
life would suck and everything that goes. How will I relax?
How will I have fun? But it's my favorite thing
in the world, but it's my only reward, YadA, YadA, YadA.
(33:43):
But then how literally, how do I go on a
double date with another couple to celebrate something and tell
them I'm not drinking or not dive over the table
and like grab the un right, yeah, And like just
that block and tackling in a really practical way is
(34:06):
like another step that is you have to do.
Speaker 3 (34:11):
You know, I have to do it.
Speaker 1 (34:12):
And we literally go through scenarios in the book for
how to do this, And what I say is, do
you know why a race car driver can take that
curve at two hundred miles per hour?
Speaker 3 (34:27):
It's because they've practiced. Yeah, you know.
Speaker 1 (34:29):
Why they can safely get out of a crash, It's
because they've been in a simulator. Why Captain Sully could
land that plane on the Hudson River is because he
had practiced, right. And so you don't want to be
in a situation and have to figure it out. You
conjure up those situations in your brain in advance, and
(34:50):
you practice, Okay, this is what I'm gonna do. If,
this is what I'm gonna do if, and then you
also practice if I find myself in a situation that
I haven't practiced, this is my go to, Yeah, that
I'm gonna do. And the more you do those reps,
it gets easier and easier and easier to say I'm
not drinking and people are like what, and you're like, oh,
(35:11):
you think that's weird. I'm getting the best sleep I
was ever getting when I was drinking.
Speaker 2 (35:15):
Yes, yeah, I love that.
Speaker 1 (35:18):
You already have your one liner queued up right, Oh yeah.
Speaker 2 (35:22):
And you know what you're going to order, and you've
told someone in advance you're not drinking when you ask
someone with you for support, and that's a right, all
all the things, all the thing. So you talk about
the seventy five percent success rate, which, by the way,
I'm just going to keep saying so people.
Speaker 3 (35:38):
Over and over over, thirty more times before we finish.
Speaker 2 (35:42):
Yes, but you talk about it in the context of
the impact of long term treatment for addiction, and obviously
that doesn't only mean inpatient rehab. That's right, So tell
me what the different factors are in terms of what
you think of when you think of long term treatment
for it, because for some people that's scary, right, Like,
(36:05):
I'm going to attend twelve step meetings for the rest
of my life and talk about what a horrible person
I am, but also surround myself with people who are
not drinking and label myself. So what are the sort
of tears or options or any of that.
Speaker 3 (36:19):
Yeah, So I want to think broader. I want the
word treatment to people to mean like your broader action plan.
And so I'm going to talk about diabetes because I
always do, because I think it's easy for people to
grasp and by the way, the stigma about that, and
there's no stigma. That's exactly what I talk about it.
Speaker 2 (36:40):
It's like nobody's like, oh my god, yeah right, it's
just a condition you treat. It's like like I take
medication for anxiety and I also try to work out,
and I also.
Speaker 3 (36:53):
Totally all the things right, totally right.
Speaker 1 (36:56):
And so what if we thought the treatment for diabet
for a person that had diabetes so severe their blood
sugar got so high they went into a coma and
they had to go on the ICU. They went in
the ICU for five days and we were like, all right,
that's it. That's kind of like the concept of detox, Like,
that's it.
Speaker 3 (37:15):
No, if we just.
Speaker 1 (37:16):
Get them out of the coma and send them right
back out to the exact same set of circumstances with
no medication, no support, no understanding of the illness, they're
gonna be back in a coma.
Speaker 3 (37:27):
Right.
Speaker 1 (37:28):
What if we said, Okay, we got you out of
the coma, we took you out of ICU, we put
you on the impatient floor for a week, got your
blood sugar totally normal, then we discharged you. Good luck
living with diabetes. Nothing else, Right, diabetes is coming back.
What if we said, for.
Speaker 3 (37:45):
The rest of your life, every single day you have
to come to the doctor and get an insolent shot.
That would be like diabetes.
Speaker 1 (37:56):
Is coming back, because nobody can come back to the
doctor every single day.
Speaker 3 (38:00):
Yeah, that's not how we think about it.
Speaker 1 (38:01):
We think about it like, you go in, you get stabilized,
you come out, You get connected to some doctor that
you can meet with in the beginning frequently until you
figure out.
Speaker 3 (38:12):
What's going on. And then as you stabilize and figure it.
Speaker 1 (38:16):
Out, you know what your warning signs are for when
you need to get back. That's the way I want
people to think about this, So sober curious, try it.
Speaker 3 (38:26):
Stop drinking. Whoa felt the best you ever felt in
your life? Make the des decision.
Speaker 1 (38:34):
I'm not going to go back to drinking, either at
all or definitely not to the level where I was
drinking before.
Speaker 3 (38:40):
Get your support in place, Get.
Speaker 1 (38:42):
Your medication if you need it, Get your therapy to
address those adverse childhood experiences. Get your stress your support
system to get those stressors down. Get a new job,
find a new spouse, on my wader, whatever you have
to do right, do all of those things. Know what
your early warning sign. I am doing great. I don't
(39:03):
need to see you every month. I'll see you every
two months. I don't need to see you every two months.
I'll see you every three months. I don't need to
schedule an appointment with you. But if I notice XX
and X, I'll reach out to you. And so that's
what I mean by long term treatment. The same way
you have your primary care doctor, you should have your
person whatever role that is that you know your early
(39:27):
warning signs. They know your early warning signs. You can
get in with them before your symptoms cross that threshold.
Speaker 3 (39:34):
To you'll a relapse.
Speaker 2 (39:36):
Now. I love that, and that is so true in
my experience, not just for myself, but for so many
of my coaching clients. When I stopped drinking, I had
an online group that everybody was sort of on the
path to not drinking, so helpful. A lot of people
were three and four years on who were giving support
(39:56):
and encouragement and tips. And I had a sober coach
that I worked with. I emailed her like every single day,
we had phone calls every once in a while. And
then when I was sixty days so where I joined
Hip Sobriety School, which was like this online core slash
group slash whatever with Holly Whittaker who wrote quit like
(40:18):
a woman, Yes a day, And so that was reinforcement.
And then I started seeing a therapist once a week
and I got on some medication for anxiety or mood disorder,
and like that was my first year and it wasn't
(40:38):
like a horrible thing. It was like, oh my god,
I'm finally getting healthy. I'm finally not waking up with
a hangover, hating myself, feeling strung out with anxiety, craving alcohol,
worrying about it like this was I worked out, you know,
all the things. And then after I didn't need to
(41:01):
see my therapist anymore. And after you know, after a year,
I stopped emailing my coach five days a week. But
I had also everybody knew I didn't drink. It had
become part of my identity. I felt good about myself.
I had my sober friends, like good good friends, and
(41:22):
I also stayed in touch with my group. I knew
that if I felt really anxious or panicked or whatever,
I needed to deal with it right away, you know,
like and trust me. In eight years, I've gone back
to my therapist who knows that I don't drink, and
I keep myself in a good mental health place so
(41:43):
that I don't go back to drinking or something else, right,
but don't. I haven't seen my therapist in two years
because I'm good.
Speaker 3 (41:49):
That's right, That's right, And you know, so I love
so much.
Speaker 1 (41:53):
We talk about this in the book The Magic Formula,
and I say, what I love about the Magic Formula.
Speaker 3 (41:58):
Is that it's not magic.
Speaker 1 (42:01):
It is just your collection of things, yes, that keep
you healthy as you are defining healthy. And I love
that journey you just share with us Casey, because that
collection of things has to change over time, because your
life is changing over time. And the idea is like,
match your magic formula to what's happening for you right now.
Speaker 3 (42:25):
And so I would say people think of treatment and.
Speaker 1 (42:27):
They're like, oh god, I gotta be in AA every
day for the rest of my life, or I'm going
to be in a halfway house, or i gotta live
in residential treatment.
Speaker 3 (42:34):
I would wager to say, Casey, that part of your
treatment is this Hello Someday podcast.
Speaker 1 (42:41):
Oh god, yes, I mean one of your early warning
signs would be like if you could not bring yourself
for I'm just gonna say three weeks is probably shorter
to not make this podcast. You would be like, this
is a warning sign and I need to bring in supports.
Speaker 2 (43:01):
Yeah, yeah, I mean I tell people that all the time.
They were like, do you think it would be easier
for you to go back to drinking if you weren't
talking to people every day in a group that you're
running doing the podcast? And I'm like, hell yes, because
first of all, helping people in early sobriety reminds me
how much it sucks, Like how much drinking is not
(43:23):
what we see on TV and you talk about that too.
It's how glamorized it is and how harmless it is
and all those stuff. But like, also I get free therapy.
Like i'm talking to you, I talk to other people.
I reach out to people about the shit that I need.
Like I'm like, okay, talk to me about marriage, talk
to me about like perfectionism. I'm talking to me about
(43:43):
your Foster syndrome. But like that's the ongoing work and
it's great, it makes me happy. Okay, I'm going to
ask you a totally off topic question, okay, because I'm
just curious, and then we're going to go back to it.
So this is good to sound so stupid, but I
just want to know. So I went to my doctor recently, right,
(44:05):
and I looked through you know, they give you the
report on all your numbers and blah blah blah blah
blah and on there. I forget what there was, but
it was like anxiety blah blah blah blah blah. And
they then they said alcohol use disorder severe and maybe
they said in remission. I don't even remember, but I
read that and I was like, can I get that downgraded?
(44:29):
A bottle? Like I was kind of pissed that was
there because I was like, dude, do you know how
many of your clients patients drink a fuck load?
Speaker 3 (44:38):
I haven't had a drink at eight and a half years.
Was a shit on my chart? Is that terrible? Is
your reaction terrible? Is it terrible that you're in that
it's in your chart? Well, reaction is not too me.
I'm wondering about my reaction. I actually told my girlfriend's
wheats over. I'm like, first, why does this bother me?
Because the anxiety thing doesn't bother me? So like, clearly
(45:02):
that although I still struggle with anxiety and I don't
struggle with alcohol anymore. But b I was like, it's inaccurate.
Speaker 2 (45:11):
Well yeah, it seemed to me to be a present tense.
Speaker 1 (45:15):
Yeah, it's it's it is legitimately an inaccurate diagnosis.
Speaker 2 (45:20):
Okay, tell me about that, because I seriously it was like,
I want to go back to my doctor and be like,
I'd like you to change that you can, and I'll
give you exactly what you can ask them to. Oh please, okays,
tell me why it'scurate.
Speaker 1 (45:32):
So, yeah, it's inaccurate because we diagnose alcohol use disorder mild, moderates,
severe in early remission, or in sustained remission. Those are
five mutually exclusive diagnoses. So we have ten diagnostic criteria
for alcohol use disorder. If you only meet one, you
(45:54):
do not have alcohol use disorder. You have risky alcohol use.
