August 29, 2024 • 26 mins
Listen to part one of our two-part series on a brain health approach to addiction treatment with insights from several experts who uncover the secrets behind effective recovery strategies. Annette shares her gripping personal recovery story, detailing the evolution of addiction treatment, while Charley provides an insider's perspective on the shift in forms of treatment. This episode is packed with insights on the critical connection between brain health and overcoming addiction.
Listen and Learn:
- About the intertwined nature of substance use and mental health problems and why integrated care is essential for better outcomes
- The impact of technology and how 24/7 is crucial in recovery to prevent relapses
- Innovative digital solutions that are changing the landscape of addiction recovery
Stay tuned next week for Part 2!
Hosts
- Bob Gold, Chief Behavioral Technologist, GoMo Health
- Dave Williams, owner and host of iCRV Radio
Featured Guests
- Annette Redding, Director of Peer Support and Crisis Response Services for Rimrock Foundation
- Charley Curie, Presidential Appointee to lead the Substance Use and Mental Health Services Administration (SAMHSA)
- Dave Drap, Expert, GoMo Health
Thanks for tuning in. Subscribe today to receive alerts of new weekly episodes and follow @GoMoHealth on social for the latest in healthcare engagement.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
Exploring and optimizing your brain's
connectivity with your body.
This is Brain Training.
Welcome everyone, I'm DaveWilliams and joined by our guide
on all things brain-related,bob Gold.
Brain Training is an entireseries dedicated to maximizing
(00:23):
the brain-to-body connectivity,getting desired results
physically, emotionally, andeven advance personal health
goals.
All right.
So, bob, I'm loving doing thisbrain training series with you
and we're getting to know eachother.
So here's a story on my side ofit.
In a previous life, I used towork for a guy named Ted Turner,
(00:46):
and my favorite advertisementever done in the cable industry
was a picture of Ted and thecaption was I was cable before
cable was cool.
So cut to today and I look atyou and feel a similar
advertisement should be done,but the caption is I was brain
health before brain health wascool.
(01:06):
You've been in this space fordecades, bob.
You founded GoMo Health.
You serve as their chieftechnologist.
It all starts with the brain,with you.
Why is this?
Speaker 2 (01:17):
You know, when I saw how healthcare was taking care
of people, I saw they really cutoff everything above the
shoulders from the body, likevision is ancillary insurance
and hearing, and it never reallygot to the brain.
But yet the brain chooses yourpathway in life.
(01:37):
For example just take a simpleexample with diabetes type 2,
you're not necessarilygenetically disposed, but you
choose to not eat or notexercise, do certain things, you
become a type 2 diabetic.
So those all things could bereversed.
And the brain's a complex beingand the thing to remember the
brain creates reality.
Speaker 1 (01:58):
It doesn't just detect reality so, uh, some
shows on brain training aregoing to focus on broad topics,
like our recent peak performancein sports program.
Brain training are going tofocus on broad topics, like our
recent peak performance insports program, which was
fantastic.
Others will focus on verticals,like specific healthcare
challenges, like cancer wecovered the whole cancer journey
with a couple of fantasticdoctors or like today, where
(02:19):
we're focusing the entire showon substance abuse and addictive
behavior, bob.
Why is this an important topic?
And my guess is we'll probablydo a lot of episodes on this
area.
Why is it so important?
Speaker 2 (02:31):
Yeah well, there's 46 million Americans battling with
substance use 16% of Americaand actually only 10% are going
for treatment, and that's aninteresting question as to why.
The other aspect which I justwant to say is we all know
(02:52):
people with an addiction outthere, but there are many forms
of addiction and if you look atit, it's not just drugs, alcohol
, it's cigarettes, it's sex Lookat Tiger Woods addicted to sex,
shopping, eating, gambling andwhat most people don't realize,
who don't have an addictivebehavior, they believe oh, if
(03:12):
the person only just hadwillpower, you know they can
solve it.
But it's really a cognitivechallenge and disorder which
then becomes a physiologicalchallenge.
So there's a lot to it andwe're going to explore it today
with our guests.
Speaker 1 (03:27):
Yeah, what's really cool is, as with every episode,
you're going to share someperspective and insights with a
distinguished group of guests.
They come at the highest levelsin their respective fields and
this is actually fun becauseyou've got a unique assemblage
of experts and covering a widearea, and they'll all serve up a
whole spectrum of perspective.
(03:48):
Joining us today is AnnetteRedding.
She is the Director of PeerSupport and Crisis Response
Services at the RimrockFoundation in Billings, montana.
An interesting note Annettefirst went to Rimrock as a
person in need of treatment, aclient, and continues her
recovery.
Annette, welcome to BrainTraining.
Thanks for being here.
(04:09):
Oh, thank you so much for havingme Also joining our group of
guests.
Charlie Curie.
He was the head of SAMSA, theSubstance Abuse and Mental
Health Services Administration,during the George W Bush
presidency.
As chief, he managed what wasthen a $3.4 billion agency.
It was responsible forimproving the accountability
(04:29):
capacity and effectiveness ofthe nation's substance abuse
treatment and prevention andmental health services.
Now running his own consultingfirm, charlie educates national
and international leaders inboth government and business on
healthcare, substance abuse andmental health.
Charlie, welcome to BrainTraining.
Speaker 4 (04:48):
It's wonderful to be here, thank you.
