Ep. 16 The Humble vs Humiliated Truth About Long-Term Recovery with Dr. Robert Sanchez

What's the difference between being humble and being humiliated in recovery? Dr. Robert Sanchez, a certified intervention professional with 18 years of sobriety and over 31 years in behavioral healthcare, reveals the daily reality of maintaining long-term recovery that most people never see. After more than 20 treatment episodes across three decades, Robert discovered the profound truth that changed everything: recovery isn't just about stopping-it's about becoming someone entirely different. His journey from repeated treatment failures to sustained sobriety offers hope and practical insight for anyone navigating addiction, whether personally or with a loved one.

Robert shares the stark reality behind today's cannabis-induced psychosis epidemic, why Florida's legal framework saves lives that other states can't protect, and the critical first-year recovery statistics that determine long-term success. From his work as a forensic psychologist in maximum security prisons to his current intervention practice, Robert breaks down the neurological truth about addiction as a disease, not a choice, and explains why modern marijuana at 60-90% THC concentration is creating unprecedented mental health crises. This conversation goes beyond surface-level recovery advice to explore the deep work of rebuilding identity, maintaining humility, and creating sustainable change.

Contact Mark Astor:

Website: https://mentalhealthaddictionlawfirm.com/

Phone number: 561-517-9405

Email: mark@astorsimovitchlaw.com

LinkedIn: https://www.linkedin.com/in/markastor

TikTok: Mark G. Astor (@astorsimovitchlaw) | TikTok

Contact Dr. Robert Sanchez:
Website: AxiomHealthServices.com
Phone: 833-932-9466
Veritas Training: VeritasTrainingGroup.com

Transcript

SPEAKER_00 0:00

A part of getting sober is understanding who and what you are. And so, in order to do that, you have to have some self-honesty and some humility. And over time, we look to develop that quality because I've heard it said many times, there's two types of people in AA: the humble and the humiliated.

SPEAKER_01 0:20

It's the journey with drug and alcohol attorney Mark G. Aster. Welcome to the journey with Mark Astor. I'm your host, Mark Astor. I spent a lot of years sitting across the table from people during some of the most challenging moments of their lives as an attorney, an advocate, and as someone who understands that the road isn't always straight. What I've learned is that success, recovery, and growth rarely look the way we expect them to. There are detours, hard conversations, and moments that change everything. On this podcast, I talk with people who are willing to be honest about their journey, what worked, what didn't, and what they wish they knew sooner. So I am really excited to have not just a really good friend, but a world-class clinician, Dr. Robert Sanchez. Let me tell you a little bit about Robert because he's too humble to tell you himself, so I'm going to do it for him. Robert is a certified intervention professional with over 31 years of professional experience in the behavioral health care field. He bases his approach on empirically validated intervention strategies for various types of addiction and mental health conditions. His experience includes interventions and behavioral health care consulting across multiple states like Florida, New York, California, Texas, and many other states in this country. He has served in the capacity of Chief Executive Officer, Chief Operating Officer, and Executive Director in multiple facilities over the past three decades. Additionally, he has served as an expert consultant in forensic settings in Florida, New York, California, and Texas in courtroom forums, jury research, and mock trials for the Department of Corrections. How are you doing? So good to see you. I'm good.

SPEAKER_00 2:00

Good to see you, Mark. Good to be seeing.

SPEAKER_01 2:02

So let's start with your own personal journey. I know that you're in recovery, so tell us a bit about that. How long have you been in recovery and what was life before and what's life like since?

SPEAKER_00 2:11

I'm 18 years sober. I was somebody who had a problem with alcohol from the very first time that I touched alcohol. And my parents were really good people and put me in treatment centers. I was in a wilderness program by the time I was 14 years old for a year. I came from a highly educated family. My father was a physician, my two brothers are physicians. And I thought if I can just go to school and accumulate some degrees and take care of the career piece, that my alcohol issue will resolve itself over time. And turns out I was wrong. So I went to treatment in the 80s, I went to treatment in the 90s, and I went to treatment in the early 2000s, which is a quick overview. And after many treatment episodes, probably over 20, I came to the conclusion that I probably had this condition known as alcohol use disorder, is what we're calling it in the DSM V now. And it's referred to as alcoholism. And basically, Mark, once I start, I can't stop. And once I stop, I cannot stay stopped. There are neurological reasons for this. There are medical reasons for this. And so I joined Alcoholics Anonymous and did the clinical piece and did all the work that people like me do to get right with that particular condition, abate from the use of alcohol in its entirety, and join a 12-step based program. And for that I am truly grateful. A lot of people try, and many people don't stay in it. But I've been very fortunate to have good sponsors, good mentors, and good supports throughout this 18 years. And I'm still very active in AA. I say was doing a step series now. I was speaking at a meeting last night, sponsor a bunch of guys, read our literature, pray regularly, and do all the things that AA has taught me to do, to not just stay sober, but be happy and to have long-term contented sobriety. And that's what's most important to me. So that in a nutshell is my story.