We should be trying to prevent you from transitioning. If
you have two to three of those ten criteria, you
have alcohol use disorder mild. If you have four to five,
you have moderate. If you have six plus you have severe.
If you have not met diagnostic criteria for three months,
(46:16):
you have alcohol use disorder in early remission. If you
have not met diagnostic criteria, and remember this is not
just taking a drink, this is meeting yeah, those ten
diagnostic criteria.
Speaker 3 (46:28):
For twelve months, you have alcohol use.
Speaker 1 (46:32):
Disorder in full sustained remission. And so what happens, this
is like everybody's charge that I always ever see you
come in eight years ago. You have alcohol use disorder severe,
You get three months, nobody updates the diagnosis to early, right,
(46:53):
you get a year, nobody updates the diagnosis to full
sustained remission. And he's correct to keep that alcohol use
disorder diagnosis on your chart because we should be practicing
prevention right now, right, Like, I know, if your anxiety
is not controlled, that's giving me risk. I know, if
you're blood sugar and goes low, that's giving me risk,
that kind of stuff. But it should update it to
(47:15):
alcohol use disorder in full sustained remission. I think your
reaction part of it feels like undermining all the hard
work you've done for eight years.
Speaker 2 (47:27):
Yeah, which is true.
Speaker 1 (47:29):
Second, it's communicating something about you diagnostically that's not true.
Speaker 3 (47:34):
That never feels good.
Speaker 2 (47:36):
Yeah.
Speaker 1 (47:36):
Third, I think about it like cancer. If you had
cancer and then your cancer went into remission. When you
read your chart, you want to be reminded that your
cancer is in remission.
Speaker 2 (47:48):
Yeah.
Speaker 3 (47:49):
So I'm totally validating your reaction.
Speaker 1 (47:52):
And when you can go back to the doctor and
say so, I'm actually gonna give.
Speaker 3 (47:57):
You the code.
Speaker 2 (47:57):
Okay, do it.
Speaker 1 (47:59):
Because alcohol use disorder ICD ten we use numbers to
give the code is ten dot two. That's where your
doctor currently hasn't your chart, okay, and your doctor just
needs to choose ten dot two one all right, disorder
in remission.
Speaker 2 (48:18):
All right. I'm totally going to do that the next yeah, and.
Speaker 1 (48:21):
Have a conversation about why it matters, Like I'm eight
years not drinking.
Speaker 3 (48:25):
It's important to communicate that.
Speaker 2 (48:27):
Yeah, totally, I'm with you, all right, I love it. Okay, see,
I'm glad I asked I get all the good information,
so I loved. I have to tell you. When I
read the title of your book, six mind changing Conversations
that could Save a life, I thought it was going
(48:49):
to be like I've seen in some other books, like
among you know, like a compilation of a client story, right, like, okay,
this is is you know, Sophie and she x y
Z and you know what I mean, because I've seen
that before and I love those too. But what I
(49:09):
loved about this was it was like scripts for conversations
you can have not only about yourself, not only about
how people can support you, but like, how do you
bring it up with your kids? How do you have
the if they are like so good, like elementary school,
(49:30):
middle school, higher I mean, tell us what the conversations
are so people can kind of dive in, because this
is the practical shit that people need.
Speaker 3 (49:40):
That's right, right, that's right.
Speaker 1 (49:42):
I tried to write a super practical book that everybody
could see themselves in whether they feel like addiction has
never been part of their lives in somebody else's life,
whether they're curious this sort of thing. So the first
the conversations follow that framework that I told you inherited biological, psychological, environmental,
(50:03):
and acquired. So in inherited biological, it's how to have
the conversation with your family about how addiction has affected
our family and it helps you in making that addiction tree.
And that's not easy, right, Like a lot of families,
this is a taboo subject that nobody is going to
(50:23):
bring up, and so like, how do you have that
conversation with your family about what our risk is DNA
wise as a family. Inherited psychological is how do you
have one understand your own ass score?
Speaker 3 (50:37):
Adverse childhood experiences?
Speaker 1 (50:40):
How do you have that conversation with someone to support
you in thinking about all those harmful experiences that you
had as a child and how they are still affecting
you today. Inherited environmental is how do you have the
conversation around how the culture you grew up in and
(51:02):
the physical environment you grew up in is still affecting
your choices today, Yeah, affecting your life experience today and
then when you come into acquired biological, you had an
injury or developed an illness, or a doctor wrote a prescription,
how do you have a conversation with your doctor about
your risk for addiction and the risk of the prescription
(51:26):
they're writing you, and how you put a safety plan
around that prescription. Yeah, inherited psychological is about positive childhood
experiences which nobody ever talks about, but which totally negate.
Speaker 3 (51:41):
Adverse childhood experiences. And so it's like, how do you
have one?
Speaker 1 (51:45):
How do you have the conversation with yourself to understand
your own emotions, and then how do you talk about
those and have conversations with friends?
Speaker 3 (51:53):
And then.
Speaker 1 (51:55):
Also how do you talk about the discrimination you've experienced
and how that drives your risk? And then inherited environmentalist,
how do you have the conversation about what my physical
environment is today.
Speaker 3 (52:10):
And how and why I need to change that?
Speaker 1 (52:12):
And so it just go, oh, I'm sorry, I didn't
I think I didn't mention the script with your kids,
which you mentioned, which is every single age. Yeah, Like
I started talking to my kids when they were three,
and now they know how to talk about addiction with
their friends.
Speaker 2 (52:28):
Oh my gosh, like my kids totally know because my
son was eight when I quit, yeah, and my daughter
was two, And of course in the beginning I didn't
talk about a ton of stuff with them. I was
just like, yeah, I haven't had a I don't. My son,
of course, I had a bad day, he say, you know,
he was like, oh, Mom, want me to get you
(52:49):
a glass of wide. I was like, fuck, But they know, right,
that's mom. I mean, I can't tell you how many
women have said that. The kids go in and tell
me about your mom and like what's her favorite drink
and it's like gin and tonic, and they're right, but
you know, knew that. And then of course, because when
I had gone further, like my son and my husband
(53:12):
got me for my thousand days alcohol free. I still
have it in my office right behind me. They got
me a big glass jar and put one thousand like
little marbles in it, and it just made me so
happy and just frout and it was amazing. It makes
(53:34):
me a cake every year on my soberversary with like
I remember they did the number five with all strawberries
and blueberries, so they're pretty great. But like I've had
my daughter on my podcast when she was nine, talking
about like how we talk about alcohol, what she knows
about it, and you know, so I love that you
did that because so many women they're like, what do
(53:56):
I say in a way that's helpful and they understand,
but not like, oh my god, Bob, what's a you know,
drunk or whatever it is, because you know, it's not that.
It's mom decided not to drink, and that's super awesome.
Speaker 1 (54:11):
And that is super awesome, right, Yeah, And it's super awesome.
And you also can make the decision not to drink
if you choose to make that decision at some point. Yeah,
you have a role model that you've seen lives an
amazing life that way.
Speaker 2 (54:25):
Right.
Speaker 1 (54:26):
So people often talk about addiction as a family illness,
community illness, which is absolutely true.
Speaker 3 (54:33):
So is recovery. Like when you think.
Speaker 1 (54:35):
About those positive childhood experiences, and what we talk about
in the book is that all of these work as
adults also, so even if you didn't have them as
a child, you can put them in place as an adult.
Part of that is were you able to talk about
your emotions?
Speaker 3 (54:50):
Yep? Did you have community traditions, did you have somebody
you knew would stand up for you and so like
your husband and your son giving you a jar of
a thousand marble on the thousand to day. You already
know when you go to a restaurant and the service says,
can I get you a drink? And you're like, I
don't drink, and they're like what your husband and your
(55:10):
son are going to.
Speaker 2 (55:11):
Be like listen, yeah right, yeah, they're just like yeah, no.
And my husband still drinks, you know, and it's not
a thing. But he's super proud of me for not drinking.
And you know, in the beginning, he didn't want me
to stop drinking, right, He wanted me not to like
pass out on the couch. You know, it was like
(55:33):
part of our thing. But like that's the evolution that
you go through and you have a new normal. And
the new normal is great because mom never passes out
on the couch and Dad can't wake her up and
she's not hungover and pissed off and whatever it is.
Speaker 3 (55:49):
Right right, right, So.
Speaker 2 (55:51):
All right, I love this so much. You go through
like the coping mechanisms and mental health and policy and
personal like all the good stuff that you need to know.
I just have we not touched on any misconceptions or
myths that you've addressed in your book, Like I just
(56:14):
want to be like, we're not going to go through
them all. But here's the things you think you know
that are not true.
Speaker 3 (56:21):
The things you think you know that are not true.
Speaker 1 (56:24):
One, people don't get better because seventy five percent of
people recover. We said, we're gonna keep saying it. Two,
it's everybody else, it's all of us.
Speaker 2 (56:35):
Yeah.
Speaker 1 (56:35):
Three you have to be drunk in the gutter. Yeah,
or to be a problem, there is I would love
to talk about the cage question.
Speaker 3 (56:46):
Do that please? Second?
Speaker 2 (56:47):
Please please?
Speaker 1 (56:48):
So what I'm really, really, really advocating for is the
same way for breast cancer. We want everybody to do
their monthly breast exam because the earlier you catch a lump,
the better chance we have for sustained remission no relapse.
Speaker 3 (57:04):
The same is true.
Speaker 1 (57:05):
So I tell people, if you ask yourself, either about
yourself or about somebody you care about, should I be worried?
Speaker 3 (57:12):
The answer is yes.
Speaker 2 (57:14):
Yeah.
Speaker 1 (57:14):
It doesn't mean you have a diagnosis. I don't care
if you get a diagnosis or not. But if you
say should I, the answer is yes. And so here's
a scale that I can give you what's called the cage. See,
have you ever thought you should cut back? If yes,
give yourself one point. Hey, have you ever been annoyed
when somebody else mentioned you're drinking to you?
Speaker 3 (57:36):
Give yourself a point.
Speaker 1 (57:37):
Have you ever felt guilty because drinking prevented you from
doing something you plan to do? Or you said I'm
not going to drink today and you still drunk? Like
if you ever felt guilty over alcohol? And E is
for eyeopener, have you ever needed to drink first thing
in the morning or thought about drinking like it's the
(57:58):
first thing on your mind when you wake up. Those
four questions are called the cage. If you answer yes
to one of those questions, there is seventy seven percent
chance that you have an alcohol use disorder, whether that's mild, moderate,
or severe. Even the twenty three percent that don't have
an alcohol use disorder have an opportunity to not develop an.