Speaker 1 (04:50):
And also rounding out the troika of guests, dave
Drapp.
He is the chief growth officerfor GOMO Health, where he is on
the front lines of providingdigital therapeutic services to
health care organizations,including those addressing
addiction recovery.
He has spent nearly 30 years oneither the individual or the
company side of health andwellness and is passionate about
(05:13):
helping people in areas ofcritical need.
Dave welcome.
Speaker 5 (05:17):
Thanks for having me Excited to be here.
Speaker 2 (05:19):
I have a question for Charlie.
But first of all, when Ivisited you, Charlie, in Indiana
, what was the name?
You gave me those pickles.
What was the name of the picklecompany, Sackler.
Speaker 4 (05:29):
Pickles.
Speaker 2 (05:36):
Yeah, if anyone could buy them, they're unbelievable.
But getting back to the subjectat hand, charlie, when you were
a young stud, when you werefirst getting into the field,
versus now, like what have youthought differently or what were
you surprised to learn that younever would have realized until
you got into it in your career?
Speaker 4 (05:57):
Well, that's a great question, Bob.
I think when I first moved intomy career, both in mental health
and substance use, I really wasfocused on the whole notion of
treating treating those diseases, treating mental illnesses,
treating substance use and a lotof that treatment entailed
(06:19):
initially, especially on themental health side medications
and addressing symptoms.
I think clearly what I learnedearly on and really began to
study and embrace was the wholenotion of recovery and that had
really been evolving for manydecades On the substance use
side, the whole notion that youneed to learn how to manage your
(06:42):
illness, to manage your life,that you need to learn how to
manage your illness, to manageyour life, and that was
important we began.
It was very early on in themental health arena, a few
decades ago, that mental healthbegan to learn from that as well
.
So I think that the whole ideathat we need to approach
substance use as we're talkingabout today, holistically, that
(07:03):
in order for people who attain alevel of recovery, in order for
them to stay in recovery, theyneed to be building upon having
a life- and.
I think that's very important,because we found that people
relapsed if they did not focuson their goals, of what they
needed.
(07:24):
Goals such as purposeday-to-day could be employment,
education, social connectedness,having a safe place to live.
All of those things are veryimportant to help people sustain
their recovery.
Speaker 2 (07:38):
No, I couldn't agree more.
And today we're going to talk alittle bit about new ways to
treat from a digital healthperspective.
We're going to cover that totreat the whole person.
It involves also prevention andeducation, because if we could
help people be more self-awareor have critical awareness that
(07:58):
they may be heading down a pathbefore they do, that's really
positive.
Before they do, that's reallypositive.
And then for those people intreatment and recovery to become
better at figuring themselvesout and what makes them tick is
fascinating.
So, speaking of that, annette,why don't you just start by
telling us a little bit of ashort story on your early days,
(08:22):
of your family and what led youdown the path, and we'll go from
there, but just start with that.
Speaker 3 (08:30):
Absolutely yeah.
So you know, I grew up in ahome that you know had addiction
and alcoholism within the home,and so some of that stuff
seemed to be kind of, um, Iwould say, a little bit
normalized for me.
That that kind of lifestyle wasa little bit normalized for me,
(08:50):
um, you know, but a kiddogrowing up in that, um, it was
painful.
You know that there's somethings that happen in in the
homes of of addicts andalcoholics that that are painful
and hard for children to endureand grow up in.
And so, you know, I had, at ayoung age, decided that I was
(09:12):
not going to live like that.
My home would be different.
And just, you know, I think,naturally we often think that
we're never going to be anythinglike our parents and regardless
of what kind of home you grewup in, you're just not going to
be like your mom and your dad.
And so I set out in life withoperating under that assumption,
(09:32):
having no idea that really thegravity and magnitude of this
disease.
And so pretty soon, at a youngage, you know, I was willing to
start trying things that were,you know, at parties and things
like that.
And it's like I remember thefirst time I took my first drink
and I'll never forget itbecause I just remember feeling
(09:55):
like I had no idea how bad itwas, until I felt that good and
and instantly I would sayinstantly I sought after that
feeling um, and it was like youknow I was.
It wasn't long after that, youknow, I was probably about 15
when I was willing to tryanything that you put in front
(10:18):
of me.
I was willing to, um, you know,I look back now and I think
about a 15 year old using harddrugs, um, and I'm just, I mean,
I'm about a 15-year-old usinghard drugs and I'm just, I mean,
I'm like, oh my God, you know,they're so young, they're so
innocent.
And I realize, I look back thatI mean I had, you know, set all
caution to the wind and waswilling to try whatever I could
(10:41):
get my hands on.
You know, I got pregnant at ayoung age and I remember when I
had my daughter I thought, okay,this party lifestyle has to
stop.
And again I just reiteratedagain I just had no idea what I
was up against.
I could have passed a liedetector test if somebody would
have given me one, that I wouldnever touch another drug again,
(11:06):
I believed that I had notrealized that I had lost the
power of choice.
Speaker 2 (11:10):
Yeah, you know what's interesting about that is you
had to, because of both natureand nurture.
You had to do what we callunlearning, to learn, and you
had to go through a process tocorrect your thinking errors.
Right, like you used the termthat it was normalized in your
(11:31):
world because you grew up inthat environment.
And how do you practice ahealthier lifestyle and how do
you create, you know, a habitand we're going to get into that
in a minute.