SPEAKER_01 4:04

It's interesting. So we started to work together professionally and we've become, I think, I would probably say you're my closest guy friend. I talk about stuff with you, I probably don't share with any other guy. And so for that I'm always grateful. But when I tell families about what recovery looks like, I think I've learned the most about what that looks like from you. Because with all the years that you've been in recovery, I know that you work on your recovery daily. It's been countless times I've called you, and you're like, got to call you back. I'm in a meeting. And that's what I tell families, right? It's not just going in recovery, it's being able to maintain it. And I know that you work on that. I hate to use the word religiously, but I think that maybe that's the appropriate term because you work on your recovery all the time.

SPEAKER_00 4:44

Yeah, so that's just about daily maintenance, and that's a practice, and we learn that, and it's like health. You're never in the absence of health. You have good health, you have whatever regular health or bad health, but you have health. You cannot be absent of health. And the AA recovery program is about that, right? You have this sort of condition, and there are ways to engage in daily maintenance, such as attending meetings, sponsoring guys, reading our book, getting involved in service. And I have to tell you, Mark, that I said this last night from the podium. I'll say it here is that a life of service is a beautiful life. It's really a beautiful life. The byproduct of that life has been nothing short of amazing for me and for those around me. And that's also important to me, my family, my wife, my three stepchildren, my biological daughter, my mother, my brothers, and friends like you, and how to show up for people, right? And just how to be a better father, a better husband, a better friend. And I'm always looking to improve that, Mark. A part of what AA teaches us in 10, 11, 12, not to get I'll keep going if you keep asking. But 10, 11, 12 are the maintenance and growth steps where we constantly look at what are we doing? Aside from abstaining from drinking and aside from being sober, just how am I showing up in life every day? Am I showing up the way that that I would like to? And if I'm not, where I'm faltering, how can I improve? And I do that every day because everybody in AA does that. That is not unique to me. That is everybody that I've ever met and respect and have support with in Alcoholics Anonymous. And thank God for good sponsorships and good fellow supports in AA. It's a beautiful thing. I I don't know that I'm even able to put it into words correctly, but I'll just say that it has given me what we say around AA a lot, which is a life beyond my wildest dreams. And that's what I have today.

SPEAKER_01 6:29

Yeah, you shared a phrase with us before we came on humble versus humiliated.

unknown 6:34

Yeah.

SPEAKER_00 6:35

Sure.

SPEAKER_01 6:36

I'm always learning from you, so share that with us.

SPEAKER_00 6:38

Yeah, yeah, yeah, sure. Part of getting sober is understanding who and what you are. And so, in order to do that, you have to have some self-honesty and some humility. And over time, we look to develop that quality because I've heard it said many times, there's two types of people in AA, the humble and the humiliated. And Lord knows that I've taken plenty of feedings of humble pie in these last 18 years, but it's about staying right-sized, right? Having a modest opinion of oneself, not too high, not too low, right-sized. And that is a key component to sustaining not only sobriety, but just happiness in the world, to understand that I'm a spoke in a wheel of whatever system I'm a part of, to contribute towards the ultimate, superordinate goal, whatever that might look like. That I'm not the king of all things. That the and the alcoholic, again, I want to be clear for me, for my personality, that is something that is really important. And I would say for most people that I know in AA, humility and honesty, self-honesty are the most important features to start and sustain long-term recovery. There's a lot more to it than that, but those are key pillars to continue to grow and stay sober and be happy. Yeah. Okay.

SPEAKER_01 7:55

Let me switch gears with you for a second. I know that part of your training was working in the Department of Corrections. Tell us about that.

SPEAKER_00 8:03

Yeah, so I went down a forensic path. I hold a doctorate in clinical and forensic psychology. I hold I hold five degrees. I hold five degrees, three postgraduate degrees, an associate's a bachelor's, two masters, and a doctorate in clinical informic psychology. When I was starting to go down the path of the forensic worlds, I worked for the Department of Corrections in two settings. One was here in the state of Florida very early in two, 2003, and I worked for them for a year. My role there was to do psychological testing, psychological profiling of patients for classification purposes. And I did what are called psychiatric emergencies, psychological emergencies, we called them. If an inmate was threatening to harm himself, harm someone else, or was floridly psychotic, they would send me out to the units to do an evaluation to determine if the inmate was malingering or whether the inmate was in fact having some sort of suicidal, homicidal ideation or psychosis and needed to be put into the infirmary and sometimes transferred out of the unit. So that's what I did in Florida. In California, same thing. There were some differences. It was a maximum security prison, but it was also a mainline prison. So it was the receiving area from the county jails once inmates were sentenced. So on the one day a week, I did nothing but about 100 to 200 evals, quick, sort of brief evals on all the inmates that came in. We ran 12-hour shifts, and my job was to ensure that the classification from the medical department and from the department of mental health was accurate so that uh the Department of Corrections could make a good assessment about placement. So there's two things: there's placement for level of security, and then there's placement for any medical conditions. And then through the rest of the time, I did what I did in Florida. I evaluated and classified inmates. Sometimes, if there were question marks about diagnostic profile and psychological emergencies. So that in a nutshell is what I did for the Department of Corrections, both in Florida and in California.