Speaker 3 (58:23):
Alcohol use disorder. So ask yourself those questions.
Speaker 1 (58:29):
And this is the other myth that I want to bust,
is that it's dangerous to ask for support. It's not
dangerous to ask for support, it's dangerous not to ask
for support.
Speaker 3 (58:42):
There are so many ways, so if.
Speaker 1 (58:46):
You're thinking to yourself, I wonder give yourself the cage
or give you know, take the cage on behalf of
somebody you're concerned about, and ask for support. It is
the safest way.
Speaker 2 (58:59):
Don't ignore the lump, don't don't. And you know there
are different ways to get support, and we can talk
about all that, and I've talked about it in previous episodes,
but it doesn't mean you have to make a huge
declaration to anyone. There is support available that is, you know,
completely private, completely confidential, whatever it is. Yeah, I was
(59:24):
the first three out of those four. Yeah, and like
drink first thing in the morning, No, unless you go
out to brunch, right right. I love how we like
switch what we did.
Speaker 3 (59:35):
Yeah, exactly.
Speaker 2 (59:37):
I mean a mimosa bloody berry, Like that's just totally
run straight, right totally.
Speaker 1 (59:43):
I mean I was on the plane the other day,
because I think I'm on the plane every other day,
but I was on the plane the other day and
I was on a six am flight and we were
leaving on time, so it was five forty five am,
and the flight attendant came around and said, can I
get you anything to drink before we take off? And
this person said, I'll take a red wine at five
(01:00:05):
forty five am. And I don't jump in strangers businesses
that are seated across the aisle from me. But I
thought to myself, Man, I wish it was safe for
me to jump across the aisle and just say. I'm
just saying if you need any support here in some ways,
like if you're worried about yourself. Yeah, because at five
(01:00:26):
forty five am, that's an eye opener.
Speaker 2 (01:00:29):
Yeah, yeah, totally. And I always say to people because
they're like, oh my god, all my friends drink, but
like nobody else is worried about it, blah blah blah.
And I was like, dude, anyone who is drinking with
you the way you're drinking, they wake up at three
am worried about their alcohol consumption. There is zero chance,
Like it just doesn't happen. You guys are just not
(01:00:51):
talking about it.
Speaker 3 (01:00:52):
Yeah, we got to make it safe to have the conversation.
Speaker 2 (01:00:55):
Yeah, yeah, Okay. One thing we talked about before we
jumped on here, and I know I gotta let you go,
is we both said that we don't love the term alcoholic.
Can you tell me why?
Speaker 3 (01:01:08):
Yeah? I hate the term it for anything.
Speaker 1 (01:01:12):
So I hate diabetic, I hate schizophrenic, I hate alcoholic,
I hate asthmatic. And the reason is because that is
not who you are. You are not an alcoholic. You
may be a person that struggles with alcohol use, you
may be a person that has a diagnosis of alcohol
use disorder, you may be a person that just doesn't
(01:01:33):
want to drink. But the struggle you have with alcohol
will never ever be the most important thing about you.
It will never ever be the thing that defines you.
It's one thing that you're going through. And so I
just always start with the person first to remind us
that first and foremost, you are a person. And then
(01:01:57):
second we can use you know, words to say what
your current life experience is. But don't take on that definition.
Yeah yeah, and don't force that definition on somebody.
Speaker 2 (01:02:13):
Else, on anybody else. Like people use it so casually
be like hey, oh my god, her dad was such
an alcoholic and I'm like, it also pisses me up. Well,
mostly unless they are in a twelve step program and
they self identifying that as fantastic whatever helps, But like,
(01:02:33):
especially for people who have never struggled with addiction, when
they are casually labeling somebody else and I'm just like, wtf,
liketfu how about that? Yes, yes, yes, I believe. I
have like occasionally said that in a much chicer way,
(01:02:53):
be like, dude, uncool, uncool, and you don't know what
the fuck you're talking.
Speaker 3 (01:03:00):
Yeah, so uncool.
Speaker 2 (01:03:02):
So yeah, okay, one more, last one. It's like rapid fire.
When the hell are the medical directives information going to change?
I mean, I know there's huge lobbying stuff, but like
the American Cancer Society finally said what three four years
ago that no amount of alcohol is zero risk factor
(01:03:24):
for cancer, which they had known for fucking ever. But
like Ireland is putting labels on every single wine bottle
and beer bottle saying like alcohol causes liver, you know,
severe liver disease. Alcohol causes cancer, same way as tobacco.
US I'm not hearing shit.
Speaker 3 (01:03:46):
Yeah, it's two things.
Speaker 1 (01:03:47):
So one, I forget what the statistic is, but something
like it takes twenty two years for medical practice to change,
which is crazy.
Speaker 3 (01:03:57):
So we're in the midst of it, but it's very
slow too.
Speaker 1 (01:04:01):
Money talks, and the alcohol lobby is so rich and
it is so ingrained in our culture, which I talk
about in the book, and that's the reason why it's
so slow. But listen, young people are the future. Young
people are like totally our hope because they're like, it's
cool to not drink, yeah, and drinking, you know, and
(01:04:23):
so it will come, but it is going to be
so slow. So that's why we can't depend on the
external forces. We have to start with these conversations, just
like this and this book and just let it broadcast
into people's individual minds.
Speaker 3 (01:04:37):
Yeah, it is so slow.
Speaker 2 (01:04:39):
All right. I love talking to you. I love your book.
It's called an addiction. You guys should totally pick it up.
Your podcast is called an addiction. And tell us where
else people should look for you find you anything?
Speaker 1 (01:04:53):
Yeah, so you can find me on Instagram, Facebook formerly
known as Twitter, now called x Threads and LinkedIn at
in Zinga MD or in Zinga Harrison, MD. I co
founded this company, Eleanor Health, which I'm so proud of,
So please check out eleanorhealth dot com. And then the
book is in print, audio and digital everywhere in stores online.
Speaker 2 (01:05:16):
Do you do you read the audio?
Speaker 3 (01:05:18):
I read the audio.
Speaker 2 (01:05:19):
I love it. When the author I had an audition,
I had an audition to.
Speaker 3 (01:05:26):
You're good, but.
Speaker 2 (01:05:27):
I liked You're like other fucking podcast or I could
do this.
Speaker 3 (01:05:32):
And it was so it was awesome. I had.
Speaker 1 (01:05:34):
I had so much fun narrating the book. But yeah,
So if you want to hear more of this voice,
get the audible perfect.
Speaker 2 (01:05:41):
Thank you so much.
Speaker 3 (01:05:42):
Thank you Kasey, Thank you so much for tuning in.
Speaker 1 (01:05:45):
And if you liked this episode, please check out my
book on Addiction, Six mind Changing Conversations that Could Save
a Life, available at Barnes and Noble, Bookshop, dot org,
Union Squaring Company, Amazon, and wherever books are sold.
Speaker 3 (01:06:02):
We want to hear from you.
Speaker 1 (01:06:03):
If you identify as black or brown and have a
recovery story to share, something you've learned, a stigma that
you've undone, or a conversation that you've had about addiction.
Send us a voicemail at speakpipe dot com, slash you
apod that's speak pipe dot com, slash u a pod
What does recovery look like when it's not designed for you?
I'm doctor and Zanga Harrison, and in season four of
Unaddictioned podcast, we're featuring black and brown guests sharing their
journeys through the unique barriers to recovery shaped by their identities.
These guests have not only defined recovery on their terms,
(00:22):
but they're also creating pathways and communities that can help
you or a loved one find recovery too. This week,
we're airing an interview between myself and Casey Maguire Davidson,
host of Hello Someday, a podcast for sober curious women.
I break down the learned and inherited risk factors that
(00:42):
can lead to addiction, scripts for talking about substance use,
and important definitions that impact the stigma that people with
substance use disorders face. I hope you enjoy this conversation
and if you're a sober curious woman, definitely go check
out Casey's podcast.
Speaker 2 (01:00):
I also previously talked to in Zinga in episode one
hundred and thirty three. It was an amazing conversation about
how what you need to know about the risk factors
for alcohol use disorder and We're going to take that
conversation further today and so much more. If you're listening
to this podcast, I know you love podcast. So In
(01:22):
Zinga also has a podcast called an Addiction that I
will ask her all about. But in the meantime, welcome.
I'm so glad you're here again.
Speaker 3 (01:31):
Thank you so much.
Speaker 1 (01:32):
And I can't believe that was episode one hundred and
thirty three, Like, how many since then?
Speaker 3 (01:37):
Right?
Speaker 2 (01:38):
Oh my god, I am around two hundred and you
know by the it'll be around two hundred and thirty
three by the time it goes live.
Speaker 3 (01:46):
So incredible.
Speaker 2 (01:47):
I know, it's been crazy. It's been over four years now.
Speaker 3 (01:51):
Wow, I love it so much. That's so cool.
Speaker 2 (01:54):
Yeah, I do too, It's like my favorite part of
the job. Well, so, I this book. I was telling you,
I've been reading through it and I've got all the
notes on it and just to start, tell me about
why you wrote this book.
Speaker 1 (02:10):
Yeah, so you mentioned that I've been practicing medicine for
twenty years and I have always been an addiction psychiatrist.
Speaker 3 (02:17):
Like my passion is people who.
Speaker 1 (02:21):
Are drinking or using other drugs or substances in a
way that they're questioning is this how I want to
be using this or do I think this is helping
me the way it used to type of thing and
really kind of like being a supportive, empowering doc to
help people define what they want out of their lives
(02:41):
and you know, mark out a pathway for how to
get there. And so I had a previous podcast, thank
You for Mentioning un Addictioned, which is the current podcast.
Speaker 3 (02:51):
It was called in Recovery with Doctor.
Speaker 1 (02:53):
Harrison and Jen Keene was a listener and she reached
out through my website and was like, I'm sure you
already have a book agent, but if not, can we chat?
And I was like, oh, why would you be sure
I have a book agent because I'm never, ever, ever,
ever going to write a book.
Speaker 3 (03:09):
And then it's clear who won who won that argument?
Speaker 1 (03:12):
Right two years later, Jen was like, you're obviously passionate
about people with addiction or people who wonder if they
have it or don't. You know, we don't have to
use the word addiction, just like want a different way.
And she was like, this will get your message out,
and that's all she had to say and the rest
(03:33):
is history.
Speaker 2 (03:34):
Oh that's fantastic. So getting the message out That's something
that I'm really passionate about too, and I love talking
to people like you who are experts about it. So
much to go through in this book, But one of
the first things that I think will surprise people listening
to this podcast but everyone else as well as you
(03:55):
talk about the seventy five percent success rate in the
context of the impact of long term treatment options for addiction,
Can you tell me about that.