You know how do you unlearn tolearn.
In that regard and, dave, toget to you real quick, though,
(11:52):
on that I know you've beeninvolved and seen it from an
employer perspective, aworkplace perspective
perspective, and, interestinglyenough, the societal cost to
substance use in america economyis 532 billion dollars a year
(12:13):
and, uh, it's a very difficultsubject for, let's say,
employers and people in thewellness business to deal with.
And what are some of yourlearnings and what are things
that you think we need to do toapply to help there?
Speaker 5 (12:28):
Sure.
So to add to this conversation,we spend a lot of our adult
life at work, right?
So think about that just for aquick second.
And if you're an individual inrecovery or battling an issue,
you have to hide that many, manytimes and that can be very
(12:52):
taxing on the mind.
So what I've learned over theyears is employers, generally
speaking, do mean well and theywant to provide resources to
their employees, but they don'tnecessarily want to get deep in
regards to training and how tohandle very specific situations.
(13:13):
So to your point, thosebillion-dollar numbers sometimes
don't include absenteeism andthe lack of workforce
productivity, because I'm simplynot happy at work and I need
help from someone and myexpectation is that I want my
workplace to throw me a lifelineon some level.
(13:33):
So what we're trying to do hereat GOMO is to try to train
folks either the employee or theemployer or their direct report
to think clearly while they'rein crisis.
So you know we've got lots ofyoung moms out there across the
country.
Then their son or daughtermight have an earache, so they
(13:56):
simply panic and take their sonor daughter to the ER, where
they could have just had ateledoc visit instead.
So we're trying to shift thatcontinuum and further train the
brain, if you will, and have ourfolks practice what we're
preaching and then when they dohave a crisis situation they can
think clearly do I have thatbenefit available to me?
(14:18):
And then we can have theemployer help to train on those
types of instances and issues.
Speaker 2 (14:23):
Yeah, that's fascinating because Annette now
is a supervisor, so we're goingto get back to Annette in a
second.
But, charlie, from yourexperience heading SAMHSA and
your other activities andbehavioral health, what is the
impact of, let's say, either asupervisor at work,
(14:43):
understanding how to handlefolks with addictive behaviors
and what to do, and also havinga loved one you know as support
in that and how to help theloved one through that?
So give us some of yourthoughts of the importance of
that.
Speaker 4 (15:00):
Yes, part of my background also included a
period of time that I wasinvolved in risk management and
the one thing I learned there isthat that is very clear that
the person that has the mostimpact on someone in the
workplace is the immediatesupervisor.
So that is a critical thing.
(15:21):
Whether a person likes theirjob or not, even if they're
retrained to work after aninjury, the main determining
factor is whether they like thesupervisor more than the
progress they're making with theinjury, so that supervisor is
in a real critical position.
So training there, having toolsavailable there, is very
(15:42):
important Also supports, I mean,the individual, as Dave was
saying, in the workplace.
They're spending most of theirtime there, but they do have a
family.
They do have loved ones intheir life and loved ones many
times are at a loss.
How do I support my loved oneif they're in the throes of an
(16:09):
addiction or if they'restruggling with substance use,
for example?
Again, tools being available toloved ones to be able to
support and having a tool that'savailable 24-7, like we have in
digital therapeutics, is atremendous breakthrough.
We did not have those types oftools a decade, two decades ago.
Speaker 2 (16:24):
That's so true ago, that's so true.
And GOMO Health.
Dave and myself we're workingwith SAMHSA, now the White House
, on a national recoveryinstitute that just formed.
It's a nonprofit and GOMO isone of the toolkits and in a
little bit we're going to haveDave describe, you know, within
(16:46):
that to your point.
It provides psychologicalsafety, supervisor, training,
training for the employees andthen a special track for people
in treatment and recovery.
So, but to get back to thereason why that's important, I'd
like Annette to talk about.
You know from where she justleft off.
(17:08):
Did she have any support people?
Where did she find them?
How did she get through it?
And a little bit of her storyin that regard, of where she
ended up and came out of.
Speaker 3 (17:23):
Thank you.
Yeah, so you know, I, you knowaddiction really.
I mean it really took my life,and it wasn't until my early 30s
, late 20s, early 30s, I wassentenced to a treatment court
program.
And man, I'll tell you whatthat's.
(17:45):
A lot of work, that's a lot ofwork.
And you know, there had alwaysbeen this thing inside of me
that I wanted somethingdifferent.
I did not like the way that Iwas living.
I had lost a lot.
I was no longer able tofunction in society.
I, to be the most, was a goodmother to my children, and I
(18:11):
just lost the ability to do that.
And so, when I got into thistreatment court program, I had a
mustard seed size ofwillingness, but I really had
felt like I had fallen too fardown the scale for recovery to
be possible for me, scale forrecovery to be possible for me.
(18:33):
So the wonderful thing abouttreatment courts is they really
wrap you around with servicesand they keep you pretty busy.
And so, you know, as I got intothat program, though, I felt
like the people who maybe hadsome recovery I didn't fit in
with, and so I'd find myselfsliding backwards, you know,
calling old friends going to oldplaces, and I'd find myself in
yet again another relapse andI'd have to show up and let the
(18:56):
court know what happened and beworried that they were going to
put me in jail.
And it was just it was.
I remember it just being areally, really hard time for me,
just not knowing where I fit,not knowing where to find these
people that are actuallyrecovering.