SPEAKER_01 10:01

Okay. These days, I know that like me, you work with your wife, Jennifer, who has also become sort of part of our family. Tell us about what you and Jennifer do. What kind of services do you provide?

SPEAKER_00 10:13

Yeah, so we provide a variety of services. We'll start but the most intense and work our way down. We do interventions, we do case management in high acuity cases where they may require a Marchman Act or a guardianship or a or a Baker Act to get patients in high acuity settings safe. We can also transport patients, do coaching, and do sort of companionship. There's a number of things that we do. We also can do evaluations, make determinations about diagnostic profile. But what we love to do is we love to do all of it. And Jen's a nurse, so she brings a nursing component to the work that we do, and we do this work in concert with you, with her, which is great. That's our foundation. But Mark, I often say that we're only as good as the people we collaborate with, and I truly believe that. That is a fundamental belief of mine. And so you're, of course, one of those people. But there are people around the country that we trust and have worked with for many years, including yourself to a large degree, to save lives. Essentially, we are saving lives because oftentimes when the cases come to us, they're dysregulated, that it's a matter of I love the ad of do no harm and preserving life. And those are the values that guide the work that we do every day. But that in a nutshell is what we do interventions, case management. We can do some transports, companionship, coaching, and guiding families as to how to navigate a very challenging system through from other countries at times, and a lot of times throughout different states in the United States. And as you well know, Mark, all of the laws in each state of the 50 states work differently, and helping them navigate what their choices are and putting those choices before them when they have a loved one who is impaired, secondary to sometimes medical reasons, traumatic brain injury seizures, sometimes mental health conditions such as schizophrenia, depression, anxiety, and sometimes substance abuse that cross over and are doing both, like cannabis-induced psychosis, which of course is something that is very prevalent around our country and is on the rise, and in my opinion, will continue to rise simply because cannabis is more concentrated, cannabis is more readily available, and the laws make it very easy for lots of people to obtain cannabis in the different states in the United States. And that's a hot button topic.

SPEAKER_01 12:35

I know I'm going to spend a little time talking about that, but let's talk about the kinds of cases that we typically work. We have a new phrase that we put on our website where legal meets clinical and clinical meets legal meets legal. So let's talk about the typical family that calls either me or calls you. What are they dealing with?

SPEAKER_00 12:52

Yeah, usually by the time that they've called us, they've tried it in in some cases, they've tried other measures. They may have tried outpatient. The person may have even been to a psychiatric hospital, possibly even a rehabilitation facility. It depends. But usually they are high acuity cases. They're not always, but I would say a lot of them are what I would call high acuity cases. And what does that mean? It means that there's at least some history of suicidality, some history of homicidality, or some history of fluorid psychosis, or they're presently fluoridally psychotic. And usually the family doesn't know what's happening. Sometimes they may have some idea, but other times they don't know. And then they don't know what to do. Because when you have a loved one who is incapable of making good decisions for themselves, then it's not going to be a standard sort of intervention. Though we do also get people with alcohol use disorder, cannabis use disorder, cocaine use disorder. We see a variety of things, but by the time they call us, Mark, they usually are going to have to consider, at least in many cases, some legal mediums to not only get their loved one into treatment, because you talked about this, and I think it's key, is what does the plan look like after treatment? And what is that going to look like? What's post-treatment going to look like? And what protective factors, which is what ultimately the Marchman Act serve to do? They serve to do a few things, get them into treatment, and provide some protective factors so that treatment can continue or guardianship. And sometimes, as you well know, we have to use the combination of all three: Baker Act, Marchman Act, Guardianship, so that the family can get some protective factors around that loved one until they're have been treated for long enough at the appropriate level of care to then have a good outpatient plan in place and sustain that outpatient sort of strategy. And what I find, and I'm sure you've seen the same, is that even when patients go to treatment and do well, if the outpatient plan is not intact and is and there's not some mechanism to help support that patient along the way, then there's a high rate of relapse and recidivism back into what they were dealing with prior to that treatment episode.

SPEAKER_01 15:01

Okay. Can you talk to us about the whole idea, the whole sort of concept of disease versus choice? Because a lot of the sometimes the we speak to families and say, why doesn't he just stop doing this? Or she stopped doing this. And I think the evidence is that it's not necessarily a choice, it's more of a disease, right? And can you shed some light on that from a clinical perspective?