Speaker 1 (04:07):
Yeah, So I'll start with the name of the book
is a word that we made up on addiction, and
kind of how we came up with it was like, Okay,
what are the things we need.
Speaker 3 (04:18):
To unlearn that we think we know about addiction?
Speaker 1 (04:22):
That is like actually one wrong to not helpful? Two,
what are the things what are the stigma that we
need to undo that's like keeping people from getting support
or keeping people from getting better. And then number three,
what are the conversations we need to uncover? And that's
like the tagline for the book, six mind changing conversations
(04:44):
that could save a life. And so the first thing
we have to unlearn is that people don't recover. Yes, right,
Seventy five percent of people who have struggled with a
substance in whatever way consider themselves recovered or in recovery.
Speaker 3 (05:05):
That is three out of four.
Speaker 1 (05:07):
Yeah, that is more than one out of four, and
one out of four is very important because you know,
one out of four is still too high. And if
we can unlearn other things that we need to unlearn
and undo stigma and talk about it, we could get
that one to four even lower. But the medical literature
tells us for any condition that we're dealing with, when
(05:29):
you believe there is a chance for you to recover,
there is a better chance for you to recover. And
so we can't only talk about devastation and people who
are dying and the people that don't recover, we have
to talk about them, but we cannot only talk about them.
Can we start from a place of hope and possibility? Yeah,
(05:53):
then figure out how we get there for some balloons
for more people.
Speaker 2 (05:58):
Yeah. I love that so much because because a couple
thoughts I had when you were talking about this. I
remember being back in my office in my corporate job,
and one of my friends, who by the way, I
loved wine as much as I did. You know, whatever
it was, was like hungover on Monday after some Bunco
(06:19):
game with her girlfriends was talking to me about the
fact I don't drink, and it kind of cracked me up.
She was like, yeah, but you decided to stop. You
didn't have a problem with alcohol. Actually, I think she
put it in the present tense. She was like, you
don't have a problem with alcohol. And that cracked me
(06:39):
up in a few ways. One because why was it
so important to her to make sure I was in
ex category versus why category? And be what I said
to her, I was like, well, yes, I chose to stop,
but alcohol is addictive, and you know it is designed
to take you down the path and becoming more on it.
(07:01):
But be in my mind, I'm eight and a half
year sober now, I was like four years sober at
the time. I was like, I haven't had a drink
it four years. I am zero problem with alcohol. And
Craig Ferguson at one point said like, I didn't get
one really quick, right. But what I loved about that
is in my mind, I'm like, you were hungover on Lunday.
(07:22):
I haven't had a thing to drink in X number
of years. Like it cracks me up that you're like, oh,
but you don't have a prom Like as if if
I had, it would be a lifelong thing. Anyway. I
just I thought that was interesting because now I haven't
had a drink at eight and a half years, and
I don't consider myself to be struggling with alcohol at all.
(07:46):
I just don't touch that.
Speaker 1 (07:47):
That's right, No, you know, I think it's it's this
this human phenomenon of needing to protect ourselves from the scary.
So you are colleagues working in the same job, coming
in on Monday morning, kind of with a life that
is similar in that way, and so it's probably very
(08:08):
scary for her to see you as a person who
had a problem with alcohol, because maybe that means I
could also have a problem with alcohol. And this is
getting to like undoing the stigma. Yeah, I think the
concept that we have of people that quote have a
(08:30):
problem with alcohol is homeless, drinking out of a paper bag,
has lost everything, is begging for money on the street.
And if you think about the whole spectrum of what
quote a problem with alcohol means, it goes all the
(08:50):
way from when I have a glass of wine, I
wake up with a migraine, but I keep having a
glass of wine all the way to that very severe
that I just described, but we've made it so scary
and so dangerous to say out loud, like I don't
think alcohol is doing for me what I wanted to
(09:12):
be doing. So I'm gonna stop, Like, can we just
make that easy? Yeah, I don't drink alcohol, that's awesome,
what's next? Yeah, but it's like, oh, you don't drink alcohol.
Speaker 2 (09:22):
Yes, there must be summer And I want to be
like back in the day when I was fully immersed
in like wine culture and very you know, all of
my friends drank and everything else. I seriously believed that
the only people who didn't drink were like pregnant, yeah,
(09:43):
had an issue with addiction, aka like they can't drink
or were super bored. And now it cracks up because like,
I know so many people who don't drink who are incredible.
But it is interesting to me. The other thing I
loved that you wrote and I wanted to ask you
about is so we have this seventy five percent success
(10:07):
rate in terms of the context of long term treatment
for addiction and recovery, and I want to dive into
like all every single word and piece it apart. But
those are people who have sought treatment and help and
support for addiction. Now, there are so many people in
(10:28):
this world, including women who contact me every day and
they're already on the path to getting support and resources,
but who really struggle with this every day and don't
seek support, probably because they see it as this futile
I'll never stop anyway, what's the point? My life will
(10:49):
be over, it won't work. But also it is positioned
as this life sentence of deprivation and isolation, and you
know their ness from everyone they know. So I wish
that more people who struggled with addiction, drinking, whatever it
(11:09):
is would seek treatment. Because of seventy five percent recover,
that's pretty fucking awesome, right, I mean, you don't have
to feel that way anymore.
Speaker 1 (11:18):
So true, so true, And these are the conversations that
we have on the Unaddictioned podcast, Like what was the
scariest thing for you about thinking about stopping or changing?
Speaker 2 (11:31):
Right?
Speaker 1 (11:31):
Because I think that's also important is that the definition
of recovery is not abstinence for everyone. For some people
the definition is for apps is abstinence. For other people
the definition is different.
Speaker 3 (11:43):
But like, what was what was the scariest thing?
Speaker 1 (11:45):
And what I hear over and over is like, I
had no idea how was going to have fun if
I stopped using Excellent. I had no idea how was
gonna socialize at work when that happens at happy hour
in a bar, No idea how it was going to
go on a girl's trip with my friends and not drink, right, Like,
(12:07):
it is those things that are very, very very important
to us, and culturally, at least here in the US,
definitely other countries as well. We see alcohol as a connector,
and other drugs also act as a connector for people.
And so yes, I wish more people. I wish it
was safer for me, more people to even say, I'm
(12:29):
not even sure this is a problem, but I think
it might be early intervention, early right, And you don't
necessarily have to like sign up for the life sentence
of committing to never drink another drop ever again. You
might get to the point where you're like, you know what,
I don't need to drink another drop ever again. But like,
let's just start with making it safe for people to wonder,
(12:54):
like be curious, I wonder if I made a change
what I feel differently in XX way that I want
to feel differently, and then just try it. Just try it,
and that doesn't have to be treatment for everybody. Sometimes,
I mean I talk about connection more than I talk
about treatment, and so I think about this the same
way I think about diabetes. The doctor tells you, like
(13:18):
h you know, diabetes runs in your family. Your blood
sugar is a little higher than I want it to be,
even though you don't have diabetes yet.
Speaker 3 (13:25):
Maybe go join the gym.
Speaker 1 (13:27):
The gem is not treatment, but it's a source of
connection and changing a choice that can help prevent an
illness from developing. Right. You know, alcohol use disorder runs
in your family. And I know you're only drinking two
glasses of wine a night, but you're telling me your
(13:47):
mood feels a little crunchy. Why don't we just try
a month with no alcohol and see if your mood
feels less crunchy.
Speaker 3 (13:54):
I wish we could just get.
Speaker 1 (13:56):
To investing in people's curiosity. Yeah, and just trying different things.
That doesn't equal. You have to go see doctor Harrison.
She's an addiction specialist and she's going to make you
vow to never do X ever again in your life, which.
Speaker 2 (14:11):
We're like, diagnose yourself with something, nurse you do.
Speaker 3 (14:14):
You have to get diagnosed. You don't have to get diagnosed.
You don't need a label.
Speaker 1 (14:19):
All you need to know is you're like, I wonder
if you wonder, we have an opportunity.
Speaker 2 (14:25):
Yeah, I love that, And that's the reason that this
podcast is called, you know, the Hello Sunday Podcast for
Sober Curious Women because I love the whole sober curious movement.
I mean, and it's everywhere right like New York Times,
Good Morning America. Everybody's talking about it. Yeah, But also
the idea is that to make it more approachable, but
(14:49):
also like try try to see like longer period of
time alcohol free. I recommend one hundred days, That's what
I started with, and then like see because that way
you'll see that you can socialize and you can go
on vacation and you can watch TV, and after a
hard day of work you can try a different coping
(15:09):
mechanism and like at the end of that time, you
feel better. One you know, I have a group of
women who are all, you know, in the process of
going out call free and just the fact that you know,
one of them said, oh my god, I woke up
with like a cold, the flu of migraine. I didn't sleep,
I can't believe I used to feel this way every day.
(15:31):
I can't believe how shitty I felt, and like I'm
having one day of it and I'm just like, now
I know what healthy feels like.
Speaker 1 (15:40):
Yeah, I love that so so so much. And this
is like you said, you recommend one hundred days, which
I love one hundred days because I didn't think I'd
be able to go on the girls trip or live
and all this kind of stuff. The book is called
six Mind Changing Conversations, and there are actually scripts in
the book like how to have this conversation, And one
(16:02):
of them is like, Okay, we're going on a girl's
trip and either I'm choosing not to drink or I
have a friend who's drinking. I'm worried about. How do
we talk about it before we go? Like, what is
your plan for when you find yourself in a situation
you're in a hundred days not drinking, what's your plan
for when you go out to dinner? Yeah, and the
(16:26):
server has great intentions and has been instructed by their
boss to offer everyone a drink.
Speaker 3 (16:31):
And you're gonna say, that's.
Speaker 2 (16:32):
Where they make their profit margin, right, That's where they
make their profit.
Speaker 1 (16:35):
Margin, Right, I was at a business dinner and it
started out with drinks, and so the server came around
and was taking everybody's drink and everybody was ordering an
alcohol drink. And that was back when I was still drinking.
But me and my husband decided to stop drinking. It's
been like a year now.
Speaker 2 (16:52):
Oh my god. The last time we talked, you were like,
I don't drink a lot, but I do barely.
Speaker 1 (16:57):
I barely drink. And then I was like, why am
I been spending money?
Speaker 2 (17:01):
But that's amazing.
Speaker 1 (17:03):
Yeah, So he was actually the one. He was like,
I'm gonna stop drinking. I was like, okay, I'll stop drinking.
So we haven't drunk for like a year. We're like
totally into non alcoholic cocktails. That's oh my god, me too,
Oh my god.