One thing that I really valueabout GOMO Health is, you know,
(19:18):
we have it set up for our drugcourt participants where they
can text, and so it's not likethey're lifting, you know, a
hundred pound phone to callsomebody they don't know.
We have peer supports availableto people 24 hours a day, seven
days a week, and all they needto do is text that I'm triggered
(19:40):
, I'm going to relapse, andwe're responsive to them.
We get a hold of them rightaway.
Figure out what they need andprevent that relapse from
happening.
Way, figure out what they needand prevent that relapse from
happening Because really, truly,crisis doesn't usually happen
Monday through Friday from eightto five.
right, there's a counseloravailable.
(20:00):
There's a counselor availableto somebody.
Typically you're in a group oryou, you know.
But after five o'clock, whenthe businesses are shut down and
a person who's early inrecovery is home alone and
they're with their thoughts andI'll tell you what a newly sober
person's mind is like a ghetto.
They should not be there alone,because it gets rough and you
(20:21):
just start thinking about lifeand what it could be and what it
has been, and pretty soonyou've talked yourself into
having a drink or going andgetting high, and so the the
ability to provide support afterhours is a really, really big
deal.
Speaker 2 (20:38):
Let's get into some of the aspects of, you know,
brain training, cause I knowAnnette you've also talked about
in the past which you knowmaybe you were fine in the
morning and four hours later youwere depressed or off the rail,
and you know how do you managethat.
So in my world of braintraining, it's in unlearning to
(21:01):
learn and correcting thinkingerrors.
It's sort of fascinating.
Healthcare hasn't really had away to practice.
How do you practice not beingaddictive, right?
So there's one thing you couldsit in treatment an individual
(21:22):
session, group session and thenyou go back to your daily life,
right, and you have all thestressors and embarrassment, not
feeling you could take care ofyour kids, belonging, all those
things.
So what we've done from adigital treatment to augment the
human care management team ishelp you practice.
And to give you an example, ifyou're learning to play piano,
right, so you may go toinstructor for half an hour.
(21:44):
They come to your house or yougo there, but what does the
instructor tell you?
Hey, if you want to get good,you have to practice an hour a
day.
You want to make the highschool team three hours a day?
You want to make the BostonSymphony six hours a day.
So it's up to you and they'llgive you some skills but you
have to practice them.
So in the digital therapeuticfor substance use, we provide
(22:08):
people to correct their thinkingerrors, we give them things to
reflect on practice activitiesand we make them self-aware and
critical awareness of that.
So I would like the three ofyou to comment on that.
But, annette, talk about youknow that substance use.
(22:28):
In many respects you've lostthe ability to choose freely and
it takes a disciplined time andeffort to get out of that.
So maybe you talk about yourstruggles and what has helped
you.
Speaker 3 (22:41):
Absolutely, yeah, you know.
So when your brain is wired forimmediate gratification, I mean
I'm feeling some feelings.
I don't want to feel them, I'mgoing to, I'm going to seek some
sort of chemical comfort to getme out of this.
That, for a period of time, isinstantly where your brain goes.
(23:07):
And so when I was early inrecovering, when I found myself
in those moments of this hasgotten really uncomfortable, I
don't know how I can handle this.
Um, I would really practice thispositive self-talk.
You know this um, sort of thesedbt skills of like I'm gonna,
(23:27):
I'm gonna be in the moment rightnow.
I know this is gonna pass, um,I'm and.
And if it doesn't pass, youknow, let five, I let five
minutes go by.
I'm still feeling okay, this isnow.
I know I need to reach out tosomebody, and typically reaching
out in connection with anotherperson will sort of bring me to
right where I'm at right now andnot you know where my head's
(23:52):
telling me I should be.
When you're so used to being insuch a negative head space,
being able to allow yourself tostart to look for positive
things every day, start to, ifit's a mantra, if it's a daily
(24:12):
devotion, if it's aninspirational message to start
your day out with that and thenbring your mind back to that
when you are you know when fourhours later you're a mess again.
Speaker 2 (24:23):
No, absolutely.
And you know what's interestingthere's almost a 50% crossover
between mental health andsubstance use.
Substance use, Charlie, haveyou seen a shift from years ago
to now where maybe they treatedthem wholly separately, like
substance use didn't recognizemental health, mental health
(24:44):
didn't recognize, but they bothtrigger each other?
Have you seen a shift in howhealthcare is addressing that?
Speaker 4 (24:51):
Yes, I have, and it's a positive shift.
Again, going back to when Istarted out in the field over 40
years ago, you had separatetreatment for substance use,
separate agencies, as well asfor separate agencies for mental
health, and yet, as youindicated, a very high
percentage 50% or more, we'rereally talking people have
(25:14):
co-occurring mental healthissues along with substance
abuse, and we also have foundthrough the years that if you
treat them, in an integrated wayor concurrently.
At the same time, you get muchbetter results than if you treat
them separately.
Unfortunately, years ago peoplewould go to a substance use
agency and if it was determinedthey had a mental health problem
(25:36):
, it's like, well, you need tohave your mental illness treated
before we can treat you forsubstance use.
Go to a mental health facility.
You need to have your addictiontreated before we can treat you
.
I think we're getting beyondthat today, which is great news.
And again, integrated care,whole person care.