SPEAKER_00 15:20

Certainly. There's been a number of really amazing studies, and with modern technology, with functional MRIs and brain mapping techniques and things we weren't able to do 50 years ago, we've been able to not only identify that this is a neurological condition, and by the way, this was noted as a neurological condition in the 50s. So it's not new, it's 70 years old. But after it was classified as a medical condition, as per the American Medical Association and American Psychiatric Association, there's been studies and research and data to show that the brains of people who have substance abuse conditions, just like in mental health conditions, are neurochemically and neurostructurally different than that of the normal population. So the data speaks for itself. And the treatment then often is looked at in this way. So, for example, we know that what causes psychosis is an excess amount of dopamine. So we know that a patient cannot just decide to have less dopamine, much like a patient can't decide to tell their pancreas to produce more or less insulin, right? Which is the premise of diabetes. So much like a medical condition, it's not about choice in terms of having the condition. We know that alcoholism, addiction, and even mental health conditions are not an issue of morality, as was thought some time ago, but they are a function of neurochemical imbalance, just like any other medical condition, that is about a lack of homeostasis, right? Our body has millions of systems that it uses every day to keep things in balance. And when one of those systems fails or is faulty, then it creates uh a medical condition. We know that this is true. What I would say to some families when they say those things is it's not the loved ones' fault that they have this condition, but once they're stable, it is their responsibility to remain in treatment. The problem, Mark, is that in the middle, like before they get into treatment, many patients are not capable of using good executive functioning because they're no longer able to think clearly. Else the families wouldn't need us, nor would the patient. They could just go seek treatment. But by the time they call us, there's usually a serious problem about the patient's ability to make good decisions for themselves and manage their own lives in those areas. This just leads me to a couple of things I want to share.

SPEAKER_01 17:52

I wanted to start with you. Um one of the things that I think that we both deal with when families consult with us is that for whatever reason the family's not able to make that, for lack of a word, commitment, right, to put a loved one into treatment. And I know there's a psychological component with that. Can you talk about that?

SPEAKER_00 18:12

Yeah, so just give a talk about this at the AS conference. And basically what I was discussing was a few things. And one is the fractured family, and that is where you have someone in the family system or dynamic who is not in alignment with what the messaging is or what should happen to the patient next. There are also people that, for many different reasons, Mark, that are too lengthy to go into here, including their family of origin, because you have to look at all of this, right? You have to look at socioeconomic status, you have to look at culture. What country are they from? How long have they been in this country? You have to look at their religious background, you have to look at a number of factors, and then you can come to some conclusions about why certain family members or even entire systems are not, they're not comfortable maybe doing an intervention or using legal mediums. And there's usually a number of dynamics that come with that. Some families believe that their loved ones should be allowed freedom of choice even if they have extreme mental illness. Some families believe that if little Johnny or little Jenny doesn't have buy-in, then they don't want to engage in the treatment process or trying to get them into treatment. And in another case, they may not believe in medication. I had a family in the Northeast in the last few months where the patient came from a family in another country that basically does not believe in Western medicine, and that was a real sticking point for the patient. In that case, the loved one was all for the medication, but the identified patient was not. So there are a number of reasons you get fractured families. And Mark, all we can do is educate and support them, right? And we we give them psychoeducation, we support them, we share the data with them, we point to NIDA, SAMSHA outside resources to talk about what the prognosis of this kind of profile or this kind of diagnostic impression looks like. And then you have to let families make their decisions. But there are a number of reasons. I'll give you just one other quick example. We had another family where there was some abuse by the biological father, and the identified patient was the daughter, and the biological mom had uh in some overwhelming guilt about some of that abuse that had happened to her in childhood, and because of that, wanted to please the patient and didn't want to force any issues. I think the other thing is these families worry that the patient is not going to like them or be happy with them after they do this. But usually patients will come around after a period of time. They may or may not, and there's risk involved. Let's be clear, we have to tell the families about the risk. But if you're looking at the preponderance of the evidence in terms of which way you should go, clearly doing an intervention and risking that the identified patient might be a little angry at you versus someone who's psychotic or suicidal or engaging in high sort of risk behaviors, the benefits outweigh the risks. And our job is not to convince a family of something, our job is to educate the family and let them make their choices. But I find, Mark, that you're right. There's a number of scenarios where families are not ready to act, and oftentimes that's for the reasons that we've just stated.

SPEAKER_01 21:24

I want to talk about the marijuana thing because that's been a bit of a hot button topic. I know that you use the word psychosis, and I hear that word thrown around by all types of people, many of whom are not clinicians. Tell us what you mean by that.

SPEAKER_00 21:36

You're saying it very well, and that is that a lot of people say words and it becomes popular in it becomes frequently used in popular media and different venues, and so people will pick up a word and say it all the time. And that's one of them. Like they may say, Oh gosh, my friend was psychotic last night. And what they really mean is maybe he was loud and boisterous and out of hand, but that's not really what. The medical term, as per the DSM 5TR or any of the DSMs lays out as psychosis. Let me make it very clear and easy to understand. Psychosis basically is two things. It's about hallucinations, and it can be any one of the five senses that you have. And then it is about delusions, and delusions are thought conditions. There are many types, but there are thoughts that are not based in reality or fact. So if somebody hears things, sees things, feels things, smells things, or has experiential tactile things happening to them in the absence of stimuli, that is what a hallucination is. A common one is a sort of paranoid hallucination where they hear voices and the voices are telling them that people are out to get them. That is a very common type of hallucination. But people also see things that aren't there, smell things that aren't there, feel things that aren't there, etc. Delusions are thoughts that are not based in reality. An example might be that someone is a religious figure. They often will say, I'm Jesus, or I'm this or I'm that. Sometimes it's about aliens or stealing my thoughts. They're bizarre, and so they're pretty easy to spot. Sometimes they're a little bit more subtle, and so they may be harder to spot. Oh, I'm sure someone's tapping my phone if they're based in paranoid delusions, but without getting too far down the rabbit hole, it's basically hallucinations and delusions. Those two things in concert are what are referred to when we're talking about psychosis.

