Addiction Medicine Made Easy | Fighting back against addiction
Addiction is killing us. Over 100,000 Americans died of drug overdose in the last year, and over 100,000 Americans died from alcohol use in the last year. We need to include addiction medicine as a part of everyone's practice! We take topics in addiction medicine and break them down into digestible nuggets and clinical pearls that you can use at the bedside. We are trying to create an army of health care providers all over the world who want to fight back against addiction - and we hope you will join us.*This podcast was previously the Addiction in Emergency Medicine and Acute Care podcast*
Addiction Medicine Made Easy | Fighting back against addiction
Stories From My Patients That Teach Me About Addiction
Can personal stories of struggle and resilience reshape our understanding of addiction? The answer is YES! My patients teach me about addiction all the time!
Join me, Dr. Casey Grover, as I share the powerful stories of three patients whose experiences challenge society’s perceptions of addiction. Their journeys highlight the need for understanding over judgment and the vital role healthcare providers play in supporting those in need.
This episode is a heartfelt call to action. Byy raising awareness and extending support, we can improve addiction treatment and break the stigma surrounding this complex issue. Listen in and join a community committed to compassion, advocacy, and meaningful change.
To contact Dr. Grover: ammadeeasy@fastmail.com
Welcome to the Addiction Medicine Made Easy podcast. Hey there, I'm Dr Casey Grover, an addiction medicine doctor based on California's Central Coast. For 14 years I worked in the emergency department seeing countless patients struggling with addiction. Now I'm on the other side of the fight, helping people rebuild their lives when drugs and alcohol take control. Thanks for tuning in. Let's get started.
Speaker 1:Today I will be sharing some patient stories. My patients are wonderful people. Yes, they struggle with addiction, but they are kind and intelligent people. I do have some challenging cases, but for the most part, going to work, seeing my patients with addiction is awesome. Some of my patients are among the nicest people that I have ever met and they teach me things all the time.
Speaker 1:I am going to share three stories with all of you today that can help us to understand addiction better. One story comes from one of my patients who sent me one of the most insightful messages that I have ever received about addiction while he was in active relapse. Another story is from one of my patients who was about six months sober and using poetry to process her PTSD that led to addiction. And the final story is from one of my patients who recently died from overdose. His mother and I had been corresponding after his death and she asked me to highlight what a kind and caring person he was when he was sober. So let's start with the first story. This is a gentleman who struggles with alcohol use. He's really intelligent and has incredible insight about his addiction. While he was in active relapse, he sent me the following message. While he was in active relapse, he sent me the following message. I edited it slightly to make it fit better in podcast format and he gave me permission to share it with all of you. I share this to point out that while my patient is in active relapse, actively under the influence of substances, he remains a thoughtful and intelligent person. I sent him a message to find out how he was doing, and here's what I got in return.
Speaker 1:Quote no, I just blew up. Every single thing in my life. Every single thing that I worked so hard for is now gone. Every single dollar is gone. Credit cards are maxed out from cash withdrawals. I'm on day 15 of this binge. I have zero money for travel. My family is disgusted with me. Every business client will be gone in about two days if I don't find a way to cram 60 hours of work into two 10-hour work sessions.
Speaker 1:Worst part about this is I think I did this all on purpose. I know you're not a psychotherapist, but I'm going to tell you this anyways, because you're the only one who has been there for me to really try and help me and not look at me like I'm less than human. And that's how most of the world sees us addicts like we're less than human. I see it in people's eyes when they walk past homeless people on the streets. I can see it in their eyes when they look at me. Moreover, every time I've built something up for myself, I completely destroy it. It's just a matter of time.
Speaker 1:The funny thing is, I just randomly learned that the writer Dostoevsky, after he would write a successful book and make a whole bunch of money, he would go lose it all at the casino, because having nothing would give him the motivation to write his next great novel. I realized that's what I've been doing to myself. I'm in a cycle of self-destruction, because it's almost like being addicted to re-creation. I cannot see or find a way out, since I don't have any damn money left. This will most likely be my last drinking day and I desperately need to get sober. My intuition is that these withdrawals are going to be brutal, since I've barely eaten any food during this binge. I'll take that naltrexone shot after I get sober, but before I do I would like to understand all the side effects that can potentially happen.