We're understanding that andpeople are getting better
results, and tools like thedigital treatment that you've
(25:59):
offered through Black Girldefinitely help facilitate that
process of addressing both whatneeds to be addressed with
mental health as well assubstance use.
Speaker 2 (26:10):
Yes, so I think now we're just thank you, charlie,
and actually, when we get backfrom break Dave, we're going to
talk about some of the digitaltools that are helping that
crossover that Charlie justmentioned.
Speaker 1 (26:22):
Plus, our listeners have really come to enjoy a
little bit of a pause as we playsome brain games, which are
just examples of how you can getyour brain to be more fit as
well.
So we got that coming up, plusmore with our guests on Brain
Training.
Exploring and optimizing your brain's
connectivity with your body.
This is Brain Training.
Welcome everyone, I'm DaveWilliams and joined by our guide
on all things brain-related,bob Gold.
Brain Training is an entireseries dedicated to maximizing
(00:23):
the brain-to-body connectivity,getting desired results
physically, emotionally, andeven advance personal health
goals.
All right.
So, bob, I'm loving doing thisbrain training series with you
and we're getting to know eachother.
So here's a story on my side ofit.
In a previous life, I used towork for a guy named Ted Turner,
(00:46):
and my favorite advertisementever done in the cable industry
was a picture of Ted and thecaption was I was cable before
cable was cool.
So cut to today and I look atyou and feel a similar
advertisement should be done,but the caption is I was brain
health before brain health wascool.
(01:06):
You've been in this space fordecades, bob.
You founded GoMo Health.
You serve as their chieftechnologist.
It all starts with the brain,with you.
Why is this?
Speaker 2 (01:17):
You know, when I saw how healthcare was taking care
of people, I saw they really cutoff everything above the
shoulders from the body, likevision is ancillary insurance
and hearing, and it never reallygot to the brain.
But yet the brain chooses yourpathway in life.
(01:37):
For example just take a simpleexample with diabetes type 2,
you're not necessarilygenetically disposed, but you
choose to not eat or notexercise, do certain things, you
become a type 2 diabetic.
So those all things could bereversed.
And the brain's a complex beingand the thing to remember the
brain creates reality.
Speaker 1 (01:58):
It doesn't just detect reality so, uh, some
shows on brain training aregoing to focus on broad topics,
like our recent peak performancein sports program.
Brain training are going tofocus on broad topics, like our
recent peak performance insports program, which was
fantastic.
Others will focus on verticals,like specific healthcare
challenges, like cancer wecovered the whole cancer journey
with a couple of fantasticdoctors or like today, where
(02:19):
we're focusing the entire showon substance abuse and addictive
behavior, bob.
Why is this an important topic?
And my guess is we'll probablydo a lot of episodes on this
area.
Why is it so important?
Speaker 2 (02:31):
Yeah well, there's 46 million Americans battling with
substance use 16% of Americaand actually only 10% are going
for treatment, and that's aninteresting question as to why.
The other aspect which I justwant to say is we all know
(02:52):
people with an addiction outthere, but there are many forms
of addiction and if you look atit, it's not just drugs, alcohol
, it's cigarettes, it's sex Lookat Tiger Woods addicted to sex,
shopping, eating, gambling andwhat most people don't realize,
who don't have an addictivebehavior, they believe oh, if
(03:12):
the person only just hadwillpower, you know they can
solve it.
But it's really a cognitivechallenge and disorder which
then becomes a physiologicalchallenge.
So there's a lot to it andwe're going to explore it today
with our guests.
Speaker 1 (03:27):
Yeah, what's really cool is, as with every episode,
you're going to share someperspective and insights with a
distinguished group of guests.
They come at the highest levelsin their respective fields and
this is actually fun becauseyou've got a unique assemblage
of experts and covering a widearea, and they'll all serve up a
whole spectrum of perspective.
(03:48):
Joining us today is AnnetteRedding.
She is the Director of PeerSupport and Crisis Response
Services at the RimrockFoundation in Billings, montana.
An interesting note Annettefirst went to Rimrock as a
person in need of treatment, aclient, and continues her
recovery.
Annette, welcome to BrainTraining.
Thanks for being here.
(04:09):
Oh, thank you so much for havingme Also joining our group of
guests.
Charlie Curie.
He was the head of SAMSA, theSubstance Abuse and Mental
Health Services Administration,during the George W Bush
presidency.
As chief, he managed what wasthen a $3.4 billion agency.
It was responsible forimproving the accountability
(04:29):
capacity and effectiveness ofthe nation's substance abuse
treatment and prevention andmental health services.
Now running his own consultingfirm, charlie educates national
and international leaders inboth government and business on
healthcare, substance abuse andmental health.
Charlie, welcome to BrainTraining.
Speaker 4 (04:48):
It's wonderful to be here, thank you.
Speaker 1 (04:50):
And also rounding out the troika of guests, dave
Drapp.
He is the chief growth officerfor GOMO Health, where he is on
the front lines of providingdigital therapeutic services to
health care organizations,including those addressing
addiction recovery.
He has spent nearly 30 years oneither the individual or the
company side of health andwellness and is passionate about
(05:13):
helping people in areas ofcritical need.
Dave welcome.
Speaker 5 (05:17):
Thanks for having me Excited to be here.
Speaker 2 (05:19):
I have a question for Charlie.
But first of all, when Ivisited you, Charlie, in Indiana
, what was the name?
You gave me those pickles.