SPEAKER_01 23:40

Okay, so let's talk about marijuana because we're see you and I are both seeing so many cases that are really fueled by marijuana. And what I tell families is I grew up in the United Kingdom, I had a number of friends who use marijuana. I don't see what when they talked about legalizing it, I didn't think it was going to be that big of a deal here in Florida because most of my friends went on to have productive lives. They were married, they had kids, they had careers, all that. But what I've learned is that the marijuana of the 80s is not the marijuana of 2026.

SPEAKER_00 24:09

Yeah.

SPEAKER_01 24:10

Shed a little light on that for us.

SPEAKER_00 24:12

Certainly. So there's a couple of things happening at the same time, which is putting us into at least a mental health crisis, and some would argue that we are already into a cannabis epidemic. Cannabis has a few problems. One is that the cannabis of the 80s and 70s was anywhere from about 1 to 4%. Some studies reflect 2 to 5% concentration of THC. The cannabis of 2026 is weighted in about anywhere from 60 to 90% concentrated. So that's problem number one. Problem number two is that it's not classified as an FDA-regulated drug would be. So people often take cannabis and don't know exactly how much they're taking. So that's the second problem, though that is beginning to be looked at at the federal and some state levels, but we are far away from good classification in terms of concentration of THC. So that's problem number two is the availability of it. So it's very easy to access cannabis in just about any state in the United States. And the third challenge is the route of ingestion. So you can now take it in gummies, you can take it in cookies, you can ingest it in so many different ways. And so people, some patients, some people are ingesting it around the clock. So it's easily accessible, highly concentrated, being used around the clock in high concentrations, and we know that it is loading very highly in terms of a factual analysis of that people that do those three things, use it frequently in high doses, often are ending up in areas of very acute depression, very acute anxiety, and psychosis.

SPEAKER_01 26:03

Is that a new phenomenon? Because I I know when we opened up our office in 2016, the bulk of my cases were really alcohol, recreational drug use. And then two things really changed. People were locked down and the legalization of marijuana, which really saw this massive shift really for us into the mental health arena. Is that something you have seen?

SPEAKER_00 26:21

Yeah, it's a good question. So we know that post-COVID, a lot of conditions spiked because of the nature of what COVID did to everyone psychologically. We weren't sure what was going to happen in the world next in that epidemic. We know that post-COVID there's been an increase in all substance use and specifically in cannabis. But to your point, yes. I don't know that I don't know that I would classify it as new. I would say that the prevalence rates are reaching higher levels because prior to the legalization of cannabis, we weren't seeing any of those cases. I don't know that I had ever seen one in my career. So, yes, the prevalence rate is higher, hence, we are seeing it more often. The only types of substance-induced psychosis I was seeing prior to that, let's talk about early 90s when I started in the field, would be cocaine-induced psychosis, crystal methamphetamine-induced psychosis, sometimes inhalant abuse, glue, paint, other things along those lines. But I don't recall ever seeing a case back then that it was secondary to cannabis-induced psychosis. And again, it's because of the concentrate, the frequency with which they use it. And there's another component, and that's the age group factor. So we know that males between the ages of 18 and 25 are at a much higher risk, but it doesn't mean that people outside of those ages or of a different sex can't have the same happen. One more quick point that I think is important is that cannabis is a fat-soluble drug. THC is a fat-soluble drug. So you have water-soluble drugs and fat-soluble drugs. And without going into all of the biology around that, I'll just say that cannabis is stored in your fat cells for up to 30 days. The problem is that if you're taking it at 60 to 90 percent all around the clock, it doesn't have your body doesn't have the capacity to expel the THC, which just causes toxic levels of THC in your central nervous system. And we believe in science is supporting and empirically derived research that is causing a dysregulation in serotonin and dopamine receptors, which ultimately is leading to this increase in psychosis. Okay, from a clinical perspective, how difficult are those cases? How challenging are those cases? Yeah, anytime you're dealing with somebody who's psychotic, whether it's cannabis-induced or schizophrenic or schizopactive disorder, bipolar disorder with psychosis, major depression with psychosis, it's more challenging because the patient is not able to sit down and have a conversation. I want to be clear, I've never seen in my experience a patient who's psychotic 24 hours a day. So you do have windows, but the problem is their thought process is not rooted in logic. So it's very difficult to have a logical exchange of cogent thoughts and ideas to pull someone to maybe talk to them about treatment and consequences of their life. Because when you're psychotic, you're essentially coming from a space that's not rooted in, it has no basis in reality. So patients' sense of self is altered, time is altered, consequences are altered, they don't really understand. So cases they are difficult to manage. Typically, we're working with the families to help put systems in place to help manage that patient. As I say to families, and I'll say to you, those cases tend to go on for a while. They don't resolve in a week or a month, usually. They can, but they usually don't, because by the time they come to us, even in cases where the response is positive, we've had cases, a few, not many, but we've had a few get into treatment centers using the mediums we've discussed, and they clear relatively quickly, four to six weeks. But most of the cases we're seeing are taking months plural to resolve in treatment with the separation of the substance, with a good medication regime and a good team of psychiatrist and medical staff and clinical staff. And that's why I say we're only as good as the people we consult with and the people we collaborate with, right? Because it's it takes all of those parts. It takes sometimes a legal arm to help get the patient into treatment, and then it's about knowing what centers around this country do well in that space, who does excellent work, and then it's about helping coordinate those services with the family and making sure that they don't pull them out prematurely and they make sure that there's a good aftercare plan in place.