Speaker 2 (17:15):
I love non alcoholic beer. That's my jam.
Speaker 1 (17:17):
Ooh, I hate beer, so I love non alcoholic beer
for other people. But for like the book launch, we
did a total non alcoholic spread. So we had non
alcoholic Heineken, non alcoholic Corona, non alcoholic sparkling wine, which,
like sparkling wine was my jam.
Speaker 3 (17:33):
So now non alcoholic sparkling wine is my jam. I
love it.
Speaker 1 (17:36):
And cocktails. Anyway, before that, I was at this business dinner.
Everybody's ordering a drink, so I was gonna get a prosecco.
Speaker 3 (17:44):
That's what I used to drink.
Speaker 1 (17:46):
But the person before me, so it's like twelve of
us we're on like person number seven, I'm like number
eight six people order alcohol drink. Person number seven says,
do you have anything non alcoholics?
Speaker 2 (18:01):
Like damn, and the.
Speaker 1 (18:04):
Bar happened to have non alcoholic cocktail and they're like, yeah,
we can do a blah blah blah.
Speaker 3 (18:09):
And he was like I'll take that.
Speaker 1 (18:10):
And I was like, I was planning on ordering a prosecco,
but I'm gonna go for the non alcoholic drink he disordered,
And do you know, of the next five people, three
people chose to do a non alcoholic drink and two
other people changed their order they did from alcoholic to
non alcoholic. Like he just unwillingly made it okay.
Speaker 2 (18:35):
When we were all like whispering about, like bring me this,
so people think I'm still drinking or.
Speaker 3 (18:41):
None of that, just as like do you have anything
not alcoholic?
Speaker 1 (18:44):
And I was like, oh, I'm just seeing you role
model how I plan to be going forward it was incredible.
So back to Sober Curious as like you Hello Someday podcast,
all of the people in New York Times, all of
the people on the web that are like, yeah, I.
Speaker 3 (19:02):
Just decided to stop drinking.
Speaker 1 (19:04):
You're making it safe for somebody else to say, I'm
gonna try it, like I love it so much.
Speaker 2 (19:09):
I mean, I love it too, And it's become such
a thing with like dry January, dry July like this,
the younger generation not drinking as much. Like there's a
zero proof cocktail menu or a non acolic beer that's
actually good, that's not crap right on almost every single menu.
And I mean when I quit drinking eight years ago,
(19:32):
I actually tried for the first time eleven years ago.
That was not a thing.
Speaker 3 (19:36):
Yeah, it was not a thing. It was not a thing.
And it's so good.
Speaker 2 (19:40):
I mean.
Speaker 1 (19:42):
I talk about the cultural pressures, yes, right, I love
the face, and this is one of them. I mean,
we basically you and I are the same age. We
were just talking about that.
Speaker 3 (19:58):
We're the same age.
Speaker 1 (19:59):
And when we we grew up, I think we pretty
much started getting programmed with just wait until you can
get smashed when you turn, when you get to high school,
in elementary school, we're seeing that on TV, right, And
so you just grow up with this concept that there
is no life without alcohol, and there's amazing life yeah,
without alcohol. And for some people there's amazing life with
(20:23):
alcohol before a lot of people there's not amazing life
with alcohol.
Speaker 3 (20:28):
So how do we create space?
Speaker 2 (20:30):
Yeah? And the way it works too, from my experiences,
it starts very innocuous, and it starts because of your culture.
And you know, although the first time I got drunk,
I like blacked out in this stuff, but that I
was doing that on purpose for summer. I mean, I
didn't want to blackout, but I wanted to get super
(20:51):
drunk because you know, opportunity. But you know, when I
was growing up, it was like there was a bottle
of wine on the dinner table night because that's what
adult strength. My grandparents had like happy hour before dinner.
And we're going to talk about all the risk factors.
Nobody in my immediate family meaning like parents, grandparents, sibling, whatever,
(21:14):
struggles with alcohol. I definitely did, but you know, the
underlying stuff of like anxiety or you know, you various
things were going to talk about. But also when I
went to college, I joined the women's rugby team, and
I had a very big keg college culture. And the
(21:35):
rugby team was like a four year crash course on
problematic binge drinking and blacking out and throwing up and
like that was like I was like, oh, this is
what we do, right, that's where you talk about culture
to everyone. I knew bene strength, you know, all the
(21:57):
time it was like the purpose of drinking was to
get so drunk that anything could happen. And you know it,
it does skew the way your brain works. You know
it does.
Speaker 3 (22:09):
It does.
Speaker 1 (22:09):
And you mentioned nobody else in your family has struggled
with alcohol. I imagine someone else in your family has
struggled with anxiety or digression, or cigarettes or other thoughts
or suicidal thoughts, or food addiction or work addiction. Right, Like,
(22:30):
all of these are running through the same pathways in
our brains. And so that you experienced anxiety yourself made
you particularly vulnerable to that keg culture in college.
Speaker 2 (22:44):
Right. Okay, I want to dive into the conversations and
the factors. But the one thing I also wanted to
ask when we talk about that seventy five percent recovery rate,
is everyone talks about relapse, and I absolutely love that
you talk about that. Relapse is not a part of
the IT film. God throw it in of people with
(23:08):
substance use disorder recover and return to use in the
first couple months, in the first year, where's the tipping point?
Can you like teach us all of that stuff?
Speaker 3 (23:20):
Totally?
Speaker 1 (23:21):
So I'm going to go a little medical here, and
what i want people to know about the book is, yes,
I'm a doctor.
Speaker 3 (23:27):
This is not a textbook.
Speaker 1 (23:28):
I wrote this book lack a conversation, or at least
that was my goal, right, But I'm gonna get a
little textbooky doctor it here for.
Speaker 3 (23:38):
Just a minute.
Speaker 2 (23:39):
Facts, right, that's what you talk about on versus Reality totally.
Speaker 1 (23:44):
And so in medicine, when we talk about chronic conditions,
we talk about relapse and remission. When you get diagnosed,
that is because you meet diagnostic criteria for fill in
the blank, diabetes, high blood pressure, alcohol use disorder, if
we're talking about alcohol addiction. When you go into remission,
(24:07):
that means your symptoms have come down below the threshold
that meets diagnostic criteria for active illness. When you have
a relapse, that means symptoms of the illness have come
back above that threshold. We talk about, like that person relapsed.
People do not relapse illnesses relapse. We talk about, you
(24:31):
had one drink, that's a relapse. One drink does not
meet diagnostic criteria. That is not a relapse, right, And
so what is so critically important when people say relapse
is part of the disease.
Speaker 3 (24:46):
I hate it. Throw it in the trash.
Speaker 2 (24:51):
Because that like plants that seat when you talk about
planting the.
Speaker 3 (24:54):
Seed, like there's no other totally.
Speaker 2 (24:57):
And you're just like, like it's inevitable.
Speaker 3 (25:00):
Yeah, like it's inevitable.
Speaker 1 (25:02):
That would be like if I diagnosed you with breast
cancer and I said, I'm diagnosing you with breast cancer.
We're gonna do everything we can do to get you
in remission, seventy five percent chance that you're gonna recover.
But relapses part of the disease. I just told you, Like,
no matter what you do, cancer is coming back. That
is awful and it's not even true, right, And it's
(25:24):
not even true. Okay, So what we have to say
instead is, you know what, I'm really concerned about your
alcohol use. It meets diagnostic criteria for alcohol use disorder
mild moderate or severe. Right, you have seventy five percent
chance of recovery from this illness, and based on my
medical knowledge, these are the things we can do to
(25:46):
give you the best chance to be in that seventy
five percent. Now, there is a chance of relapse with
this illness, and what relapse means is these are the
diagnostic criteria and the risk factors that drive your risk
for relapse are xxxx and X.
Speaker 3 (26:05):
So we're going to make a plan for XXX and
X so that hopefully relapse does not become part of
your illness process. Yeah, that's the way to have the conversation.
Speaker 2 (26:16):
Yeah, absolutely, And so let's first talk about what are
the things that will say you've stopped drinking, say that
previously you met the diagnostic criteria, or you didn't, or
you did. Curious like fuck, that's right, but like you've
stopped drinking, your intention is to not go back to
(26:39):
it because you feel like shit and it you pick
up all your thoughts and whatever it is. What are
the things that you would do to make sure that
you're in that seventy five percent.
Speaker 3 (26:50):
The first thing is understanding your risk, right, and so
this book is divided into six chapters, and each one
of the chapters is dedicated to a certain type of risk.
So you can think of this framework in the first
bucket for any chronic condition. There are biological reasons why
(27:11):
you develop it. There are.
Speaker 1 (27:15):
Ecological reasons why you develop it. There are environmental reasons,
and the environment splits into two. That's the cultural environment
as well as the physical environment.
Speaker 3 (27:24):
You're born into a biological set of risk factors. That's
your DNA.
Speaker 1 (27:28):
Right, So people don't know forty to sixty percent of
your risk of developing addiction is coded in your DNA
the day you're born.
Speaker 2 (27:34):
Is that because of family history or because people in
your family have also had those biological things? Like it's
is it passed down or you happy to have smilary?
Speaker 1 (27:48):
Okay, It is DNA that has passed down to you,
just like DNA for a high blood pressures passed down
to you.
Speaker 3 (27:55):
DNA for cholesterol has passed down to you.
Speaker 2 (27:57):
Okay, So got it.
Speaker 1 (28:00):
Of your risk for developing an addiction coded in your DNA,
higher than diabetes, higher than an asthma, higher than high
blood pressure. Okay, born with it. But that means sixty
to forty percent because we add up to one hundred
is psychological and environmental. You are also born into early
childhood experiences psychological risk factors. You are also born into
(28:24):
a cultural and physical environment. So I call that inherited
biological risk factors. That's your DNA, inherited psychological risk factors,
that's your childhood inherited environmental risk factors. That's the culture
and physical environment you grow up in. That's one, two, three,
Repeat those three again as you become an adolescent, young adult,
(28:46):
older adult, whatever's in the middle, just adult.
Speaker 3 (28:49):
I think me and you right now are just adults.
Speaker 1 (28:51):
Right when you grow into that, you start to acquire things,
things start to happen to you in life that can
also be risk factor. So Biologically, maybe you get a
car accident and break a bunch of bones, that's a
biological risk factor. Maybe a doctor writes you a prescription
for opioids, that's a biological Respector for people who are
(29:11):
alcohol sober curious, maybe a doctor writes you a prescription
for xanax. Yeah, and xanax is alcohol and pill form
works on the exact same receptor in the brain. Right,
that's a biological risk factor. Psychologically, you develop the.
Speaker 3 (29:25):
Stress of.