What was the name of the picklecompany, Sackler.
Speaker 4 (05:29):
Pickles.
Speaker 2 (05:36):
Yeah, if anyone could buy them, they're unbelievable.
But getting back to the subjectat hand, charlie, when you were
a young stud, when you werefirst getting into the field,
versus now, like what have youthought differently or what were
you surprised to learn that younever would have realized until
you got into it in your career?
Speaker 4 (05:57):
Well, that's a great question, Bob.
I think when I first moved intomy career, both in mental health
and substance use, I really wasfocused on the whole notion of
treating treating those diseases, treating mental illnesses,
treating substance use and a lotof that treatment entailed
(06:19):
initially, especially on themental health side medications
and addressing symptoms.
I think clearly what I learnedearly on and really began to
study and embrace was the wholenotion of recovery and that had
really been evolving for manydecades On the substance use
side, the whole notion that youneed to learn how to manage your
(06:42):
illness, to manage your life,that you need to learn how to
manage your illness, to manageyour life, and that was
important we began.
It was very early on in themental health arena, a few
decades ago, that mental healthbegan to learn from that as well
.
So I think that the whole ideathat we need to approach
substance use as we're talkingabout today, holistically, that
(07:03):
in order for people who attain alevel of recovery, in order for
them to stay in recovery, theyneed to be building upon having
a life- and.
I think that's very important,because we found that people
relapsed if they did not focuson their goals, of what they
needed.
(07:24):
Goals such as purposeday-to-day could be employment,
education, social connectedness,having a safe place to live.
All of those things are veryimportant to help people sustain
their recovery.
Speaker 2 (07:38):
No, I couldn't agree more.
And today we're going to talk alittle bit about new ways to
treat from a digital healthperspective.
We're going to cover that totreat the whole person.
It involves also prevention andeducation, because if we could
help people be more self-awareor have critical awareness that
(07:58):
they may be heading down a pathbefore they do, that's really
positive.
Before they do, that's reallypositive.
And then for those people intreatment and recovery to become
better at figuring themselvesout and what makes them tick is
fascinating.
So, speaking of that, annette,why don't you just start by
telling us a little bit of ashort story on your early days,
(08:22):
of your family and what led youdown the path, and we'll go from
there, but just start with that.
Speaker 3 (08:30):
Absolutely yeah.
So you know, I grew up in ahome that you know had addiction
and alcoholism within the home,and so some of that stuff
seemed to be kind of, um, Iwould say, a little bit
normalized for me.
That that kind of lifestyle wasa little bit normalized for me,
(08:50):
um, you know, but a kiddogrowing up in that, um, it was
painful.
You know that there's somethings that happen in in the
homes of of addicts andalcoholics that that are painful
and hard for children to endureand grow up in.
And so, you know, I had, at ayoung age, decided that I was
(09:12):
not going to live like that.
My home would be different.
And just, you know, I think,naturally we often think that
we're never going to be anythinglike our parents and regardless
of what kind of home you grewup in, you're just not going to
be like your mom and your dad.
And so I set out in life withoperating under that assumption,
(09:32):
having no idea that really thegravity and magnitude of this
disease.
And so pretty soon, at a youngage, you know, I was willing to
start trying things that were,you know, at parties and things
like that.
And it's like I remember thefirst time I took my first drink
and I'll never forget itbecause I just remember feeling
(09:55):
like I had no idea how bad itwas, until I felt that good and
and instantly I would sayinstantly I sought after that
feeling um, and it was like youknow I was.
It wasn't long after that, youknow, I was probably about 15
when I was willing to tryanything that you put in front
(10:18):
of me.
I was willing to, um, you know,I look back now and I think
about a 15 year old using harddrugs, um, and I'm just, I mean,
I'm about a 15-year-old usinghard drugs and I'm just, I mean,
I'm like, oh my God, you know,they're so young, they're so
innocent.
And I realize, I look back thatI mean I had, you know, set all
caution to the wind and waswilling to try whatever I could
(10:41):
get my hands on.
You know, I got pregnant at ayoung age and I remember when I
had my daughter I thought, okay,this party lifestyle has to
stop.
And again I just reiteratedagain I just had no idea what I
was up against.
I could have passed a liedetector test if somebody would
have given me one, that I wouldnever touch another drug again,
(11:06):
I believed that I had notrealized that I had lost the
power of choice.
Speaker 2 (11:10):
Yeah, you know what's interesting about that is you
had to, because of both natureand nurture.
You had to do what we callunlearning, to learn, and you
had to go through a process tocorrect your thinking errors.
Right, like you used the termthat it was normalized in your
(11:31):
world because you grew up inthat environment.
And how do you practice ahealthier lifestyle and how do
you create, you know, a habitand we're going to get into that
in a minute.
You know how do you unlearn tolearn.
In that regard and, dave, toget to you real quick, though,
(11:52):
on that I know you've beeninvolved and seen it from an
employer perspective, aworkplace perspective
perspective, and, interestinglyenough, the societal cost to
substance use in america economyis 532 billion dollars a year
(12:13):
and, uh, it's a very difficultsubject for, let's say,
employers and people in thewellness business to deal with.
And what are some of yourlearnings and what are things
that you think we need to do toapply to help there?
Speaker 5 (12:28):
Sure.
So to add to this conversation,we spend a lot of our adult
life at work, right?
So think about that just for aquick second.