SPEAKER_01 30:53

Yeah. One of the things when I heard you, there was a cut, so you and I spoke at a conference here in South Florida about a month ago, and I there was I've learned so much from just listening to you speak, but one of the things you talked about was the idea that once somebody experiences psychosis, it's much easier for them, say the second or third time, if they start to use again to experience psychosis.

SPEAKER_00 31:14

Can you share a little bit of light on that? So once you have any type of central nervous system injury, you're more susceptible to having it again. What we are seeing in the cannabis space is that if somebody has already uh reached a place where they have become psychotic secondary to cannabis use, and let me be clear, that's not just cannabis, that's all substances. If you have a patient who uses cocaine and becomes psychotic, the chances of it happening the second, third, fourth, fifth time are greatly increased. And that has to do with neuroplasticity. There's already a freeway, if you like, in the brain, whereby the reaction of your central nervous system, your brain, is that you get elevated spikes of dopamine, which we know causes psychosis. The problem with cannabis is that somebody who goes to treatment and clears out, let's say they're there two, three months, if they start using again, they're more likely to become psychotic faster. And the bigger problem is the psychosis is going to be more resistant to treatment on the second, third, and fourth pass. So it complicates the case to a large degree. And we've had cases like that. Sometimes we get the case after they've gone to treatment, the psychosis abated, they were separated from the substance, got on a medication regime and came back out and kept using cannabis. There's one in particular I'm thinking about that the patient went back to their respective state and where cannabis was made readily available, and the patient became fluidly psychotic and had to be in treatment for a good 12 to 18 months before they were stabilized. This is a serious problem that we're contending with, and I don't think it's going to get any better simply because of all the factors that we've talked about that have gotten us here. And until some of those things change, if they change, then this is going to be an ongoing problem, in my opinion.

SPEAKER_01 33:05

Yeah. One of the things that we share with families when we talk to them is we they say, Well, how long is it going to take? And I say, you know what, as a general rule, this is probably a year-long journey. You don't necessarily need us for a year. And then I heard you speak, and I think the statistic you gave out was that if you can keep somebody in recovery for a year, there's a 70% chance they stay in recovery. You said, well, if you can get up to five years, it's 83%. I remember these numbers. Tells me is the first year, right? That's the most important time from now until the next 12 months. That's the key. Talk about what that looks like in terms of what does a 12-month recovery journey look like?

SPEAKER_00 33:42

It's a sensitive time. So what these research numbers indicate, and I'll share the sources, but what it tells us in our field is that time matters and that there is sensitivity, especially in that first year, but ongoing up into about five. That doesn't necessarily equate to everyone. Sometimes it's longer than five years. But here's what the numbers in research reflect. These numbers are from the PRN system. I gave a talk on this, and someone was asking about some of these numbers, but these numbers are from agencies known as the PRN systems. And they also have them for lawyers and they have them for nurses.

SPEAKER_01 34:24

What's PRN?