Speaker 1 (29:28):
Racism, the stress of discrimination, the stress of gender discrimination,
the stress of being the only woman in the workplace,
the stress of being the only mom who's not a
stay at home mom, or the only mom who is
a stay at home mom in your needs kids or
high kids are divorced, right whatever, use of relationships, all
(29:49):
of those things. Environmentally, cultural environment. You go to a
school and join the rugby team, and it's the keg
culture physical environment. You live in a place where all
your kneedes are not being met, right, and so that biological, psychological,
environmental repeats. Again, these are the six buckets. So your
question was, how do you know what to look for?
(30:09):
First is knowing what you have in each bucket. So inherited, biological,
do your addiction family tree have the conversations. There's a
script in the book to help you have the conversation.
Inherited psychological, you're aces adverse childhood experiences, know what they are,
(30:30):
put a plan in place to start dealing with the
impact they are still having on you.
Speaker 3 (30:37):
Environment.
Speaker 2 (30:37):
Can you give it just a couple example of aces
in case someone doesn't know what those are totally?
Speaker 1 (30:43):
And also you can google aces adverse childhood experiences and
you'll find it. I do not recommend that you just
google it and take it without having a support system
in place for yourself. And the book goes through this,
but ACES are for example, did you experience emotional abuse
as a child, did you experience physical abuse as a child.
(31:04):
Did you have a parent who had a mental health
condition or addiction? Did you have a parent who left
the house because of divorce. Did you have a parent
who was incarcerated?
Speaker 2 (31:17):
Right?
Speaker 1 (31:17):
And so there are ten there are ten questions and
if you get a one for every yes question, and
if you have a score four, higher your risk for
developing all sorts of chronic conditions adulthood, including addiction, premature birth, obesity,
cigarette smoking, premature I mean, asthma, HIV cancer, like literally
(31:41):
all kinds of things are associated with this.
Speaker 3 (31:44):
My ACES score is five.
Speaker 1 (31:48):
My inherited biological risk is probably closer to that sixty
percent because I have addiction both on my mom's side
and on my dad's side to different substances.
Speaker 3 (31:56):
Right.
Speaker 1 (31:57):
That allows me to understand my risk, but also allows
me to start having a conversation with my kids about
their risk. And then same thing biological, psychological, environmental when
you grow up.
Speaker 3 (32:10):
So, Casey, what is your biological risk.
Speaker 1 (32:15):
If you've decided you don't want to drink again, then
I need to look at how much biological risk we
have because that means I have to do even more
with your environment to try to undermine that risk. What's
your ASIS score? We need to address all those experiences
that you have. What environment are you currently in? What
(32:35):
are the people places, emotions, physical sensations.
Speaker 3 (32:42):
How are you going to talk to your friends? What
are you going to say at work when your boss
says come to happy hour?
Speaker 2 (32:47):
Right?
Speaker 1 (32:47):
Like we have to make a plan for all those
risk factors to increase the chance that you're in the
seventy five percent.
Speaker 2 (32:55):
Yeah.
Speaker 3 (32:55):
Yeah, that was the longest answer, and I love it.
Speaker 2 (32:59):
It's so important. And that, like that last piece, other
than the hope and the curiosity, is a lot of
the work that I do is Okay, you want to
stop drinking, but you keep going back to it, Like
what is your home environment? Like what conversations have you had?
How can you have them without it being scary or
(33:20):
getting pushed back? Like how do you go to dinner
with your spouse? What do you say it happier? How
do you go on a business trip? All of those
things because for me, it was one the fear that
life would suck and everything that goes. How will I relax?
How will I have fun? But it's my favorite thing
in the world, but it's my only reward, YadA, YadA, YadA.
(33:43):
But then how literally, how do I go on a
double date with another couple to celebrate something and tell
them I'm not drinking or not dive over the table
and like grab the un right, yeah, And like just
that block and tackling in a really practical way is
(34:06):
like another step that is you have to do.
Speaker 3 (34:11):
You know, I have to do it.
Speaker 1 (34:12):
And we literally go through scenarios in the book for
how to do this, And what I say is, do
you know why a race car driver can take that
curve at two hundred miles per hour?
Speaker 3 (34:27):
It's because they've practiced. Yeah, you know.
Speaker 1 (34:29):
Why they can safely get out of a crash, It's
because they've been in a simulator. Why Captain Sully could
land that plane on the Hudson River is because he
had practiced, right. And so you don't want to be
in a situation and have to figure it out. You
conjure up those situations in your brain in advance, and
(34:50):
you practice, Okay, this is what I'm gonna do. If,
this is what I'm gonna do if, and then you
also practice if I find myself in a situation that
I haven't practiced, this is my go to, Yeah, that
I'm gonna do. And the more you do those reps,
it gets easier and easier and easier to say I'm
not drinking and people are like what, and you're like, oh,
(35:11):
you think that's weird. I'm getting the best sleep I
was ever getting when I was drinking.
Speaker 2 (35:15):
Yes, yeah, I love that.
Speaker 1 (35:18):
You already have your one liner queued up right, Oh yeah.
Speaker 2 (35:22):
And you know what you're going to order, and you've
told someone in advance you're not drinking when you ask
someone with you for support, and that's a right, all
all the things, all the thing. So you talk about
the seventy five percent success rate, which, by the way,
I'm just going to keep saying so people.
Speaker 3 (35:38):
Over and over over, thirty more times before we finish.
Speaker 2 (35:42):
Yes, but you talk about it in the context of
the impact of long term treatment for addiction, and obviously
that doesn't only mean inpatient rehab. That's right, So tell
me what the different factors are in terms of what
you think of when you think of long term treatment
for it, because for some people that's scary, right, Like,
(36:05):
I'm going to attend twelve step meetings for the rest
of my life and talk about what a horrible person
I am, but also surround myself with people who are
not drinking and label myself. So what are the sort
of tears or options or any of that.
Speaker 3 (36:19):
Yeah, So I want to think broader. I want the
word treatment to people to mean like your broader action plan.
And so I'm going to talk about diabetes because I
always do, because I think it's easy for people to
grasp and by the way, the stigma about that, and
there's no stigma. That's exactly what I talk about it.
Speaker 2 (36:40):
It's like nobody's like, oh my god, yeah right, it's
just a condition you treat. It's like like I take
medication for anxiety and I also try to work out,
and I also.
Speaker 3 (36:53):
Totally all the things right, totally right.
Speaker 1 (36:56):
And so what if we thought the treatment for diabet
for a person that had diabetes so severe their blood
sugar got so high they went into a coma and
they had to go on the ICU. They went in
the ICU for five days and we were like, all right,
that's it. That's kind of like the concept of detox, Like,
that's it.
Speaker 3 (37:15):
No, if we just.
Speaker 1 (37:16):
Get them out of the coma and send them right
back out to the exact same set of circumstances with
no medication, no support, no understanding of the illness, they're
gonna be back in a coma.
Speaker 3 (37:27):
Right.
Speaker 1 (37:28):
What if we said, Okay, we got you out of
the coma, we took you out of ICU, we put
you on the impatient floor for a week, got your
blood sugar totally normal, then we discharged you. Good luck
living with diabetes. Nothing else, Right, diabetes is coming back.
What if we said, for.
Speaker 3 (37:45):
The rest of your life, every single day you have
to come to the doctor and get an insolent shot.
That would be like diabetes.
Speaker 1 (37:56):
Is coming back, because nobody can come back to the
doctor every single day.
Speaker 3 (38:00):
Yeah, that's not how we think about it.
Speaker 1 (38:01):
We think about it like, you go in, you get stabilized,
you come out, You get connected to some doctor that
you can meet with in the beginning frequently until you
figure out.
Speaker 3 (38:12):
What's going on. And then as you stabilize and figure it.
Speaker 1 (38:16):
Out, you know what your warning signs are for when
you need to get back. That's the way I want
people to think about this, So sober curious, try it.
Speaker 3 (38:26):
Stop drinking. Whoa felt the best you ever felt in
your life? Make the des decision.
Speaker 1 (38:34):
I'm not going to go back to drinking, either at
all or definitely not to the level where I was
drinking before.
Speaker 3 (38:40):
Get your support in place, Get.
Speaker 1 (38:42):
Your medication if you need it, Get your therapy to
address those adverse childhood experiences. Get your stress your support
system to get those stressors down. Get a new job,
find a new spouse, on my wader, whatever you have
to do right, do all of those things. Know what
your early warning sign. I am doing great. I don't
(39:03):
need to see you every month. I'll see you every
two months. I don't need to see you every two months.
I'll see you every three months. I don't need to
schedule an appointment with you. But if I notice XX
and X, I'll reach out to you. And so that's
what I mean by long term treatment. The same way
you have your primary care doctor, you should have your
person whatever role that is that you know your early
(39:27):
warning signs. They know your early warning signs. You can
get in with them before your symptoms cross that threshold.
Speaker 3 (39:34):
To you'll a relapse.
Speaker 2 (39:36):
Now. I love that, and that is so true in
my experience, not just for myself, but for so many
of my coaching clients. When I stopped drinking, I had
an online group that everybody was sort of on the
path to not drinking, so helpful. A lot of people
were three and four years on who were giving support
(39:56):
and encouragement and tips. And I had a sober coach
that I worked with. I emailed her like every single day,
we had phone calls every once in a while. And
then when I was sixty days so where I joined
Hip Sobriety School, which was like this online core slash
group slash whatever with Holly Whittaker who wrote quit like
(40:18):
a woman, Yes a day, And so that was reinforcement.
And then I started seeing a therapist once a week
and I got on some medication for anxiety or mood disorder,
and like that was my first year and it wasn't
(40:38):
like a horrible thing. It was like, oh my god,
I'm finally getting healthy. I'm finally not waking up with
a hangover, hating myself, feeling strung out with anxiety, craving alcohol,
worrying about it like this was I worked out, you know,
all the things. And then after I didn't need to
(41:01):
see my therapist anymore. And after you know, after a year,
I stopped emailing my coach five days a week. But
I had also everybody knew I didn't drink. It had
become part of my identity. I felt good about myself.
I had my sober friends, like good good friends, and
(41:22):
I also stayed in touch with my group. I knew
that if I felt really anxious or panicked or whatever,
I needed to deal with it right away, you know,
like and trust me. In eight years, I've gone back
to my therapist who knows that I don't drink, and
I keep myself in a good mental health place so
(41:43):
that I don't go back to drinking or something else, right,
but don't. I haven't seen my therapist in two years
because I'm good.
Speaker 3 (41:49):
That's right, That's right, And you know, so I love
so much.
Speaker 1 (41:53):
We talk about this in the book The Magic Formula,
and I say, what I love about the Magic Formula.