Speaker 1:Finally, I know your education is in medicine and you think in terms of medications to help people, there's also legality on what you can and cannot do. You speak publicly about addiction, you have a podcast about addiction, and so it seems to me like you're really trying to tackle this beast head on. In my humble opinion and from my experience with this, you will never solve this problem with medication. The medication is vital to getting us sober and helping ensure that we don't die from the withdrawals, but if you really want to change the world and make a dent in addiction, there needs to be drastic push for more treatment centers that are not like jail in the middle of nowhere, surrounded by nature, for a mandatory 12 month stint. 30 days won't cut it either. The people who go there must work the land there's no escape and they will reconnect with their soul and what matters most. Some of these exist, but they're like $30,000 and just for 30 days. I and others like me can't afford that. Programs need to be publicly funded, but the standard of care needs to be maintained to the highest level so that it doesn't become like our public education system. In my opinion, it's all about changing the environment in a way that can let the brain heal.
Speaker 1:If you're unfamiliar with the rat experiment with cocaine, please look it up and you'll understand what I'm about to tell you about. They put rats in confined spaces and they put rats for comparison in an open playground. Both had access to cocaine through their water bottles. The rats in confined spaces, I think, died or overdosed. The rats in the playground didn't even want the cocaine.
Speaker 1:My point is medication, while necessary in certain situations, is not the answer. It has been and will always be a temporary fix. It doesn't solve the root of the problem. The reason I'm saying all of this is because there is a serious problem brewing in our society and no one is talking about it enough to where it's actually going to make a difference. We're going to need doctors like you willing to take on this challenge in the right way. The opioids and heroin are wreaking havoc. Alcohol kills everything it touches. Cannabis is going to kill societal productivity. Methamphetamine is making people commit heinous crimes. Cocaine withers people away until they're nothing. I truly believe that the way to help us is by putting us in an environment where we can fully heal. We need more treatment centers, we need more psychotherapists and we need people not to give up on us when we keep messing up time after time after time after time. End quote. I just want to pause and appreciate the wisdom in his words. The reference he made about rats refers to an experiment often called Rat Park that found that isolated rats in a cage by themselves used drugs compulsively, while rats in a fun and social environment with other rats did not. There's actually a great TED Talk on this topic on YouTube by the author Johan Hari that explains it in detail. If you want to learn more, I would definitely check it out.
Speaker 1:Next, one of my patients gave me permission to share some of her poetry. She's actually currently doing great. She's about six months sober and wants to become a drug and alcohol counselor. She's had a rough time in her life, including surviving assault and serving time in prison, and yet, as you'll hear from her poetry, she is a very thoughtful and intelligent person. Here's her first poem, free From the Inside.
Speaker 1:Quote free from the inside, in shadows, deep where secrets lie. A child's heart learned to survive Through pain and struggle, silent cries. A spirit fought to stay alive, innocence lost, a stolen youth, a mind confused, searching for truth. The games they played, the lies they told left scars that time could not withhold. Years went by, the pain remained, a soul in torment, deeply stained In prison walls. Survival's art, a hardened shell, a guarded heart, with every braid, each drawing made a piece of hope, a light displayed Through letters penned. Connections sought a way to cope, a battle fought. Drugs became a fleeting friend, a means to numb, a way to mend. But deep inside, a voice would say there's more to life, a brighter day, released at last. The world seemed strange, a mind in turmoil seeking change. In therapy, the healing starts, a journey back to mend the heart Now free from chains, both seen and felt. A story, shared emotions dealt Through pain and struggle. Strength is found, a life rebuilt on solid ground. And here's her second poem, the Journey Within Quote.
Speaker 1:The Journey Within Quote unfolds in whispered dreams and paths untold, through valleys deep and mountains high. I search for me beneath the sky, in mirrors gaze and shadows cast. Reflecting on the moments past, I find the threads of who I've been weaving the fabric of the unseen. With every doubt and every fear, a clearer voice begins to steer Through the storms and through the night, guided by an inner light Embracing flaws, embracing grace. I see the beauty in this place. The battles fought, the scars I bear shape the soul that I now wear. For in the silence, in the still, I find the strength, the iron will to be the self I'm meant to be, unveiling life's true mystery. So here I stand, unmasked, alive, no longer hiding. I now thrive In knowing me. My spirit's free, in finding self. I'm finally me. End quote. Ooh, that was a good one. I just got goosebumps. I'm going to reflect on this a bit Now.