SPEAKER_00 34:25

Yeah. PRN is the name of the sort of organization in Florida. They have different names around the country, but it's the professionals recovery network. It's sometimes it's responded to, referred to as the physicians recovery network. The lawyers have an impaired lawyers program as well as do the nurses. IPN, I believe, is the name of the one for nurses. So they kind of have good data, right? Because they have good longitudinal data, because what these programs are is they're essentially monitoring programs for licensed professional people in the state who have shown to have a substance abuse or drug problem. They also have them for pilots. The FAA also makes their pilots go through these programs. So there's a lot of good data. And basically, what they've landed on, and this is how they design their contracts. So their contracts for most impaired practitioners or pilots are somewhere between two to five years for the reasons that I've that you just stated. That of the people that get to a year sober, data indicates that 70% of those people go on to get multiple years sober, which means they can put two and three and four together. But the more astounding number to me is that of the people that can get to five years sober, that 83% of those people go on to stay sober for life. So what that tells me is, and this is assuming intrinsic value because we have to factor for that. Some people may not want to stay sober. But assuming all things, it says to me that what you pointed out, and that is that the first year of recovery is really a sensitive time. And that's why treatment and support around those patients is important. And as you said, it may or may not involve us, us meaning me or you, but we will tell the families that this is what is shown to work. And then you can reassess. In a perfect world, everyone would have some sort of five-year program in place because the numbers reflect that we would have better outcomes. But most people aren't willing to commit to that. And let me be clear, I'm not saying that they need a year of treatment, like in a residential program treatment, but they do need a year of treatment in the way of support. Maybe that looks like outpatient, or maybe that looks like psychiatry, or maybe that looks like 12-step programming or SMART or Dharma recovery, some sort of social component in the way of support. There's also really good studies that reflect that social support makes a huge difference in outcomes. So families that are supporting their loved ones and are getting their own support, assuming that we can get to these numbers, there are good outcomes and good studies with Samsha and NIDA that show that these factors play a large role in the difference in outcomes between success and failure if we're measuring failure as somebody who relapses. Of course, even relapses is not often the end of the story. Sometimes they take a second or third or fourth swing at the bat. But I was at a conference last week and I heard someone say that she detests when someone says relapse is a part of everyone's story. And she's right, it doesn't have to be, and it sometimes it isn't, but sometimes it is. And it's just about making sure that patient is sober long enough to make good decisions and have good support around them to allow the brain in post-acute withdrawal, which we haven't talked about, but post-acute withdrawal is basically the brain resetting itself secondary to substance abuse, and research reflects that which we talked about. If you can keep somebody sober for a year or five, their chances greatly increase of staying sober going forward.

SPEAKER_01 38:02

Let's switch kids for a second because you and I are both our teams, our respective teams, are talking to families from all over the country. In fact, I would say that the bulk of the families that we work with are not in Florida. That's true. They're from all over the country. So either their loved ones here, coming here, or we're getting them here. Yeah. And so people say, why would I want to send my loved one from New York or California to Florida? What's magic about Florida? So let's talk about that and maybe share your thoughts on why we like bringing people to Florida.

SPEAKER_00 38:36

One of the challenges in some of the other states is that the mental health and substance abuse laws do not support the families' abilities to get their loved ones into treatment involuntarily. And even if they are able to talk them into going into treatment, they can't keep them there if the loved one decides to leave. Florida has some really specific laws that allow families to do things that in some instances maybe can get done in other states in extreme situations, but usually, as a general rule, are very difficult or close to impossible to make to help the patient to get into treatment. So we have a Marchman Act, which you're the expert there. I'll let you talk about that. But the Martrin Act is just an amazing tool that we have to get people into treatment for secondary to substance abuse impairment where otherwise they might not go. And it saves lives. I firmly believe that. And so I think it is a great tool to start the journey in the process to get someone on that path. Of course, we have Baker Act laws. Now, most states, if not all states, have involuntary commitment laws, but a brilliant lawyer once told me, know your state, know your county, know your judge. So even if you have these involuntary commitment laws, oftentimes law enforcement and even their mobile crisis teams may or may not be of assistance because the threshold is so high in certain states, in a lot of states, to get their loved one into treatment, even though one would think it's obvious the interpretation and the zeitgeist of that law and how it's interpreted in that state varies from state to state greatly. And then the third medium that we have is a guardianship medium, which I think is just brilliant because I think most people think of guardianship and they think of their elderly demented grandparent that they needed to take conservatorship over. But these laws can be used in Florida to help people who have substance abuse impairment, mental health impairment, or a combination therein to help the family guide their loved one into treatment and have a little bit more, uh, a little bit more agency in the placement and the making sure that the patient doesn't pull releases to help their loved one sort of not just get into treatment but stay in treatment. And sometimes, as you well know, you can use all three of those laws. And sometimes you have to do that because that's how impaired the particular patient is. I have gotten calls from families where their loved ones have been into a psychiatric hospital 15 times, but then it's released after 24 hours. I think that's why we often bring people to Florida to at least get them started in the right direction.

SPEAKER_01 41:20

Okay, I think the other thing that the other reason we like Florida is because we have good treatment down here. I mean, if we have some great facilities, yes, yes, we do. I know that we could count on one hand, there's a small select group of facilities, not naming names, that you and I both really like working with because they get great results.

SPEAKER_00 41:37

Yeah. What I would say is there are good facilities around the United States. It's true. There are some really spectacular facilities in the United States that we work with. But I would also say the challenge is that if you don't have some of those supportive laws, you can't keep them there. And to your point, you can't maybe get them there, you can't keep them there. Although in some instances you can. But when it crosses a certain level of acuity, the chances of that working are very low. But to your point, Mark, yes. There are a handful, if not less than a handful, of really good facilities in the state of Florida that understand these laws and understand this work that we do and have excellent psychiatric and clinical teams. That's true.

SPEAKER_01 42:18

I think that's why you and I are big fans of come to Florida at least for the first three to six months, and then you can go home. Because at that point, hopefully someone is stable enough that they don't necessarily need what we have in Florida in terms of the legal system. But the first that first three to six months is the key to the second three to six months. Obviously, we're bringing people into Florida from different parts of the country. And a lot of times families will say, why? It's because obviously the goal here is to is especially with the first three to six months, is to get them into treatment and get them stabilized, and then they can go back to their home state, right? It could be New York, it could be California, it could be Utah, right? But if we don't get them through that first three to six months, then the second half of the recovery program or the recovery journey is never going to happen. So that's why we say come to Florida, because we have great treatment, and we can keep your loved one here long enough so that when they go back, they're capable of actually doing some things without needing us to babysit them, without having to mandate them. So that's why coming to Florida is key.