Speaker 3 (41:58):
Is that it's not magic.
Speaker 1 (42:01):
It is just your collection of things, yes, that keep
you healthy as you are defining healthy. And I love
that journey you just share with us Casey, because that
collection of things has to change over time, because your
life is changing over time. And the idea is like,
match your magic formula to what's happening for you right now.
Speaker 3 (42:25):
And so I would say people think of treatment and.
Speaker 1 (42:27):
They're like, oh god, I gotta be in AA every
day for the rest of my life, or I'm going
to be in a halfway house, or i gotta live
in residential treatment.
Speaker 3 (42:34):
I would wager to say, Casey, that part of your
treatment is this Hello Someday podcast.
Speaker 1 (42:41):
Oh god, yes, I mean one of your early warning
signs would be like if you could not bring yourself
for I'm just gonna say three weeks is probably shorter
to not make this podcast. You would be like, this
is a warning sign and I need to bring in supports.
Speaker 2 (43:01):
Yeah, yeah, I mean I tell people that all the time.
They were like, do you think it would be easier
for you to go back to drinking if you weren't
talking to people every day in a group that you're
running doing the podcast? And I'm like, hell yes, because
first of all, helping people in early sobriety reminds me
how much it sucks, Like how much drinking is not
(43:23):
what we see on TV and you talk about that too.
It's how glamorized it is and how harmless it is
and all those stuff. But like, also I get free therapy.
Like i'm talking to you, I talk to other people.
I reach out to people about the shit that I need.
Like I'm like, okay, talk to me about marriage, talk
to me about like perfectionism. I'm talking to me about
(43:43):
your Foster syndrome. But like that's the ongoing work and
it's great, it makes me happy. Okay, I'm going to
ask you a totally off topic question, okay, because I'm
just curious, and then we're going to go back to it.
So this is good to sound so stupid, but I
just want to know. So I went to my doctor recently, right,
(44:05):
and I looked through you know, they give you the
report on all your numbers and blah blah blah blah
blah and on there. I forget what there was, but
it was like anxiety blah blah blah blah blah. And
they then they said alcohol use disorder severe and maybe
they said in remission. I don't even remember, but I
read that and I was like, can I get that downgraded?
(44:29):
A bottle? Like I was kind of pissed that was
there because I was like, dude, do you know how
many of your clients patients drink a fuck load?
Speaker 3 (44:38):
I haven't had a drink at eight and a half years.
Was a shit on my chart? Is that terrible? Is
your reaction terrible? Is it terrible that you're in that
it's in your chart? Well, reaction is not too me.
I'm wondering about my reaction. I actually told my girlfriend's
wheats over. I'm like, first, why does this bother me?
Because the anxiety thing doesn't bother me? So like, clearly
(45:02):
that although I still struggle with anxiety and I don't
struggle with alcohol anymore. But b I was like, it's inaccurate.
Speaker 2 (45:11):
Well yeah, it seemed to me to be a present tense.
Speaker 1 (45:15):
Yeah, it's it's it is legitimately an inaccurate diagnosis.
Speaker 2 (45:20):
Okay, tell me about that, because I seriously it was like,
I want to go back to my doctor and be like,
I'd like you to change that you can, and I'll
give you exactly what you can ask them to. Oh please, okays,
tell me why it'scurate.
Speaker 1 (45:32):
So, yeah, it's inaccurate because we diagnose alcohol use disorder mild, moderates,
severe in early remission, or in sustained remission. Those are
five mutually exclusive diagnoses. So we have ten diagnostic criteria
for alcohol use disorder. If you only meet one, you
(45:54):
do not have alcohol use disorder. You have risky alcohol use.
We should be trying to prevent you from transitioning. If
you have two to three of those ten criteria, you
have alcohol use disorder mild. If you have four to five,
you have moderate. If you have six plus you have severe.
If you have not met diagnostic criteria for three months,
(46:16):
you have alcohol use disorder in early remission. If you
have not met diagnostic criteria, and remember this is not
just taking a drink, this is meeting yeah, those ten
diagnostic criteria.
Speaker 3 (46:28):
For twelve months, you have alcohol use.
Speaker 1 (46:32):
Disorder in full sustained remission. And so what happens, this
is like everybody's charge that I always ever see you
come in eight years ago. You have alcohol use disorder severe,
You get three months, nobody updates the diagnosis to early, right,
(46:53):
you get a year, nobody updates the diagnosis to full
sustained remission. And he's correct to keep that alcohol use
disorder diagnosis on your chart because we should be practicing
prevention right now, right, Like, I know, if your anxiety
is not controlled, that's giving me risk. I know, if
you're blood sugar and goes low, that's giving me risk,
that kind of stuff. But it should update it to
(47:15):
alcohol use disorder in full sustained remission. I think your
reaction part of it feels like undermining all the hard
work you've done for eight years.
Speaker 2 (47:27):
Yeah, which is true.
Speaker 1 (47:29):
Second, it's communicating something about you diagnostically that's not true.
Speaker 3 (47:34):
That never feels good.
Speaker 2 (47:36):
Yeah.
Speaker 1 (47:36):
Third, I think about it like cancer. If you had
cancer and then your cancer went into remission. When you
read your chart, you want to be reminded that your
cancer is in remission.
Speaker 2 (47:48):
Yeah.
Speaker 3 (47:49):
So I'm totally validating your reaction.
Speaker 1 (47:52):
And when you can go back to the doctor and
say so, I'm actually gonna give.
Speaker 3 (47:57):
You the code.
Speaker 2 (47:57):
Okay, do it.
Speaker 1 (47:59):
Because alcohol use disorder ICD ten we use numbers to
give the code is ten dot two. That's where your
doctor currently hasn't your chart, okay, and your doctor just
needs to choose ten dot two one all right, disorder
in remission.
Speaker 2 (48:18):
All right. I'm totally going to do that the next yeah, and.
Speaker 1 (48:21):
Have a conversation about why it matters, Like I'm eight
years not drinking.
Speaker 3 (48:25):
It's important to communicate that.
Speaker 2 (48:27):
Yeah, totally, I'm with you, all right, I love it. Okay, see,
I'm glad I asked I get all the good information,
so I loved. I have to tell you. When I
read the title of your book, six mind changing Conversations
that could Save a life, I thought it was going
(48:49):
to be like I've seen in some other books, like
among you know, like a compilation of a client story, right, like, okay,
this is is you know, Sophie and she x y
Z and you know what I mean, because I've seen
that before and I love those too. But what I
(49:09):
loved about this was it was like scripts for conversations
you can have not only about yourself, not only about
how people can support you, but like, how do you
bring it up with your kids? How do you have
the if they are like so good, like elementary school,
(49:30):
middle school, higher I mean, tell us what the conversations
are so people can kind of dive in, because this
is the practical shit that people need.
Speaker 3 (49:40):
That's right, right, that's right.
Speaker 1 (49:42):
I tried to write a super practical book that everybody
could see themselves in whether they feel like addiction has
never been part of their lives in somebody else's life,
whether they're curious this sort of thing. So the first
the conversations follow that framework that I told you inherited biological, psychological, environmental,
(50:03):
and acquired. So in inherited biological, it's how to have
the conversation with your family about how addiction has affected
our family and it helps you in making that addiction tree.
And that's not easy, right, Like a lot of families,
this is a taboo subject that nobody is going to
(50:23):
bring up, and so like, how do you have that
conversation with your family about what our risk is DNA
wise as a family. Inherited psychological is how do you
have one understand your own ass score?
Speaker 3 (50:37):
Adverse childhood experiences?
Speaker 1 (50:40):
How do you have that conversation with someone to support
you in thinking about all those harmful experiences that you
had as a child and how they are still affecting
you today. Inherited environmental is how do you have the
conversation around how the culture you grew up in and
(51:02):
the physical environment you grew up in is still affecting
your choices today, Yeah, affecting your life experience today and
then when you come into acquired biological, you had an
injury or developed an illness, or a doctor wrote a prescription,
how do you have a conversation with your doctor about
your risk for addiction and the risk of the prescription
(51:26):
they're writing you, and how you put a safety plan
around that prescription. Yeah, inherited psychological is about positive childhood
experiences which nobody ever talks about, but which totally negate.
Speaker 3 (51:41):
Adverse childhood experiences. And so it's like, how do you
have one?
Speaker 1 (51:45):
How do you have the conversation with yourself to understand
your own emotions, and then how do you talk about
those and have conversations with friends?
Speaker 3 (51:53):
And then.
Speaker 1 (51:55):
Also how do you talk about the discrimination you've experienced
and how that drives your risk? And then inherited environmentalist,
how do you have the conversation about what my physical
environment is today.
Speaker 3 (52:10):
And how and why I need to change that?
Speaker 1 (52:12):
And so it just go, oh, I'm sorry, I didn't
I think I didn't mention the script with your kids,
which you mentioned, which is every single age. Yeah, Like
I started talking to my kids when they were three,
and now they know how to talk about addiction with
their friends.
Speaker 2 (52:28):
Oh my gosh, like my kids totally know because my
son was eight when I quit, yeah, and my daughter
was two, And of course in the beginning I didn't
talk about a ton of stuff with them. I was
just like, yeah, I haven't had a I don't. My son,
of course, I had a bad day, he say, you know,
he was like, oh, Mom, want me to get you
(52:49):
a glass of wide. I was like, fuck, But they know, right,
that's mom. I mean, I can't tell you how many
women have said that. The kids go in and tell
me about your mom and like what's her favorite drink
and it's like gin and tonic, and they're right, but
you know, knew that. And then of course, because when
I had gone further, like my son and my husband
(53:12):
got me for my thousand days alcohol free. I still
have it in my office right behind me. They got
me a big glass jar and put one thousand like
little marbles in it, and it just made me so
happy and just frout and it was amazing. It makes
(53:34):
me a cake every year on my soberversary with like
I remember they did the number five with all strawberries
and blueberries, so they're pretty great. But like I've had
my daughter on my podcast when she was nine, talking
about like how we talk about alcohol, what she knows
about it, and you know, so I love that you
did that because so many women they're like, what do
(53:56):
I say in a way that's helpful and they understand,
but not like, oh my god, Bob, what's a you know,
drunk or whatever it is, because you know, it's not that.
It's mom decided not to drink, and that's super awesome.
Speaker 1 (54:11):
And that is super awesome, right, Yeah, And it's super awesome.
And you also can make the decision not to drink
if you choose to make that decision at some point. Yeah,
you have a role model that you've seen lives an
amazing life that way.
Speaker 2 (54:25):
Right.
Speaker 1 (54:26):
So people often talk about addiction as a family illness,
community illness, which is absolutely true.