And if you're an individual inrecovery or battling an issue,
you have to hide that many, manytimes and that can be very
(12:52):
taxing on the mind.
So what I've learned over theyears is employers, generally
speaking, do mean well and theywant to provide resources to
their employees, but they don'tnecessarily want to get deep in
regards to training and how tohandle very specific situations.
(13:13):
So to your point, thosebillion-dollar numbers sometimes
don't include absenteeism andthe lack of workforce
productivity, because I'm simplynot happy at work and I need
help from someone and myexpectation is that I want my
workplace to throw me a lifelineon some level.
(13:33):
So what we're trying to do hereat GOMO is to try to train
folks either the employee or theemployer or their direct report
to think clearly while they'rein crisis.
So you know we've got lots ofyoung moms out there across the
country.
Then their son or daughtermight have an earache, so they
(13:56):
simply panic and take their sonor daughter to the ER, where
they could have just had ateledoc visit instead.
So we're trying to shift thatcontinuum and further train the
brain, if you will, and have ourfolks practice what we're
preaching and then when they dohave a crisis situation they can
think clearly do I have thatbenefit available to me?
(14:18):
And then we can have theemployer help to train on those
types of instances and issues.
Speaker 2 (14:23):
Yeah, that's fascinating because Annette now
is a supervisor, so we're goingto get back to Annette in a
second.
But, charlie, from yourexperience heading SAMHSA and
your other activities andbehavioral health, what is the
impact of, let's say, either asupervisor at work,
(14:43):
understanding how to handlefolks with addictive behaviors
and what to do, and also havinga loved one you know as support
in that and how to help theloved one through that?
So give us some of yourthoughts of the importance of
that.
Speaker 4 (15:00):
Yes, part of my background also included a
period of time that I wasinvolved in risk management and
the one thing I learned there isthat that is very clear that
the person that has the mostimpact on someone in the
workplace is the immediatesupervisor.
So that is a critical thing.
(15:21):
Whether a person likes theirjob or not, even if they're
retrained to work after aninjury, the main determining
factor is whether they like thesupervisor more than the
progress they're making with theinjury, so that supervisor is
in a real critical position.
So training there, having toolsavailable there, is very
(15:42):
important Also supports, I mean,the individual, as Dave was
saying, in the workplace.
They're spending most of theirtime there, but they do have a
family.
They do have loved ones intheir life and loved ones many
times are at a loss.
How do I support my loved oneif they're in the throes of an
(16:09):
addiction or if they'restruggling with substance use,
for example?
Again, tools being available toloved ones to be able to
support and having a tool that'savailable 24-7, like we have in
digital therapeutics, is atremendous breakthrough.
We did not have those types oftools a decade, two decades ago.
Speaker 2 (16:24):
That's so true ago, that's so true.
And GOMO Health.
Dave and myself we're workingwith SAMHSA, now the White House
, on a national recoveryinstitute that just formed.
It's a nonprofit and GOMO isone of the toolkits and in a
little bit we're going to haveDave describe, you know, within
(16:46):
that to your point.
It provides psychologicalsafety, supervisor, training,
training for the employees andthen a special track for people
in treatment and recovery.
So, but to get back to thereason why that's important, I'd
like Annette to talk about.
You know from where she justleft off.
(17:08):
Did she have any support people?
Where did she find them?
How did she get through it?
And a little bit of her storyin that regard, of where she
ended up and came out of.
Speaker 3 (17:23):
Thank you.
Yeah, so you know, I, you knowaddiction really.
I mean it really took my life,and it wasn't until my early 30s
, late 20s, early 30s, I wassentenced to a treatment court
program.
And man, I'll tell you whatthat's.
(17:45):
A lot of work, that's a lot ofwork.
And you know, there had alwaysbeen this thing inside of me
that I wanted somethingdifferent.
I did not like the way that Iwas living.
I had lost a lot.
I was no longer able tofunction in society.
I, to be the most, was a goodmother to my children, and I
(18:11):
just lost the ability to do that.
And so, when I got into thistreatment court program, I had a
mustard seed size ofwillingness, but I really had
felt like I had fallen too fardown the scale for recovery to
be possible for me, scale forrecovery to be possible for me.
(18:33):
So the wonderful thing abouttreatment courts is they really
wrap you around with servicesand they keep you pretty busy.
And so, you know, as I got intothat program, though, I felt
like the people who maybe hadsome recovery I didn't fit in
with, and so I'd find myselfsliding backwards, you know,
calling old friends going to oldplaces, and I'd find myself in
yet again another relapse andI'd have to show up and let the
(18:56):
court know what happened and beworried that they were going to
put me in jail.
And it was just it was.
I remember it just being areally, really hard time for me,
just not knowing where I fit,not knowing where to find these
people that are actuallyrecovering.
One thing that I really valueabout GOMO Health is, you know,
(19:18):
we have it set up for our drugcourt participants where they
can text, and so it's not likethey're lifting, you know, a
hundred pound phone to callsomebody they don't know.
We have peer supports availableto people 24 hours a day, seven
days a week, and all they needto do is text that I'm triggered
(19:40):
, I'm going to relapse, andwe're responsive to them.
We get a hold of them rightaway.
Figure out what they need andprevent that relapse from
happening.
Way, figure out what they needand prevent that relapse from
happening Because really, truly,crisis doesn't usually happen
Monday through Friday from eightto five.
right, there's a counseloravailable.