SPEAKER_00 43:19

Just to expand on what you're saying, it absolutely is a good start. And in some cases, we can do the stabilization piece here. What it does is it does a few things. It slows the process down so that families can meet with outside professionals, people that do what I do, and talk about one, what is happening to their loved one, two, what's treatment going to look like? But most importantly, three, what should treatment look like when they go home? What kind of unifying messages can the families give to support the loved one and ensure that they are following a good post treatment plan, whatever that may look like? Could be psychiatry, could be therapy, could be coaching, could be your endroit. Screens could be a number of things, and every family and every patient has a unique set of challenges and benefits and things that work well. And so, someone that sort of does the work I do is one of the things is to put those plans in place. But to your point, we can stabilize them here in Florida and put good outpatient systems in place when they return back to their respective states.

SPEAKER_01 44:23

Yeah, that's right. All right. So for the folks that are watching this, how do they get in contact with you? How do they find out more about what the work that you do?

SPEAKER_00 44:32

They can go to axiomhealth services.com. Axiomhealth services.com is our website. Or they can call us toll-free at 833-932-9466. And they can also call Jen directly if they so choose. They can call Jen at 954-232-4856. And what we do is we'll take the initial call and schedule a consult, find out more about what's going on, see if we're an appropriate fit, and make decisions with the family from that call on to see what's appropriate.

unknown 45:08

Okay.

SPEAKER_01 45:09

I want to address one other thing before I let you go. Sure. And this is really for any, if there's any clinicians watching this, they should go to the Veritas training. So I want you to tell for our clinicians what is Veritas, and what when's the next training, and how do they register for it?

SPEAKER_00 45:26

Yeah, thank you so very much for that. So I have a colleague in New York, his name is Jonathan Rauge. He's an LMSW. He's been in the field for 25 years. It's amazing. And we decided sometime back that there was a real need for additional training for those that are coming up in our field because of what you've talked about, Mark. Increases in mental health acuity, increases in complex cases with a lot of dynamics. And so we opened up a Veritas Training Corporation. They can find us at Veritas Training Group.com and also they can call the same number at 1054-232-4856. If they go to the website, they can register there. And we have already had two trainings and are very excited about what we're doing. We're getting a lot of excitement from the participants. And our job is to have an intentional conversation with professionals around the country as to what we need to talk about. Uh, aside from the fact that our specific training is about higher acuity mental health cases, how to manage those cases. But I don't just mean for interventionists, though the focus is it could be for therapists, it could be for behavioral health care executives, it could be for attorneys, it could be anyone who's in the ancillary space, just to start talking about the diagnostic profiles and what we're seeing in 2026. And so we're really excited about that. And thank you for allowing me to plug that in, Mark. I appreciate it. And then the next training is going to be in California. Yeah, the next training is July 17th in Santa Monica, California. And then we will have one more to wrap up the year on November 6th in Austin, Texas. And so we'll certainly keep you posted. And I would love to have anyone that that thinks it's a good fit for them to come out.

SPEAKER_01 47:16

Yeah, I've learned so much from going to these, and I'm going to be in California. It's a really good excuse to go to California. And just for us, just really being involved in the behavioral health space with clinicians, it just helps us to do a better job, yeah, as lawyers, right? Because it's not just about let's file some papers and that's it. And I always tell clients, if you just want a lawyer to file papers, I'm the wrong lawyer for you.

unknown 47:39

Yeah.

SPEAKER_01 47:39

Find the cheapest lawyer. If you want someone who actually is going to put together a plan for you so you can save your loved one, that's a different conversation. That's what we want to have.

SPEAKER_00 47:46

So let me say that when people like yourself come, it helps everyone because we can have a conversation and a dialogue about the work that you do and how, to your point earlier, how clinical and legal cross over and how we can ultimately do what we're there to do, which is help the patient and the patient families to get better outcomes. And so it does help. And it's not a one-way street of us just teaching people in that room. We want to know about them too and create an environment where intentional conversations and communication can be had to bring us all up. Because as I've said, Mark, and I truly believe this at a fundamental level, we are only as good as the people we collaborate with. And in so doing, when we collaborate and join up in conferences like this one or trainings like this one, it makes us all better because then we understand how best to come up with effective strategies to help patients and patient families. Yeah.

SPEAKER_01 48:41

I'm so glad you came on. I always enjoy spending time with you. Thanks for having me, Mark. Yeah, and I know I'm going to see you coming up this weekend, so that's all good. And we'll probably talk about eight times before then anyway, so it's all good. Okay. Of course we will. For the folks that are watching this and you want to find out more about what we do, the main website is mental health addiction lawfirm.com. That's mental health addiction law firm.com. Until next time, thanks for tuning in.