Speaker 3 (54:33):
So is recovery. Like when you think.
Speaker 1 (54:35):
About those positive childhood experiences, and what we talk about
in the book is that all of these work as
adults also, so even if you didn't have them as
a child, you can put them in place as an adult.
Part of that is were you able to talk about
your emotions?
Speaker 3 (54:50):
Yep? Did you have community traditions, did you have somebody
you knew would stand up for you and so like
your husband and your son giving you a jar of
a thousand marble on the thousand to day. You already
know when you go to a restaurant and the service says,
can I get you a drink? And you're like, I
don't drink, and they're like what your husband and your
(55:10):
son are going to.
Speaker 2 (55:11):
Be like listen, yeah right, yeah, they're just like yeah, no.
And my husband still drinks, you know, and it's not
a thing. But he's super proud of me for not drinking.
And you know, in the beginning, he didn't want me
to stop drinking, right, He wanted me not to like
pass out on the couch. You know, it was like
(55:33):
part of our thing. But like that's the evolution that
you go through and you have a new normal. And
the new normal is great because mom never passes out
on the couch and Dad can't wake her up and
she's not hungover and pissed off and whatever it is.
Speaker 3 (55:49):
Right right, right, So.
Speaker 2 (55:51):
All right, I love this so much. You go through
like the coping mechanisms and mental health and policy and
personal like all the good stuff that you need to know.
I just have we not touched on any misconceptions or
myths that you've addressed in your book, Like I just
(56:14):
want to be like, we're not going to go through
them all. But here's the things you think you know
that are not true.
Speaker 3 (56:21):
The things you think you know that are not true.
Speaker 1 (56:24):
One, people don't get better because seventy five percent of
people recover. We said, we're gonna keep saying it. Two,
it's everybody else, it's all of us.
Speaker 2 (56:35):
Yeah.
Speaker 1 (56:35):
Three you have to be drunk in the gutter. Yeah,
or to be a problem, there is I would love
to talk about the cage question.
Speaker 3 (56:46):
Do that please? Second?
Speaker 2 (56:47):
Please please?
Speaker 1 (56:48):
So what I'm really, really, really advocating for is the
same way for breast cancer. We want everybody to do
their monthly breast exam because the earlier you catch a lump,
the better chance we have for sustained remission no relapse.
Speaker 3 (57:04):
The same is true.
Speaker 1 (57:05):
So I tell people, if you ask yourself, either about
yourself or about somebody you care about, should I be worried?
Speaker 3 (57:12):
The answer is yes.
Speaker 2 (57:14):
Yeah.
Speaker 1 (57:14):
It doesn't mean you have a diagnosis. I don't care
if you get a diagnosis or not. But if you
say should I, the answer is yes. And so here's
a scale that I can give you what's called the cage. See,
have you ever thought you should cut back? If yes,
give yourself one point. Hey, have you ever been annoyed
when somebody else mentioned you're drinking to you?
Speaker 3 (57:36):
Give yourself a point.
Speaker 1 (57:37):
Have you ever felt guilty because drinking prevented you from
doing something you plan to do? Or you said I'm
not going to drink today and you still drunk? Like
if you ever felt guilty over alcohol? And E is
for eyeopener, have you ever needed to drink first thing
in the morning or thought about drinking like it's the
(57:58):
first thing on your mind when you wake up. Those
four questions are called the cage. If you answer yes
to one of those questions, there is seventy seven percent
chance that you have an alcohol use disorder, whether that's mild, moderate,
or severe. Even the twenty three percent that don't have
an alcohol use disorder have an opportunity to not develop an.
Speaker 3 (58:23):
Alcohol use disorder. So ask yourself those questions.
Speaker 1 (58:29):
And this is the other myth that I want to bust,
is that it's dangerous to ask for support. It's not
dangerous to ask for support, it's dangerous not to ask
for support.
Speaker 3 (58:42):
There are so many ways, so if.
Speaker 1 (58:46):
You're thinking to yourself, I wonder give yourself the cage
or give you know, take the cage on behalf of
somebody you're concerned about, and ask for support. It is
the safest way.
Speaker 2 (58:59):
Don't ignore the lump, don't don't. And you know there
are different ways to get support, and we can talk
about all that, and I've talked about it in previous episodes,
but it doesn't mean you have to make a huge
declaration to anyone. There is support available that is, you know,
completely private, completely confidential, whatever it is. Yeah, I was
(59:24):
the first three out of those four. Yeah, and like
drink first thing in the morning, No, unless you go
out to brunch, right right. I love how we like
switch what we did.
Speaker 3 (59:35):
Yeah, exactly.
Speaker 2 (59:37):
I mean a mimosa bloody berry, Like that's just totally
run straight, right totally.
Speaker 1 (59:43):
I mean I was on the plane the other day,
because I think I'm on the plane every other day,
but I was on the plane the other day and
I was on a six am flight and we were
leaving on time, so it was five forty five am,
and the flight attendant came around and said, can I
get you anything to drink before we take off? And
this person said, I'll take a red wine at five
(01:00:05):
forty five am. And I don't jump in strangers businesses
that are seated across the aisle from me. But I
thought to myself, Man, I wish it was safe for
me to jump across the aisle and just say. I'm
just saying if you need any support here in some ways,
like if you're worried about yourself. Yeah, because at five
(01:00:26):
forty five am, that's an eye opener.
Speaker 2 (01:00:29):
Yeah, yeah, totally. And I always say to people because
they're like, oh my god, all my friends drink, but
like nobody else is worried about it, blah blah blah.
And I was like, dude, anyone who is drinking with
you the way you're drinking, they wake up at three
am worried about their alcohol consumption. There is zero chance,
Like it just doesn't happen. You guys are just not
(01:00:51):
talking about it.
Speaker 3 (01:00:52):
Yeah, we got to make it safe to have the conversation.
Speaker 2 (01:00:55):
Yeah, yeah, Okay. One thing we talked about before we
jumped on here, and I know I gotta let you go,
is we both said that we don't love the term alcoholic.
Can you tell me why?
Speaker 3 (01:01:08):
Yeah? I hate the term it for anything.
Speaker 1 (01:01:12):
So I hate diabetic, I hate schizophrenic, I hate alcoholic,
I hate asthmatic. And the reason is because that is
not who you are. You are not an alcoholic. You
may be a person that struggles with alcohol use, you
may be a person that has a diagnosis of alcohol
use disorder, you may be a person that just doesn't
(01:01:33):
want to drink. But the struggle you have with alcohol
will never ever be the most important thing about you.
It will never ever be the thing that defines you.
It's one thing that you're going through. And so I
just always start with the person first to remind us
that first and foremost, you are a person. And then
(01:01:57):
second we can use you know, words to say what
your current life experience is. But don't take on that definition.
Yeah yeah, and don't force that definition on somebody.
Speaker 2 (01:02:13):
Else, on anybody else. Like people use it so casually
be like hey, oh my god, her dad was such
an alcoholic and I'm like, it also pisses me up. Well,
mostly unless they are in a twelve step program and
they self identifying that as fantastic whatever helps, But like,
(01:02:33):
especially for people who have never struggled with addiction, when
they are casually labeling somebody else and I'm just like, wtf,
liketfu how about that? Yes, yes, yes, I believe. I
have like occasionally said that in a much chicer way,
(01:02:53):
be like, dude, uncool, uncool, and you don't know what
the fuck you're talking.
Speaker 3 (01:03:00):
Yeah, so uncool.
Speaker 2 (01:03:02):
So yeah, okay, one more, last one. It's like rapid fire.
When the hell are the medical directives information going to change?
I mean, I know there's huge lobbying stuff, but like
the American Cancer Society finally said what three four years
ago that no amount of alcohol is zero risk factor
(01:03:24):
for cancer, which they had known for fucking ever. But
like Ireland is putting labels on every single wine bottle
and beer bottle saying like alcohol causes liver, you know,
severe liver disease. Alcohol causes cancer, same way as tobacco.
US I'm not hearing shit.
Speaker 3 (01:03:46):
Yeah, it's two things.
Speaker 1 (01:03:47):
So one, I forget what the statistic is, but something
like it takes twenty two years for medical practice to change,
which is crazy.
Speaker 3 (01:03:57):
So we're in the midst of it, but it's very
slow too.
Speaker 1 (01:04:01):
Money talks, and the alcohol lobby is so rich and
it is so ingrained in our culture, which I talk
about in the book, and that's the reason why it's
so slow. But listen, young people are the future. Young
people are like totally our hope because they're like, it's
cool to not drink, yeah, and drinking, you know, and
(01:04:23):
so it will come, but it is going to be
so slow. So that's why we can't depend on the
external forces. We have to start with these conversations, just
like this and this book and just let it broadcast
into people's individual minds.
Speaker 3 (01:04:37):
Yeah, it is so slow.
Speaker 2 (01:04:39):
All right. I love talking to you. I love your book.
It's called an addiction. You guys should totally pick it up.
Your podcast is called an addiction. And tell us where
else people should look for you find you anything?
Speaker 1 (01:04:53):
Yeah, so you can find me on Instagram, Facebook formerly
known as Twitter, now called x Threads and LinkedIn at
in Zinga MD or in Zinga Harrison, MD. I co
founded this company, Eleanor Health, which I'm so proud of,
So please check out eleanorhealth dot com. And then the
book is in print, audio and digital everywhere in stores online.
Speaker 2 (01:05:16):
Do you do you read the audio?
Speaker 3 (01:05:18):
I read the audio.
Speaker 2 (01:05:19):
I love it. When the author I had an audition,
I had an audition to.
Speaker 3 (01:05:26):
You're good, but.
Speaker 2 (01:05:27):
I liked You're like other fucking podcast or I could
do this.
Speaker 3 (01:05:32):
And it was so it was awesome. I had.
Speaker 1 (01:05:34):
I had so much fun narrating the book. But yeah,
So if you want to hear more of this voice,
get the audible perfect.
Speaker 2 (01:05:41):
Thank you so much.
Speaker 3 (01:05:42):
Thank you Kasey, Thank you so much for tuning in.
Speaker 1 (01:05:45):
And if you liked this episode, please check out my
book on Addiction, Six mind Changing Conversations that Could Save
a Life, available at Barnes and Noble, Bookshop, dot org,
Union Squaring Company, Amazon, and wherever books are sold.
Speaker 3 (01:06:02):
We want to hear from you.
Speaker 1 (01:06:03):
If you identify as black or brown and have a
recovery story to share, something you've learned, a stigma that
you've undone, or a conversation that you've had about addiction.
Send us a voicemail at speakpipe dot com, slash you
apod that's speak pipe dot com, slash u a pod
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