(20:00):
There's a counselor availableto somebody.
Typically you're in a group oryou, you know.
But after five o'clock, whenthe businesses are shut down and
a person who's early inrecovery is home alone and
they're with their thoughts andI'll tell you what a newly sober
person's mind is like a ghetto.
They should not be there alone,because it gets rough and you
(20:21):
just start thinking about lifeand what it could be and what it
has been, and pretty soonyou've talked yourself into
having a drink or going andgetting high, and so the the
ability to provide support afterhours is a really, really big
deal.
Speaker 2 (20:38):
Let's get into some of the aspects of, you know,
brain training, cause I knowAnnette you've also talked about
in the past which you knowmaybe you were fine in the
morning and four hours later youwere depressed or off the rail,
and you know how do you managethat.
So in my world of braintraining, it's in unlearning to
(21:01):
learn and correcting thinkingerrors.
It's sort of fascinating.
Healthcare hasn't really had away to practice.
How do you practice not beingaddictive, right?
So there's one thing you couldsit in treatment an individual
(21:22):
session, group session and thenyou go back to your daily life,
right, and you have all thestressors and embarrassment, not
feeling you could take care ofyour kids, belonging, all those
things.
So what we've done from adigital treatment to augment the
human care management team ishelp you practice.
And to give you an example, ifyou're learning to play piano,
right, so you may go toinstructor for half an hour.
(21:44):
They come to your house or yougo there, but what does the
instructor tell you?
Hey, if you want to get good,you have to practice an hour a
day.
You want to make the highschool team three hours a day?
You want to make the BostonSymphony six hours a day.
So it's up to you and they'llgive you some skills but you
have to practice them.
So in the digital therapeuticfor substance use, we provide
(22:08):
people to correct their thinkingerrors, we give them things to
reflect on practice activitiesand we make them self-aware and
critical awareness of that.
So I would like the three ofyou to comment on that.
But, annette, talk about youknow that substance use.
(22:28):
In many respects you've lostthe ability to choose freely and
it takes a disciplined time andeffort to get out of that.
So maybe you talk about yourstruggles and what has helped
you.
Speaker 3 (22:41):
Absolutely, yeah, you know.
So when your brain is wired forimmediate gratification, I mean
I'm feeling some feelings.
I don't want to feel them, I'mgoing to, I'm going to seek some
sort of chemical comfort to getme out of this.
That, for a period of time, isinstantly where your brain goes.
(23:07):
And so when I was early inrecovering, when I found myself
in those moments of this hasgotten really uncomfortable, I
don't know how I can handle this.
Um, I would really practice thispositive self-talk.
You know this um, sort of thesedbt skills of like I'm gonna,
(23:27):
I'm gonna be in the moment rightnow.
I know this is gonna pass, um,I'm and.
And if it doesn't pass, youknow, let five, I let five
minutes go by.
I'm still feeling okay, this isnow.
I know I need to reach out tosomebody, and typically reaching
out in connection with anotherperson will sort of bring me to
right where I'm at right now andnot you know where my head's
(23:52):
telling me I should be.
When you're so used to being insuch a negative head space,
being able to allow yourself tostart to look for positive
things every day, start to, ifit's a mantra, if it's a daily
(24:12):
devotion, if it's aninspirational message to start
your day out with that and thenbring your mind back to that
when you are you know when fourhours later you're a mess again.
Speaker 2 (24:23):
No, absolutely.
And you know what's interestingthere's almost a 50% crossover
between mental health andsubstance use.
Substance use, Charlie, haveyou seen a shift from years ago
to now where maybe they treatedthem wholly separately, like
substance use didn't recognizemental health, mental health
(24:44):
didn't recognize, but they bothtrigger each other?
Have you seen a shift in howhealthcare is addressing that?
Speaker 4 (24:51):
Yes, I have, and it's a positive shift.
Again, going back to when Istarted out in the field over 40
years ago, you had separatetreatment for substance use,
separate agencies, as well asfor separate agencies for mental
health, and yet, as youindicated, a very high
percentage 50% or more, we'rereally talking people have
(25:14):
co-occurring mental healthissues along with substance
abuse, and we also have foundthrough the years that if you
treat them, in an integrated wayor concurrently.
At the same time, you get muchbetter results than if you treat
them separately.
Unfortunately, years ago peoplewould go to a substance use
agency and if it was determinedthey had a mental health problem
(25:36):
, it's like, well, you need tohave your mental illness treated
before we can treat you forsubstance use.
Go to a mental health facility.
You need to have your addictiontreated before we can treat you
.
I think we're getting beyondthat today, which is great news.
And again, integrated care,whole person care.
We're understanding that andpeople are getting better
results, and tools like thedigital treatment that you've
(25:59):
offered through Black Girldefinitely help facilitate that
process of addressing both whatneeds to be addressed with
mental health as well assubstance use.
Speaker 2 (26:10):
Yes, so I think now we're just thank you, charlie,
and actually, when we get backfrom break Dave, we're going to
talk about some of the digitaltools that are helping that
crossover that Charlie justmentioned.
Speaker 1 (26:22):
Plus, our listeners have really come to enjoy a
little bit of a pause as we playsome brain games, which are
just examples of how you can getyour brain to be more fit as
well.
So we got that coming up, plusmore with our guests on Brain
Training.
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