Speaker 1:I don't know about you, but I never knew this side of addiction growing up. I was taught growing up that addiction was a condition of weakness, of poor morals. Only bad people developed addiction, and that wasn't just from my family or my school. That was very pervasive at the time and, interestingly, I was taught something very similar as I finished medical school and began my residency training in emergency medicine. I was not given good education about addiction and I now know that, addiction being something about weakness or poor morals. That could not be farther from the truth. Most of my patients have lived through horribly traumatic and difficult experiences and they use drugs and alcohol to cope with the negative emotions that came with those traumas. And yet, despite those traumas, they persevere as intelligent and kind people. And that's this patient's story. She's been through so much and now she's starting to process these traumas and heal. I actually saw the patient who wrote these poems the day before I recorded this episode. We had a great visit and I'm really excited for her to become a drug and alcohol counselor. She will do a fantastic job.
Speaker 1:Now on to our final story. I lost my first patient to overdose in the past few months, and let me clarify I've had many patients die over the years in my career in emergency medicine, but this was the first patient who I took care of in addiction medicine and followed, who died from an overdose. He came to see me under the influence of substances at his first visit with me. He was very uncooperative during the visit and even hostile. The visit was tense and I offered to follow up with him after our first visit. We connected for a phone call after he had sobered up and he actually apologized to me for his behavior and asked for help. He wanted me to restart his psychiatric medication, which I did the next time I saw him in the office. He was incredibly pleasant and we actually had a great visit. He was motivated for recovery and expressed hope for the future. Unfortunately, he relapsed after that visit and I did not hear from him again. He died from overdose a few months later.
Speaker 1:His mom reached out to me after his death. She asked me to share his story to educate about addiction. I am going to share with you what she shared with me. His name was Christian and here's what his mother wrote about him. Quote Christian had a heart of gold. Anyone from his childhood or adult life could confirm he was kind, funny, charismatic, selfless and loyal In turn, doing his best to block out the negatives, which is where his addiction came into play. Drugs offered Christian an escape from his demons he faced throughout his life. Silence would mean Christian's death was in vain, but if one person's life is saved by his story, we could tell it a million more times. We know the pain of his suffering. We know the pain of our own suffering as his family, and we know there are hundreds of other people in our community suffering as addicts or as loved ones to them, speaking the truths, no matter the circumstances surrounding the epidemic of drug use, may be the difference between life or death. In honor of Christian, I want them to know his story, end quote.
Speaker 1:I wanted to highlight his story to point out how people with addiction can be really kind and genuine. Many of them, as Christian's mother spoke about, have suffered through trauma and are just trying to deal with negative emotions by using drugs and alcohol to cope. We've heard that multiple times in this episode. Unfortunately, people with addiction can be very different. When under the influence of substances and an active addiction, it can be very difficult for family members to see the wonderful people that they are sober, in contrast to how they act when under the influence of drugs and alcohol.
Speaker 1:If you want to, you can go back and listen to the last episode from this podcast on dual brain psychology. My guest on that episode, a Harvard-affiliated psychiatrist, shares insight on how behavior can change so much during addiction. I want to leave you all with a simple take-home message we need to stop judging people with addiction. We need to help them get treatment and get them on the path to help and happiness that they deserve. I hope you learned something and thank you for your interest in improving access to treatment for addiction.
Speaker 1:Before we wrap up, a huge thank you to the Montage Health Foundation for backing my mission to create fun, engaging education on addiction, and a shout out to the nonprofit Central Coast Overdose Prevention for teaming up with me on this podcast. Our partnership helps me get the word out about how to treat addiction and prevent overdoses To those healthcare providers out there treating patients with addiction. You're doing life-saving work and thank you for what you do For everyone else tuning in. Thank you for taking the time to learn about addiction. It's a fight we cannot win without awareness and action. There's still so much we can do to improve how addiction is treated. Together we can make it happen. Thanks for listening and remember treating addiction saves lives you.